The politics of drinking
            December 24, 2010

Cheap booze, cheap lives

Snow stopped me from getting to the Alcohol Education and Research Council’s symposium on home drinking the other week, which was a bit of a bugger as I was speaking - about what’s happening to pubs.

Most importantly I would have been talking to an audience those of us who start on the booze side of the fence rarely engage with – the people who have to clear up the human mess caused by drink problems. I do believe we have a common cause, though, in creating the conditions for a healthier drinking culture. I use the word ‘healthier’ in its broadest sense.

This theme came to mind again as I was reading a research report in Addiction journal, based on interviews with ‘ill drinkers’ in Edinburgh. These people are, I suppose, what we used to call alcoholics, but the term has become pretty meaningless, except as a sort of shorthand, since we’ve been unable to nail down precisely what alcoholism is.

The report’s aim is to support the case for minimum pricing by trying to demonstrate that it will have a significant effect among heavy drinkers in reducing their consumption. I’m not sure it succeeds – and neither, for that matter, are its authors - but some fascinating stuff is thrown up in the process.

The interviewees, patients at two hospitals in the city, were very heavy drinkers indeed, sinking an average of nearly 200 units a week, equivalent to 100 pints of cooking bitter or, more realistically but no less frighteningly, a bottle of vodka a day. Quite a number exceeded 300 units. One managed 800 units. That’s what I call a drink problem.

They were paying an average of 43p a unit, comfortably below the 50p a unit touted as a minimum – and that’s only the average. Cheapest unit price paid was 9p – for two-litre bottles of white cider in the supermarket.

Compared with the general Scottish population the patients were paying 29p less per unit and there was a clear inverse correlation between the amount consumed and the price paid for it, right down the line. If it’s just the ethanol you’re after that’s rational behaviour, of course.

And if the report demonstrates anything, it is that drinking at these undoubtedly dangerous levels is largely an off-trade issue. Only a quarter of respondents bought any drink at all in the pub or club, and on-trade purchases account for a mere 7.4% of total units consumed.

“Our clinical experience,” says the researchers, “acquired unsystematically from drinkers’ self-reports, suggests that it is sometimes preferable for a dependent drinker to drink in a pub or club where there are external controls on the amount consumed and the level of intoxication and also possible mental health benefits of social interaction.”

Intuitively, this has to be correct, but you crave something more scientific to back it up and, as yet, it doesn’t seem to exist. Which is what makes the AERC symposium interesting, and I look forward to reading the briefing paper that comes out of it, to see what I missed.

As for whether minimum pricing, or any other price constraint, can reduce consumption, the report is honest enough to say that we can’t know until we try it.

Charging 9p a unit can’t be right. But price is only one factor in a multiplicity of determinants that cause people to drink like this. Give minimum pricing a go if you like, but I can’t get my head round the idea that someone who’s ruining their lives and the lives of people round them through alcohol is doing it just because it’s so jolly cheap.

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