SA Needs Evidence Based Alcohol Policy
The Ethekwini Resolution on the Second Biennial Summit on Substance Abuse includes 34 resolutions, most of them related to alcohol. Alcohol abuse is a problem in South Africa. A recent WHO report clearly indicated that South Africans drink a lot of beer. The report is focused, unsurprisingly given the source, on alcohol-related health impacts and suggests that South Africa is fairly high-risk in terms of this. It also suggests, for the record, that South African adult (15+) alcohol consumption hasn’t changed all that much in recent years. This report has been cited by government as the catalyst for a heavy focus on alcohol abuse (or possibly alcohol use) at the recent summit.
The resolutions of the summit are wide-ranging. Some aim to improve after-care for young people (learners), increase sports and recreation activities, run public awareness campaigns about the dangers of substance abuse and, for some reason, finalizing and implementing legislation related to the trafficking in persons (a noble objective but perhaps not entirely relevant to substance abuse?).
Substance abuse measures – measures to protect people using substances like alcohol in a way that is bad for society – necessarily involve limitations on people’s choices. This is not unreasonable.
Some relate specifically to improving policing of drug-related crimes and ensuring that South Africa fulfils international commitments related to drugs. Measures to ensure more equitable access to and more coordinated prevention and treatment efforts around substance abuse are also proposed.
The majority, however, relate specifically to alcohol. Government (and others attending the summit) agrees to harmonize laws so that the same liquor sale restrictions apply uniformly to all provinces and municipalities. The parties resolve to raise the legal age for purchase and public consumption of alcohol to 21. Restrictions will be placed on the time and days of the week when alcohol may be sold, across all provinces. Regulations will be put in place to limit the number of liquor outlets in a geographic area, including revised licencing and zoning regulations. Increased taxes and tariffs on alcohol products on a sliding scale based on alcohol content are intended to reduce demand. Regulation will be introduced for warning labels on alcohol products. In the medium term alcohol advertising is to be banned and in the short-term preventing alcohol advertising that might be seen by children or present alcohol as associated with sport or social and economic status. Alcohol industry sponsorship of sports, recreation, arts and culture and related activities will be banned. Current legal blood-alcohol limits will be reduced to discourage drinking and driving. Novice drivers (0-3 years after obtaining a licence) will not be allowed to drive after consuming any alcohol at all. Also, all public sector functions will be alcohol free in order to set a good example.
All these restrictions and regulations may seem reasonable. This seems like the way to reduce alcohol use. These are not novel or innovative. In fact they are pretty standard fare in the pursuit of governments to reduce alcohol use. The problem with all of these measures is that each is intended to solve a specific problem, some aspect of alcohol use – driving while under the influence of alcohol, alcohol being too easily available on a Sunday, etc. All limit the ability of ordinary citizens to purchase and consume alcohol as and when they choose, in the interests of solving a problem – a problem that has not yet been defined. Is the problem that alcohol abuse is raising health costs? Is the problem, as implied by the minister of Social Development when launching this meeting, underage drinking? Is the problem that certain individuals develop alcohol addictions? Is alcohol itself a problem?
To what extent does a legal age-limit on drinking reduce alcohol consumption by minors? Does not selling alcohol on a Sunday decrease alcohol abuse? More importantly, do any of these measures have a direct impact on problem-drinking? This is the crux of the problem. Substance abuse measures – measures to protect people using substances like alcohol in a way that is bad for society – necessarily involve limitations on people’s choices. This is not unreasonable. The same kind of steps have been taken with nicotine. But nicotine has a directly observable impact on other people. Had anyone been convinced that the impact of smoking was sufficiently harmful to the smoker, smoking would have been banned altogether. The indirect impact of alcohol use – crimes committed while under the influence of alcohol, drunk driving, etc. – is not directly addressed by this policy. Instead, the policy seeks to limit the freedoms of all on a vague notion that decreasing the availability and consumption of alcohol generally with reduce problem-drinking, without ever addressing the social constructs that support and perpetuate problem-drinking, the nature of addiction in the cases where this is the problem and, more generally, why South Africans drink the way they do.
The way in which alcohol is used by some people in South Africa is a problem. Government should be addressing this and taking measures to prevent alcohol-related health problems, crime and deaths. Simply demonizing all drinking on the assumption that less drinking will automatically produce less problem-drinking is both lazy and irresponsible. Perhaps the next summit can work from the premise that policy must address an identified problem, not simply begin with raising the legal drinking age and other knee-jerk reactions.
Image by mountainhiker