How the use of alcohol becomes a public health threat
Not only does it have a long history dating back into ancient times but alcohol is said to be pervasive and present at almost all social gatherings and night life.
Alcoholic drinks and beverages, which come in different varieties, bottles, colours and prices, are largely driven by a huge global market.
Perhaps, it is these features of alcohol that continually fuels the raging war about making alcohol undesirable or desirable between those for and those against its consumption.
Industry movers and shakers in giant alcoholic beverage companies advance arguments that they are providing a “benign” service, which is a source of relaxation and pleasure to many consumers, in addition to creating jobs.
However, anti-alcohol crusaders are countering these arguments, saying alcohol has no significant benefits at all.
For instance, IOGT International, a global social movement for alcohol prevention and control with 117 member organizations from 51 countries, has used four words – death, disease, destruction and despair – to tag alcohol and its effects on consumers and society.
A third force, best described as neutral stakeholders, made up mainly of public health advocates and experts, are meanwhile intensifying efforts to deal with the public health implications of consuming alcohol.
In a few days, these stakeholders would gather at the World Health Organisation’s headquarters in Geneva, Switzerland, on June 27 and 28, to discuss the public health significance of alcohol-related deaths and illnesses.
This meeting, known as the Second Forum on alcohol, drugs, and addictive behaviours, is to among others, bring a new impetus to international activities led or implemented by the World Health Organisation (WHO) in reducing the health and social burden associated with substance use and addictive behaviours.
According to the WHO, the meeting is happening against a “rapidly changing global health landscape and increasing commercialization.
It says “strong international collaboration and partnerships are needed to address the harmful use of alcohol and public health dimensions of drug use and achieve Universal Health Coverage for people suffering from disorders due to substance use and addictive behaviours.”
The need to focus global attention on these issues and especially on alcohol, has become necessary because alcohol consumption is said to be the seventh leading risk factor for premature death and disability, this is according to the WHO Global Status Report (GSR) on Alcohol and Health, 2018.
Alcohol consumption contributes to more than three million deaths globally every year and over 5 per cent of the global burden of disease and injury.
The GSR has added that it is also a major risk factor for non-communicable diseases (NCDs), including cancers and cardiovascular diseases, communicable diseases such as TB and HIV/AIDS, violence, and injuries.
The report estimates that 2.3 billion people are currently alcohol drinkers however, consumption varies across regions.
This is not surprising, since alcohol has had a long history as well as impacted on the socio-economic lives of people, over the centuries.
Economic history
In 1996, the WHO Regional Office for Europe, in a document titled: Alcohol and the workplace, citing from a number of studies and articles by experts, notes that the importance and value attached to alcohol historically can be seen, to some extent, in its use as a form of currency.
It said before the Industrial Revolution in Russia, for example, “vodka was used as a cash substitute when there was scarcity of money, a practice also believed to have occurred in other regions including England, continental Europe, and the British colonies in the Americas.”
“Even when cash was available, there was some advantage for employers paying their labourers in kind because of the difference between real and nominal values….”
It says alcohol was also used to attract alcohol dependent people to labour- intensive jobs in times when labour was scarce.
The document is also mindful that alcohol is the most widely used drug in the world today and an integral part of the social, cultural and economic life of many countries.
It, meanwhile, notes that a number of studies have shown alcohol use within the workplace to be linked to both positive and negative consequences.
“Alcohol use can be particularly serious within the workplace, as it has an impact on human performance that can affect, for example, productivity, accident rates, working relationships and absenteeism.”
“On the one hand, it has been linked to thefts, aggression, arguments with bosses and customers, and lost promotion. It has also been found to encourage the formation of informal groups, which can be destructive in that often these groups may not reveal work -related plans to other colleagues and may thereby adversely affect production.”
According to the document, on the other hand, alcohol use can help to sustain informal groups, improve relationships between managers and employees, help with team -building and work as a reinforcer to some extent.
It also touches on the overall economic impact of the alcohol industry and adds that the scale and importance of the alcohol industry can be gauged to some extent through estimates of, for example, the number of people who regularly drink alcohol, the economic “value” of the industry, and the number of people employed in the production, distribution and selling of alcoholic products.
Industry players
Unless there are clear lines drawn about the usefulness or otherwise of alcohol consumption, there would be arguments for and against its consumption.
For instance, in 2011, an updated code of ethics by the alcoholic beverage industry in Quebec was adopted by its General Assembly. In the introduction, it was noted that alcohol had always been part of the human landscape.
Some issues were put forward in what sounded like convincing arguments for alcohol use.
“In all our social and cultural references, it is associated with the values of conviviality, responsibility and even health. Created essentially as something good and beneficial, alcohol is an integral part of many human rituals.”
“It served Louis Pasteur in his scientific work and, of course, is mentioned frequently in the Bible. “Wine and music rejoice the heart,” says the Book of Ecclesiastics … followed immediately by ‘but the love of wisdom is above them both,’ indicating that even the Ancients understood that moderation was always in good taste! Clearly, the fact that some people abuse alcohol should not tarnish the reputation of the product itself,” it argues.
According to this code of ethics: “From this perspective, alcohol may be seen for what it is – a cultural product associated with life’s pleasures – whereas its abuse causes it to be perceived as a health menace and source of criminal behaviour.”
“Therein lies the difficulty in defining our relationship to alcohol. For Quebecers, that relationship has always been open, yet complex and sometimes contradictory. And while, as a society, we managed to escape the wave of prohibition that swept North America in the early 20th century, we have not been spared the questioning and public debates that still surround the issue of drinking,” it adds.
They argue that some positions make no distinction between drinking and abuse. And say alcohol is seen only as a potential danger from which people must be protected. A few go so far as to suggest that people must be protected from themselves.
“The fact remains that more than 80 pe rcent of Quebecers drink alcohol in one form or another, and only a tiny proportion of them have a drinking problem. The vast majority of drinkers have no problem at all. On the contrary, they enjoy the qualities and benefits of alcohol, and the way it contributes to creating a warm, convivial environment.”
The code of ethics adds that, “We recognize that alcohol abuse and misuse can lead to dependence. And no doubt there is but a fine line between the joys of moderation and the problems of excess.”
They then add that they promote the culture of taste and moderation (as opposed to the culture of drunkenness), consumer education, and accountability on the part of individuals and the alcoholic beverage industry.
Public health issues
These are fine sounding arguments yet alcohol consumption still remains at the heart of public health concerns since it has negative impacts on the realization of the SDGs.
A business and financial news network, CNBC, recently carried a news report, which made reference to a study by the Lancet Medical Journal, noting that alcohol consumption at all levels can have damaging health implications.
“The research, which claims to be the most comprehensive of its kind, pours cold water on previous reports that said drinking in moderation could have health benefits. The report’s researchers have called for global medical guidance to be revised,” the news item said.
It said the majority of national guidelines suggest that one or two glasses of wine or beer per day are safe for an adult’s health.
However, the report’s authors said, “Our results show that the safest level of drinking is none.”
The IGOT International organization, with a vision to free people from the harm caused by alcohol and other drugs, has also in a recent publication titled: “Alcohol and the Sustainable Development Goals major obstacle to development, noted that in and near neighborhoods, with a high density of alcohol outlets, there is a higher rate of violence.
“It means, when bars, liquor stores and other businesses that sell alcohol are close together, more assaults and other violent crimes occur.”
According to IGOT International, not only are the alcohol industry manufacturing pre-death, disease, injuries and violence but that under the guise of promoting responsible drinking, they are providing misleading information to undermine the public’s and lawmakers’ understanding of alcohol’s cancer risk.
It accuses the International Alliance for Responsible Drinking (IARD) as being directly funded by large multinational alcohol corporations and attacking taxes on alcohol.
The unethical business strategies of the alcohol industry have also come under scrutiny by IGOT International, saying the industry is using self-regulation, corporate social responsibility strategies, unethical marketing, aggressive lobbying and political interferences, among others, to ruin the lives of victims of alcohol.
The organization, citing various studies around the world, branded the production and consumption of alcohol as being responsible for a variety of socio-economic issues, such as poverty, violence against women, threat to water security in many parts of the regions of the world, saying that the water footprint of beer is horrific as per one liter of beer, 298 liters of water has to be used while for wine, to get one liter, 870 litters of water are needed.
It has also exposed the climate change impact of alcohol, noting that the alcohol industry contributes to global warming, greenhouse gas emissions, high energy use, pollution and the use of natural resources by refrigeration in the hospitality industry, use of fertilizers, water use, packaging, transportation of raw materials and distribution of products.
The WHO has lent support to the fact that alcohol significantly impacts several SDGs health goals.
The WHO has expressed the hope that during the meeting on Second Forum on alcohol, drugs, and addictive behaviours in Geneva this June, an opportunity would be provided for different groups and parties to make their contributions and discuss topics organized around three major thematic tracks addressing the public health dimensions of alcohol, including the psychoactive drug use, the challenges of the opioid crisis and cannabis use, addictive behaviours including gaming and gambling disorders.
Meanwhile, the WHO Global Monitoring Framework for NCDs includes a target to reduce harmful use of alcohol by at least 10 per cent by 2025.
There has always been a global strategy to reduce harmful use of alcohol since 2008.
In May 2010, the 63rd session of the World Health Assembly adopted by consensus a resolution which endorses a global strategy to confront the harmful use of alcohol, since it is a serious health burden, and it affects virtually all individuals on an international scale.
The WHO recently launched the SAFER alcohol control initiative to prevent and reduce alcohol-related death and disability
In September 2018, the WHO released the SAFER package outlining five high-impact strategies to help governments reduce the harmful use of alcohol and related health, social and economic consequences.
By Eunice Menka
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