lecture 36: the role of public policy in managing harm from alcohol Flashcards
1
Q
What is policy?
A
- a course or principle of action, adopted or proposed by a government, party, business, or individual - Australian concise oxford dictionary
- the term is used in many different ways but there are some central features common to all good policy:
- it states matters of principle
- it is focused on action, stating what is to be done and by whom
- it is an authorative statement, made by person or body with power to do so
2
Q
What is an example of good public policy?
A
- it is estimated that 46,000 people haven’t died
- and 600,000 people haven’t been seriously injured due to prevention of RTA
3
Q
What has been the effect of public policy re: tobacco?
A
- national tobacco campaign launched in 1998
- male lung cancer rates/100,000 today are as low as they were in 1963
- death rates for heart disease now as low as they were immediately post WW2
4
Q
What are essential elements for behaviour change?
A
- evidence
- legislation and regulation (advertising, promotion, sponsorship)
- pricing and taxation
- community mobilization, understanding, support
- communications - social marketing/ counter advertising
5
Q
What is the lifetime risk of death per 100 male drinkers (NAG)/
A
- depends on number of standard drinks and frequency of consumption
- e.g. someone who drinks 8 standard drinks everyday has lifetime risk of 10 in 100
- but 1 standard drink everyday has risk of 0/1 in 100
6
Q
What is the lifetime risk of hospitalisation through alcohol related injury per 100 male drinkers?
A
7
Q
Australia: a nation built on alcohol?
A
- Milton Lewis, authour of The Rum State says heavy drinking was an established cultural norm in the UK and was transported to Australia at the time of its colonisation
- this happened at a time of the gin epidemics that devastated communities in Britain - “per capita consumption of gin was astonishingly high”
- Ross Fitzgerald, the author of Under the Influence says Australia “was from the outset launched on a sea of spirits”
- once in australia, these heavy drinking norms or traditions contributed significantly to the destruction of indigenous culture
- at the same time heavy drinking became enshrined within various rituals of male solidarity
8
Q
What were two drinking practices established that exist today?
A
- ‘shouting’ - in which each person in turn buys a round of drinks for the whole group
- the other is ‘work and bust’ - a prolonged drunken spree following a long period of hard work in the bush- an early term for our contemporary notion of binge drinking
9
Q
What other factors were at play?
A
- for a time spirits were used in barter and convicts were part-paid in rum
- in this way rum became a currency of the colony - hence the term ‘ a rum state’
- the control of alcohol gave enormous political power
- and alcohol has been reported to be involved in the only miltary coup in Australia - the Rum rebellion in 1808
10
Q
What have been different social meanings of alcohol over the years?
A
- in australia and elsewhere wine, brandy, beer and stout have been seen as good dietary supplements for invalids
- alcohol was once seen as a good healthy food
- nursing mothers were encouraged to drink stout because there was a popular belief that it would help with the production of breast milk
- so over time alcohol has been used as a beverage, a food, a medicine and a psychoactive drug
- as milton lewis says it has been consumed as a sacrament, a toast, a fortifier, a sedative, a thirst-quencher, and a symbol of sophistication
11
Q
What were the temperance organisations?
A
- sprang up in early 18th century, active in Australian colonies from 1830s
- they intially advocated moderation, but would eventually demand prohibition
- they were affiliated with Christian churches, and in some ways were a reaction by the middle classes to an upsurfe in lower-class drinking of spirits, due to more industrialised production of distilled spirits - the feat of the working class being more dangerous when it is drunk
- the highpoint of Temperance came during WW1, with the imposition of 18:00 closing time, which in turn led to the 6 o’clock swill
- consumptuon went down dramatically across english speaking world, to a low point of 2-3 litres per head per year in the early 1930s, largely due to the depression
12
Q
What happened post World War II?
A
- there was a backlash against the anti-alcohol movement
- drinking rates began to climb again along with the growing prosperity and cultural shifts such as the changing role of women, shaped the way we drank
- ‘civilised’ drinking became the norm - drinking with food, and in moderation
- wine became a much more popular drink by the 1960s and australia invented the wine cask
- there may be however, many wine lovers who refuse to countenance the notion of “civilised” and “wine cask” existing in the same sentence
13
Q
What significant change occurred in Victoria in 1986 with the Niewenhausen report?
A
here is an extract from Epicure in the Age in 2006, 20 years after the report:
- before his reforms, Victorian-era wowserism ruled
- hotels had a monopoly on serving alcohol and restaurants wanting a liquor licence had to submit a lengthy, expensive, cumbersome and paternalistic application process
- Nieuwenhuysen, then an economist at Melbourne University, had a vision of European-style liberalisation, of civilised drinking and freedom of choice
14
Q
What is the overall per capita consumption in Australia?
A
- in 2010
- australia’s total per capita consumption of alcohol (PCC) has been increasing significantly over time because of a gradual increase in the alcohol content and market share of wine and is now at one of its highest points since 1991-92
15
Q
What is the lifetime risk of death from alcohol-related disease?
A
- per 100 drinkers, by number of standard drinks per occasion, Australia 2002
18
Q
What is alcohol advertising?
A
- along with deregulation we have had rapid increases in advertising and promotion
- ad new 25 march 2005
- alcoholic beverages
- “a strong performing category in 2004, finishing 16.3% ahead of 2003, after a 15.7% growth over 2002”
- below the line forms such as word-of-mouth campaigns called buzz marketing, mumble campaigns, give-aways, ‘guerilla’ marketing and ‘roach’ baiting
19
Q
What is the growth in liquor licenses in victoria?
A
- ~3000 in 1986
- almost 18,000 in 2006
21
Q
What is seen in victorian male secondary school student rates of risky.high risk drinking?
A
- 20 years of data show increasing
22
Q
What are determinants, behaviours and outcomes of alcohol-related harm?
A
- modifiable determinants:
- cultural place and availability
- price
- outlet locations
- opening hours
- minimum purchase age
- service practices
- law enforcement
- promotion
- social norms and values
- cultural place and availability
- target behaviours
- drinking to intoxication (BAC more than 0.08)
- long term heavy drinking
- outcomes
- public safety and amenity
- violence
- property damage
- anti-social behaviour
- perceptions of safety
- short term (acute) health impacts
- road injuries
- assaults
- drowning
- suicides
- falls
- fire/smoke injuries
- sexually transmitted infections
- long term (chronic) health impacts:
- cancers
- cirrhosis of liver
- dependence
- mental illness
- public safety and amenity
