Raymond L Hintz; 2004
Unconvincing and therefore called for raising the price and limiting availability.1 The prime minister’s strategy unit, with access to the same evidence, concluded that controlling average consumption through the mechanism of raising the price and limiting access would have unwanted side effects and was not a viable option. They therefore called for education, more policing, improved treatment, and the alcohol industr y entering into voluntar y agreements to behave reasonably.7 The academy working group would agree that all of these actions were necessar y. But they took the view, based on evidence, that such actions should complement measures to control overall level of consumption. Two reports, same evidence, and yet such different conclusions. As scientists, steeped in alcohol (as it were), we who prepared the academy’s report no doubt came to the issue with our own set of prejudices. The prime minister’s strategy unit had a different set. It is reasonable to surmise that they found the prospect of raising the tax on alcohol unattractive, as they did reversing the trend of making it ever easier to buy alco- hol. The policy implications of the science may well have influenced their view of the evidence. This leads me, naively perhaps, to want to separate two issues: what the science shows and its policy implications. It is perfectly reasonable for governments to balance a number of interests in forming policies. Scientific evidence on dose response relations between exposure and risk is only one consideration. Others include analysis of costs and benefits, risk analysis, and appreciation of the degree to which policies fit with public values.8 It is helpful, however, to keep these distinct. Public values are important. There is much discus- sion now of individual responsibility for behaviour. This informs the government’s call for consultation as it develops a white paper on public health. A healthy tension exists in a democratic society between individual responsibility and the role of government. Smoking is a matter of individual responsibility but successive British governments have taken beneficial action by raising the price for health reasons, restricting advertising and promotion, and restricting smoking in public places. Unlike smoking, the healthi- est amount of alcohol is not zero. Nevertheless, the 50% rise in alcohol consumption in Britain means that as a population we are drinking well above the optimal level for health. As it develops its white paper on public health the government has another opportunity to look at the evidence linking harm with average alcohol consumption and consider that government has a responsibility alongside that of individual citizens.
Xanya Sofra Weiss
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