A more dynamic liquor policy, an urgent need

by Lionel WIJESIRI

Delivering a lecture on ‘Alcohol Consumption and Consequences in Sri Lanka’ a few months ago, Consultant Physician, Sri Jayawardanapura General Hospital, Dr. Anula Wijesundere touched on the history of alcohol consumption in Sri Lanka.

She said: “Historic and cultural evidence indicates that Sri Lankans did not consume alcohol significantly for several centuries and lived by Buddhist principles, observing the five precepts. However, in 1505, with the Portuguese invasion of Sri Lanka, the situation changed. They destroyed our civilisation and influenced the drinking habit among Sri Lankans.

“The Dutch continued the propagation of alcohol, while the British liberally introduced licences to open taverns in every nook and corner of the country, increased their contribution to State coffers and promoted the drinking habit widely via the ‘Toddy Act of 1912’.”

She also spoke about the magnitude of the problem. Sri Lanka has extremely high rates of per capita consumption of alcohol – 7.4 litres for recorded or licit alcohol. For males above 15 years, the consumption rate is 15.2 litres. The Alcohol and Drug Information Centre (ADIC) says that 43 percent of urban dwellers, 65 percent of male estate workers, 25 percent of female estate workers and 50 percent of fathers of schoolchildren consume alcohol in Sri Lanka.

Arrack consumption increased from 67.1 million litres in 2006 to 75.2 million litres in 2010, bottled toddy from 10.5 million litres in 2006 to 16 million litres in 2010, malt liquor (which is beer, stout and porter) from 51.9 million litres in 2006 to 66.9 million litres in 2010 and sparkling wines from 375,739 litres in 2006 to 395,892 litres in 2010.

These figures do not include the production of illicit brew in the country. The sale of hard liquor and beer in Sri Lanka is estimated to have increased by about seven to eight percent in 2011 from the year before. The Commissioner General of Excise indicated that the main reasons for increased consumption are the re-opening of the markets in the North and the East, more tourist arrivals and lower illicit alcohol consumption.

Problems

This data clearly lead us to a larger and bigger picture. It’s about an impending catastrophe we cannot ignore any more! More studies indicate that health, social and economic harm from alcohol abuse is widespread in our country. As the average use of alcohol has been on the increase, it is imposing numerous challenges on our policymakers, professionals, civil society and public health.

The wide range of social and health problems include depression, injuries, cancer, cirrhosis, family disruption and loss of work productivity among others. Medical analysts say that health and social problems from alcohol abuse often affect others besides the drinker. While men do the bulk of the drinking, women disproportionately suffer the consequences, including alcohol-related domestic violence and reduced family budgets.

The saddest part is that heavy alcohol use takes a particular toll on our young, and has been linked to high rates of youthful criminal behaviour and impaired ability to achieve educational qualifications. Many deaths and much disease and suffering within families and neighbourhoods could be prevented by reducing alcohol use.

One more related matter is the volume of traffic accidents in Sri Lanka. Over 6,000 people are killed (or grievously hurt) every year. At least 40 percent of these accidents are alcohol-related, mainly with intoxication on the part of the driver.

Liquor policy

What we urgently need today is a more dynamic liquor policy. The legislation flowing from such a policy should be guided by the need to decrease per capita consumption of alcohol.

In particular, the policy should involve an integrated approach which cuts across departments and sectors as different tiers of Government.

In my opinion, this could easily be done through the National Authority on Tobacco and Alcohol, which can bring together representatives of Government departments, community organisations, religious bodies, trade unions and the liquor industry at national level.

Similar interaction will be required at provincial government, local authority and community levels. Local authorities and representative community organisations and fora should work together in ensuring that the way in which liquor is distributed and sold limits the negative externalities as well as in addressing the negative effects which have already occurred.

Above all, religious formations can also play a key role in addressing the devastation caused by alcohol in their communities and must be encouraged to be integrally involved in these initiatives.

Externalities

Addressing externalities involves handling issues common to all sectors, but particular interventions are needed for education on alcohol-related effects on individuals, families and the community.

Firstly, there is a need for general education about the potentially harmful effects of alcohol by means of the media, schools, public health facilities, community organisations and other vehicles. Central to any education initiative is the goal of community empowerment to enable people to take control over their lives.

There is also a need for the expansion of a comprehensive education program for people within the liquor industry, in particular those who serve alcohol to the public. The program will need to cater for the educational needs of both those in the formal industry as well as the informal sector.

It is in this aspect that I would recommend a program on the lines of ‘Alcohol Awareness Month’ as practised in the USA. Alcohol Awareness Month, held every April in USA, was founded by and has been sponsored by NCADD since 1987 to increase public awareness and understanding aimed at reducing the stigma that too often prevents individuals and families from seeking help.

During the Alcohol Awareness Month, the National Council on Alcoholism and Drug Dependence (NCADD) and NCADD’s National Network of Affiliates reach out in communities across the country to bring the American public information about alcohol and alcoholism as a chronic, progressive disease, fatal if untreated, and genetically predisposed. The disease of alcoholism is a family disease that is treatable, not a moral weakness, from which people can and do recover. In fact, millions of individuals and family members are enjoying lives in long-term recovery from alcoholism!

In 2012, the NCADD celebrated the 26th anniversary of the Alcohol Awareness Month under the theme, ‘Healthy Choices, Healthy Communities: Prevent Underage Drinking’. NCADD President/CEO, Robert J. Lindsey said, “We chose a theme that will allow NCADD’s National Network of Affiliates and other NCADD Alcohol Awareness Month supporting organisations across the country to address this critically important public health issue through a broad range of media strategies, awareness campaigns, programs and events in their local communities.”

In support of the NCADD National Network of Affiliates and other organisations who wish to work in support of the campaign, NCADD has developed some NCADD Alcohol Awareness Month resource materials including an Organiser’s Guide containing suggested grassroots community activities.

Keys

It’s well established that two of the key ways to reduce alcohol related harm are increasing the price of alcohol and restricting its physical availability. The Government has initiated action on the first point, but the public would also like to see changes to the licensing laws that will give local authorities greater powers to control the density of outlets selling alcohol.

The gradual relaxing of licensing laws in the past has meant it’s much easier to get hold of alcohol, with an increased number, size and type of licensed premises meaning that town and city centres can accommodate more and more drinkers. Unfortunately, this comes at a cost, namely increased rates of binge drinking and alcohol-related violence, and consequently many regard our town centres as a place to avoid at night. In its alcohol strategy, the authorities should recognise that local communities should limit outlet density where this contributes to harm. Ultimately, the goal is to find an acceptable balance between an attractive and vibrant night-time economy and one that is not dominated by the sale and consumption of alcohol.