Posted July 5.
Photo: Alcoholic drinks decanted into soft drink bottles in Alice Springs.
With a floor price for alcohol and no take-away sales on Centrelink payday, the People’s Alcohol Action Coalition (PAAC) would achieve its aims. Not much more harm minimisation could be expected through supply reduction, says the group’s spokesperson John Boffa, who in his day job is a doctor at Central Australian Aboriginal Congress.
“At that point we would turn our attention more fully to other strategies,” says Dr Boffa, “because we know that restrictions on alcohol are not a magic bullet.
“Even with optimum restrictions in place, there’ll still be a lot of excessive drinking in Alice and the NT as a whole and a lot of violence flowing from that.”
With the cooperation of retailers a partial floor price – a minimum price per unit of alcohol – in Alice Springs has been achieved. Perhaps more importantly, the publicity around it has given momentum to a national push for the introduction of a floor price around the country. On Wednesday (July 6) Dr Boffa joins like-minded lobbyists in Canberra for meetings with some 60 politicians. PAAC was accepted as a member of the National Alcohol Action Alliance around two months ago and must be one of the group’s most useful recruits, given the focus on the issues that it has been able to generate.
Dr Boffa says the national alliance’s main platform is about getting price mechanisms to play a role in consumption reduction. He says it’s good policy for government, as it’s proven to work on a population-wide basis and costs virtually nothing.
What about the popular outcry that is bound to ensue?
Dr Boffa urges people to stop and think: do they really consider that a minimum price for a standard alcoholic drink that is no more than the price of a can of Coke and often cheaper than bottled water is too much for people to reasonably pay?
“As Coles have said, there is still a very large volume of affordable alcohol available. All that has been eliminated is the ridiculously cheap alcohol.”
The price mechanisms being lobbied for by the national alliance are a floor price and a volumetric tax. The latter applies the same rate of tax per litre of alcohol across all beverages.
The alliance wants both, but Dr Boffa’s personal view is that a floor price is more achievable and fairer. Both work to eliminate from the market ultra-cheap wine, the big baddy from a public health point of view. However a volumetric tax would also increase the price of wine in the bracket that many responsible drinkers choose from, the current $10 to $14 range, while significantly decreasing the price of very expensive wines. Meanwhile, the price of beer would also rise by about 5%. So the tax, unless it was formulated to overcome these consequences, would advantage wealthy drinkers, while disadvantaging the not so wealthy.
A floor price is a relatively new concept and at present has been applied nowhere in the world. Dr Boffa’s confidence in its impact is based on research into the way other price mechanisms, making the cheapest wine dearer, have worked.
In Alice Springs the removal from sale of four-litre cask wines from September 2006 and the restricted availability of two-litre casks and fortified wines led to a 19.6% drop in population consumption, a 70% switch to beer (less harmful than wine), an 85% move away from cheap wine, and a corresponding 21% reduction in serious harms.
Consumption started to rise from mid-2009 when ultra-cheap bottled wine began to be promoted. Currently population consumption is 14% below pre-restrictions levels. Dr Boffa is confident that it would return to around 20% if an effective floor price could be achieved. This would require the remaining two local bottleshops (at Todd Tavern and Gapview Hotel) to cease selling two litre casks.
Tennant Creek’s Thirsty Thursday and ban on liquor in containers larger than two litres, introduced back in 1995, also achieved a 20% drop in consumption and a big switch to beer.
More recently restrictions were introduced in the WA town of Halls Creek. From mid-2009 you could not buy take-away full-strength beer there and you could not start drinking at the town’s pub before midday unless it was with a meal. A review of the restrictions after 12 months showed a “significant” drop in alcohol-related incidents requiring police response and “significantly fewer” alcohol-related injuries and presentations at the hospital. However, there had also been “some” displacement of drinking to other towns, with Kununurra experiencing an increase in general violence and alcohol-related harm. (The displacement of problems from one town to another demonstrates the value of a national approach.)
This evidence all relates to Australian examples. Dr Boffa also points to international research, including a study of 18 pricing policies for alcohol in England. The results, published in the British medical journal, The Lancet, last year, showed that price increases were effective for “reduction of consumption, health-care costs, and health-related quality of life losses in all population sub-groups”.
The World Health Organisation, in a 2008 paper on strategies to reduce the harmful use of alcohol, also says price is “an important determinant of consumption”, and that a “particular concern emerges when alcoholic drinks are cheaper than nonalcoholic alternatives such as bottled water”.
Dr Boffa said this is the kind of evidence that PAAC have previously presented to Coles and that he would take them through again when and if they visit Alice, as suggested by their General Manager of Corporate Affairs Robert Hadler (see report below). He says action on Alice’s alcohol issues requires leadership based on evidence, not on popular opinion. In any case, he argues, the current views of the majority are unknown as there has been no proper survey of residents’ attitudes since 2000. At that time 96% of respondents rated alcohol as a serious to very serious problem for Alice Springs, while 36% supported some kind of restrictions on availability of alcohol as a solution.
He says the NT alcohol problems are not confined to Aboriginal drinkers. Statistics published in the Medical Journal of Australia in 2010, by a team of researchers including Dr Steven Skov, Public Health Physician for the NT Department of Health and Families, show that non-Aboriginal consumption in the NT is about 1.43 times the national average, while Aboriginal consumption is 1.97 times. Deaths attributed to alcohol occur in the NT at 3.5 times the national rate; for the non-Aboriginal population the rate is double the national rate – bad enough – while for the Aboriginal population, it is 9-10 times higher, a profoundly tragic state of affairs. Hospitalisations related to alcohol in the NT occur at twice the national rate.
Dr Boffa says that the Central Australian statistics for Aboriginal and non-Aboriginal populations are likely to be worse than the NT-wide statistics.