Should alcohol advertising be banned? Public health experts reply

A senior scientist, Professor Michael Good, has called for a ban on alcohol advertising. It’s a significant call, especially considering the clout that Good wields, as head of the QIMR, chair of the NHMRC, and co-chair of the health stream at the 2020 Summit (although it should be pointed out that he made the call as an individual and not on behalf of any organisation or group).

It’s also significant because Good, although a self-confessed convert to public health, comes from a hard core medical science background. So what does the public health community make of his call? Here are some views, and please feel free to add your own comments.

Fredrik Welander (who is involved in a community-wide program in WA to tackle the grog culture):

“Although I fully support a complete ban on alcohol advertising, my personal opinion is that the only way of reducing the harms associated with excessive alcohol use is to apply a comprehensive approach where we look at changing current drinking norms in Australia, obviously advertising plays an important role here, and that the wider community stop condoning current practice by being silent.

Most people do not realise that excessive alcohol use affect everyone, drinkers and non-drinkers, because we all have to carry the financial cost associated with excessive use through cost for hospitalisations (e.g. liver cirrhosis patients, victims of alcohol fuelled violence, etc.), cost for the legal system (e.g. policing, court costs, imprisonment), the cost for industry (e.g. lost production, increased sickness absence and early retirement) most of this costs is covered by the taxes and insurance premiums we all pay.

We also need a change in the way alcohol is taxed, from a health perspective alcohol should be taxed according to alcohol content not based on the colour of the drink (i.e. alco-pops) as this would encourage both consumers and the liquor industry to move towards alcoholic drinks with lower alcohol content (e.g. mid-strength beer or wine with lower alcohol content).

Levels of alcohol use has over the past 10 years not increased in a significant way, what we have seen, on the other hand, is a significant change in the way people consume alcohol. The effects related to severe binge drinking is quite horrific with signs of brain damage among well educated men and women in their early to mid 20’s, together with an increase in antisocial behaviour, domestic violence and assaults.

The key problem with current attempts to tackle risky alcohol use is that it is fragmented and neither increased taxes on  alco-pops, TV advertisements focusing on drinkers like the one-punch ad or the most recent federal campaign targeting drinkers will have a significant impact.

In Kalgoorlie-Boulder the Kalgoorlie Alcohol Action Project, a project run by the National Drug Research Institute, there have been focus groups run with young (20-35 year old) women to ascertain what kind of messages would adhere to them and the results clearly shows that messages related to alcohol use should be targeted at youth aged 10-12 years of age, before they have begun drinking alcohol and messages aimed at current drinkers will have little or no effect.

So, yes, alcohol advertising should be banned, but that should only be one of the first steps towards a comprehensive countrywide, evidence based, harm reduction approach.

Todd Harper, CEO of VicHealth:

It’s pleasing to see more and more individuals and organisations recognize that our best shot at changing the harmful drinking culture in Australia is through a multi-pronged approach which includes bans on alcohol advertising as a key part of the plan.

I agree with Professor Good that it is hard to see any positives for public health from allowing alcohol advertising to continue unabated in Australia. The alcohol industry’s constant deployment of marketing tools such as infamous binge drinking sportsmen, semi-naked women, and sesame street style brand icons suggests the industry are being just a bit disingenuous.

The alcohol industry have little credibility left in the debate about restricting alcohol advertising, given their poor track record at implementing and enforcing their own self-regulatory code – the Alcohol Beverages Advertising Code. Just reflect for a moment on some recent alcohol advertising you may have seen, and now contrast that with the code’s prohibition on using images of “sexual or sporting success” in alcohol advertising. Most people probably don’t even know there is such a code given the never ending stream of irresponsible advertising trotted out by the industry.

We need a long vision of a new, safer and healthier drinking culture, but we also need some short term goals. An obvious place to start in restricting alcohol advertising is the free reign it currently has during live sporting broadcasts. Australian children are being exposed to thousands of alcohol advertisements every year because of this loophole which not only promotes drinking to young people, but also tells kids that sport and alcohol go hand in hand. High-profile alcohol-fuelled incidents among athletes in our nation’s most popular sporting codes over the past few years are proof enough that its time to stop mixing sport and alcohol together.

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Associate Professor Kate Conigrave FAChAM, FAFPHM, PhD
Discipline of Addiction Medicine, University of Sydney

While there are many lessons to be learnt from the ongoing battles to reduce smoking rates, which have had a large measure of success, there is not an exact parallel between smoking and alcohol. Smoking is a black and white issue. Smoking is bad for you. You are definitely better off not smoking at all. No health practitioner would ever encourage moderate smoking.

With alcohol it is more messy. There appears to be no harm with low level drinking, and very likely low level drinking on 3-4 days per week may actually improve your health. And I mean LOW level. In one Harvard study, the benefits were available from as little as half a drink four times per week. This is not license to party. There are biological mechanisms that explain the benefit for ischaemic heart disease (less sticky platelets, higher levels of “good cholesterol” etc); there is temporal association (ie what you drink before influences what happens to your heart disease afterwards), repeated studies etc.

And in case you’re thinking it – no, I have absolutely no links with the alcohol industry, and I drink very little. My job involves treating people who are facing death as a result of their past alcohol consumption. And not all of them are alcoholic, some just drank a bit above the old NHMRC limits and happened to have sensitive livers. I also regularly see the disastrous social complications of drinking.

O’Keefe aptly describes alcohol consumption as “the razor-sharp double-edged sword” (Amercian Journal of Cardiology, 2007). You drink a little, you get lower rates of ischaemic heart disease. You drink too much, you get a flabby, useless heart (cardiomyopathy). You drink a little, your body responds better to insulin, and you get lower risk of diabetes. You drink a lot, your body becomes resistant to insulin or your pancreas is destroyed (in a painful process), and you get diabetes. You drink a little you become socially relaxed. You drink a lot you may become stupid, more likely to injure yourself, violent or unable to keep themselves safe from cars, human aggressors or predators. Then of course, there’s alcohol’s link with cancer…. no good side to that coin.

So should the alcohol industry be allowed to advertise alcohol? The current approach is concerning. It often targets young people, and is linked in advertisements to being young, adventurous, socially and sexually attractive. Advertising is not just through the media, but through eye catching handouts at pubs and bottle shops. Sports teams, sponsored by the alcohol industry, tend to drink more – and provide a model for other young people to drink more.

With young people, the situation is much clearer: NO physical benefits have been documented with drinking in youth (you’re unlikely to get heart disease at that age anyway) and the more you drink the more likely you are to die, usually from a violent cause: road accident, suicide, violence. So targeting advertising to young people would appear to be a bad idea from a health perspective. Sadly, in contrast, it is an good idea for the pockets of the alcohol industry.

What about alcohol advertising targeting adults? For sure, the health department (with their relatively tiny education budget) can advise people to stick below certain limits, but the alcohol industry, with their relatively massive budget, to make often creative and entertaining ads, makes that alcohol look awfully attractive.

Also remember that up to one in 24 adults are psychologically or physically dependent on alcohol. It’s a common condition. For many individuals with alcohol dependence visual cues to drinking can create an intense craving for drink, matched by a neurobiological flare on brain imaging (MRI) scans. And if they have a first drink this creates an even more intense “priming” effect, which drives them to keep on, and on. And then there are many more adults (up to one in six in some estimates) whose drinking causes major injury to themselves or their familes, or quietly erodes their health.

You would have to say, that advertising such a product is a highly hazardous affair, and should be reconsidered.

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Mr Terry Slevin

I agree 100% with Michael. The Australian “drinking culture” is not a culture – it is a notion substantially driven and fuelled by relentless, carefully researched and very generously funded advertising and marketing activities run by those who profit from its success. Alcohol manufacturers and retailers.

“If it is a legal product it should be legal to advertise it” they tell us. Sure (fresh from the tobacco industry play book 1978) – but it is not legal for under 18s. Sure, no kids watched the Bathurst speed and booze fest weekend with almost constant associations between car racing and beer. Nor would there be any kids interested in cricket and its link with yet more beer. The list of examples is endless. Advertising, sponsorship, special deals and promotions. All just normal business. No harm done….

Especially as we are protected by a (‘voluntary’ – ‘industry enforced’) code of conduct for our advertising. Phew – that’s a relief !

In truth the self regulation system really means no regulation. Flagrant breaches are ignored and campaigns that do attract complaint are long finished and sales boosted before any consideration of the complaint are addressed, let alone action taken.

The enormous damage caused by alcohol consumption to individuals, families and communities is pushed aside as being the problem drinking of a small and aberrant minority.

It seems people who challenge the monolithic alcohol industry, and particularly its very effective and various marketing arms and industry lobby groups, are quickly charged with being fun busters and wowsers – labels everyone wants to avoid.

And that labelling works. My observation is that health professionals, politicians, journalists, policy makers, anyone who gives this issue any real consideration, run any policy debate about alcohol through the filter of their own drinking behaviour. No one wants so be labelled a hypocrite so “anything that makes me feel uncomfortable about what I drink – must be wrong”.

There are plenty of vital policy levers to be pulled to reducing the health and social burden of alcohol consumption on our society. Tax, licencing controls, enforcement of drink driving and other related regulations. And all of those will be harder to pull effectively when the best marketing minds in the country are handsomely paid to focus on creating the sexiest, most popular and attractive image for the people who drink (…fill in your favourite tipple here…).

“Stop them advertising booze – unAustralian !” Well done Michael – I’m with you.