CIGARETTES are good for your throat, according to advertisements from half a century ago. Today such claims are unthinkable, as smokers face malevolent stares of contempt whenever they light up. Die-hards apart, society now accepts the huge damage to health wreaked by smoking, both to smokers themselves and to others through passive smoking – a change in attitudes with huge benefits for public health.
Now the World Health Organization is launching the first global war against alcohol abuse (see “First global strategy to deal with booze’s dark side”). Can it replicate the success of the anti-smoking campaign?
Some of the ways to curb excessive alcohol consumption are similar to those used against cigarettes, such as increasing taxes and reducing availability. We report on research that shows how these measures can penalise heavy boozers more than tipplers. And as with cigarettes, there may also be scope for making drinking less glamorous through clampdowns on marketing and advertising.
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In this magazine, we have argued that these kinds of policies should be drawn up on the basis of evidence of harmfulness – to individuals and to society. But the problems of alcohol abuse have in the past been taken lightly. Excessive drinking has often been accepted, even celebrated, with hangovers and ill-considered liaisons seen as comical interludes that lighten the daily grind.
This attitude of casual acceptance is central to the challenge facing the WHO. It obscures a problem which killed 2.4 million people in 2004, half the toll of smoking, and is .
The first line of attack, as with smoking, will be to get everyone to accept that alcohol abuse takes a huge toll. We need to erase the jolly caricature of the town drunk who occasionally falls off his stool. The WHO argues that we should borrow another aspect of the anti-smoking message and regulate so-called “passive drinking” – the effect on others of a person consuming alcohol – pointing to the role it plays in violence, family breakdown and road deaths. But “passive drinking” is a misleading term. While drinking is like smoking in that it causes collateral damage, no one else (save an unborn or breastfed child) can passively consume the alcohol imbibed by another. Any harm results from a drinker’s actions, not exposure to the substance iself.
“Drinking, like smoking, causes collateral damage, but no one else is passively consuming the alcohol”
Talk of passive drinking deflects attention from a more shocking aspect of the problem. The overall harm caused by alcohol is . When society stops thinking of alcohol as as relaxing tipple and regards it as another drug, that will signal the biggest change in thinking of all.