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Phil Mellows

The Politics of Drinking

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I worry for Dame Sally Davies. The chief medical officer has revealed that every time she reaches for a glass of wine she thinks about cancer. This can’t be healthy.

It’s understandable that she’s so zealously taken on board her own recommendations on alcohol guidelines, which for the first time state that there is no safe level of consumption, but I’m not sure she’s properly understood them.

Recommended guidelines are, erm, recommended guidelines, not a strict rule. They are meant to encourage a relaxed and rational assessment of risk, not a cringing in fear whenever someone offers you a glass of pinot grigio.

It’s curious, too, that it’s specifically cancer Davies is worried about. Alcohol-related liver disease is a much bigger killer. But, of course, cancer is scarier.

She should also know that guidelines don’t have much effect on an individual’s decisions about how much to drink. Not even hers. As the public health lobby is constantly reminding the drinks industry, educating people is not enough.

This was confirmed by some reflections on the British Medical Journal’s website by one of the CMO’s advisors on the matter, Dr Theresa Marteau.

There is little evidence, she says, for “any effect of health-related guidelines on behaviour”. On the other hand, “they may shift public discourse on alcohol and the policies can reduce our consumption”.

See what they’ve done there?

I am, myself, sceptical about whether alcohol guidelines work. As I argued in the Off Licence News recently, it is extraordinarily difficult to apply them in actual drinking situations.

I did leave the door open a crack, though, by suggesting that they might play a role in arming doctors and other medical staff in their conversations with people whose drinking has become a problem for them.

We know that these conversations, or brief interventions as they’re called, can be effective in encouraging someone to reduce their consumption. But I suppose the length of time doctors are allowed with patients these days might make their interventions a little too brief.

So we are left with what I feared – that, whatever the strength of the science behind them, the guidelines are disingenuous. They are not meant to guide, but instead provide propaganda and headlines for cranking up the fear of the bottle and, in turn, persuading politicians to push ahead with the whole population policies that obsess certain sections of the health community.

Dame Sally Davies seems to be an early victim.

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It’s sobering, in the sense of making you stop and think, when you hear reports from the frontline of alcohol treatment. Often these people are much more worth listening to than those who comment and policy-wrangle at a safe distance.

The Guardian at the weekend carried a “secret alcohol liaison nurse’s diary”, a revealing glimpse of people with drink problems and those who try to help them.

There’s the man who fell over while drunk and didn’t go into A&E with his serious head injury for three days, because he feared they’d keep him in and he wouldn’t be able to drink his daily bottle of vodka. He dies.

As does a 36-year-old woman who continues to drink despite the support she’s had over the previous two years.

These people know that if they carry on drinking they’ll kill themselves. Yet they carry on doing it.

The nurse sounds surprised when another client has actually taken the advice and given up her two bottles of wine a night. It makes a heart-breaking job worthwhile.

There is huge frustration, though, that overspills in the diary.

The nurse is supported by a team of volunteers, recovering alcoholics rather than professionals. They are passionate about helping others in a similar plight, but it shouldn’t be like this.

“Why don’t we have an all-singing, all-dancing NHS alcohol service? Cuts are having a devastating impact,” says the nurse, against which her other plea, “Why don’t we have a minimum alcohol unit price?” sounds slightly odd.

More expensive alcohol will surely not help people who are undeterred by the certainty that if they carry on drinking they’ll die.

There is a barely sketched out narrative, of course, that the people who turn up at A&E as a result of a chronic drink problem might not have got that way if alcohol had been made less available to them – which means less available to everyone.

And perhaps price does play its part, but it is a part in a complex drama with many players that we understand very little about – why is it that a small minority of people get into such serious difficulty with drink?

Looking upstream towards the causes of alcohol problems is the right thing to do, but we need to go further upstream than price and availability to the dark source of despair.

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Of course it’s an artificial construct. Humbug. But you can’t stop people thinking that 2016 might have its own discrete identity that can be neatly bundled up into a tidy package. And as they say, if you can’t beat them, join them, so here are the five stories I predict will dominate the pubs and drinking headlines over the coming months.

Drinking guidelines

Details of the long-awaited review of the recommended drinking guidelines, due to be published by the Chief Medical Officer at the end of January, have already been leaking out. It looks like they’re going to suggest two alcohol-free days a week, a reduction in what men are allowed to bring them into line with women and assert there is no safe level of alcohol consumption.

We probably ought to wait for the full document before saying too much, but if these are the concrete proposals they are hugely disappointing.

The problem with the guidelines has been that people don’t understand units, that they don’t fit in with drinking behaviours nor the variety of strengths of drinks. Reducing them will have no effect at all on that.

And declaring there’s no safe limit at the same time as trying to persuade people to adopt a safe limit makes no sense and undermines the credibility of the whole exercise.

Minimum pricing

In spite of the European Court ruling, it’s still not clear whether minimum unit pricing is, or isn’t, legal. In 2016 the Scots themselves will need to decide whether they can put through the legislation because there is no alternative – for instance taxation.

I’m wondering if the fact that the Scottish Government has no tax-raising powers will be the clincher, and minimum pricing will happen after all – but leave Scotland as a peculiar anomaly within Europe.

But what do I know.

Pubs code

Consultation on the statutory code for pubs closes mid-January. No doubt there’ll be some more fiddling about, but the big players are already making their moves. The industry restructuring triggered by the 1989 Beer Orders will enter a new phase.

Pub protection

Fair play to the Co-op, which has worked with Camra to draw up guidelines that aim to avoid it closing viable pubs to make way for another convenience store.

The devil, however, is in that word ‘viable’. Businesses that look hopeless can be turned around by the right operator with the right investment and the right offer. Similarly, a pub might have community support but it won’t necessarily survive if the resources aren’t there.

Big brewery craft beer

Some might consider it a paradox, but there’ll be no stopping global brewers muscling in on the growing market for craft beers, whether it’s by developing their own or taking over existing portfolios.

What difference will it make? We’ll find out.

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Three decades ago I was invited to the launch party for EastEnders, a new TV soap opera that the BBC hoped would rival ITV’s Coronation Street. Which it did.

But what was a humble licensed trade hack doing at such a momentous occasion? I was invited because the pub, the Queen Vic, was so important to the show. As was the Rovers Return in Corrie and the Woolpack in Emmerdale Farm (as it was called then).

Even more so than in real life, the local pub in soaps was, and still is, at the heart of the action, the place where characters interacted, where storylines were progressed, where dramas unfolded.

If one or two became a little tipsy as a result, all the better. Those hidden secrets and thinly-veiled antagonisms that audiences thrived on had permission to burst to the surface. In vino veritas, indeed.

But now a boffin, who really should find something better to do, has declared this a bad thing. After analysing 3,000 minutes of soaps, dramas and sitcoms, media psychologist Emma Kenny uncovered what she described as an “unacceptable state of affairs regarding the representation of healthy hydration”.

Soaps dedicated no less than 39% of ‘drinks screen time’ to alcohol with only one in 20 drinks being water – shocking perhaps only to the National Hydration Council, which commissioned the research.

Kenny seems to mistake soap opera for an arm of health education which has inexplicably gone rogue. It’s true, of course, that radio’s The Archers (which has The Bull) was originally envisioned as an educational vehicle for farmers, and still includes the occasional awkward didactic moment.

(At least that’s what I’m told. I’ve been allergic to The Archers, and agriculture in general, since a close encounter with a cow’s underparts on a school trip.)

Believing soaps are principally there to “positively influence viewers’ lifestyles” through showing people how healthy lives should supposedly be lived is wildly wrong-headed, however.

Even if you wanted to do that – and soaps can provoke important debates on all kinds of issues – nobody is going to watch or listen unless you create an interesting fictional world that uses dramatic device and narrative structure to make it believable, engaging and a whole lot less boring than real life.

Drinking healthy amounts of water, I’m afraid, just won’t wash.

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I drank a little more than I intended on Friday night and ended up watching the music shows on BBC4 into the larger small hours, a classic consequence of mild intoxication already documented by my insightful academic acquaintance Will Haydock*.

It was far from a terrible consequence, carrying me back as it did to the heyday of 10CC and telling me lots of things I didn’t know about one of my favourite bands of the 1970s, as well as confirming my good taste.

Anyway, I’d stayed longer than usual in one of my local pubs because of what the Irish call ‘the craic’: all sorts of people I knew and didn’t know dropping in, against a background of more songs that took me back to my distant youth plus, of course, a drinkable pint of Harvey’s.

It was without doubt a good night, and I was fine the next morning, too. I might have been feeling a bit knackered by Saturday night but if I was inclined to carrying out cost-benefit analyses I’d say I was well up.

I tell you this rather ordinary tale because it appears the Irish government itself is turning against the craic. A new Public Health (Alcohol) Bill, due to come out before Christmas, wants to ban scenes of people enjoying themselves in pubs from alcohol advertising. Only product shots will be allowed.

The aim is to ‘de-glamorise’ drinking, about which I’ll make two points.

Firstly, alcohol consumption in Ireland has fallen even faster than in the UK, down 25% since it peaked in 2001, so if they’re thinking to make people drink less they’re pushing at an open door.

Secondly, there is the argument that if you’re going to drink it’s much better to do it socially, in a pub, since there’s a kind of natural policing of behaviour going on, and there are community benefits to boot.

Recent ad campaigns in the UK, such as the generic There’s A Beer For That and the new ones from Greene King, actively promote the pub as a site for all sorts of good things, with drinking at the centre.

Is this glamorising alcohol? Or is it simply reflecting a genuine experience of what drinking down the pub can be like?

Sometimes I think we can overdo the goodness of pubs, much as I love them. It’s not always like that. But when it’s good, when all the elements of a great night out click into place, oiled along by a pint or three, there’s nothing beats it.

And trying to ignore that is not going to change anything.

*www.twitter.com/WilliamHaydock

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About The Author

Phil Mellows

Phil Mellows is a freelance journalist and writer specialising in the UK pub industry and alcohol policy. For more information, and the Politics of Drinking blog, go to www.philmellows.com

You can also follow Phil on Twitter at @philmellows