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Demonising the alcohol industry doesn’t lead to effective public health policy

Dr Stephen Black

British Medical Journal

12 February 2014

Letter to the editor

I’m worried about the way the debate on alcohol pricing is being conducted. We seem to have adopted a Manichean worldview, where gallant public health scientists fight an industry that wields enormous power over government and cares not for the health of its customers. This attitude will not lead to good public health policies.

Gornall’s desire to rubbish any criticism of minimal pricing makes him confuse important political and moral arguments with critiques of the evidence. The idea that we behave virtuously only when an angelic government makes us do so is the first step towards an Orwellian nightmare. This argument should not be casually dismissed because of a tenuous association with industry lobbying.

Then there is the allegation that industry has conspired to corrupt the evidence on pricing. It implies we can’t trust any opposition because most will have been sponsored by industry vested interests. No doubt we should be wary of lobbying, but we should also judge arguments on their merit and not their sponsor. Anti-alcohol campaigners think the Sheffield model and the Canadian evidence are robust and applicable to England because industry doesn’t like them. But the evidence isn’t that good or that reliable, as people like me have argued since it was first published.

The most disturbing thing is that the lack of critical thinking around minimal pricing has made people believe it is a magic bullet for such a deeply rooted problem as alcohol misuse. To combat alcohol misuse, we need a range of harder, less headline grabbing policies that will have more effect in the long term.

By not criticising the arguments for minimal pricing, we are also ignoring signs that people’s behaviour has already improved, without them being forced to change by government. Alcohol consumption has fallen in England in the past decade, even among the young. But these facts are rarely discussed because they would undermine lobbying for further restrictions like minimal pricing.

Dr Stephen Black is a health management expert at PA Consulting Group


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