There are about 700,000 heavy drinkers in NZ. A heavy drinker is essentially anyone who is drinking the equivalent of a bottle of wine or more on a regular basis. The heavy drinking culture can be thought of as the collective attitudes of these fellow citizens, 120,000 of whom have alcohol dependence.

The alcohol industry has more than a passing interest in this subpopulation because they provide the industry with more than half of its enormous profit. The alcohol industry targets them with its marketing in order to keep them in the habit of heavy drinking as well as targeting new recruits – our children.

Over the past two decades the alcohol industry has run marketing campaigns aimed at young people and women. So it is not surprising that, over the past 10 years, there has been a 9% increase in the per capita consumption of alcohol in NZ despite an ageing population; increasing numbers of heavy drinkers are young people and women.

Heavy drinking can be found in every town and city of NZ. Our national game, rugby, is so intimately associated with alcohol that it could be usefully known as “drugby”.

The starting point for rational discussion about alcohol is recognition that it is indeed a drug. In fact, if alcohol was invented as a new drug today it would undoubtedly be banned here. Research using the Government’s Expert Advisory Committee on Drugs’ criteria for scheduling new drugs puts alcohol in the category of a Class B drug (High Risk to Public Health) alongside morphine, ecstasy, and d-amphetamine.

But we are not calling for prohibition of alcohol. This is an extreme strategy with serious consequences related to a black market and increase in criminal activity. Prohibition is at the other end of the pendulum to the extreme policy we have in place – excessive commercialisation of alcohol. The answer lies in finding middle ground, middle ground where alcohol is more strictly regulated.

So how can New Zealand’s damaging heavy drinking culture be changed? The Government (our collective representative mind) has a vital and leading role to play, as it has had with every other major social reform – the most relevant in this context being smoking.

The international evidence is clear about what measures work. A World Health Organisation-sponsored publication, Alcohol: No Ordinary Commodity, assembled this evidence in 2003. Alcohol Action NZ has summarized it in the form of the 5+ Solution: 1. Raise alcohol prices; 2. Raise the purchase age; 3. Reduce alcohol accessibility; 4. Reduce marketing and advertising; 5. Increase drink driving countermeasures; Plus: Increase treatment opportunities for heavy drinkers

This is the general regulatory strategy that would work if the Government had the will to lead reform.

It’s important to note that education and social marketing campaigns are not particularly effective in changing the behaviour of heavy drinkers, in exactly the same way that these have not brought about landscape changes in smoking over the last 40 years. Just waiting around for heavy drinkers to become “more responsible” isn’t an effective strategy either.

The Government’s recent response to the historic Law Commission’s review has been deeply disappointing. The Law Commission’s review has been a once-in-a-generation opportunity to change the heavy drinking culture, based on the international evidence, and the Government is on the brink of wasting it.

The Government’s response has been full of PR spin centred round the assertion they are enacting 126 of the 153 recommendations of the Law Commission. What they are actually doing is focusing on youth binge drinking, even though less than 10% of the heavy drinkers in New Zealand are under the age of 20 years, and so far omitting anything that would make a substantial difference to heavy drinkers.

Alcohol Action NZ recently sharpened up the 5+ Solution into a set of four specific alcohol measures. These are measures that would change the heavy drinking culture, but none appear in the Government’s response to the Law Commission’s review to date: 1. End ultra-cheap alcohol by introducing a minimum price for alcohol followed by strategic increases in excise tax; 2. Stop the highly normalised access to alcohol by restoring supermarkets to being alcohol free; 3. Put an end to industry self-regulated alcohol advertising by banning all broadcast advertising and sponsorship of sport and cultural events; 4. Ban legal drunk driving for adults by reducing the blood alcohol level from 0.08 to 0.05.

It is now a political struggle, just like it has been with the tobacco industry and their grip on the Government.

The Law Commission’s historic review is coming to an end very soon with a new Alcohol Bill being introduced into Parliament some time in October. The last opportunity we have to influence the Government at this time is through making a submission to the Select Committee after this First Reading of the new Bill in Parliament.

If you would like to become more actively involved in the campaign, including putting in a submission, then visit www.alcoholaction.co.nz and sign up for information to be sent to you directly.

Doug Sellman, MBChB, PhD, FRANZCP, FAChAM, is a psychiatrist and addiction medicine specialist who has been working in the addiction treatment field in New Zealand for the last 25 years. He has been Director of the National Addiction Centre (NAC), University of Otago, Christchurch, since 1996. He was promoted within the University to a Personal Chair in Psychiatry and Addiction Medicine in 2005. He began his career working with adults who have addiction and mental health problems and, for the last 15 years, has worked as a consultant psychiatrist for the CDHB’s Youth Specialty Service. He has begun promoting evidence-based alcohol policy in NZ and is a medical spokesman for Alcohol Action NZ.