by Aurelijus Veryga
In principle, the goal of any public health policy is to make people’s lives in terms of health problems as boring as possible. When people don’t have to worry about their health, they can live out their normal lives, they can spend time with their families, they can work. Here is why I think lives in Europe are not boring enough yet.
Health issues are surrounded, unfortunately, by a range of persisting myths. Let me pick one of the most damaging to public health in my view: It is the idea that tobacco and alcohol are different in their effects on people’s health and well-being. When we look at how the debate on tobacco is shaped across Europe, it is common sense that there is no "safe" level of tobacco consumption. It is also common sense that there aren’t any health benefits from smoking. This message is clear and it is well understood.
When we look at alcohol, though, we see a completely different picture, in fact we see manipulation. This manipulation aims at – and it is very successful in doing so – making people think there are certain benefits of drinking alcohol, that it actually can be good for your health. So essentially the argument is: as long as people drink responsibly, whatever that means, they are not harming but are doing something good for their health. This is utter nonsense, though. When an individual starts to drink, we cannot predict whether he or she will be an alcoholic. Whether or not we become dependent once we start to consume alcohol regularly is up to many factors, e.g. our genes and our metabolism, and it basically is a lottery. There is no overall "safe limit" for alcohol for everyone. Just as with tobacco.
But why does this myth persist among people?
It has to do with the market and political control (or rather the lack of the latter). The market for alcohol has become more and more global. We know that, for example, the global production of beer is held in very few hands. It is not anymore like it was in Belgium or Germany, where the small breweries used to make beer in local communities for local consumption. Of course they still exist, but now we have big brands, big companies dominating most of the market in the world. The same trend is true for wine and hard liquor.
The big players in this market spend a lot of money on marketing and we can see the effect: despite increasing efforts to communicate the dangerous impact of alcohol, consumption in Europe remains high. According to the WHO, the European Union is the heaviest-drinking region in the world and the WHO European Region (which includes more countries than the EU) has the highest proportion in the world of total ill health and premature death due to alcohol. For the entire region, alcohol consumption is only decreasing very slowly, and in some countries, especially in Eastern Europe, consumption has even increased. Here we can see that the drinking habits of the younger generation are different from the ones of their parents: not only do the young drink more but they also drink different kinds of alcohol. In my home country Lithuania, for example, the older generation prefer liquors like brandy or vodka. They believe that this kind of alcohol is healthier (another myth). The younger generation in contrast drinks beer, wine, and cider and are then confident to say “We are not alcoholics!”.
Now, marketing alone is not the problem. Also tobacco companies have had big marketing machineries. The problem is the lack of alcohol control in Europe. Whereas for tobacco we have the EU Tobacco Products Directive and its revision, which is legally binding, there is no equivalent for alcohol. At the EU level, alcohol is still treated as a food product and then again it is not even regulated like other food products. There is no labelling, no calorie count. To put it in one sentence: Alcohol control is in the Stone Age in the EU.
What Europe therefore needs are EU-wide measures to support the member states in establishing effective alcohol control mechanisms. This is especially true for smaller countries which are too weak to resist the pressure from big multinational companies. That was clearly understood with tobacco, but it is not with alcohol.
What we also need to do is making people believe one thing: not drinking is at least as normal as drinking. Nowadays in many places people consider not drinking as not normal. Everyone of us has been in or can imagine a situation where it is not socially accepted to refuse a glass of wine or beer. If you still do, you are pressured to join in or exposed to jokes. We have to help those who are already motivated to change their behaviour: they need to feel that they are socially accepted, and that they are indeed very normal people – with hopefully boring lives when it comes to health problems.
About the author:
Aurelijus Veryga, President of the Lithuanian National Tobacco and Alcohol Control Coalition, Professor and Head of the Health Research Institute at the Lithuanian University of Health Sciences, Kaunas/Lithuania.