It is a facet of human nature that if we recognize a problem and wish to change it, we wish to do so in a manner that requires as little change and as few sacrifices as possible.
The smoker who starts having trouble breathing, wishes to cut-down rather than stop smoking entirely, the man with a heart attack wants to eat less pies rather than none at all or the new mother who wants both time with her child yet also her independence.
The degree to which change without sacrifice is possible depends entirely upon the problem at hand. I suggest that we consider where on this spectrum of sacrifice-for-change, alcohol advertising falls.
Alcohol advertising is effective
First off, we need to acknowledge that alcohol advertising does indeed increase drinking. Multi-billion dollar companies would not be spending hundreds of millions of rands advertising alcohol if it was ineffective. To think otherwise is simply naive.
Indeed, a research review of all longitudinal studies between 1990 and 2008 assessed the impact of advertising on more than 38000 young people and found that out of 13 studies, 12 demonstrated that exposure to alcohol advertising is associated with higher initiation of drinking as well as heavier drinking in a dose-response type relationship (risks proportional to the amount of advertising seen). But does this mean we should ban alcohol advertising?
Until South Africans recognize that alcohol abuse is an important problem in need of urgent change, the need for making any type of trade-off to address this will not be accepted. Do most of us know, for example, that South Africans rank amongst the top 5 heaviest drinkers in the world?
Or that we have the highest rates of alcohol-related harm in the world: 10 fold the global average of male violence, double the global average of road deaths and amongst the highest rates of HIV, TB and Fetal Alcohol Syndrome in the world?
Weekend binge drinkers cause most of the harm, not alcoholics. In a country where alcohol is one of the top 3 leading causes of death and disability what good reasons are there for us to be promoting drinking so heavily?
Many in the advertising industry suggest we should continue to advertise alcohol to save jobs in the media industry, but should we promote jobs at any cost?
One of the most admirable features of humanity is that we do not knowingly support industries that are harmful. This is why we test consumer products for safety, such as medications or motor vehicles and is why we do not promote tobacco, cocaine or child labour.
Alcohol is a dangerous product, causing the loss of approximately 130 lives per day in South Africa. Is saving 130 lives a day worth the estimated R3 billion projected loss in advertising (Moerdyk, 2011)?
How does this balance with the further R38 Billion annual cost of alcohol to our economy incurre d through alcohol-related violence, crime, HIV, absenteeism, low productivity, and incarceration, for example?
A recent economic study has indicated very clearly that the economic benefits of the alcohol industry, which tend to accrue to the wealthier sectors of society, are more or less equally matched by the economic costs of alcohol abuse, which tend to accrue to the poorest sectors of society.
Alcohol advertising limits our freedom of choice
Why do South Africans not know these things about alcohol? Why do so many South Africans falsely believe that it is only harmful to drink excessively if you are driving or pregnant?
Most of the messaging we get about alcohol is from the alcohol industry that has a vested interest in selling more alcohol. What gives the liquor industry the right to constantly bombard us (including people under the age of 18) with images and messages about alcohol on radio, billboards, television, sports matches and the internet?
At the same time, they make little effort to advertise responsibly or educate people about the harms of alcohol, with budgets for this less than 10 percent of that for promoting drinking. The liquor Industry Association for Responsible Advertising (ARA) has a staff of two people and only advertises its advertising complaints hotline on its website.
If nothing changes, nothing changes
It is true that alcohol advertising bans alone are not sufficient to curb alcohol abuse; a global body of evidence has demonstrated that to be most effective in reducing alcohol-related harm (by up to 44%) one should simultaneously reduce access to alcohol (shorter hours of trade, lower liquor outlet density and/or increase the price of alcohol).
This is of course another highly controversial issue-its effectiveness is beyond dispute (to those aware of the evidence), but of course us drinkers do not like the idea of less convenience in a world where we are used to companies ensuring us the easiest possible access to their goods at all times. The solution to alcohol abuse that appeals most to people’s sense of agency and self-determination is to educate people.
Unfortunately, hundreds of research studies show us that just telling people to drink less because alcohol may harm them is about as effective as sending a Christmas wish-list to Santa. Education is however a necessary adjunct to a broader alcohol policy that includes reducing demand for alcohol (through less advertising, for example) as well as reducing the supply of alcohol.
Both of these measures require some trade-offs but we should not forget that there is strong evidence to show that the net effect will be positive. This is why we make sacrifices because if nothing changes, nothing changes.
Dr Joanne Corrigall is a Senior Public Health Specialist in the Western Cape Department of Health and an Honorary Research Associate at the School of Public Health, University of Cape Town
This article originally appeared in the Mail & Guardian newspaper as a sponsored supplement