The reasons for such patterns seem equally clear: the extreme stress, boredom, trauma and isolation of a protracted and dangerously mismanaged pandemic, combined with Britain’s deep-rooted drinking culture and the general human penchant for alcohol’s relaxing properties . These demand-side factors are important to understanding alcohol use here – or anywhere else. Beer, wine and spirits are not consumed unilaterally by the British public, but consumed with enthusiastic participation by drinkers. But what we don’t talk about nearly enough is the influence of supply-side factors on our national consumption: namely, the incredibly powerful multinational corporations that produce and sell alcohol for huge profits, including brewers (such as AB InBev and Heineken). distillers (such as Diageo and Pernod Ricard) and ‘off-trade’ and ‘on-trade’ retailers (such as Tesco and Stonegate, respectively). Alcohol has an extraordinarily long and complex history, but its ever-increasing ubiquity is largely the product of its commodification and deregulation by Big Alcohol. The industry and its army of trade associations and front groups fight relentlessly to increase consumption, market share and profits by manipulating and influencing prices and taxation, licensing and retail density, advertising and sponsorships, international trade agreements, obscuring scientific findings and delaying public health efforts. Rather than subjecting itself to strong tobacco-style restrictions, the alcohol industry has so far successfully fought to maintain “self-regulation” and offload responsibility for alcohol-related harm to individual “problem” users, especially through its “responsible alcohol consumption”. “. But alcohol-related harm is not limited to those who experience dependence (around 600,000 people in England alone). Even relatively low doses of alcohol consumed on a regular basis increase the risk of health problems, including digestive and cardiovascular diseases, traumatic injuries, and cancers of the esophagus, liver, and breast. A recent study estimated that almost 750,000 new cases of cancer in 2020 were due to alcohol use worldwide, including about 100,000 from “moderate drinking”. Previously reported claims of alcohol, especially red wine, providing a “protective” function for issues such as heart disease and diabetes are also being questioned and are now considered to be “offset by monotonous [closely correlated] associations with cancer”. The crisis in alcohol-related harm is caused primarily by the fact that the profit-motivated alcohol industry provides structural incentives for higher-risk alcohol consumption. Industry revenue would fall by 38%, or £13 billion a year, if all drinkers consumed alcohol below the recommended guidelines, according to a study. Companies have a clear interest in preventing such declines, yet it is precisely these kinds of structural changes – rather than the voluntary and ineffective measures preferred by the industry – that are needed to seriously limit alcohol harm. Public health organizations such as the World Health Organization have long called for measures to reduce the power of the alcohol lobby through advertising bans, restrictions on retail density and hours, and increases in taxes and the minimum price per unit. Other policies in this vein include mandatory nutrition information and warning labels, banning industry from participating in policy-making, and coordinating global restrictions to curb predatory capital flight. The profit motive that drives the continued expansion of consumption should also be curbed through increased public ownership of production and retail. But restrictions alone will not be enough. We also desperately need to start a conversation around genuine alternatives to its use. For starters, there needs to be a massive expansion of free and public alcohol-specific health care for higher-risk drinkers that does not require sobriety as a condition of use, including managed alcohol programs, treatment, medication-assisted treatment, and psychiatric care. This should also include the public development of desirable alternatives such as ‘synthetic alcohol’, the legalization and regulation of lower-risk psychoactive drugs, and the promotion of public spaces that are not exclusively geared towards alcohol use. Ultimately, it’s about expanding opportunities for relaxation, socialization, and pleasure in ways that ultimately don’t kill, injure, or harm. It’s no doubt a huge undertaking, given Big Alcohol’s dominance of global politics, discourse and imagination. Radical and systemic political action is urgently needed if we are to have any chance of tackling Britain’s big alcohol problem – otherwise we will continue to mourn it.
