Nau mai ki te rā tatauranga 2018 / Happy census day
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Communities around the country will be hoping that 2018 is the turning point towards taking serious action to address alcohol-related harm. The strong focus on mental health and addictions, poverty reduction, improving the tax system so that it works for all New Zealanders, and the increasing attention to the role of corporates in policy-making are all steps in the right direction towards realising our potential to be a fairer and healthier society.
Since our last e-news we have heard the urgent calls by Emergency Department physicians at breaking point asking for help with overflowing waiting rooms as well as the growing need for more prison cells. The role that alcohol plays in relation to these environments would be obvious to the majority of New Zealanders.
The coming months bring numerous opportunities for evidence-based action to reduce alcohol harm and its inequities. We look forward to close collaboration to effect positive change.
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THE TYRANNY OF AVERAGES - IS CONSUMPTION GOING UP OR DOWN?
In recent weeks, current trends in alcohol use have been a hot topic in the media and in the Parliamentary debating chamber. We have heard that per capita availability of alcohol for consumption has been falling, which is true. In 2012, availability was 9.20 litres of pure alcohol per person which reduced to 8.85 litres per person in 2017. Although a downward trend has been evident, it hasn’t been exactly consistent over the years.
The tyranny of averages (or per capita consumption) highlights how averages are often too blunt and can fail to show the full picture. Averages can mask significant inequities. We would hope that a declining average or per capita consumption means that everyone is drinking less and in fewer drinking occasions, but in reality, consumption is more complex and averages can mask diverging drinking patterns. This has been the case in NZ (and internationally), whereby polarised drinking trends are evident between population groups.
In NZ, we have seen declines in the proportion of adolescents taking up drinking and being classified as hazardous drinkers. The major changes took place from 2006/07 to 2011/12, with no significant change from 2012 to 2017. This is something to celebrate as alcohol has irreversible effects on brain development, particularly female brains. We also know that the more alcohol-related harms a NZ adolescent experiences, the less likely they are to complete high school.
On the other hand, there have been significant increases in hazardous drinking every year from 2011/12 until 2015/16 (and no change to 2016/17). Many groups have higher proportions of hazardous drinkers than they did in 2006/07. When we look closer, we see that it is women’s drinking (particularly 25-64 year-olds) showing the largest increases: this is particularly concerning given that cancer (e.g. breast cancer) is the main cause of alcohol-attributable death among NZ women. Given women may be more price sensitive and many preferentially consume wine (which is 30% more affordable today than it was four years ago), we must take evidence-based action to reduce harm to this vulnerable population.
Let’s turn these changes into numbers. In 2016, there were 199,000 more hazardous drinkers in NZ than in 2011/12. That's almost the total population of Wellington. Let's break this increase down by age group: +21,000 18-24yrs, +37,000 25-34yrs, +33,000 35-44yrs. +44,000 45-54yrs, +37,000 55-64yrs, +22,00065-74 yrs, +4000 75+yrs.
There is a lesson here: the presence of small declines in per capita consumption may be both a good and bad news story.
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SUBMISSION ALERT: LOUISA WALL'S PRIVATE MEMBERS' BILL
Local Alcohol Policies were introduced in the Sale and Supply of Alcohol Act 2012 to improve community input into decisions concerning local alcohol availability. Four years have passed since Councils around the country could adopt Local Alcohol Policies (LAPs). Research released in December has shown that 29 (43%) of the 67 Territorial Authorities now have adopted LAPs. This represents 24% of all New Zealand residents. The report found the appeals process resulted in policies being considerably amended to be less restrictive.
It is well known that the physical availability of alcohol increased markedly following the Sale of Liquor Act 1989. The number of on-licences trebled and off-licences doubled. As a result, many communities have become saturated with alcohol outlets and there are gross inequities in their distribution.
However, LAPs cannot address the density of existing licences in a neighbourhood as they only apply to new licence applications. To address this matter, Hon. Louisa Wall has drafted a Private Members' Bill, detailing that the inability to reduce current levels of alcohol availability have rendered LAPs nugatory.
This “ Renewal of Licences Amendment Bill” was pulled from the ballot on December 14 2017, amended in February and had its first reading on February 21. Submissions are now open and close on Anzac Day, Wednesday 25 April 2018. See below for information on Alcohol Healthwatch submission templates and public forums. |
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Alcohol use is widely recognised as a cause of poor mental health. In New Zealand, toxicology reports of suicides in 2014 show that 57% had a trace (23%) or more (34%) of alcohol in their system. Poor mental health is also a risk factor for hazardous alcohol use.
Alcohol Healthwatch welcomes the announcement of the national Mental Health and Addictions Inquiry. The Panel will be meeting with sector groups, consumer groups, Māori health providers, and representatives of diverse other sectors (eg housing, corrections, police). A series of public (and potentially private) hui, fono and hearings will also be held around the country and the public also have opportunities to engage with the Inquiry through social media and the internet.
Tentative timeline:
- End March / Early May : Release of consultation document
- April to May : Submissions open
- May to June 2018 : Hearings
- March to August / September : Direct engagement with interested parties
Alcohol Healthwatch will be preparing submission templates and holding public forums to inform community submissions.
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The Tax Working Group is seeking the views of as many New Zealanders as possible about the future of tax. The Terms of Reference for the Working group include such matters as fairness, promoting the long-term sustainability and productivity of the economy, supporting a sustainable revenue base to fund operating expenditure around current levels, treating all income and assets in a fair balanced and efficient manner, and ensuring a progressive tax and transfer system.
Alcohol excise tax (as well as the Health Promotion Agency levy on all alcohol sold) are components of New Zealand’s tax system. Alcohol Healthwatch will be making a submission to the Working Group on the fairness of taxes as they relate to alcohol consumption and harm in society. Our public forums will also showcase the strong evidence linking price, affordability and consumption.
In January, we had the pleasure of a 15-minute kōrero with the Finance and Expenditure Select Committee in relation to the Budget Policy Statement 2018. We presented on the need to increase the excise tax rates on alcohol in light of evidence demonstrating the increasing affordability of alcohol in New Zealand. We now have supermarkets selling a 750ml bottle of wine for $5.99 (<80c per standard drink). After paying excise taxes, the supermarket and alcohol producer stand to make just over one dollar each. You can read our submission here. |
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Please remember that in the upcoming months (potentially March-May) there will be two submission opportunities in relation to:
- Nutritional Information Panels on alcoholic products
- Alcohol and Pregnancy warning labels on alcoholic products
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We will be holding a public forum in relation to upcoming submission opportunities in Auckland and Christchurch in the week of 9-13 April. We will be sending out a panui with dates shortly. These forums will focus on the following submissions: Renewal of Licences Amendment Bill, the Tax Working Group, and the Mental Health and Addictions Inquiry.
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Cheap alcohol causes significant harm. Massey University research has shown that harmful young drinkers in NZ concentrate their purchasing in lower priced products.
To address cheap alcohol, many countries and jurisdictions are looking to Minimum Unit Pricing policies. It can be said that momentum is definitely gaining in relation to setting a floor price for alcohol.
For example, last week the Northern Territory of Australia announced the move to implement a AUS$1.30 (NZ$1.40) per standard drink minimum price. Scotland looks to kick off their NZ$1.20 per standard drink in May 2018, whist Ireland is currently debating a NZ$1.50 MUP, and Wales and Western Australia have it on their policy agenda.
The ability of Minimum Unit Pricing to significantly reduce inequities in alcohol-related harm signal its importance in terms of contributing to a fairer society. |
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UMR polling last month has shown strong support for increases in alcohol taxes that are earmarked for mental health and addition services.
The representative polling found:
- 63% support overall
- 71% support in Christchurch
- 68% support in 30-44 year olds
- 70% support among people of Pacific ethnicity
- 84% support among NZ First voters
- 72% support from people with children
Evidence has shown that increasing the price of alcohol is a fair and cost-effective strategy to reduce alcohol-related harm. Raising the excise tax on alcohol is all about fairness; those who drink the most, pay the most. Furthermore, there are significant cost savings to society (in the hundreds of millions of dollars saved per year).
We believe that the opportunity is ripe for leadership to create a healthier, fairer society. Particularly in light of the fact that around 20% of New Zealand adults do not drink, yet they also pay for the considerable cost of alcohol harm in our society. Benefits to society are numerous, extending to better mental health, safer roads and communities, and more productive workplaces and economy.
- Our media release can be found here
- To watch Dr Nicki Jackson discuss alcohol policy with TVNZ’s Jack Tame click here
- To watch Prime Minister Ardern discuss alcohol policy with TVNZ’s Jack Tame, click here
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A study of 6639 children from a population of 13,146 first-graders of predominantly (79%) white maternal ethnicity, identified a total of 222 cases of fetal alcohol spectrum disorder (FASD). The study, published in the Journal of the American Medical Association (2017), estimated a prevalence of FASD among first-graders in 4 US communities ranging from 1.1% to 5.0% using a conservative approach.
Estimating the prevalence of FASD using routine passive surveillance methods has proven unreliable due to FASD being infrequently recognised and frequently misdiagnosed. By contrast, active-case ascertainment methods that have been applied in several other countries (where school children screening positive are assessed), has resulted in consistently higher prevalence estimates. Though more costly and time-consuming, these studies provide the children assessed with positive intervention opportunities.
These new USA findings raise the question of a likely FASD prevalence in New Zealand. With rates of hazardous drinking by young women during peak fertility years rising and in the absence of a representative prevalence study here, we can only speculate that New Zealand is likely to be at the higher end of the prevalence scale. |
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Professor David Nutt was in New Zealand last month to deliver a lecture on the flaws within current drug control policy approaches. His work has received international attention, especially his study that was published in Lancet demonstrating the higher levels of harm from alcohol in society when compared to all other drugs in the market.
During an interview on Radio New Zealand, Professor Nutt commented that, “ If we care about the harms of drugs to the point where people are dying then you’ve got to do something about alcohol.”
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Last weekend we read that the Green Party will open up their diaries to the public and refuse to accept free meals or tickets in a bid to combat money in politics. The diaries of the Green Party's ministers will be proactively released quarterly. Co-leader James Shaw stated:
"Generally speaking it isn't community-based organisations or environmental groups that have the resources to do this kind of bidding. They're not usually organisations who advocate for the homeless or for single mums, or groups that are fighting to protect our water, or native bush."
"They are usually deep-pocketed corporates, or lobbyists acting on their behalf, who have a financial interest in preserving the status quo."
Gifts over $500 are already required to be declared. From February 2016 to January 2017, records show the following alcohol-sponsored gifts of >$500:
· All Blacks vs Australia game corporate hospitality – Lion Company
· Meukow Grande Champagne XO Cognac and six assorted bottles of single malt Scotch whiskey
· Tickets to ASB Tennis Classic
· Tickets to and hospitality at Bledisloe Cup rugby match (x2) – Lion
The release of diaries is a step in the right direction, especially in light of legislation requiring such activity not reaching the second reading in 2013.
The recent parliamentary debate on Ireland’s alcohol law reforms have showcased the lobbying which has occurred during the process. Ireland (like Australia and other countries) has a lobbyist register is in place – this has shown the following to occur during the law reform process:
Drinks industry representatives extensively lobbied Government Ministers, TDs and Senators about controversial legislation to deal with Ireland’s alcohol crisis, according to the latest figures from the lobbying register. It is estimated the drinks sector, led by Ibec’s umbrella group the Alcohol Beverage Federation of Ireland (ABFI), had meetings with 14 Government Ministers and Ministers of State and 10 special advisers about the Public Health (Alcohol) Bill. |
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Tackling Big Booze: Price, Promotion, Primary Care and Politics
Alcohol Healthwatch was honoured to co-convene the first ever University of Otago (Wellington) summer school on alcohol policy.
The day was opened by Sir Eddie Durie (Chair of the NZ Māori Council) and a range of international and national experts presented on aspects of evidence-based alcohol policy. The videos of (some) international and local speakers will be available on the Alcohol Healthwatch website shortly.
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NEWS:
Jan 2018 - the Lithuanian government introduces the strictest alcohol laws in the European Union, raising the legal purchase age from 18 to 20, restricting opening hours for off-licences and banning all advertising for beers, wines and spirits.
Jan 2018 – Sweden becomes one the first countries in the world to move towards restricting online alcohol marketing. A white paper on alcohol marketing in digital media was presented to the Swedish government proposing to ban all alcohol advertising on social media.
Feb 2018 - Alcohol Healthwatch endorses the joint open letter regarding the Global Fund and Heineken partnership
RESEARCH:
Hot off the press is a wealth of high-quality alcohol research. Email Alcohol Healthwatch if you are unable to access any of the full-text versions:
New Zealand studies
Other
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DON'T FORGET!
Don’t forget to encourage others to visit our new website and sign up to our e-news!
Also, if you would like to receive our daily media clippings on alcohol-related stories, email Suzanne at ahw@ahw.org.nz
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