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Public Health England is putting all its efforts into alcohol unit pricing – but is it really the right thing to do?

Last week, the Parliamentary Health Select Committee was listening to the views of Public Health experts on the issue of minimum unit pricing for alcohol. Rosanna O’Connor from Public Health England told them that:

Around 4.4% of the population are drinking just under a third of the alcohol consumed in this country. That’s around 2 million drinking just over 30% of the alcohol.

Apparently, the drink of choice amongst this group is high-strength, low-cost cider. Indeed, Prof Nick Sheron of the University of Southampton even went in for a somewhat unusual bit of product placement, adding that:

A typical Frosty Jack’s drinker would be drinking about 16 litres a week and they would be paying about £20 for it – now that would go up three-fold, they’d be paying about £70 for it.

I don’t know how many ‘Cost of Living’ blog readers are up to speed with current trends in the strong cider market, but I am not. So, I went to have a quick look at ‘Frosty Jack’s’. After all, it sounded interesting.

Aston Manor Ciders (the producers of FJ’s) describe the drink as “a refreshingly crisp sparkling cider made from the juice of culinary apples to deliver its characteristically pale appearance”. And that “Frosty Jack’s is amongst the top five bestselling cider brands in the UK, with the most loyal drinkers of any brand within the cider category.”

Pausing to muse that ‘loyalty’ is, no doubt, an admirable quality in a drinker, I continued reading and got to the sentence where the social setting/food pairing for FJ’s is described:

It is enjoyed on a regular basis by both men & women alike as their ‘tried & trusted’ cider for regular any day, low tempo ‘winding down’ drinking occasions in the home, often with food or watching TV.

I suspect and speculate that not all of the 2 million miscreants targeted by O’Connor from PHE actually have a home with a TV. I am going to go out on a limb and say that some of them don’t even have a home. And, some of them don’t have a TV. And I’m concerned that, when the price of their FJ’s goes through the roof, significant damage will be done to already precarious personal and family budgets because some of the 2 million will want to continue with at least some “regular, any day, low tempo ‘winding down’ drinking occasions”. And the money has got to come from somewhere.

So, is this the best that PHE can do? I remember when I first had the concept of ‘Public Health’ explained to me by a pair of slightly inebriated epidemiologists in a pub in Abergavenny sometime in the late 1980’s. They told me the fable of the riverside village. Where the residents keep finding half-drowned people floating downstream. They begin to spend more and more time and effort pulling them out of the water and caring for them. Until a bright villager says: “I’ll tell you what we really need to do – we need to find out who’s chucking them in!”. And, to be fair, the story does indeed put the public health thing in a nutshell.

Remembering this while reading about the Health Select Committee, I realised that the price of cider is really a very superficial target. Because many of the 2 million are heavy drinkers for a reason. Yes, they celebrate, relax and enjoy themselves like any drinker. But also (like many drinkers) they are using alcohol as a “drug of solace“. Through transient euphoria and even temporary anaesthesia they are escaping aspects of life that are making them miserable. A lack of money, debt, social exclusion, homelessness, depression, domestic violence, anxiety, loneliness etc etc. That’s what drugs of solace are for.

So to tackle the “who’s chucking them in?” question, Public Health England need to be pleading with Westminster to address the scandalous levels of unhappiness that govern the lives (and the health profiles) of such a large section of the population. Against that measure, a ghastly little “nudge policy” that attempts to manipulate the personal micro-economies of the poorest people in the land doesn’t really cut it. It doesn’t even look for the root causes of poor health and it just ends up as a nasty attack by the comfortable élite on people much less fortunate than themselves.

If alcohol consumption is a demonstrable health risk (which I understand it is), then it may well be appropriate for a government to tax alcohol heavily and put the funds directly into alcohol-related health services. Mandating the purveyors of cheap booze to hike the prices that poor people pay seems a less ‘socially-just’ response. Indeed, it is reasonable to ask who benefits financially because minimum pricing isn’t a tax. It’s just an order to vendors to put prices up. It’s unlikely the extra money would contribute to alcohol-related NHS costs – it just goes into the pockets of private companies.

If people use ‘drugs of solace’ to cope with poverty, exclusion and despair, then the entire unit-pricing issue is nothing more than a side-show.  Regarding the bigger cultural picture, the most interesting aspect of the whole sorry affair is that it is such a clear exposure of the political vacuum and moral bankruptcy that infect the heart of contemporary Public Health.