Tricky balance as BMA tackles alcohol

The tobacco war has been won. Now it is the turn of alcohol. The British Medical Association opened a new front in the battle to cut excessive drinking today with a call for a total ban on advertising and marketing of alcohol, including sports and music festival sponsorship, an end to happy hours and the imposition of a minimum price per unit on alcoholic drinks.

"The BMA is not against alcohol," Vivienne Nathanson, head of science and ethics insisted today. Few people will believe that.

The Wine and Spirit Trade Association lost no time in pointing out that "the measures proposed by the BMA would hit the pockets of millions of consumers and threaten the livelihoods of thousands of people working in the drinks industry, media, advertising and television."

In other words, the health fascists are on the loose again. First it was cigarettes, now it is drink - what next? Chocolate?

Emboldened by the success against tobacco - who would have guessed five years ago that smoking would be banned in pubs? - the

BMA has chosen to stick its head above the parapet and join the campaign on drinking kicked off by Sir Liam Donaldson, chief medical officer, who called for a minimum price on alcohol in his annual report last March - to the intense irritation of No 10, who leaked his report in advance in order to rubbish it.

But not even Sir Liam went as far as calling for an advertising ban. The difficulty for the BMA is that alcohol is a more complex issue than smoking. The message on smoking is simple: don’t. The message on alcohol is that a little is OK, and may even be good for you, but a lot is not. Deciding when the danger line has been crossed is a difficult personal and political judgement. Drawing it tighter is seen, for the moment, as a vote loser.

The damage done by alcohol is not in question - measured in shattered families, rocketing hospital admissions, violence on the streets and increasing signs of dependency among young people. Spending per household on drink increased 81 per cent between 1992 and 2006, fuelled by £800 million of promotional spending by the industry, which has a vested interest in people drinking to excess, as Professor Gerard Hastings, chief author of the BMA report, said today. If the 37 per cent of drinkers who consume above the recommended limits cut down to the appropriate level the industry would lose a fortune.

Yet even those organisations who might have been expected to back the Association’s call for an advertising ban declined to do so.

Professor Ian Gilmore, chairman of the 27-member Alcohol Health Alliance and president of the Royal College of Physicans, while broadly supportive of the BMA’s recommendations, notably omitted any reference to the ban on advertising.

"Strong public policy measures [are needed] on price and the availability of alcohol underpinned with greater investment in prevention," he said.

Professor Alan Maryon Davis, president of the Faculty of Public Health confessed to "reservations about a blanket ban on marketing alcohol" while strongly supporting minimum pricing and the need to "get tough" with the drinks industry.

Privately, senior BMA figures admit they are flying a kite, to get the debate going. Like Sir Liam Donaldson they speak of the need for a "change in the culture" to discourage rather than encourage excessive drinking. In Scotland a proposal for a 40 pence minimum price per unit for alcohol will shortly be put before the Edinburgh parliament. Scotland, with Ireland, led the way on the smoking ban. Could it be in the vanguard again?