Raising a glass to the health of a nation

If Britain becomes more European in its drinking habits, public order may improve. But what of our health? By David Fickling

The troubled revolution in Britain's drinking laws started out with such a rosy vision. British drinkers were born good, the thinking went: it was misguided laws that made them bad. Change the laws and you will change the drinking habits of a nation.

For policy-makers, the problem was that Britain has a love-hate relationship with the bottle. In southern Europe alcohol is an uncomplicated part of everyday life, but in Britain it is seen as shameful in the home and then used to excess down the pub. We treat booze like a guilty, addictive secret.

Sociologists have a term for this distinction: southern Europe has a "wet" culture while Britain and north America have a "dry" one. Changing a dry culture to a wet one, according to the theory, requires no more than removing the legal stigma around alcohol.

"The greater the number of formal restrictions on drinking the more alcohol-related problems a society has," declared Liberal Democrat peer Baroness Walmsley in a 2002 House of Lords debate. "Societies in which alcohol is integrated into daily life have relatively few of the problems we commonly associate with drinking." After three years of headlines about the horrors of binge-drinking Britain, it's hard to remember this sense of optimism which greeted the introduction of the Licensing Bill in 2002.

But the legislation's promise to permit 24-hour drinking and make councils responsible for licensing seemed to have the support of all the important policy bodies.

Take the view of consultants MCM Research, whose 1992 paper on drinking and public disorder was a key influence on government thinking. Their questions to Italian drinkers about the links between booze and violence were mostly met with blank incomprehension.

"Our translators were unable to convince many of them that there was not a 'hidden agenda' to the questioning," they wrote. "The vast majority of interviewees could not understand how anyone could imagine a connection between drinking alcohol and aggressive behaviour."

The jury is still out on whether the Licensing Act, will succeed in taking the aggression out of drinking. But one thing should be more certain when the new licensing regime comes into force on 24 November: if we do end up with a wet drinking culture, the toll in terms of health problems will be grave.

You wouldn't think it from the way we talk about it, but Britain actually has a relatively good record compared to other countries when it comes to alcohol-related health problems. The reason for this is simple: we drink less than most of our counterparts in Europe.

For every two drinks the average British adult puts away, his or her French counterpart is polishing off three; for every three drinks the French have, the Portuguese are enjoying five.

This should come as no surprise to those who framed the wet culture-dry culture distinction: after all, one obvious result of a stigma against alcohol is reduced alcohol consumption.

The positive effects of this can be seen in the health figures. On average throughout France, Germany and Austria, more than 30 men in 100,000 die as a result of alcohol-related illnesses every year. Throughout parts of England and Wales, the figure never creeps above 20 in 100,000 and in most places it is under 10. That means that 3,000 to 6,000 lives are potentially being saved every year by our stigma.

But there are signs that this distinction is dissolving as Britain's drinking culture becomes wetter and those in Europe become drier. One marker that sociologists use to distinguish wet cultures from dry ones is whether people drink mostly wine or mostly beer and spirits, and on that measure there has been a marked shift to the wet in Britain in recent years.

The average adult in Britain increased the amount of wine they were drinking by 25 per cent between 1995 and 1999, so that he or she was now drinking 25 bottles a year.

This should be cause for concern, because the pleasant image of Mediterranean-style drinking habits better reflects social prejudices than public health priorities.

The stereotype is that binge-drinking and drinking to excess are the preserve of the underprivileged, but taking a look at the figures is a salutary shock. In fact, there's an almost direct correlation between income and alcohol-drinking, and the better-off you are, the more likely you are to be drinking too much.

On every measure recorded in British government figures, people in managerial and professional jobs out-drink those in technical and manual work, drinking on more days each week and putting awaying more over the course of the week.

Among those earning over £800 a week, around a third of both men and women have a drink five days a week; among those earning less than £200 a week, the figures are 18 per cent for men and 12 per cent for women.

In households bringing in £1000 a week, the average man is falling just a fraction short of the medically advised limit of 21 units every week, while the average woman is doing a little better with 11 units against a recommended 14.

Indeed, some researchers argue that Britain's problem is not that society disapproves of alcohol, but that our disapproval takes the wrong forms. Writing in the British Medical Journal this September, Professor Wayne Hall of the University of Queensland cited the contrast between Australia's 25 per cent drop in alcohol consumption since 1980 and Britain's 30 per cent rise.

Government restrictions - such as lower taxes for low-alcohol beer and tougher drink-driving restrictions - had succeeded in changing behaviour in Australia, and could do the same in Britain. Plans to improve habits through deregulation were doomed to failure.

"Epidemiologists see the key drivers of rising consumption as the reduced price of alcohol, its increased availability and its extensive promotion in British cities. These changes have resulted from the enthusiasm for deregulation," wrote Hall.

If Britain changes its habits and become an easy-going "wet" culture then the government may have succeeded in its social experiment. But the risk is that it will have solved a public order problem by creating a health problem.