‘Price, price and price’ – one answer to alcohol and smoking issues


GRAPHIC HEALTH warnings on the packaging for alcohol and junk food should be considered in future to highlight the dangers of cancer and obesity, one of the world’s leading public health experts has said.

Dr Judith Mackay, an advisor to the World Health Organisation (WHO) who took on the tobacco lobby in Asia, said there were lessons to be learned from the fight against smoking in efforts to “de-normalise” excessive alcohol or calorie consumption.

Dr Mackay, speaking at a conference on ‘Women and Alcohol’ in Edinburgh, said the WHO’s convention on tobacco control offered a potential template for similar international cooperation to reduce intakes of alcohol and unhealthy foods under the banner of cancer and diabetes prevention. In only a decade, the tobacco convention has driven widespread crackdown on advertising as well as the roll out of smoking bans, price and tax interventions, plain packaging and graphic health warning on cigarette packs.

Dr Mackay said: “About 100 out of nearly 200 signed up to the convention on tobacco have these graphic health warnings on the cigarette packs and many are getting plain packaging. Would the same happen to food labels and bottles of alcohol? It’s an interesting question.

“The problem is that everybody has to have food. It’s much more nuanced and complicated, and would be fought tooth and nail by the food industry. It’s a matter of degree – if you have one hamburger a year, it’s not really going to harm you. On the other hand, if your diet is constantly hamburgers it would.

“I think for alcohol it would be easier because we know the harm – it’s not entirely inappropriate to put warnings on label not to drink in pregnancy for example, or not to give children alcohol – so there are some messages that countries could start with that would probably be accepted across the board, before food, but it would be a challenge for both of them.

“For a long time with alcohol we have recognised that there is a problem with alcoholism, with liver damage, with people becoming drunk. But what’s happened in the last decade is the realisation that there is a link between alcohol and cancer – to breast cancer, colorectal cancer, and oesophageal cancer, and some people are saying it is almost as harmful as tobacco in terms of causing cancer. That is an additional imperative to realise that we really need to do something about that.”

Dr Mackay, a graduate of medicine from Edinburgh University who now teaches in Hong Kong, has spearheaded efforts to introduce tobacco control in countries including China, Mongolia, Vietnam and more recently North Korea, and that the same intervention which drove down tobacco consumption would also apply to alcohol.

She said: “If I had to name to top five things to do about tobacco it would be price, price, price, price and price – it has the most fundamental effect, and I suspect it would too in alcohol. Minimum pricing, banning cheap alcohol in supermarkets – price, availability and tax, these are the issues that are going to bring the epidemic down.”