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Global impact of alcohol licensing laws: Australia, Spain and Nigeria

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MFAC1521Health and Maintenance B, UNSW Medicine

A3: Global impact of alcohol licensing laws

(Australia, Spain and Nigeria)

Student No.: 3341589

Date: 15/08/2011

Word Count: 2000

Not including:Headings, content page, references and appendix


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Content Page

1. Orientation and Direction of Report2. Investigating the epidemiology of alcohol use, different levels of alcohol use and

alcohol-related harm across the three countries

2.1. Australia 5

2.2. Spain 5

2.3. Nigeria

2.4. Comparison across the 3 countries 6

3. Examining alcohol licensing laws across the three countries3.1. Australia

3.2. Spain

3.3. Nigeria

3.4. Comparison of alcohol advertising restriction across the three countries

4. Social and cultural issues which influence the patterns of alcohol use and accountfor the implementation of licensing laws across the three countries

3.1. Australia

3.2. Spain

3.3. Nigeria

5. Comparison of effectiveness of alcohol advertising restriction in preventingalcohol-related harm in comparison to two other public health initiatives

5.1. Effectiveness of alcohol advertising restriction


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5.2. Effectiveness of law enforcement

5.3. Effectiveness of taxation

6.Conclusion 8

7. Reflections 9

8. References 10

9. Appendix 13

1. Orientation and Aim of Report

1.1.Overview

This report is aimed at examining the factors behind the global incidence of alcohol use,

health burden and liquor laws focusing on Australia, Spain and Nigeria. Lastly, the

effectiveness of alcohol advertising restrictions will be contrasted with two other public

health initiatives.


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1.2. Defining Alcohol

What is alcohol?

National Drug and Alcohol Research Centre (NDARC) defines alcohol as an intoxicating

substance made from fermented starches and a central nervous system depressant

which can adversely affect an individuals body if he is unable to tolerate large amounts.

Quantifying alcohol consumption

In Australia, a standard drink contains 10g of alcohol. It is on this basis that the amount of

alcohol consumed can best be quantified depending on the different types of alcohol-

containing beverages and varying drinking serving sizes. National Health and Medical

Research Council (NHMRC) recommends that both men and women should drink no more

than two standard drinks daily.

Figure 1: NHMRCs Australian Guidelines to Reduce Health Risks from Drinking Alcohol, 2009.

2.Epidemiology of alcohol use and health burden

2.1. Australia

In Australia, beer is the most consumed beverage (46%), followed by wine (32%) and

spirits (22%). Per capita alcohol consumption increased from the 1960s and peaked in


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mid-1970s along with beer consumption, and finally returned to a stable figure of 10 litres

of pure alcohol in the last two decades.

Figure 2: WHO, 2011.

Despite the significant drop of the number of Australians drinking daily from 8.9% to 8.1%

between 2004 and 2007, 22% of teenagers drink weekly. 9 in 10 of them had consumed

alcohol at certain points and 82.9% had drunk in the previous year.

Figure 3: National Drug Strategy Household Survey (AIHW, 2007).

Alcohol-related health burden

The National Drug Strategy 2010-2015 estimates the cost of alcohol to Australian society to

be at $15.3 billion. Alcohol consumption is responsible for 3.2% of the total burden of

disease and injury with 3430 deaths and at least 85 disability-adjusted life years (DALYs)


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per annum (Begg et al., 2007). A larger number of youth died from acute conditions

(deaths and hospitalisations caused by road accidents and violent attacks), whereas

chronic diseases (liver cirrhosis, cognitive issues, pancreatic injury as well as heart and

blood diseases) occurred amongst those above 30 years old (Chikritzhs et al., 2003).

Alcohol-attributable injury and disease are especially high among the Indigenous, with the

rate of alcohol-related deaths being twice that of the non-Indigenous Australians

(Chikritzhs et al., 2007).

2.2. Spain

Similarly in well-developed Spain, the most consumed alcoholic beverage is also beer

(45%), followed by wine (36%), spirits (13%) and other types (6%).


Spaniards consumed much more alcohol, especially wine, per capita compared to the

Australians and Nigerians in the past. Beer consumption is steadily rising to a level

comparable with Australias. Another similarity is that almost 90% of the Spanish

population has drunk alcoholic beverages in their lifetime.


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Figure 5 shows that half of the Spanish population drinks weekly and around 20% admit to

have suffered a drunkenness episode the previous year.

Figure 5: Spain: National Household Surveys on Drugs (Gual, 2006).


The alcohol-related death rates seem to be decreasing from 2000 to 2005 for both liver

cirrhosis and road traffic accident cases. However, it is inadequate to confirm that the

burden is also decreasing with the high current per capita consumption of 10 litres.

2.3. NigeriaNigeria is a developing country where traditional home-made liquor constitutes 94% of

alcoholic drinks consumed.


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Figure 7: Taken from WHO, 2011.

Per capita consumption of alcohol increased steadily throughout the 1970s and peaked at 8

litres in 1981, declined until about 1995 and increased slowly to an estimated 10 litres in

2001 similar to both Spain and Australia. Alcohol was the most commonly used drug, both

in terms of lifetime history and recent use in five geo-political regions of Nigeria (Gureje et

al., 2007). Heavy episodic drinking, rather than regular moderate drinking, is common

among users of alcohol in Nigeria (Gureje, 2007).

Amongst Nigerian men, 81% of liver cirrhosis cases and 22% of cancers were attributed to

alcohol (WHO, 2004).

2.4. A simple comparison of epidemiology

Country

Recorded

Consumptio

n

Unrecorded

Consumptio

n

Total

Consumptio

n

Beer

Wine

Spirits

Other

Total

M

ale

drinkers

Total

Fem

ale

drinkers

Totaldrinke

rs

Australia 9.89 0.13 10.02 4.56 3.12 1.16 1.02 16.30 7.20 11.90


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Spain 10.22 1.40 11.62 4.52 3.59 1.31 0.61 24.80 15.60 21.10

Nigeria 9.78 2.50 12.28 0.54 0.01 0.02 9.17 36.90 23.00 32.10

In relative terms, Nigeria has the most number of drinkers, followed by Spain and lastly

Australia. However, the latter two largely consume beer and wine while Nigeria mainly

consumes other forms of alcohol including traditional brew.

Comparing WHO (2011)s scores regarding patterns of drinking, Spain was the least risky

followed by Australia and Nigeria being the most risky, suggesting that the latter has the

highest alcohol-attributable disease burden amongst the three countries.

3.Examining alcohol licensing laws

3.1. Australia

In Australia, alcohol licensing laws are exercised independently within each individual

state and territory jurisdiction. The object of these Acts was previously centralised around

developing the liquor industry in order to encourage economic and social growth. In

recent times, the focus now is shifted to harm minimisation considering how the

repercussions of loose legislation are hindering growth, not excluding NSW.

In NSW, liquor legislation is now guided by the Liquor Act 2007 (repealing the previous

Liquor Act in 1982), including Liquor Regulations 2008 (NSW, 2007). The Casino Liquor

Gaming and Control Authority, in charge of handling applications and considerations made

under the Act, has replaced the previous Liquor Administrative Board. An example of major

changes is the reduction of license categories from twenty-one to just six in hope of

diminishing the incentive for vendors to obtain a license and thus restrict liquor supply.

(Tsia&Mouakkassa, 2008)


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Regulating alcohol advertising

For young people, studies have proved that exposure to alcohol commercials and drinking

role models can be directly linked to acute alcohol consumption.

There are currently no alcohol advertising bans in Australia unlike that of tobacco. The

Liquor Act does not clearly emphasise on advertising controls; the Alcohol Beverages

Advertising Code (ABAC) is more relevant in this case. As a separate law along with other

codes, it works on the basis of various legislative and self-regulatory mechanisms

pertaining to events, internet and retail advertisements. However, other than a system

whereby the public can lodge a complaint, there are no other direct controls over drinkpromotions to limit excessive consumption. (ABAC, 2009)

3.2. Spain

In 1976 a code for television advertising was adopted by the Commission for Control of

Television Advertising. In 1988 and 1990, the General Advertising Law of 1988 and the

Television Advertising Resolution were introduced to forbid advertising of alcoholic

beverages containing over 20% alcohol by volume on broadcast media. Advertising alcohol

is also not permitted before 9.30 p.m. (sterberg, andKarlsson, 2002).

Similar to Australias situation, the Spanish Brewers Association instated a self-regulation

code in 1995 which expects all members to include a responsible consumption message in

all advertisements (Hurst, Gregory &Gussman, 1997).

3.3. Nigeria

Nigeria Brewing and Guinness Nigeria both sell popular alcohol products in the market.

Because of their large economies of scale, they now monopolise Nigerias beer industry andhave since forced the shutdown of many smaller breweries since the 1980s.

Their marketing activities are catered towards the youth (Obot&Ibanga, 2002). Michael

Power is one famous example who serves as the beer icon for Guinness in Africa. They

include sponsorship of sports events, fashion shows and beauty contests on campus and


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Sponsorship of sporting events by the liquor industry is common and it is arguable

whether associating alcohol with sport disregards the advertising code due to its adverse

effects on minors. One ethical issue is autonomy and freedom, what environments exist for

the youth to enjoy participating in sport that is free of these pressures and links to alcohol

(Jones, Phillipson&Lynch, 2006).

4.2. Spain

Spain has had a long-lasting tradition of alcohol consumption, where such beverages are

also seen as a crucial part of the social, nutritional, and dietary needs of the Spaniards. New

drinking patterns across Europe bring with it a permissive wet drinking culture(theBotelln phenomenon), making alcohol relatively cheap and easily accessible to all

young people. Rapid urbanisation in this developed country has increased the popularity of

beer especially amongst young people who consider it as part of their modern and casual

lifestyle (sterberg and Karlsson, 2002).

The influence of peers in Spains drinking context is not far off from Australias and

Nigerias; it is considered to occur through peer pressure, peer leaders or going out with

alcohol-using friends. The perception of alcohol as a health hazard also seems to be

diminishing.

4.3. Nigeria

Alcohol has always been a part of Nigerian heritage, where the Kofyar people in Jos

consumed for social harmony (Odejide, 2006). Traditional wines, including palm-wine and

alcohol produced from cereals, have been consumed for centuries. The drink is is present

in cultural ceremonies revolving around birth, death and to resolve disputes. However, due

to the lack of government support, complacency and education, Nigeria continues to be in

the high-consumption countries along with Australia and Spain (WHO, 2004).

In recent times alcohol is perceived to be a religious divide between Muslims and

Christians where liquor availability led to conflict and communal violence in Northern


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Nigeria. Sale and consumption are banned in sharia states such as Zamfara and Kano

(Babor&Winstanley, 2008).

Severe licit drug use including alcohol spread from urban and historically advantaged

regions to rural and disadvantaged communities, where the youth have a tendency to link

alcohol abuse with fun, enjoyment and survival. Some studies conducted in Nigeria suggest

that the use of local alcoholic beverages is also gradually decreasing with rising

commercialization and social affluence, further compounded by the two major beer

companies uncontrolled media advertising (Odejide, 2006).

5.Comparing alcohol advertising restrictions with other initiatives

5.1. Alcohol advertising

ABAC is a self-regulating system which is dependent on the publics knowledge of the code

and an independent authoritative body to act on complaints. Recent studies have shown

that 72% of those surveyed lacked knowledge on restrictions regarding alcohol advertising,

and that it is estimated that a mere 3% of Australian adults are aware of the ABAC Schemeand its role. Among the 30% of people who reported being concerned about any alcohol

advertising, only 2% had formally lodged a complaint (King, Taylor & Carroll, 2005).

In 2003 the Ministerial Council on Drug Strategy (MCDS) identified that at present ABAC

fails to bring up public health concerns on alcohol promotions and consumption, and that

the lack of community confidence is contributed by the large amount of time spent to settle

complaints.Despite the ABAC Schemes rule to discourage advertising that has strong or

evident appeal to children or adolescents, research shows that a significant amount of

alcohol advertising is communicated to the youth (National Preventative Health Taskforce,

2011).


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5.2.Effective law enforcement

Despite bans on serving minors and the intoxicated, efficacy depends on the degree to

which these laws are enforced. The NSW police have adopted the Alcohol Linking Program

which obtains feedback to police regarding any alcohol-related crimes that have followed

drinking at a specific licensed premise, which has seen results. Responsible Service Alcohol

(RSA) programs have the potential to raise awareness of relevant issues. Publicizing severe

financial penalty has also been particularly effective at encouraging licensees to regulate

their premises, reducing harm. However it is uncertain whether these penalties are

impactful in the long run without regular and obvious examples of enforcement (Wiggers

et al., 2004).

5.3. Taxation

Despite the principles that price controls would certainly reduce alcohol consumption

especially for the price-sensitive group of young drinkers, the current tax system, based on

differential tax rates on different alcoholic beverages, produces undesirable distortions.

The Northern Territory Living with Alcohol Program suggested the levy itself had a major

impact on reducing alcohol-related deaths rather than the programmes the levy was used

to fund, proving that tax can still play an important role. Introducing a tiered volumetric-

based excise system based on alcohol content is currently under review (Findlay, Sheehan,

Davey, Brodie&Rynne, 2002).

6. ConclusionTight law enforcement by the police seems to be the most direct impact on reducing

alcohol-related harm amongst the three initiatives above. More reforms are needed for the

advertising code to be more useful in educate and reduce the exposure of alcohol to youth.

A better tax system will also take a long time to be implemented. In order to tackle the high

consumption levels amongst these three countries, a myriad of policies must be in place.

This would be a greater challenge for developing countries like Nigeria.


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7. Reflections

8. References

1. Alcohol Beverages Advertising Code (ABAC). (2009). The ABAC Scheme Annual Report.

Retrieved July 26, 2011 from

http://www.abac.org.au/files/ABAC2009AnnualReport.pdf

2. Australian Institute of Health and Welfare (AIHW). (2007). National Drug StrategyHousehold Survey: First results. Retrieved July 26, 2011 from

http://www.aihw.gov.au/publication-detail/?id=6442468084

3. Babor, T. F., &Winstanley, E. L. (2008). The world of drinking: national alcohol controlexperiences in 18 countries.Addiction, 103(5), 721-725.

4. Begg, S., Vos, T., Barker, D.C., Stanley, L. & Lopez, A. (2007). Burden of disease and injury

in Australia in the new millenium: measuring health loss from diseases, injuries and

risk factors. Medical Journal of Australia, 188, 3640. Retrieved July 28, 2011 from

www.mja.com.au/public/issues/188_01_070108/beg10596_fm.html

5. Chikritzhs, T., Catalano, P., Stockwell, T., Donath, S., Ngo, H., Young, D., et al. (2003).

Australian Alcohol Indicators 1990-2001: Patterns of alcohol use and related harms for

Australian states and territories. National Drug Research Institute, Curtin University of

Technology and Turning Point, Alcohol and Drug Centre Inc. Retrieved July 20, 2011

from http://ndri.curtin.edu.au/local/docs/pdf/naip/naipaaiexecsumm.pdf

6. Chikritzhs, T., Catalano, P., Pascal, R., &Henrickson, N. (2007). Predicting alcohol-related

harms from licensed outlet density: a feasibility study. Monograph Series, 28. Hobart:

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7. Findlay, R. A., Sheehan, M. C., Davey, J., Brodie, H., &Rynne, F. (2002). Liquor Law

Enforcement: policy and practice in Australia. Drugs: Education, Prevention, and Policy,

9(1), 85-94.

8. Gual, A. (2006). Alcohol in Spain: is it different?Addiction, 101(8), 1073-1077.

9. Gureje, O., Degenhardt, L., Olley, B., Uwakwe, R., Udofia, O., Wakil, A., et al. (2007). A

descriptive epidemiology of substance use and substance use disorders in Nigeria

during the early 21st century. Drug and Alcohol Dependence, 91(1), 1-9.

10.Hurst, W., Gregory, E. &Gussman, T. (1997). International Survey: Alcoholic Beverage

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11.Jones, S.C., Phillipson, L. & Lynch, M. (2006). Alcohol and sport: can we have one without

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