Statements on Alcohol Consumption in Ireland

I was happy to swap with my colleague Senator Rónán Mullen because I would not have wished him to feel he was being silenced by not being able to contribute to the debate on the forthcoming referendum. I welcome Ms Suzanne Costello from Alcohol Action Ireland, who is in the Visitor’s Gallery.

I welcome the Minister for Health, Deputy Varadkar, to the Seanad and applaud him for what he is doing in this area. I accepted an invitation from the Department of Health to attend a seminar entitled “Influencing Healthy Lifestyles: Nudging or Shoving? The Ethical Debate.” It was really informative, and I thank the Minister for extending the invitation to us.

The public health (alcohol) Bill 2015, as the Minister outlined, deals with labelling, minimum unit pricing, marketing, advertising sponsorship, availability and price-based promotions. The Joint Committee on Health and Children, chaired by our excellent Chairman, Deputy Jerry Buttimer, held a series of meeting on the subject and is finalising its report. The Minister came to the final hearing of this series of debates on the heads of the Bill to hear the views of the members. What the Minister said today in the Seanad shows me that he took on board a number of the committee’s sentiments with regard to the public health (alcohol) Bill. I thank him.

I note with sadness that according to the OECD report Tackling Harmful Alcohol Use: Economics and Public Health Policy, Ireland has the fourth highest level of alcohol consumption in the OECD, behind Estonia, Austria and France, at 11.7 litres per capitafor those aged 15 years and over. To be placed fourth in this category is not the position we want to hold on this league table.Several of my colleagues have referred to the executive summary of this OECD report, from which I will quote:

 

Alcohol has an impact on over 200 diseases and types of injuries. In most cases the impact is detrimental; in some cases it is beneficial. In a minority of drinkers, mostly older men who drink lightly, health benefits are larger. … Harmful drinking is normally the result of an individual choice, but it has social consequences. The harms caused to people other than drinkers themselves, including the victims of traffic accidents and violence, but also children born with foetal alcohol spectrum disorders, are the most visible face of those social consequences. Health care and crime costs, and lost productivity, are further important dimensions. These provide a strong rationale for governments to take action against harmful alcohol use.

 

People often talk about the consumption of alcohol by young people and children, but they do not necessarily refer to the impact of alcohol on children in families. We see the figures in reports on domestic violence. The example set by the parents’ lifestyle impacts on the household. Senator Colm Burke referred to the students who won the Young Scientist exhibition with their project entitled: “Does the apple fall far from the tree?”, who made a presentation to the Joint Committee on Health and Children. In their project they quoted from a recent ISPCC report in which one child noted: “If you see your parents get drunk, whether you like it or not, it will have an effect on your life.” What surprised me was that one fifth of parents surveyed were not concerned about the prospect of another parent or adult supplying their adolescent with alcohol. That shows me how normal it is for adolescents to drink alcohol. If the adults in these young people’s lives think it is acceptable to buy a young person alcohol, it shows how much needs to be done in informing and educating the adults as well. We have to focus on young people. There is an issue with young people and alcohol which is European-wide, but, as the saying goes, they do not lick it off the ground. The adults in their lives are the role models and they very often set the norms. It is the norm for adults to go to the pub to socialise. We do not have other avenues. We need to ensure we have other avenues and that we provide other examples for our young people.

I fully endorse minimum unit pricing. The excellent report by Dr. John Holmes and Dr. Colin Angus from the University of Sheffield is comprehensive and goes through everything. They have been very open. I have gone back and forth to them with questions and they have been open about addressing any concerns we have. I would be very happy to share this report with colleagues.

I am concerned that the code of practice must be placed on a very strong footing. I have observed how the drinks industry can find every loophole in the system. Could we look at the threshold for the audience profile measurement, which stands at 25% at present? That is far too high. It should be at 10%. I would prefer if there was no alcohol advertising, but at the very least we need to reduce the level of advertising. I raised the issue of online marketing at the committee hearings. We know that some years ago Diageo announced that 21% of its marketing budget would go to online marketing. Recently legislation was introduced in Finland to ban alcohol apps that contained games, location settings and information on the nearest place to drink. Clearly, these apps are targeted at children. It is a social engagement. As my colleagues have said, a young person who visits YouTube will see advertisements for alcohol that I do not see. The drinks industry is very skilled at targeting particular groups. They know what sites and YouTube videos people are looking at, and the advertising is targeted at them. I have seen the effects of this at first hand. If I walk into any classroom and ask children to name their favourite advertisement on television, I guarantee that alcohol advertisements are up there in their choice. The young people score highly on brand recognition.

This brings me to the issue of sports sponsorship. I really believe we should set a date, no matter how far forward it is, to cease all alcohol-related advertising. It is very telling that neither the drinks industry nor the sports organisations will tell us how much sports sponsorship is worth. We do not have a figure. I think that is unacceptable that we do not know what we are talking about. Youth organisations which do so much voluntary work across the country will not take a single cent from the drinks industry, and I do not see the Government being put under pressure to replace it. In fact, the funding of youth organisations was cut by 40% during the recession, yet these organisations are still delivering those services. I acknowledge that some sporting organisations have stopped taking money from the drinks industry, but the sporting organisations who are still taking sponsorship money should let us know how much we are talking about. Last year, a school principal from Munster spoke at an Alcohol Action Ireland hearing on the issue of sports sponsorship. When Munster won what in France is called the H Cup, he invited the team to visit the school and he was delighted a few team members said they would go. They had a great day, but when they arrived with all the sponsorship and drinks advertising, he realised that he, as the principal of the school, had brought alcohol advertising to the school and he apologised to his students for doing so.

How the drinks industry has a handle on us is subliminal and insidious. It is unacceptable and we need to examine it. At a recent hearing, Katherine Brown of the Institute of Alcohol Studies stated alcohol sponsorship of sport is a way past children’s bedroom doors because they have a picture of a sporting hero on the bedroom door with the nice alcohol branding linking it to sporting success. She stated that if we are really serious, we need to tackle and deal with the issue of separation.

We also need to address the drinks industry role in decisions taken. I am concerned when I see jobs advertised by certain drinks companies. According to the job descriptions, they want to stay one step ahead of regulatory developments. They want to ensure they can beat the system. They will tell us it is all about education and if we were all more informed, we would all make the choices. I know about education, healthy eating and lifestyle. I am not as good as I should be because it is not what changes my behaviour. This is where legislation is important and why the Minister has my absolute and full support. I want us to go further and to do more. I want us to follow policies like that recently announced by the HSE, whereby it will have no truck with the alcohol industry. Why are the Departments of Education and Skills and Health not coming out with similar statements? The Child and Family Agency is thinking about it. It should have no truck with the drinks industry. We must do a lot more in Ireland.

Role of drinks industry in Schools – Commencement Matters

I thank the Cathaoirleach and welcome to the Visitors’ Gallery Ms Siobhán Creaton from the Royal College of Physicians of Ireland and Ms Suzanne Costello from Alcohol Action Ireland. The issue I have raised with the Minister for Education and Skills pertains to the role the drinks industry is trying to develop with regard to the education of children in Ireland. I will begin by applauding the Government on the public health (alcohol) Bill. As a member of the Joint Committee on Health and Children, I have been very much involved in the consultations and the process. If anything, I would like it to go further, but I certainly will do everything I can to ensure that it comes into law.

However, as part of those consultations, the first red flag went up for me when I saw, for example, the Alcohol Beverage Federation of Ireland saying how the industry decided in 2014 to refocus its initiatives in the education space and to concentrate activity on drinkaware.ie. It currently is establishing Drinkaware as an organisation whose work will be modelled upon the influential UK Drinkaware Trust. Unfortunately, if one looks at independent evaluations of Drinkaware in the United Kingdom, one concludes that it is not a model we wish to see in our schools. It has not come out well from an evaluation. Not surprisingly, the drinks industry believes it is excellent, which makes me even more worried about it. The second flag for me was the Stop Out-of-Control Drinking campaign, rolemodels.ie, which is due to produce its report shortly. I can nearly see what this report will say. It will state that we need to educate children, because this is the constant mantra of the drinks industry – namely, that education is needed and that, were everyone educated, it would reduce our risk regarding alcohol-related harm. All the evidence shows that education informs our behaviour but that it does not change or influence it. That is why we introduce laws in respect of, for example, speeding. We all know what is good or bad for us, but legislation is often necessary in order to ensure that we do what is right. A recent Drink Aware advertisement relating to the post of education programme manager refers to the successful applicant working directly with schools. This is despite the fact that a spokesperson for Drink Aware indicated that this is not intended to be the case. If that is so, then the advertisement to which I refer misrepresents the position, because it refers to working with teachers, unions, principals, the Professional Development Service for Teachers, the Department of Education and Skills and the National Council for Curriculum and Assessment. It is obvious that those responsible for Drink Aware want it to become embedded within the education system. I know someone who applied for the position of education programme manager but whose application was unsuccessful. The person in question was informed about the rolemodels.ie campaign, which is going to lead to what I have just outlined. There are no surprises here.

The HSE is not often applauded, but I want to take this opportunity to applaud it most heartily. On 23 April the executive issued a statement to the effect that it is no longer prepared to take any money from the drinks industry and that it will not be associated with said industry, particularly in the context of public health advice or any form of partnership. The statement in question was quite unequivocal in terms of public health advocacy. In my opinion, it reflects what the World Health Organization has said, namely, that public health policies concerning alcohol need to be formulated by public health interests without interference from commercial interests. I am seeking an assurance from the Minister of State that the drinks industry will play no role in our schools. The HSE has worked on the SPHE model with schools. I am concerned by the fact that the National Parents’ Council Primary has put its name to the rolemodels.ie campaign, and I really hope it will withdraw its support. The National Parents’ Council Post-Primary has distanced itself from the campaign and indicated that it would question the motive behind any campaign funded by the drinks industry and aimed at educating our children.

I tabled this matter because I believed the time was right to do so. What I have stated reflects Government policy. We cannot just leave matters stand and wait to discover what people think. The majority of people do not know that Drink Aware equals the drinks industry. The idea of representatives from the tobacco industry going into schools and telling children about anti-cessation measures relating to smoking is abhorrent. We should also abhor the fact that those in the drinks industry even think it is acceptable for their representatives to go into our schools. It will be reprehensible if the Department of Education and Skills says that it is sorry but there is nothing it can do about this matter. It is not acceptable for those in the drinks industry – regardless of whatever costume they may choose to wear – to have any hand, act or part in the education of the children of Ireland.

Minister Kevin Humphreys (response):

I am taking this matter on behalf of my colleague, the Minister for Education and Skills, Deputy Jan O’Sullivan, who sends her apologies.

The Department of Education and Skills is working very closely with the Department of Health in respect of the overall Healthy Ireland agenda. This encompasses co-operation in a range of areas including physical activity, healthy eating and student well-being, as well as substance misuse. At national level, the Department of Education and Skills is represented on key Government structures that provide a co-ordinated approach to addressing substance misuse. These include the national co-ordinating committee for drug and alcohol task forces. The Minister does not believe it appropriate for her to write to schools to prohibit particular materials or resources that may be developed by certain organisations, including the drinks industry. This could form a dangerous precedent for the future. However, officials at the Department of Education and Skills will continue to co-operate with the HSE and the Department of Health to ensure a co-ordinated and partnership approach to alcohol misuse and the range of other areas that are encompassed by the Healthy Ireland agenda. One recent example of such co-operation is the development of healthy lifestyle guidance that is currently being finalised. This guidance is intended to encourage schools to promote physical activity and healthy eating. It is also designed to encourage their participation in the health-promoting schools initiative, which is supported by the Department of Health and the HSE.

It is important to recognise that while education has a role to play in addressing the problem of alcohol misuse, behavioural change will not happen without the support and co-operation of parents, industry and society as a whole. Parents have a responsibility to help children and young people to adopt sensible and responsible attitudes and behaviours regarding alcohol and drug abuse. At present, the education sector is supporting national policy on substance misuse. In particular, schools are equipping students with the key skills and knowledge to enable them to make informed choices when faced with a range of difficult situations.This includes providing students with age appropriate information on the issue of alcohol abuse through aspects of the curriculum such as the social, personal and health education, SPHE, programme. This programme is mandatory in all primary schools. It will also form part of the new mandatory Wellbeing component of junior cycle, along with physical education and civic, social and political education, CSPE. Schools are also encouraged to deliver the SPHE programme in senior cycle. The substance use module of the SPHE curriculum focuses on the issues relating to the use and misuse of a range of substances. It actively seeks to promote healthy and responsible choices by students in a range of areas, including alcohol.

The latest data taken from Department of Education and Skills’ Lifeskills survey 2012 indicate that 90% of primary and 100% of post-primary schools provide their students with information on alcohol abuse through SPHE and other means. These results were almost identical to the position reported by schools through the 2009 Lifeskills survey. The 2015 Lifeskills survey is currently being completed by schools and the Minister hopes to publish the results before the end of the year. This will allow for the measurement of schools’ progress in this area since 2012.

Schools have access to a number of programmes and resources that support the delivery of SPHE and increase students’ awareness of well-being, including drug and alcohol issues. Examples include the Walk Tall programme for primary pupils and a post-primary resource available from the Professional Development Service for Teachers, called On My Own Two Feet. It is a matter for schools and teachers in the first instance to determine what resources and supports they will use to support their implementation of the curriculum. Teachers are equipped to make such decisions as a result of their initial teacher education and the ongoing support provided by the Professional Development Service for Teachers. I am confident that teachers are best placed to identify the most suitable resources to assist them in delivering the SPHE curriculum in their classrooms.

I listened carefully to the Senator’s contribution. She has raised red flags in respect of alcohol awareness and the industry in regard to that. She has been strong and logical about this. The Senator also referred to education, behaviour and role models and expressed concern about the involvement of the drinks industry in both primary and post-primary schools. She made some good points and I will ensure they are highlighted to the Minister. I will ask her to consider the important issues the Senator has raised.

Jillian van Turnhout:

I thank the Minister of State and appreciate that he was not in a position to answer my questions but perhaps he will also relay these questions to the Minister. The drinkaware.iejob advertisement for education programme manager states: “To manage relationships with relevant stakeholders, including the Department of Education, the National Council for Curriculum and Assessment and the Professional Development Service for Teachers”. These are all within the Minister’s remit. I cannot see any reason for the drinks industry to have a relationship with the Department or the NCCA. I seek the Minister’s assurance that they will not have a relationship with the industry.

I appreciate the Minister cannot write to schools to say they cannot do this but, at the very least, could she write to them to advise them that drinkaware.ie equals the drinks industry. It is nothing else. drinkaware.ie is the costume the industry chooses to wear today. It will come up with something else when drinkaware.ieis exposed to people. Schools need to be warned and a warning bell is needed in this regard.

Minister Kevin Humphreys:

I thank the Senator. I will raise those points. I have a meeting with the Minister later this afternoon at which I will ask her to look at the Senator’s contribution and reply to her directly.

Jillian van Turnhout:

I thank the Minister of State.

Alcohol Pricing – Motion

16th November 2011

I welcome the Minister of State to the House and welcome her stated commitments on this issue. I also thank the Fine Gael Members, in particular Senators Noone and Colm Burke, for tabling this Private Members’ motion. It addresses the issue of alcohol related harm. This is not a pro or anti-alcohol discussion but pertains to alcohol related harm. It is estimated that the cost to the State in 2007 was approximately €3.7 billion which, if translated into the cost per taxpayer, is €3,318. Moreover, the profound societal ramifications of the harmful use of alcohol in Ireland makes it imperative this problem be tackled in a determined, concerted and swift fashion.

The motion as tabled correctly recognises that alcohol related crimes have risen in the past decade. This is supported by recent analysis from the Garda PULSE system, which recorded a 30% increase in alcohol related crimes between 2003 and 2007. It also showed the total number of offences among minors increased in the observed period by a staggering 54%. According to the same data, the 18 to 24 year group was responsible for two fifths of offences, while figures for those under 18 constitute 17% of offences, which is a matter of concern to me. As for the issue of harmful use of alcohol during pregnancy, it has a proven association with impaired foetal brain development, impaired intellectual development and cognitive and behavioural dysfunctions that can restrict educational attainment and stifle future development in life.

As previous Members have stated, the harmful use of alcohol can result in substantial economic costs or in the cost of labour market productivity. It has been suggested that absenteeism has cost Irish businesses €1.5 billion per year. A recent survey by IBEC found that alcohol was blamed by employers as the primary reason for 4% and 1% of short-term absences from work by their male and female employees, respectively. In respect of the health and health care cost implications, alcohol liver disease rates and deaths have almost trebled between 1995 and 2007. Among the 15 to 34 year age group, the rate of deaths from alcohol liver disease has increased by 247%. Seven out of ten men and four out of ten women who drink do so in a manner that is damaging to their health. Moreover, a total of 10% of general inpatient costs, 14% of psychiatric hospital costs, 7% of GP costs and up to 30% of emergency health care costs are alcohol related. Each night in Ireland, 2,000 hospital beds are occupied for alcohol related reasons.

I refer to the issue of children and the indirect impact of alcohol, as well as its direct impact. According to the recent report launched by the Minister of State, entitled Hidden Realities: Children’s Exposure to Risk from Parental Drinking in Ireland, 587,000 children are regularly exposed to risk from parental hazardous drinking. The harmful use of alcohol in the home is associated with increased incidences of verbal and physical abuse, witness to violence, neglect, isolation and insecurity. The exposure of children to risk from parental alcohol problems is amplified by the significant burden children bear, such as a care role reversal and keeping secret the problem, which has a great cost to the child concerned in respect of school and developmental life.
I thank Fine Gael for incorporating the proposals that were put forward by Senator Crown and myself in our amendment, which I appreciate. I would like the programme to be added for the following reason. The latest HSE alcohol awareness campaign, for example, speaks of the weekly standard drinks allowance, which is 14 units for adult women and 21 for adult men, and advises that one standard drink is equivalent to 10 g of pure alcohol. My understanding is that the standard drink measurement will be reconverted back to grams across the board, so I propose this amendment to pre-empt this change.

With regard to below cost selling, I thank Fine Gael for adding the words “and very cheaply”. This is a specific pricing strategy. It is important to note that “very cheap alcohol” is a term that is preferred by quite a number of organisations, such as Alcohol Action Ireland, Barnardos, Focus Ireland, No Name clubs, Rape Crisis Network Ireland, the Ballymun Local Drugs Task Force, the Irish Cancer Society, the Irish Heart Foundation, the Irish Medical Organisation, the ISPCC, the National Youth Council of Ireland and the North West Alcohol Forum. It is also supported by the Vintners Federation of Ireland. I welcome the amendment and the harmony we have reached.

The reason I had a difficulty with the term “below cost selling” is that there is no agreed definition of how to calculate and define cost pricing. It still allows alcohol to be sold very cheaply, given that the unit cost can be varied by the retailer depending on a number of factors. It is not clear that, if a below cost selling plan was put in place, it would be sufficient to reduce alcohol consumption and, therefore, would not necessarily have the desired impact. There are also difficulties in monitoring, compliance and securing convictions for below cost selling. In fact, if one looks back, this was one of the key reasons behind the repeal of the groceries order in 2006. Finally, the price is not linked to the strength of the drink as it does not relate to the number of units or grams of alcohol the drink contains. I appreciate the addition of the words “and very cheaply”, which will address my concerns and will achieve what I believe is everybody’s intention in this motion.

What has been said by all speakers is important. This is not just one measurement which looks at pricing. We need to look at culture as well as the enforcement of our current laws. There are many laws in place that can be enforced in regard to drink driving and many other issues. We must look at advertising and marketing, including social marketing. I was shocked to see that when my nephews are on YouTube and Facebook, they get very different advertisements to the ones I get. Twelve year olds are regularly seeing drinks advertising on their screens whereas I do not get these on my screen, which tells us something about who these products are being marketed at. It is also about protecting children who are indirectly impacted by alcohol. As noted in the motion, pricing is an issue in this regard.

In the cause of harmony in the House, I thank Members for working together. This is good for the Seanad. It should be a first step in addressing the harmful effects of alcohol and the price it has for us in Ireland.

The Lancet

In July 2021, Jillian co-authored an article in the world-renowned medical journal “The Lancet”