Love letters

In today's NZMJ:

Marketing and supplying alcohol to young people

The posting of a video of an extremely intoxicated 9-year-old boy resulted in a media furore in recent weeks reflecting the extreme youth of the individual and a heightened focus on Internet postings; it also illustrated increased public concern over alcohol related harm and highlighted some key public health issues which require urgent action.

This case is a ‘tip of the iceberg’ illustration of what our survey data suggests is happening in New Zealand among young people (although data does not cover children as young as 9 years). As controls on sale from licensed premises have become better enforced and compliance has increased—only 9% of 16-year-old drinkers and 14% of drinkers aged 17 purchasing their own alcohol in 2012 (unpublished data, HRC funded Alcohol Policy in New Zealand [APINZ] survey)—social supply has become a major source of alcohol for those under the minimum purchase age. Much supply is from older friends or relatives and, on average, about 11 cans of ready-to-drinks (RTDs) or equivalent are supplied.1

The Sale and Supply of Alcohol Act 2012 introduced greater clarity to the law regarding supplying alcohol to minors. The Act now makes it an offence to supply without ‘express consent’ of the parent or guardian. Charges have been laid against three people in connection with this case providing an opportunity to capitalise on a public health message about the law and the likelihood of prosecution.

The supply of 8 cans of Cody RTDs and 2 shots (about 150 ml of absolute alcohol in total) illustrates the importance of RTDs. In a recent study RTDs were found to be the beverage young suppliers reported supplying most often to those under the minimum purchase age.1

Attempts overseas to introduce specific taxes on RTDs have not been successful because of substitution to alternative beverages2 or amelioration of costs by provision of multipack options3 but evidence shows affordability of alcohol is very important4 and the cost entailed in this supply (about $20.60) was obviously not sufficient to deter the generous spirit of the suppliers.

Increasing excise tax by 50% as recommended by the Law Commission in 2010, but rejected by government, would have increased the cost by only about $3 but would have been a move in the right direction. The results from the APINZ survey show heavier drinkers purchase cheaper alcohol.5 Tax increases are effective to reduce alcohol-related harm and significant tax increases, as have been applied to cigarettes in New Zealand, are urgently needed.

Equally urgent is action to reduce the exposure of young people to the marketing of all alcohol beverages including RTDs. Cody, with the third largest share of the high potency RTD market in NZ, carried out a significant television campaign in 20126 and is prominent in the bottle store displays to which children are exposed.

Then there is the question of distribution: high potency RTDs were to be subject, in the new Act, to greater controls. The original recommendation from the Minister, following the Law Commission review, was to prohibit RTDs above 5% alcohol potency.7 This was reduced to prohibiting sale from off licenses of 6% RTDs while still allowing sale from on-license premises.8 However, after government consulted the producers of RTDs these clauses were withdrawn with a promise the industry would adopt a voluntary code and government would regulate quickly if needed. It is not clear what would trigger regulation or if an organisation independent of the industry will monitor.

Which brings me to a final relevant issue in the media coverage of this story: while there were no comments from the vested interest groups, producers or retailers, one NZ Herald story did quote Dr Eric Crampton, a University of Canterbury economist, who said the video was shocking because ‘rare and sad events are shocking’. He also said ‘while several prominent anti-alcohol commentators have used this tragic case to argue for higher alcohol prices and broader restrictions on where alcohol can be sold, the overall statistics on youth drinking suggest that things are improving’.

Dr Crampton was referring a decrease in the proportion of young drinkers classified as hazardous drinkers or binge drinkers in recent surveys. The Ministry of Health (MoH) NZ Health Survey for example, reported 1 in 5 of those aged 15–17 years were hazardous drinkers (down from about 1 in 4 in 2006/7). There is no doubt there is some improvement but whether enough to argue against improved alcohol control policies is another question.

The University press release and NZ Herald story did not contextualise this ‘expert’ opinion, but in a recent news item it was announced that Dr Crampton and the University of Canterbury had accepted 3 years of funding from the Brewers Association of New Zealand.

In the words of the Director of External Relations of the Brewers Association, Jenny Cameron: “This funding ... will add to the voices in the public debate over alcohol and alcohol policy.”9

Sally Casswell

Director
SHORE and Whariki Research Centre
School of Public Health, Massey University
Auckland, New Zealand

References:

1. SHORE and Whariki. Social Supply of Alcohol to Young People in Taranaki and Mangere. Auckland: Shore and Whariki Research Centre, School of Public Health, Massey University, 2012, December.
2. Müller S, Piontek D, Pabst A, et al. Changes in alcohol consumption and beverage preference among adolescents after the introduction of the alcopops tax in Germany. Addiction. 2010;105(7):1205–13.
3. Jones S, Barrie L. RTDs in Australia: Expensive designer drinks or cheap rocket fuel? Drug Alcohol Rev. 2011;30(1):4–11.
4. Wall M, Casswell S. Affordability of alcohol as a key driver of alcohol demand in New Zealand: a cointegration analysis. Addiction. 2013;8(1):72–9.
5. Wall M, Casswell S, Huckle M, Yeh L-C. Effects of increases in alcohol excise tax: modelling based on results from the IAC survey in New Zealand. Alcohol Clin Exp Res. 2013;submitted.
6. Euromonitor. Rtds/High-Strength Premixes in New Zealand, 2012. http://www.euromonitor.com/rtds-high-strength-premixes-in-new-zealand/report
7. Office of the Minister of Justice. Alcohol Law Reform. 2010. Accessed 20 January, 2014. Available at: http://www.justice.govt.nz/policy/sale-and-supply-of-alcohol/regulation-of-alcohol/alcohol-law-reform-cabinet-paper-final.pdf
8. Ministry of Justice. Regulatory Impact Statement: Alcohol Reform Bill – Policy Amendments for inclusion in the Government Supplementary Order Paper. 2012, 6 September. Accessed Available at: http://www.justice.govt.nz/policy/sale-and-supply-of-alcohol/regulation-of-alcohol/Final%20RIS%20-%20Alcohol%20Reform%20Bill%20-%20Policy%20Amendments%20for%20Inclusion%20in%20the%20Government%20Supplementary%20Order%20Paper.pdf
9. Brewer's Association. Brewers Association to fund Alcohol Policy Research. Scoop; 2013, 6 December. Accessed 20 January, 2014. Available at: http://www.scoop.co.nz/stories/SC1312/S00025/brewers-association-to-fund-alcohol-policy-research.htm

I've just sent this letter to the NZMJ. Perhaps they'll publish it. Their standards on letters seems pretty low. [Update 14 February: it's published here.]

Dear NZMJ,

I note with interest Sally Casswell’s letter in the most recent NZMJ.[1] She writes:

“Which brings me to a final relevant issue in the media coverage of this story: while there were no comments from the vested interest groups, producers or retailers, one NZ Herald story did quote Dr Eric Crampton, a University of Canterbury economist, who said the video was shocking because ‘rare and sad events are shocking’. He also said ‘while several prominent anti-alcohol commentators have used this tragic case to argue for higher alcohol prices and broader restrictions on where alcohol can be sold, the overall statistics on youth drinking suggest that things are improving’.

Dr Crampton was referring a decrease in the proportion of young drinkers classified as hazardous drinkers or binge drinkers in recent surveys. The Ministry of Health (MoH) NZ Health Survey for example, reported 1 in 5 of those aged 15–17 years were hazardous drinkers (down from about 1 in 4 in 2006/7). There is no doubt there is some improvement but whether enough to argue against improved alcohol control policies is another question.

The University press release and NZ Herald story did not contextualise this ‘expert’ opinion, but in a recent news item it was announced that Dr Crampton and the University of Canterbury had accepted 3 years of funding from the Brewers Association of New Zealand.”

Here’s some context, if your readers would be interested.

The University of Canterbury’s media person contacted me requesting a press release on this issue. I was not inclined to comment on the case, knowing nothing of the circumstances of the 9-year-old in the video. But I was then disappointed to hear repeated instances of anti-alcohol commenters suggesting that this case served as exemplar of a worsening trend in youth drinking. I consequently wrote a release focusing on results from the most recent Ministry of Health and Auckland Youth ’12 data that show that youth drinking has been decreasing. I also insisted that the last line of the press release note what might be perceived as a conflict of interest. It reads, “Dr Crampton is a senior lecturer in economics at UC. He also advises the Brewers Association of Australia and New Zealand on alcohol economics and policy.”[2] I forwarded a copy of the release to the Brewers Association as a courtesy; it was the first time that I had talked with them about the matters discussed in the release. They did not request or initiate the release.

It is strictly incorrect for Casswell to insinuate that I was hiding any potential conflicts; they’re noted in the press release. My full disclosure statement has been up on my blog, Offsetting Behaviour[3], since the University entered into this arrangement with the Brewers to facilitate my work, and were also announced in a separate press release in December. It is also incorrect to suggest that my press release pointing to the actual statistics on youth drinking were in any way motivated by this arrangement. I just get annoyed when policy activists try to mislead the public about the underlying statistics. And I continue to be amazed by those who think tax increases are the appropriate way of dealing with those adults who think it hilarious to get 9 year olds drunk.

1. Casswell, S. Marketing and supplying alcohol to young people. New Zealand Medical Journal, 2014;127(1388).
2. The full release is archived at Scoop. http://www.scoop.co.nz/stories/AK1401/S00225/video-showing-a-drunk-nine-year-old-shocking-for-good-reason.htm
3. My disclosures statement is here: http://offsettingbehaviour.blogspot.com/2013/12/alcohol-work.html