Canada: Population health versus convenience: The sobering cost of alcohol policy liberalization (opinion)
By Samantha Wells, Pegeen Walsh, Andrew Murie Contributors
November 17, 2021
The Ontario government has been substantially expanding the places and times where alcohol can be purchased. Its stated objectives are twofold: improving choice and convenience for consumers and supporting jobs in the hospitality industry.
Certainly, governments consider many factors when developing alcohol policy. There may be a case for alcohol retail expansion from these standpoints. But what is lacking from discussions on this topic is the key tradeoff between convenience and public health: that is, choice and convenience will undoubtedly come at the expense of population health.
This may sound like an overdramatic statement. It is not. The effects of alcohol policy have been studied for decades, and there is no mystery as to what happens when alcohol availability increases, even modestly. As consumption goes up, so does a wide range of harms.
Many people are unaware of the range and scope of harms caused by alcohol. It is responsible for more than 18,000 deaths a year across Canada, with costs amounting to an estimated $17 billion annually in health care, lost productivity, criminal justice, and other direct costs, far exceeding the monetary benefits.
Meanwhile, alcohol consumption has increased during the pandemic, including binge drinking. This is a concern in itself, but one does not even have to drink heavily to experience harms: research has shown that even moderate consumption is linked to increased rates of cancer. A shocking recent trend in the United States is that life expectancy is declining, with alcohol playing a prominent role — and Canada may soon follow suit. Further liberalization of alcohol sales will accelerate these trends.
A common argument in favour of increasing convenience is that many jurisdictions, including several Canadian provinces, sell alcohol in grocery or convenience stores, with little apparent impact on public health or safety. But the scientific evidence tells a different story.
In both Alberta and British Columbia, for example, privatization of alcohol sales and increases in the number of privately owned alcohol retail outlets were associated with increases in alcohol-attributable deaths. Study after study in numerous jurisdictions shows that as alcohol availability increases, so does a range of acute and chronic health harms.
People of lower socio-economic status are disproportionately affected by these kinds of policies. These trends have been observed time after time across the world, which is why the World Health Organization recommends strong regulationson alcohol availability, including reduced number and concentration of retail outlets and reduced hours of sale.
Liberalization of alcohol sales has been happening in Ontario for some time and has occurred regardless of which party is in power. But recently we have seen major increases in the number of locations where alcohol is sold, longer hours of sale, and lower prices. This provincial government has also promised to allow alcohol to be sold in convenience stores. Decades of research leave no room for doubt: these increases in alcohol availability will have harmful effects on population health.
It is up to citizens and our elected representatives to weigh the competing priorities of population health and convenience. But how are we to balance them when we don’t recognize the clear relationship between availability and harm?
Too often we approach regulations on alcohol as though it was a regular product like milk or apples. It is not; alcohol is a drug that comes with inherent health risks and causes significant harm, even at lower levels of consumption. We are not arguing for a return to prohibition or calling for people to stop drinking.
Simply put, alcohol policy must be developed with the recognition that it is no ordinary product. Its under-regulation has direct negative effects on and costs to population health.
From a health perspective, our alcohol policy is going in the wrong direction. Ontario should not allow alcohol to be sold in convenience stores. We need a freeze on further liberalization of alcohol sales. The provincial government should develop a provincial alcohol strategy in consultation with stakeholders in the public health and safety sectors — and independent from the alcohol industry. And as a society, we need to be rethinking our approach to alcohol.
Dr. Samantha Wells is senior director and senior scientist with the Institute for Mental Health Policy Research at the Centre for Addiction and Mental Health. Pegeen Walsh is the executive director at the Ontario Public Health Association. Andrew Murie is the chief executive officer at MADD Canada.