Alcohol control policy: evidence-based medicine versus evidence-based marketing

Authors


Comprehensive and stringent alcohol control policies (e.g. on both availability and marketing) are associated with lower alcohol consumption by adolescents [1]. Accordingly, Müller et al. showed that the German experience of alcopops taxes, a limited action, induced a switch for beverages associated with riskier drinking patterns [2].

French policy has chosen another way. In June 2009, the government issued a new law, ‘Hospital, patients, health and territories’, a major reform to ‘improve’ the health-care system, which allowed advertising for alcohol on the internet, the most used medium by young people. This (i) disregarded both medical associations' claims and results of public polls indicating that eight out of 10 French citizens oppose such a measure and (ii) almost nullified ‘Evin's law’ issued in 1991 to ban or limit alcohol advertising in other media and during sports events [3,4].

The Department of Health took specific measures because the Code of Public Health has a chapter (III) requiring the ‘protection of the under-aged’ in the section entitled ‘Fighting alcoholism’. It issued mandatory posters (31 January 2010) to be posted in places where alcohol is sold [5]. Under the headline of ‘To protect the youngest and against public drunkenness’, they have three points, such as: (i) it is forbidden to sell alcohol to those under 18s; (ii) ‘happy hours’ are forbidden unless there are non-alcoholic beverages; and (iii) drunkenness is forbidden in public places [5].

The first point of the poster might look fine. In Florida and many other states, trade organizations and retailers have opposed measures that limit youth access, including punishment of vendors making under-age sales [6]. Would they have opposed such measures if these measures were not decreasing their sales? Sadly, the efficiency of the first point is very highly questionable in France, because laxity and impunity prevail on enforcement. For example, selling tobacco was forbidden for the under-16s (the ‘Hospital, patients, health and territories’ law also shifted this ban to 18 years). However, the European Project on Alcohol and Drugs (ESPAD) study showed that 65% of the 13-year-old daily smokers (10% of this age) buy their cigarettes from a tobacconist [Bulletin épidémiologie hebdomadaire (BEH thématique), issue 21–22, 27 May 2008, p. 189]. In France, there are no mechanisms to ensure that these laws are enforced and no administration uses sting operations even if serious breaches are patent.

On 18 October, the Ministry of Health announced a 2% increase in tobacco sales during the past 5 years ‘due to women and the crisis’, without noting that the French government had consistently refused to increase tobacco taxes since 2004. French health policy is flying in the face of best evidence for reducing tobacco and alcohol consumption, already sliding down what appears to be a slippery slope in terms of smoking, suggesting a willingness to sacrifice its citizens' health.

Declarations of interest

Professor Dubois chairs ‘Alliance Prévention Alcool’, a charity established in June 2010 to federate the organizations that oppose dangerous and inconsistent policies. He is currently being sued for libel by the Confédération des Buralistes (the French tobacconists' union) since September 2009. Dr Braillon, a senior tenured consultant in Professor Dubois' unit at Amiens since 2005, was sacked in December 2009 with the approval of the National Management Centre (Department of Health) against the advice of the National Statutory Committee (Whistleblowing and the abuse of libel law: view from France; HealthWatch, issue 79, October 2010; available at: http://href.fr/healthwatch_oct10.pdf).

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