Key policy priorities in summary
Evidence to support these recommendations is summarised in the next section (evidence informing policy).
Reform alcohol pricing policy
Development of the Australian alcohol taxation system has been incremental and ad hoc, resulting in a medley of inconsistencies, which adversely influence alcohol use and related harm. Australia's alcohol taxation system is not based on alcohol harm minimisation principles. The formulation of alcohol pricing policy should acknowledge that alcohol is responsible for major harms in our community including cancer. Increasing the price of alcohol through taxation is one of the most effective ways to reduce alcohol use and associated harms.
Alcohol taxation should be volumetric – calculated according to alcohol content – with higher taxes on products with higher alcohol content by volume. Changes to alcohol taxes should not have the effect of decreasing the price of alcohol products, other than low alcohol products. The actual price of alcohol products should increase steadily over time. The current practice of adjusting alcohol excise taxes every six months by reference to the Consumer Price Index should be maintained. For public interest minimum pricing of alcohol should be introduced so that the actual price of alcohol products does not drop.
Cancer Council supports the allocation of a proportion of alcohol taxation revenue for the purpose of recovering the costs of alcohol-related harm and funding education, harm prevention and alcohol treatment programs.
Currently, alcohol sales data are collected only in Victoria, Queensland, South Australia, Western Australia, the Northern Territory and the Australian Capital Territory. Wholesale and retail alcohol sales data are valuable for monitoring alcohol use levels and patterns as well as evaluating the impacts of prevention policies and programs including changes in alcohol pricing and taxation. This data should be collected in all States and Territories, and be made available to researchers and policy planners, to improve the evidence base for alcohol taxation policy and the evaluation of policy changes. Additionally, Cancer Council seeks a commitment from the Australian Government to ensure independent monitoring and evaluation of any reformed alcohol taxation scheme, together with research into potential improvements.
Restrict alcohol advertising and promotion
Currently, regulation of the content and placement of all forms of alcohol marketing is limited. Alcohol advertising is largely self-regulated, predominantly through voluntary industry codes of practice. There are few legislative restrictions upon the content or placement of alcohol advertising and promotion in commercial or subscription media and social media. Increased restrictions on where, when and how alcohol can be marketed are needed. Cancer Council recommends introducing legislation to restrict alcohol advertising and promotion that either appeals, or is connected with content that appeals, to people under 25 years in all media.
A comprehensive legislative framework for regulating alcohol advertising in Australia is required that:
- a) covers all forms of alcohol marketing;
- b) establishes clear public policy goals for the regulation of advertising, such as protecting vulnerable groups like children and young people;
- c) creates an independent regulatory body for administering the system with the powers to formally investigate and penalise breaches of the alcohol advertising rules; and
- d) introduces meaningful sanctions for serious or persistent non-compliance by advertisers.
Evidence indicates that legislative controls on alcohol advertising decrease alcohol use and would be more cost-effective than current practices. A staged approach could be used to phase out alcohol promotions from times and placements which have high exposure to young people aged up to 25 years including:
- Advertising during all sport programs
- Advertising during high adolescent/child viewing
- Sponsorship of sport and cultural events (e.g. sponsorship of professional sporting codes; youth-oriented print media; internet based promotions)
- Advertising on outdoor signage and public transport
- Consider additional measures to address alcohol advertising and promotion across other media sources
Restrict availability of alcohol
Restricting the availability of alcohol (via reduced hours of sale) is one of three best buy policies recommended by the World Health Organisation (WHO) to reduce the harmful drinking . Restricting availability, along with reforming alcohol taxation and marketing restrictions, are the most cost-effective options available to governments recommended by the World Health Organisation (WHO) to reduce alcohol use at a population level. WHO also recommends enacting and enforcing an appropriate minimum age for purchase or use of alcoholic beverages and reducing the density of retail outlets to reduce harmful alcohol use. In Australia the sale and supply of alcohol is addressed under state and territory liquor regulations. To support public health, it is essential that liquor regulations in Australia are evidence-informed and appropriately restrict the availability of alcohol.
Enhance public education about alcohol and cancer risk
It has been known for more than 30 years that alcohol can cause cancer. In 1988, the International Agency for Research on Cancer (IARC) classified alcoholic beverages as Group 1 carcinogens—known to cause cancer in humans. Any level of alcohol use increases the risk of developing an alcohol-related cancer; the level of risk increases in line with the level of consumption. Australia's relatively high burden of alcohol-related cancer reflects high levels of alcohol use in Australia by world standards; Australia ranks within the top 20 highest nations out of 180 countries on a drinking alcohol per capita basis.
However, public awareness of the link between alcohol and cancer is low. A national public education campaign using social marketing to raise awareness of the NHMRC guidelines and the link between alcohol and cancer is needed. Research has found that alcohol harm reduction advertising that communicated long-term harms were more effective than those communicating short-term harms in motivating people to reduce their alcohol use. Health information and warning labels on alcohol products also have the potential to increase public awareness of alcohol harms. Improving public understanding of the modifiable risk factors such as alcohol use and its association with cancer has been globally identified as a key cancer prevention strategy.
- Saffer H, Dave D. Alcohol consumption and alcohol advertising bans. Applied Economics, Taylor and Francis Journals 2002;34(11):1325-34.
- Doran C, Vos T, Cobiac L, Hall W, Asamoah I, Wallace A, et al. Identifying cost-effective interventions to reduce the burden of harm associated with alcohol misuse in Australia. Brisbane: The University of Queensland; 2008. Sponsored by Alcohol Education Rehabilitation Foundation. Available from: http://fare.org.au/wp-content/uploads/Identifying-Cost-effective-Interventions-to-Reduce-the-Burden-of-Alcohol-Harm.pdf.
- World Health Organization. The updated Appendix 3 of the WHO Global NCD Action Plan 2013-2020. Geneva: WHO; 2017 [cited 2020 May 15] Available from: https://www.who.int/ncds/management/WHO_Appendix_BestBuys.pdf.
- World Health Organization. Management of substance abuse. [homepage on the internet] Geneva: WHO; 2018 [cited 2020 May 15]. Available from: https://www.who.int/substance_abuse/safer/en/.
- Department of Health. National alcohol strategy 2019-2028. Canberra: Commonwealth of Australia; 2019 [cited 2020 May 15] Available from: https://www.health.gov.au/sites/default/files/documents/2020/01/national-alcohol-strategy-2019-2028.pdf.
- World Health Organization, International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans. Volume 44. Alcohol drinking. Summary of data reported and evaluation. Lyon, France: IARC; 1988 Available from: http://monographs.iarc.fr/ENG/Monographs/vol44/volume44.pdf.
- World Health Organization. Global status report on alcohol and health 2014. Geneva: WHO; 2014 [cited 2019 Jul 25] Available from: https://www.who.int/substance_abuse/publications/global_alcohol_report/en/.
- Bowden JA, Delfabbro P, Room R, Miller CL, Wilson C. Alcohol consumption and NHMRC guidelines: has the message got out, are people conforming and are they aware that alcohol causes cancer? Aust N Z J Public Health 2014 Feb;38(1):66-72 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/24494949.
- Wakefield MA, Brennan E, Dunstone K, et al. Features of alcohol harm reduction advertisements that most motivate reduced drinking among adults: an advertisement response study. BMJ Open 2017;7:e014193. doi:10.1136/bmjopen-2016-014193 Abstract available at https://bmjopen.bmj.com/content/7/4/e014193.