Under the counter
Dr Charles Parry
Director Alcohol & Drug Abuse Research Group, MRC
Exco Member SA Central Drug Authority

The negative reaction from liquor industry to the Department of Health's tender on the developing and testing counter advertising messages aimed at reducing the abuse of alcohol is to be expected. The liquor industry is the largest conveyor of information on alcohol to the public in this country spending, for example, R342 million on above-the-line advertising between May 2001 and April 2002. It has not been possible to gauge the amount spent on below the line advertising (sports sponsorships, entertainment (e.g. Castle Loud), and other promotions), but it is likely to run into hundreds of millions of rands. Through this the industry conveys the idea that alcohol consumption is to be equated with "friendship", "patriotism", "being cool", and with "success".

In the interest of making informed choices about drinking it is important that the public has other sources of information not paid for by the liquor industry whose main interest, (understandably) is profit. The Department of Health with the support of the Central Drug Authority (CDA), the Medical Research Council (MRC), the South African National Council on Alcoholism and Drug Dependence (SANCA) and other organisations is striving to ensure that South Africans are given more balanced messages about alcohol consumption and the harms associated with alcohol use.

The Industry Association for Responsible Alcohol Use (ARA) has threatened that the liquor industry will consider placing information on the benefits of alcohol on containers if they are forced by government to include health warnings on their packaging. Such action would be misleading as health benefits are only likely to occur for older individuals, with drinking levels as low as one drink every two days. These benefits are replicable through other means such as stopping smoking, eating a balanced, low fat diet, exercise, and taking aspirin. Drinking to intoxication which is fairly commonplace among many drinkers is likely to negate any health benefits. Information on the health benefits of drinking would be detrimental to the bulk of South Africa's population who are under 30 years of age and who are far more likely to die from alcohol-related intentional and non-intentional injuries or alcohol-related risky sex than from heart disease.

The public would like to see greater controls on alcohol advertising. A study conducted in 2001 by the MRC on a representative, national sample of South Africans found that three-quarters of respondents supported regulations requiring alcohol manufacturers to place warning labels on alcohol containers, two-thirds supported calls for either banning radio/TV advertisements for alcohol or at least only allowing them after 9 pm. Just under half indicated that sports sponsorships should be banned from all events or at least banned for events attended/watched by audiences comprising persons under 18, and just under half felt that billboard advertising of alcohol should be banned.

The liquor industry equates counter-advertising with warning labels. Warning labels comprise only one form of counter-advertising. International research on warning labels has been mixed, but the warning labels studied have typically been smaller than we have on cigarette packaging in South Africa and have not involved the use of pictures. Warning labels are currently required in nine countries, including the USA, Brazil and Mexico. Other more creative forms of counter-advertising are required, including radio and TV spots, thought provoking messages on T-shirts and billboards, etc.

Globally alcohol was recently listed by the World Health Organization in the 2002 World Health Report as one of the top ten risks in terms of the burden of diseases they cause. No one believes that counter advertising will be a magic bullet that will address all the problems associated with alcohol abuse. Nevertheless the Department of Health, the MRC, SANCA and the CDA believe it is an important element in a multi-pronged approach to reduce the burden of alcohol abuse in this country.