Lizzy Buchan: One-size-fits-all approach will not solve alcohol problem

NHS Shetland has suggested preventing shops from selling alcohol during the day.
NHS Shetland has suggested preventing shops from selling alcohol during the day.
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Nothing is more likely to generate furious debate - except perhaps the new US president-elect - than changes to our drinking habits.

The predictable outrage ensued this week when public health experts at NHS Shetland stuck their heads above the parapet by suggesting that shops and off-licences stop selling alcohol before 5pm.

The suggestion is a throwaway line in a board paper but it has whipped up a frenzy of feeling around personal freedom and public health.

Scotland’s dysfunctional relationship with drink is abundantly clear.

The burden on the health service is also evident, with around 670 hospital admissions a week due to alcohol, while 22 people die every seven days from related conditions.

Policy makers must act but it is a tricky path to tread.

People do not like to be told what to do, especially around drinking which is so embedded in the fabric of our society.

Yet past interventions such as the indoor smoking ban have had dramatic effects on both the image and popularity of cigarettes.

So how best to make people aware of the risks of drinking to excess without spoiling their fun?

The Scottish Government’s recent legal victory over minimum unit pricing legislation is a good start, as it will set a floor price on extremely cheap spirits and ciders.

Around three quarters of all alcohol drunk in Scotland is bought from supermarkets, so rather than penalising pubs, the legislation aims to reduce how much people drink at home, where measures are likely to be more generous.

Minimum unit pricing may help the wider population as a whole but academics have previously warned that it could hit problem drinkers hard as their bodies adjust to the loss of booze they can no longer afford.

For others, it will probably have a limited impact on the cost of anything other than the cheapest alcohol but sends a powerful message about the dangers of drink.

NHS Shetland’s idea is based on research done in Aberdeen on how to help recovering alcoholics to stay away from alcohol, rather than advice for those who enjoy the odd glass of wine on a Friday night.

I have spoken to recovering addicts in the past, who said they felt trapped by the proliferation of adverts and opportunities to buy alcohol wherever they turned.

However some licensing experts are sceptical that this kind of ban could ever come to pass, and whether it is fair on shopkeepers who are already tightly governed by law.

There has also been some suggestion that a daytime sales ban might provoke stockpiling among both sensible and problem drinkers.

It seems to me to that rather than reacting with anger to NHS Shetland’s proposals, we should see it as a good example of how different areas can use health policy to meet the specific needs of their residents.

One of the problems with national initiatives is it forces everyone to adopt a one-size-fits-all approach.

Alcohol policy must consider poor alcoholics, teenage partygoers, wealthy drinkers and every other shade of grey in between.

The diversity of Scotland’s communities must also be taken into account as an approach that works in Sutherland may not be applicable to people in Clydebank or Niddrie.

Bold thinking and open discussion is the only way to find a solution.