Letter: Holistic approach

Your report (18 September) of Professor Raj Bhopal's investigation which intimated that Scots born in Scotland and Ireland are more likely to die of alcohol-related liver disease than Scots born in England and Wales cast serious doubt on the minimum price policy as a means of addressing Scotland's health problems across the country.

Since relative alcohol consumption in Scotland and in England and Wales cannot account for the large differences in liver disease and since native born Scots and non-native born Scots are genetically similar, cultural factors such as diet, smoking and life-style may be primary factors that cause our comparatively poorer health.

The "Glasgow effect" studies by David Walsh, of Glasgow Centre for Population Health, suggested that alcohol may not be the primary cause of our alcohol-related health problems.

Other European countries which consume more alcohol than we do in Scotland have better health and live longer. If alcohol is a secondary or "related" factor, why target alcohol alone in the fight to improve the health of the nation?

Prof Bhopal stated that some groups have "greater susceptibility" to the risk of alcohol-related poor health. No one group is more important than the other in this country. Since a minimum price of 45p will mainly affect the poor, who buy cheaper drinks such as cider and vodka, the liver disease caused by a combination of unacceptable cultural habits and more expensive alcoholic drinks, unaffected by a 45p minimum price, should not be ignored by a purposeful policy to improve the nation's health. The research quoted by this paper strongly suggests that a targeted approach to deal with alcohol-related deaths is necessary. Alcohol should not be made the scapegoat of a serious health problem which should be addressed as a whole.

PROFESSOR EMERITUS GEOFF PALMER

Waulkmill Drive

Penicuik, Midlothian