Nation of drunks struggles to call last orders

Our consumption of alcohol remains near its record high, with a marked increase among women. Picture: Getty

This unflattering description, uttered by the First Minister in his now notorious interview with GQ magazine, has been greeted with horror by those who believe that, when it comes to Scotland, anything other than a eulogy is an act of treachery.

But, really, isn’t it how we most like to present ourselves? Isn’t the image of the gallus inebriate one we celebrate on posters and tea towels and TV shows? Whether it’s I Belong To Glasgow, Rab C Nesbitt, or the traffic cone on the Duke of Wellington’s head, we revel in the idea that we are always up for a swally and a laugh. What other country would mark its Commonwealth Games with a poster depicting alternative sports such as “throwing” – a man with his head down a toilet – or “marathon” – half a dozen pints lined up on a bar?

Our conception of ourselves as always on the bevvy is not misplaced, although, with its associated crime and mortality figures, it is scarcely something to be proud of. While alcohol sales have dipped slightly in the past few years as a result of the recession and, arguably, a crackdown on supermarket promotions, Scotland continues to outstrip the rest of the UK in its consumption. Last year, 10.9 litres of alcohol per adult (the equivalent of 21 units per adult per week) was sold here. That’s 19 per cent more than south of the Border, with sales of vodka in Scotland more than double those in England and Wales. We continue to have one of the highest alcohol mortality rates in western Europe and alcohol misuse costs us £3.6 billion a year. The impact in terms of crime and antisocial behaviour is also huge, with recent figures showing 50 per cent of prisoners were drunk at the time of offending.

Alcohol-related illnesses are linked to poverty and yet studies have shown that our higher rates of liver disease are not merely the product of our higher rates of deprivation. When the Glasgow Centre for Population Health (GCPH) compared Glasgow with Liverpool and Manchester, cities with similar levels of need, it found Glasgow not had only a lower life expectancy, but a higher proportion of alcohol-related deaths (three times higher in the 1980s). The number of alcohol-related deaths increased in all three cities over the next three decades, but a sharp rise in deaths in the 1990s was unique to Glasgow.

Why Glasgow/Scotland should be particularly prone to excessive drinking is something of a mystery. In an attempt to understand the city’s lower life expectancy, the GCPH, examined, among other things, social capital and found that, compared to the other cities, people in Glasgow were less likely to go to church, join clubs or volunteer. They speculated this diminished sense of connectedness could have been caused by a greater fragmentation of communities when tenement dwellers were decanted to the new towns, but their research did not address the city’s alcohol problems per se or look beyond Glasgow itself.

Academics may not yet be able to explain it, but we all know from personal experience that alcohol is now central to Scottish culture. For many, “having a good time” has become synonymous with drinking so much you can’t remember what happened the following day. The pressure to join in is summed up by the Chewin’ The Fat sketch in which a man who turns down the offer of a beer is greeted by one, then two, then a whole chorus of voices, urging him to “take a drink”.

“I think it is tied up with our image of ourselves as a hospitable people,” says Dr Carol Emslie, leader of the Substance Use and Misuse Research Group and senior lecturer at the Institute for Applied Health Research at Glasgow Caledonian University. “Some of the people I have spoken to talked of how, if they are out with friends or colleagues and they want to stop drinking, it’s always ‘aw, just one more,’ or ‘leave the car,’ or other phrases aimed at keeping everyone in the same boat. Some of them had lived in different parts of the UK and different countries and they felt under pressure; they said ‘it’s not socially accepted to drink, it’s socially expected’.”

For his part, Salmond has suggested it might be down to a “lack of self-confidence as a nation”, implying a destructive relationship with alcohol is deeply embedded in the Scottish psyche, an integral part of our identity, almost.

It may seem odd for the First Minister to talk of the country in these terms in the run-up to the referendum, but is he right? Are we a nation of drunks whose alcohol problems are rooted in a lack of self-worth? And if so, what can the government do to improve the situation, given its flagship plan to introduce minimum pricing is on hold until the case is heard in Europe?

Though heavy drinking has been a feature of the UK’s big cities since the industrial revolution, there is little evidence Scotland’s alcohol consumption was disproportionate until the 1970s.

“Problem drinking became a hot political topic in the Victorian era,” says Thora Hands, a researcher at the Centre for the Social History of Health and Healthcare based at Strathclyde University. “At that time, there was heavy industrialisation across the UK. Cities such as Glasgow and Edinburgh grew rapidly and the number of pubs increased. With that, came the image of the working-class man who drank too much; it was part of his culture. While I have found references to Scotland having a reputation for being more drunken than the rest of the UK, however, I have also found evidence of discussions on a parliamentary level where Scotland and particularly Glasgow were said to have managed their drinking problems more effectively than elsewhere.”

The reality is that for much of the 20th century alcohol-related mortality rates in the UK were low compared with countries such as France, Italy and Spain. In the mid-1970s, however, conditions such as cirrhosis of the liver began to decline in central and southern Europe, but rise here, until, by around 2005, the UK had eclipsed its continental counterparts. Between 1980 and 2007, the amount of alcohol consumed per adult per year increased by almost 20 per cent, the number of deaths directly related to alcohol misuse doubled and the gap between Scotland and the rest of the UK widened. Though UK consumption has dipped slightly in the past few years, it remains near a historic high, with a marked increase in drinking among women, particularly binge drinking among women over the age of 25.

The way we are consuming alcohol has changed too. In 1980, 90 per cent of beer was bought and drunk in pubs, compared with just 50 per cent today. Eighty per cent of the wines and spirits consumed in the UK are also now bought in off-licences and supermarkets. “We used to drink less per capita and we used to drink in more social situations,” says Linda Bauld, professor of public health policy at Stirling University’s Institute for Social Marketing. “Now, increasingly, we are drinking at home and at high levels that are associated with cheap alcohol and products such as white ciders and supermarket brand spirits.” Drinking at home, of course, means less awareness of the number of units consumed. There has also been an increase in getting tanked up before heading out, which causes problems of its own.

Some of this may be dismissed as a social trend. Drinking has become more fashionable over the past few decades as wine and spirits have become more popular. But, experts agree, the increase in our consumption of alcohol has been driven by three main factors: its affordability, its accessibility and the aggressive advertising campaigns which have promoted drinking alcohol as an intrinsic part of everyday life.

According to Bauld, alcohol is 60 per cent more affordable today than it was in the 1980s, even though we are in the middle of an economic downturn. Tied in with that is the loosening of licensing laws which has led to cheap alcohol being sold in supermarkets from 10am-10pm. Much of the own-brand vodka sold there costs less than 50p per unit of alcohol.

And then, of course, there is the power of alcohol marketing. “When you think about the amount of money the alcohol industry has to spend on advertising and then you look at the amount of money the government has to spend on trying to make people think about their drinking, there’s a huge imbalance there,” says Emslie. “Millions of pounds are being spent on encouraging us to drink and to think it’s normal to drink at all times of day.”

Most anti-alcohol campaigners agree the Scottish Government’s policy on minimum pricing – which would see alcohol sold for no less than 50p a unit – would have an impact on Scotland’s overall consumption. In the Canadian province of Saskatchewan, a 10 per cent increase in minimum unit prices reduced consumption of beer by 10.1 per cent, spirits by 5.9 per cent and wine by 4.6 per cent. Though critics claim it would hit the poorest communities hardest, the Scottish Government insists it is targeted at a minority of very heavy drinkers. But the Scottish Whisky Association’s challenge to the policy, and a judge’s ruling that the case must be heard by the European Court of Justice in Luxembourg, means it is unlikely to be enforced for several years. So what else could the government be doing?

Last year, Bauld helped produce a strategy document for the UK called Health First. It made a series of recommendations as to as how alcohol consumption could be reduced. These included giving over a third of all alcohol labels to health warnings, restricting the sale of alcohol in shops to designated times and areas and making the tax on every drink proportionate to the volume of alcohol it contains.

It also recommended a complete ban on advertising in the long term, while, in the short term it proposed regulations similar to France’s loi Évin (named after health minister Claude Évin), introduced in 1991. This law imposed tight restrictions, with no advertising allowed on television or in cinemas, no targeting of young people and no sponsorship of cultural or sports events. Those adverts which are sanctioned must refer only to the origin or content of the product; they must not suggest a product will make you more popular or give you sex appeal.

Bauld says the argument that excessive drinking is embedded in the Scottish psyche is demonstrably false. Even if it forms part of our cultural identity today, it is a relatively modern phenomenon. Moreover she believes the promulgation of this image may be damaging, with people drinking because they believe it’s ingrained in the Scottish character. “I wouldn’t have chosen those words,” she says, of Salmond’s “nation of drunks” comment. “I think it would be better if we portrayed Scotland in a more positive light. We have been very progressive on health – the smoking ban is a great example – and we should focus on our strengths. We can be international leaders in health.”

For Emslie, too, the success of the smoking ban, introduced in 2006, holds out the hope that Scotland’s love affair with alcohol may fizzle out. Greeted with outrage and a degree of defiance when it was first mooted, it has had a dramatic effect on the health of the nation.

The legislation brought about a cultural shift which has seen the percentage of adults who smoke drop from 30.9 per cent in 1999 to 22.9 per cent in 2012, as well as a greater awareness of the danger of passive smoking. “I think we have all been surprised by how fast the culture around smoking has changed,” Emslie says. “Although our relationship with alcohol is a problem which can seem intractable, I think there’s hope that, with the right approach, we will be able to change the culture around drinking too.”

Twitter: @DaniGaravelli1