This is a monthly discussion of "issues to watch" in the field of alcohol policy.
Campus Alcohol Policies seen to Mitigate Alcohol-Related Harms
St. Patrick's Day celebrations turned tragic when house parties extended onto the streets of London, Ontario on the March 17th, 2012 weekend. Crowds grew to an estimated 1,000 people.
On Fleming Drive, an area near Fanshawe College where many students live, the crowd swelled to as many as 1,000 people, which, mixed with alcohol, resulted in numerous charges and injuries stemming from violence and vandalism. Cars were flipped, bottles hurled, and fires were ignited. London police arrested about thirteen people, with over half of these arrests being identified as Fanshawe College students. Those arrested now face charges that include unlawful assembly, assaulting police and resisting arrest.
"It's so unfortunate that incidents like this do happen and how much it takes away from the college and the students that are doing really, really good things in our community,” President of the Fanshawe Student Union Veronica Barahona said. “It's just very disheartening."
Dr. Howard Rundle, President of Fanshawe College, was a little more direct: “This is unacceptable. It will not be tolerated. It will not be excused. And we will not have those people as students of this college.”
Many university towns face the challenge of trying to mitigate alcohol-related issues that inevitably surface among the university and college-aged populations.
Cathy Edwards is doing her part to help.
In a letter to the editor in the Kingston Whig Standard last year, Ms. Edwards, a Public Health Nurse with the Kingston, Frontenac, and Lennox & Addington Public Health Unit, argued that alcohol-related harm stemming from falls, alcohol poisoning, street parties, assaults, and drinking and driving will not go away until we collectively work towards changing the culture of drinking in our community and in our society through policies and supportive environments.
In her letter, Ms. Edwards clarified that there are several factors that increase the likelihood an individual will engage in risky alcohol use. These factors include pricing and affordability, availability and accessibility, alcohol outlet density, alcohol advertising targeting specific populations (e. g. university/ college students), and the normalization of heavy drinking.
Ms. Edwards concluded that by working together we can change the conditions that promote heavy alcohol consumption, and prevent further tragedies in communities.
Kate Humphrys is attempting to do just that.
Ms. Humphrys is the Health Promotion Coordinator at Queen’s University. Under the leadership of Vice-Provost and Dean of Student Affairs Ann Tierney, Kate is part of the Queen’s Alcohol Working Group, a group of staff, students and faculty members who are currently looking to enhance responsible alcohol use on campus through a review of campus alcohol policies programs and services.
The mandate of this group is:
- To establish an inventory of policies, programs, services and informational resources available to students at Queen’s
- To review current alcohol-related policies, programs, services and relevant information available to students to ensure these reflect the best practices in mental health, are of high quality and are appropriate to students in the Queen’s environment
- To recommend enhancements to existing programs and services or the creation of new programs and services where need arises or best practice suggests
- To develop an outline of future initiatives related to the promotion of responsible alcohol use on campus
- To oversee implementation of responsible alcohol use initiatives on campus
“Queen's University is dedicated to supporting student health, safety and success,” notes Ms. Humphrys. “The misuse of alcohol creates risks, threatens individual health, compromises the educational environment, and undermines our community. Our policy work reflects the institution's commitment to education, prevention and enforcement activities that support our community in making safe and responsible decisions related to alcohol use.”
Back at Fanshawe College, school administrators are able to impose academic penalties on students whose off-campus actions might affect the health and safety of others in the college community, under the school's Student Code of Conduct. Since the incident, eight students have been issued interim suspensions. Moreover, school administrators are conducting their own investigation alongside police efforts to learn more about the preventable violence which ensued.
Additional action is being pursued by the mayor’s office.
"The police presence, which was there on Saturday in pretty significant numbers, has to be embedded in that community," Joe Fontana, mayor of London said after the weekend riots. "We will be talking with the owners of these homes that rent to these students that want to be irresponsible. And we will be looking at zoning and curfew laws. We will be looking at all of these things to ensure that this thing doesn't happen again.
Reflections on Alcohol Policy in Ontario
Since 1995, the Alcohol Policy Network (APN) has been hosted by the Ontario Public Health Association (OPHA) where it has built a reputation as a support for a province-wide network of individuals and organizations dedicated to the promotion of healthy public alcohol policy. As announced earlier this year, APN is transitioning to Public Health Ontario (PHO) in April, 2012.
PHO will deliver APN services as part of its capacity building services within the Health Promotion, Chronic Disease and Injury Prevention department, ensuring public health practitioners benefit from increased access to PHO’s scientists, content experts, applied research and capacity for program evaluation, planning and knowledge exchange.
With this exciting announcement and upcoming transition, it is perhaps appropriate to look back over the past several years of the Alcohol Policy Network and the broader field of alcohol policy.
These years have been nothing less than dynamic.
We have seen impaired driving laws strengthened, the true costs of alcohol use examined, the release of National Low-Risk Drinking Guidelines, and a number of MPP’s and convenience store operators looking to privatize alcohol sales.
We have discussed the appropriate role of government in alcohol sales, the promotion of alcohol to children, the link of alcohol to chronic diseases such as strokes and multiple cancers, and the importance of a guiding strategy such as the proposed National Alcohol Strategy spearheaded by the Canadian Centre on Substance Abuse. We have seen a global alcohol strategy endorsed by the World Health Organization in 2010. We have seen several provinces enact alcohol strategies including Alberta and Nova Scotia, along with different provincial approaches to alcohol proposed through position papers by British Columbia, the Centre for Addiction and Mental Health, the Ontario Public Health Association, the Canadian Public Health Association, and others.
And given the immense burden alcohol has on Ontarians, we may have asked why a provincial alcohol strategy is not currently being developed for our own province.
Over the past several years, we have researched, discussed, and debated the risks associated with alcohol, the harms associated with alcohol, the effects of “second-hand drinking” on families and communities, and the benefits of alcohol. We have learned how research can influence policy, how advocacy can advance policy, and how front line workers are desperately needed to push policy locally.
The harms associated with alcohol are well documented. The World Health Organization has indicated that alcohol is the world’s third largest risk factor for disease burden and globally, the harmful use of alcohol results in approximately 2.5 million deaths each year. Alcohol is associated with increased levels of health and social costs and is causally related to over 65 medical conditions. Provincially, data shows that a significant portion of the population drink alcohol (~82%), exceed low risk drinking guidelines (~23%), binge drink (~11%) and report hazardous or harmful drinking practices (~16%).
We also know alcohol costs Ontario a lot of money … More so than it brings in. There is a profit each year from alcohol of about $1.9-2.0 billion in Ontario. At the same time however, there is a deficit of about $2.4 billion in direct hospital, lost productivity and enforcement costs. This results in a net loss to the Government of Ontario of approximately $450 million each year, and still does not include costs associated with hidden harms such as family violence, financial problems, stress, and others that often go unreported.
Over the years, we have learned challenges, pitfalls, and successes from the tobacco field, and as a result, may have asked:
- “Is this the same route for alcohol?”
- “Can we work locally to apply pressure provincially?”
- “Can we enact comprehensive, evidence-informed regional alcohol strategies to begin this process?”
We have learned that despite the prevalent harms associated with alcohol use and misuse, there are a number of evidence-based interventions that can reduce this harm.
Arguably, the leading publication on alcohol policy is the 2010 book Alcohol: No Ordinary Commodity: Research and Public Policy, 2nd edition, by Dr. Thomas Babor and colleagues. This research proposes several effective policy domains that need to be incorporated within any approach or intervention with the objective to mitigate alcohol-related harms:
- Pricing and taxation
- Regulating the physical availability of alcohol
- Modifying the drinking context and associated environments
- Drinking-driving prevention and countermeasures
- Regulating and restricting alcohol marketing
- Education and persuasion strategies; and
- Treatment and early intervention services
Considering these, and applying them to a provincial perspective, several immediate recommendations have been put forth over the past several years from those in the field. These include the following:
The province of Ontario needs to establish a strategy specific to alcohol: Based on the high financial, health, and social costs associated with alcohol, the province of Ontario should consider creating, implementing, supporting, and evaluating an alcohol strategy with a strong health mandate.
Work can be done locally to build momemtum towards an alcohol strategy: Initiatives include developing regional alcohol management strategies, creating and/or updating municipal alcohol policies, pressing for strong regualtory controls on alcohol, actively supporting alcohol-related health resolutions, and implementing proven interventions such as the Safer Bars program and Road Safety initiatives.
Prevention of alcohol controls from further erosion needs to occur: Medical Officers of Health may be better and strategically utilized as community champions to the provincial Medical Officer of Health, Members of Provincial Parliament, and other influential community members to ensure alcohol controls are maintained.
A formal alcohol-specific organizing body needs to exist: A formal well-resourced provincial alcohol-specific organizing body needs to exist to coordinate, mobilize, advocate, and respond to alcohol policy issues, specifically from a Public Health perspective.
Perhaps, however, what we have learned most of all over the past number of years is that alcohol is never boring. It is usually controversial with deep opinions made on either side. In Ontario, it has been made clear that we have a population-level problem with alcohol. Alcohol has been given a role in our society, but how prominent that role should be, has, and needs to continue to be argued.
The health and safety of Ontarians may depend on it.