This is a monthly discussion of "issues to watch" in the field of alcohol policy.
The Erosion of Ontario's Liquor Laws
On June 1st, 2011 the erosion of alcohol controls continued in Ontario despite reasoned and research-based objection from public health agencies including the Ontario Public Health Association (OPHA) and the Registered Nurses’ Association of Ontario (RNAO).
In mid-March, OPHA was consulted on the proposed changes to Ontario’s Liquor Licence Act (LLA) which included some of the following proposals:
- Festivals and events can define an area larger than beer tents where people can walk around freely with drinks. Local communities are free to customize the events to their needs.
- Restaurant and bar servers can carry drinks on public sidewalks to licensed areas such as patios.
- Special events such as weddings or charity fundraisers can serve alcohol for an extra hour until 2 a.m.
- All-inclusive vacation packages can now be sold in Ontario.
- Business owners can give a complimentary drink to customers to celebrate a special occasion like an anniversary.
Ignoring decades of research linking increased alcohol access to increased harms, Attorney General Chris Bentley amended the LLA, now placing all Ontarians at greater risk of experiencing health problems and safety risks.
“Clear evidence links increasing the hours and days of alcohol sale with the incidence of assaults, impaired driving, alcohol-related crashes, and motor vehicle casualties,” the RNAO recently reported. Additionally, the ever-growing harms associated with second-hand drinking, including verbal abuse and neighborhood crime, are a great cause for concern.
“It’s a simple equation really,” Dr. Robert Mann of the Centre for Addiction and Mental Health pointed out at a recent alcohol policy forum in Toronto. A leading researcher in alcohol policy, Dr. Mann, explained the concept in simple terms: “If you increase accessibility of alcohol, both consumption rates and related harms will increase as well.”
At this same forum, Dr. Gerald Thomas of the Canadian Centre on Substance Abuse explained that alcohol is the 3rd largest risk factor for disease and disability in Canada, according to data released by the World Health Organization, and alcohol costs Ontarians nearly $6 billion a year in heath care, law enforcement, property damage and lost productivity.
“These changes [to the LLA] run contrary to creating vibrant, equitable and healthy communities,” reads a letter co-written by RNAO Executive Director Dr. Doris Grinspun and RNAO President David McNeil. “Focusing efforts on saving lives and reducing the harmful effects of alcohol misuse should be the priority of the Ministry rather than making drinking more accessible”.
Several regional Medical Officers of Health have voiced concerns over increasing alcohol accessibility including Dr. Charles Gardner of Simcoe-Muskoka District Health Unit.
“Population-level approaches that limit and enforce the availability of alcohol are some of the most effective ways to manage alcohol related harm,” writes Dr. Gardner in a recent letter. “The changes to the Liquor Licence Act … go against what the research tells us is in the best interest of the health and well-being of the people of Ontario …”
Event organizers don’t appear thrilled with the changes either. Gord Wauchope, organizer of Summerfest at Innisfil Beach Park, will ensure alcohol consumption is contained within designated areas only, despite the LLA changes.
“We have enough problems in the (entertainment) tent,” stated Mr. Wauchope, noting additional dangers with the LLA changes now include the greater potential of people carrying beer onto busy roads or sections of his Beach Park where kids are present.
“We don’t want beer ending up in the hands of minors, either,” Wauchope confirmed. “I think the police in Toronto will have their hands full. They can keep it in the city. We don’t need it up here.”
The RNAO have recently called the province to defer all proposed changes to the LLA until a formal review of the health and economic impact of alcohol in Ontario is examined, and thereafter, the development of a needed provincial alcohol strategy to guide future decision-making.
New Alcohol Resolutions Being Considered by alPHa
The Association of Local Public Health Agencies (alPHa) will be considering two new alcohol-related resolutions at the annual general meeting in June 2011. These resolutions have been put forth by Dr. Graham Pollet, Medical Officer of Health on behalf of the Middlesex London Board of Health. The resolutions call on the Province to:
- Conduct a formal review and impact analysis of the health and economic effects of alcohol in Ontario and thereafter develop a provincial Alcohol Strategy (A11-1)
- Maintain the Current Liquor Licence Act (LLA) of Ontario (A11-2)
These resolutions build upon the alcohol-related resolutions that were passed at the 2008 Annual Meeting, which called for stronger policies on alcohol advertising, public education on its negative impacts, maintaining restrictions on its availability, and reducing legal BAC limits. These can be viewed at www.alphaweb.org/substanceuse.asp
“Boards of Health play a key role in a comprehensive approach (prevention, harm reduction, treatment, criminal justice, and advocating for healthy public policy) to reduce risk of injuries and chronic disease related to alcohol,” Dr. Pollett states in the 2011 proposed alcohol-related resolutions. “The research community has consistently found that increased availability and access to alcohol is associated with increases in consumption and alcohol-related harms. Furthermore, researchers have agreed that regulating the physical availability of alcohol, including restrictions on sales, is one of the top alcohol policy practices in reducing harm”
“alPHa Resolutions reflect the various obligations of all Ontario Boards of Health under the Ontario Public Health Standards, which include addressing substance misuse,” states Gord Fleming, Manager of Public Health Issues at alPHa. “After a resolution is passed by the general membership, alPHa’s Board of Directors develops strategies to advocate for the public policy improvements that we believe are required for our members to meet those obligations,” Fleming confirmed.
Alcohol and Community-Based Violence
A report by the Alcohol Policy Network has recently been published in the McMaster University Medical Journal. Alcohol and Community-Based Violence: A Review of Evidence and Control Policies outlines six parameters which were found to connect alcohol consumption and community-based violence. These included: alcohol outlet density, alcohol retail sale hours, price of alcohol, alcohol sales, characteristics of violent bars, and alcohol-related violent injuries in Emergency Room departments.
In research collaboration with Dr. Joel Ray of Toronto’s St. Michael’s Hospital, the article recommends eight strategies to inform public health policies intended to reduce alcohol’s contribution to community-based violence. These strategies include increasing policing and enforcement, modifying the drinking context, implementing a violence management system, and supporting provincial strategies, among other recommendations.
This research was presented at The Ontario Public Health Convention in Toronto in April 2011 and will be highlighted at the seventh annual town hall meeting Working Together for a Canada Free of Violence at the Canadian Public Health Association’s conference on June 20, 2011, hosted by Prevention of Violence Canada.