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What’s the problem with an “Out-of-Control” drinking campaign?

There has been controversy surrounding an anti-binge drinking campaign which, while having an independent Board, is funded by drinks industry giant Diageo.

NO ONE DOUBTS that Ireland has a drinking problem. Alcohol kills one thousand Irish people per year — that’s more people who have died during the lifetime of this government due to alcohol than the entire death toll of the Troubles.

Beyond deaths, alcohol has negatively impacted on hundreds of thousands of Irish families (including mine) and the HSE estimates the cost to society of €3.7 billion per year, including over one billion euros in additional healthcare costs, one billion euros in the cost of crime and over half a billion euros in road collisions.

At the same time, most Irish people (including me) enjoy having a drink in their local such that, even with these costs to society, few would argue that alcohol should be prohibited. Instead, our public health policy is focused on trying to reduce binge drinking. We try to do this through public education, taxation, restricting availability, and limiting exposure of our citizens (particularly those below the legal drinking age) to industry marketing.

A controversial new campaign 

Over the past few months, there has been controversy surrounding the Stop “Out-of-control” drinking campaign which, while having an independent Board, is funded by drinks industry giant Diageo and uses controversial lobby group Goddard Global in the UK as its secretariat.

There is certainly an argument to be made that the HSE have not delivered results from their public health education efforts and that a well-funded campaign run by people with integrity as well as campaigning experience and expertise may deliver better outcomes.

As for the industry involvement, the arguments are that the Board is completely independent and that you need industry involved in these debates to force them to commit publicly to changes and call out their hypocrisy if they later fail to live up to these commitments.

So what’s the problem with this campaign? I believe there are two inherent problems: 1) The track record of the drinks industry in public health efforts and 2) The €850 million impact on the drinks sector of any major public health success.

1. The track record of drinks industry in public health efforts

The drinks industry has a history of engaging with and frustrating public health efforts — examples of this include watering down recommendations (see the minority report by the drinks industry on the National Substance Misuse Strategy), slowing progress through legal action (Diageo is currently involved in a legal campaign against the Scottish government for bringing in pricing legislation similar to that currently being debated in Ireland), and promising self-regulation to avoid stricter legislation (the Irish government abandoned alcohol marketing legislation in 2003 after intense lobbying by the drinks industry).

2. The €850M impact on the drinks sector of any major public health success

About 38% of Ireland’s alcohol consumption is deemed by the HSE to be binge drinking (a third, fourth, fifth or more pint in a single sitting). The real number is likely to be higher as the study this analysis is based on found that survey participants are likely to have estimated their drinking habits at only 39% of the actual figures.

In a recent interview, a senior Diageo manager described this definition of binge drinking as “potentially unhelpful” in favour of the campaign’s ill-defined term of “out-of-control” drinking.

What would happen to the drinks sector if consumption was reduced by 38% along with the HSE’s definition? My best outside-in estimates are that the sector would lose €850 milllion in profits per year, becoming loss-making. (Full analysis, sources and assumptions here)

Screen Shot 2015-04-03 at 18.35.34

When we weigh up these concerns, it is unsurprising that people who have been involved in public health for decades, frequently having their efforts frustrated by the industry, are not flocking to support the campaign.

Instead of the Stop Out-of-control Drinking Board members asking public health campaigners to hold judgement and get involved, I would humbly suggest that they shut down this campaign and invest their integrity, expertise and time in getting behind the efforts of the state and independent civil society efforts using evidence-based measures.

Niall Ó Tuathail is a Director at Mobile Clipboard, a Galway-based healthcare software design firm, following work at McKinsey & Company, where he specialised in health, non-profits and infrastructure.

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42 Comments
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    Mute Ken Donegan
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    Apr 3rd 2015, 7:09 PM

    I love how the tar everyone in Ireland saying they have a drinking problem I don’t have a drink problem , my wife doesn’t have a drink problem I understand some people in Ireland have a problem but stop saying everyone in Ireland has its sickening

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    Mute Philip King
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    Apr 3rd 2015, 7:20 PM

    The problem is most irish people can’t go out for a drink. They have to go out and get drunk.
    Not a drinker myself and the looks you get when you get a soft drink on a night out. And yes the irish have a terrible reputation for drink. It’s not a fun yeah! Sure were irish reputation it’s actually pretty bad. Foreign folk are always shocked when I say I don’t drink.

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    Mute emeraldninja
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    Apr 3rd 2015, 9:37 PM

    Most people don’t have a problem with the campaign per se, just parties championing the involvement of Diageo.. trying to talk out of both sides of their proverbial mouth.

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    Mute Mark O'Hagan
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    Apr 3rd 2015, 9:42 PM

    All you need to do is to look at the amount of moaning all over the media today about the pubs being closed to decide if we have a problem with drink or not.

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    Mute emeraldninja
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    Apr 3rd 2015, 9:42 PM

    There’s a bit of over exaggeration also with the stereotype.. a great many Irish people do not have a drink problem. Many more have zero interest in it at all. This kinda lump everyone in together lark. Gets a bit tiresome.

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    Mute Niall Ó Tuathail
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    Apr 13th 2015, 2:26 PM

    Hi Ken,

    Sorry for the misunderstanding. I didn’t mean that everyone in Ireland has a drinking problem but that we do as a society. Even if we didn’t, I wouldn’t propose that the drinks industry have a leading role in our public health policy.

    Best wishes,
    Niall

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    Mute Top Cat
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    Apr 3rd 2015, 7:14 PM

    Sure thejournal have been campaigning for more drinking all day!!

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    Mute Jen Gordon
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    Apr 3rd 2015, 7:19 PM

    How many articles on alcohol today can you fit in ? Diageo has already stepped down from the board and has left substantial funding for the board to use as they see fit. When do people take responsibility for their actions ?

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    Mute Ireland Unlocked
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    Apr 3rd 2015, 9:05 PM

    This isn’t a question of individual consumer responsibility though it’s clear from ‘initiatives’ like Drinkaware.ie that the drinks industry would love us all to continue thinking that and Diageo Role Models continues the blame game.

    From a very early age we have a massive volume of advertising and sponsorship blasted at us daily telling us how to drink (as much as we can without causing socially visible problems) and when we drink (meeting with friends, watching sports etc). On top of that we have older generations who have been exposed to the same messages and our own peers reinforcing these messages to the point where over-consumption is normalised and folk think that drinking 3+ pints in one sitting multiple times per week is OK for their long term health.

    Where are the calls from Diageo Role Models for increased industry responsibility? Where are the calls to support the evidence based legislative changes in the Public Health (Alcohol) Bill 2015 that are the foundation of any change in culture we have already achieved such as the changes around seat belts, smoking in the workplace and random breath testing, all of which saved hundreds if not thousands of lives.

    As for the board of this campaign, whatever you think about their judgement participating in a project that was conceived and set up by Diageo, is funded by them and up until recently, had the Diageo Country Manager as a board member, what qualifications do they bring to really impacting on this problem? Not one public health expert on an opaque board with no legal standing or transparency tells the true purpose of this campaign – smokescreen.
    The board members could have handed over the cash to an independent body like Alcohol Action Ireland and lent their expertise and support to them rather than Diageo.

    As for how the money was spent, 12k signups for a €1m investment seems like a pretty low return – even looking at it kindly it would not be unreasonable to estimate an individual sign up cost of €40 – 50; what a waste of cash just to try to fake some kind of grass roots, industry friendly movement against ‘out of control’ drinking – a term even Diageo themselves, the creators of the campaign, can’t seem to define.

    Some of the cash is going to DCU to do ‘research’ for the design of an ‘action plan’. But, we already have had 15+ reports and 11+ committees in the last few decades culminating in the publication of the Strategy for Substance Misuse published in 2012 referred to above. This campaign is clearly designed to distract public attention away from the passage of those measures through the parliament, where the industry is doing all it can to weaken and undermine them.

    You can learn more about this at http://irishdrinklink.com & http://twitter.com/irelandunlocked

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    Mute phil
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    Apr 3rd 2015, 7:22 PM

    The definition of binge drinking is too conservative. 3 or more pints is is considered binge drinking that’s not very much at all.

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    Mute Ireland Unlocked
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    Apr 3rd 2015, 9:20 PM

    It’s funny how we seem so skeptical or even disbelieving when medical professionals recommends levels for safe alcohol consumption but we barely if at all question when they advise us on safe levels of exposure to UV light on tanning beds or daily salt intake etc. Instead we seem happy to trust the vested interests of industry when they make ambiguous and essentially meaningless suggestions like ‘enjoy sensibly’, ‘drink responsibly’ or ‘know the one that’s one too many’. What incentivises the medical profession to set the bar ‘so low’ ? Maybe it’s the all the independent evidence based studies looking at the relationship between consumption levels and alcohol harm across hundreds of different populations.

    Over-consumption has been normalised, that’s the problem.

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    Mute Niall Ó Tuathail
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    Apr 13th 2015, 2:31 PM

    Hi Phil,

    You might well be right but I wouldn’t propose that the drinks industry should define what is and isn’t binge drinking as they have a serious incentive to it be defined very high (or not defined at all). The HSE have a fairly broad definition of binge drinking where 3 or more pints is where there is a higher likelihood of accidents, injury and violence. That seems reasonable enough to me.

    All the best,
    Niall

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    Mute Drew
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    Apr 3rd 2015, 7:58 PM

    People don’t care about their health or their safety in these campaigns… They care about their looks and what people think of the them. It’s been proven a thousand times over with smoking and obesity.

    Thus the next anti-binge drinking campaign should picture fat alcoholic slobs who can’t get an erection getting rejected by women and women carefully spending hours doing their hair and make ending up falling down and puking all over themselves while their friends and peers look at them ashamed.

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    Mute David Cuddy
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    Apr 3rd 2015, 9:12 PM

    I think you’re on to something there, Drew

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    Mute Harold
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    Apr 3rd 2015, 9:15 PM

    You should be in advertising, if you aren’t already.

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    Mute funkytown
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    Apr 3rd 2015, 9:49 PM

    I think there was an ad on either uk or Irish TV a few years ago , but an ad like yours wouldn’t do any harm.

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    Mute Alien8
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    Apr 3rd 2015, 7:08 PM

    Simple: the large players in the drink industry make higher yields in pubs and of licence sales. Binge drinkers look for alternatives in lower cost, sub-premium price brands which hits they bottom lines. The effort is to push 4 pints of Budweiser on a night out instead of the cheaper pre drink 24 cans of Dutch gold. It is selfish, thinks nothing of the health of either drinker, and, like MEAS, usually has the funds to “work” with politicians and unethical health physicians to give the impression of doing good.

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    Mute F.man
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    Apr 3rd 2015, 7:53 PM

    “NO ONE DOUBTS that Ireland has a drinking problem. ”

    How did the author arrive at this definitive statement? Has he spoken to everyone in the country or world for that matter?

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    Mute Niall Ó Tuathail
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    Apr 13th 2015, 2:33 PM

    Hi F.man,

    That’s a fair cop – there probably are some people who doubt this. Not too many though.

    All the best,
    Niall

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    Mute The Todd
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    Apr 3rd 2015, 7:15 PM

    The amount of drink related articles today has driven me to the pub. Only to be met by a locked door…

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    Mute Bill Jones
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    Apr 3rd 2015, 7:16 PM

    I have a drinking problem, problem is I can’t buy any today! Amiright?

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    Mute Thomas Maher
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    Apr 3rd 2015, 7:54 PM

    The vast vast majority of people on Ireland do not have a drink problem.

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    Mute Ben Gunn
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    Apr 3rd 2015, 8:42 PM

    Perhaps, but the vast majority have a problem with drink,if not directly then indirectly in the taxes you pay to treat the results of the accidents, violence and illnesses caused by excessive drinking.

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    Mute Harold
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    Apr 3rd 2015, 9:17 PM

    the latest stats I heard have 1.6M people in Ireland drinking too much. With 1M under 18, out of a drinking population of 3.6M, that’s almost half…maybe not a majority, but a massive problem.

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    Mute Ireland Unlocked
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    Apr 3rd 2015, 9:25 PM

    We all share the common problem of having to pay alcohol harm costs of almost €4bn per year – around €1.3bn alone in the health service – that’s a lot of cash that could surely be better used.

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    Mute F.man
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    Apr 3rd 2015, 9:34 PM

    Who decided they drink “too much” Harold?

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    Mute Thomas Maher
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    Apr 3rd 2015, 10:48 PM

    No they don’t, again the vast vast majority of drinking age people do not have a problem with drink nor does it cause them any problems

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    Mute William Byrne
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    Apr 3rd 2015, 7:16 PM

    I have a drink problem …. its good friday and I could murder a pint

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    Mute Seamus Brady
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    Apr 3rd 2015, 8:02 PM

    More HSE estimates they must be accurate. I’m getting stressed about this I think I’ll have a drink

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    Mute Myles Fleming
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    Apr 3rd 2015, 11:30 PM

    I’ll take the slack for this one but Irish people for the most part are completely boring without the social lubricant. Our climate is akin to that it Vancouver or Wellington. Are we the great out doorsey nation like our counter parts. Hardly. Ive lived in some of the hottest places in the world and now now one of the coldest. Northern Alberta. People are out year round enjoying each others company in the elements “actively”. Our climate and landscape are the envy of most nations. Never too warm nor cold and a treasure of places to go to. Collectively we are social people but its time to ease off on our crutch and enjoy what’s so readily available…

    11
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    Mute Michael Vines
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    Apr 3rd 2015, 9:26 PM

    surely a lot of the people who run this country have a drink problem it,s the only job in the country that has its own in built bar and it is very well used and then they tell us that we should not be drinking to much

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    Mute barry
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    Apr 3rd 2015, 8:57 PM

    Should cars not carry a ‘health warning ‘ too? They cause deaths every year, maybe not as many as drink and cigarettes but, it’s getting there!

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    Mute Nydon
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    Apr 3rd 2015, 9:08 PM

    My car drinks the petrol.

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    Mute von
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    Apr 3rd 2015, 7:53 PM

    It’s the Irish mentality, people have to be educated and also denying drink as we do in Ireland makes it more palatable.

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    Mute Eric
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    Apr 3rd 2015, 7:09 PM

    For all the talk and political pandering, at the end of the day, it will come down to having people more.

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    Mute sinlacasa
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    Apr 3rd 2015, 7:33 PM

    I’m gonna drink 20 cans tonight because I can, as long as they allow me do anything I’m gonna do it in excess because they’ll take it away someday.

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    Mute John Stevens
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    Apr 3rd 2015, 8:56 PM

    Some people have a drink problem because they refuse to accept or deny their situation in life, they were ultimately going to become nobodies, or things didn’t work out like they planned in their own head, they refuse to deal with their false delusions.

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    Mute Tracy McCarthy
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    Apr 4th 2015, 2:22 AM

    Interesting

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    Mute Rachel Bow Browne
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    Apr 4th 2015, 3:02 PM

    Also the fact that real addiction is not being adequately dealt with or enough support offered.

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    Mute John Galvin
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    Apr 4th 2015, 9:25 AM

    Firstly, I think the discussion on alcohol in Ireland would disappear if people stuck to 4 pints or less. Following your data, this means that we are only talking about 7 percent of booze consumed in the irresponsible box.
    Secondly, if you believe, as you seem to, that low cost alcohol is a root cause of abuse, then there won’t be much value lost when the 7 percent dries up.
    People need to take responsibility for their own actions. Germany is covered with booze advertising and a beer in a local supermarket costs as little at 20 cents for a half liter. You don’t hear the Germans bleating on about how it’s everyone else’s fault alcohol is a societal issue……because it’s not- everyone takes responsibility for their own lives and alcohol abuse is a topic for a tiny minority and simply not in the national debate.

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    Mute Thomas Geoghegan
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    Apr 5th 2015, 12:25 AM

    ’4 pints or less’.

    Every day, like?

    The author makes an important point: a subtle shift in emphasis in how public health messages are made can actually be huge.

    Think about it: you may think you’re fine on 4 pints, you’ve judged yourself not ‘out of control’ so you’re not causing yourself or anyone else any hassle. Maybe you drink 4 pints per sitting 4 times a week. Then, years later, you get some bad news from a doctor – if you had heeded the evidence on alcohol consumption given by the HSE and Government, you might be in better shape. You see, everyone things at the time their drinking isn’t out of control; if you rely on yourself to determine healthy limits, often when you’re already drinking, you can get yourself in trouble.

    This is the confusion the Stop Out of Control Drinking campaign is partly designed to sow.

    This said, I don’t think the campaign is all bad.

    The author also makes the point that past public health campaigns on dangerous drinking has not led to lasting behaviour change. I’d say part of the reason is poorly designed public health communications. The fact is, people don’t like being told what to do and they just don’t listen when you say it. But say something the right way that strikes the right chord and things can begin to turn. The irony here is that when the evil profession of advertising does its job well, it can be *very* good and *very* persuasive, even when it comes to public health messaging. And The Stop Out of Control Drinking campaign certainly got people listening and talking.

    There’s a lesson there, somewhere amid the controversy.

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