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martes, 16 de julio de 2013

guardian.com, Inglaterra, 15 de Julio de 2013

Big tobacco has got its way – now let's find what big alcohol is up to

Plain packaging has been formally killed off and minimum unit pricing for alcohol sits nervously on death row for its widely trailed execution. The only winners, perhaps, big tobacco, big alcohol and big undertakers.

The power of industry lobbying in forcing these policy shifts cannot be underestimated. Labour's lead is back into double digits as people register their distaste and few believe it is a coincidence that the biggest tobacco giant of them all, Philip Morris Ltd, has said that it employs the services of the Conservative party's election coordinator Lynton Crosby's company CTF. You don't need to have a conversation about tobacco or alcohol if public health in its entirety is one of the barnacles that have been scraped off the boat.

David Cameron should delay an announcement about minimum pricing until we know whether big alcohol interests are also paying for their services.

But there is an even better case for a stay of execution; the clear evidence from Canada that minimum pricing works. Industry have relentlessly tried to undermine minimum pricing by arguing that it would make alcohol too pricey for those on low incomes and that it would penalize the poor. In fact, it wouldn't raise the price of alcohol in the pub by a penny, neither would it make alcohol expensive but it would get rid of the ultra-cheap white cider and spirits that are targeted by binge drinkers and those starting to lose control. Overstretched casualty departments and liver units do their best to pull people out of the river but it's far better to help to stop people falling in to begin with.

This has always been the role of public health but its contribution is unseen and unsexy; it's hard to count a teenager who didn't take up smoking or binge drinking and no one comes by to thank you for saving them from a lifetime of addiction.

Public health regulations are often controversial at the time but who would want to go back to the days of sitting in smoke-filled restaurants or cars without seatbelts? Do we still feel these are examples of unacceptable state nannying?

A few weeks ago I went out on patrol on a weekday afternoon with Totnes' police community support officers; at three in the afternoon they were politely escorting home an abusive drunk. Brixham's special constables tell me that alcohol-related incidents take up almost their entire workload on Friday and Saturday evenings. Almost half of violent crime is linked to alcohol and more than 700,000 children in the UK live with a dependent drinker. If the real cost of ultra-cheap alcohol was added to the price tag on the can instead of silently buried in our tax bills, there would be no argument at all about the need for action. £21bn per year is the current estimate.

Perhaps the only good thing that can now be said of the coalition's policy on public health is that they have devolved it to local government. What a shame that their ability to reduce avoidable early deaths and narrow health inequalities will be undermined by the politicians who have taken away one of the most effective tools to do their job.

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