Associate Feature: Time to be bold

Go into an Irish supermarket and an arresting sight awaits. At the entrance to alcohol aisles, waist-height barriers now stand in the way. 

This separation of wine, beer and spirits from food and other groceries is now mandatory in Ireland, part of a package of government measures brought in two years ago to reduce harm from alcohol. Backed by evidence, it’s designed to make booze products less visible to children and deter people from buying alcohol with their weekly shop. Estonia and South Australia have similar measures in place.

Rather like concealing cigarettes behind blank shelf covers, it sends a signal: that alcohol can cause harm. 

This ground-breaking initiative shows the bold action some countries are taking to reduce the deaths and ill-health that result from consuming health-harming products. 

Other initiatives include New Zealand’s bold plan to slash nicotine levels in cigarettes and ban the sale of cigarettes to a whole new generation.

Scotland has long been at the vanguard of countries pushing forward the boundaries of public health policy, but campaigners are getting worried. While other nations forge confidently ahead, they fear that Scotland is faltering.

Promised action to tackle the consumption of health-harming products is proving to be long in coming.

Progress in driving down hazardous drinking has stalled and obesity rates are rising. The decline in smoking has slowed and Scotland’s smokefree by 2034 target is set to be missed.

NCD Alliance Scotland is a group of 20 leading health organisations including BHF Scotland, ASH Scotland, Alcohol Focus Scotland, Diabetes Scotland and the Stroke Association. It is pushing the Scottish Government hard to do more and act faster to drive down deaths and ill health caused by non-communicable diseases (NCDs) like heart disease, cancer, stroke, chronic lung disease and diabetes. 

Together, these diseases caused 53,000 deaths in Scotland in 2021.

David McColgan, chair of NCD Alliance Scotland, says: “One in five of these deaths are preventable, but it will take political will to prevent them.

“The Scottish Government likes to think of itself as a global leader on public health, but the reality is that increasingly, they are playing catch-up on a lot of these things.

“Nicola Sturgeon recently announced a bill restricting price promotions of unhealthy food and drink, something we’ve long been calling for. We are pleased about that.

“Ministers have also committed to consult and legislate on the marketing of alcohol. Big tick there too, though we still await the detail.

“But yet again, we are left frustrated by the government’s lack of urgency when it comes to tackling the wider issues driving death and ill health from Scotland’s biggest killers.
“We recently launched eight calls – measures to reduce deaths caused by tobacco, alcohol and unhealthy food and drink. 

“If ministers act quickly to implement all these policies, then Scotland will truly lead the world once again in the fight against heart disease, cancer, stroke and diabetes.”

The eight calls by NCD Alliance Scotland include limiting the advertising of high fat, salt and sugar products, vaping and alcohol; separating alcohol from other products in convenience stores and supermarkets; and automatic uprating of the minimum unit price of alcohol.
A poll by YouGov for NCD Alliance Scotland shows that 67 per cent of people in Scotland believe the Scottish Government should be doing more to improve public health.

Ill health and disability caused by tobacco, alcohol, and overweight and obesity, is estimated to cost the Scottish economy between £5.6bn and £9.3bn, and the NHS £1.6bn, every year.
John Watson, Scotland director for the Stroke Association, says: “Prevention is better than cure, we all know that. 

“In the current context of a ‘severe cost crisis’ a robust prevention approach can also reduce the strain on our health and social care systems. 

“With these proposals we are setting out what a robust prevention approach looks like. Taking action now to restrict the promotion of unhealthy products, and create a more supportive environment for people wanting to take control of their own health, helps achieve maximum benefit from the resources we do have available.”

Diabetes Scotland says that it’s “vital” the Scottish Government take action to turn the tide on rising rates of obesity and type 2 diabetes. 

More than 317,000 people are living with diabetes in Scotland and the charity estimates that a further half a million are at risk of developing it. The poorest in society are more than twice as likely to develop diabetes than the richest.

The charity says: “Ultimately, the amount of money that someone has in their pocket dictates what they can buy – and often the cost-effective choice is not the healthy choice.”

As well as being less able to afford healthy food, people living in deprived areas have less access to healthy food and are targeted by a greater number of unhealthy food advertisements.

“Around 10,000 people are dying every year in Scotland, needlessly, from preventable causes,” says McColgan.

“We cannot continue to tolerate this miserable statistic. 

“The smoking ban in public places and minimum unit pricing for alcohol earned Scotland a reputation for being innovative, but it’s obvious that much more is needed.

“We should now be taking bold action on the promotion, display, advertising and marketing of health-harming products.

“Scotland does best on public health when it leads from the front.”

This article is sponsored by the British Health Foundation Scotland.