Recent developments in overall alcohol consumption and high risk drinking: a case for effective population level interventions in Canada
There is growing evidence of extensive damage from alcohol to chronic disease, trauma, social problems and high economic costs. In a number of countries there has been an increase in consumption and/or high risk drinking in recent years. However, it appears that in many context alcohol management is not yet of high priority. Canada has experienced several developments in recent years: a gradual increase in overall consumption, an increase in high risk drinking, more extensive marketing and promotion of alcoholic beverages, and easier access to alcohol. Survey data for Canada, and for Ontario, the most populous province, indicate that the proportion drinking 5+ per occasion has increased since the mid-1990s. Overall, alcohol-related harm has been conservatively estimated to contribute to $14 billion to social costs using 2002 Canadian data. There are a national and several provincial-level alcohol strategies designed to reducing alcohol-related problems, but they are at the proposal, not full-scale implementation, stage. In order to generate effective, efficient and decisive action and reduce overall harm, several recommendations are highlighted: an increase in alcohol pricing/taxation, a ceiling on further access via controls on outlet density and hours of sale, a rejuvenation of the control functions of liquor boards, and the resources to effectively implementation these measures.