FROM THE EDITOR

Alcohol harms - the next challenge

This first issue of the SAMJ for 2018 once again raises the problems with alcohol use and misuse in South Africa (SA). An article^[1] reports on information from the National Income Dynamics Study, which took place from 2014 to 2015. Interestingly, it appears that only about 30% of the population in the study drank alcohol - more men than women by quite a long way, 47.7% of men compared with 20.2% of women. However, binge drinking was reported by 48.2% of men who were drinkers, and 32.4% of women. In this study, binge drinking was defined as reported consumption of more than five standard drinks on an average drinking day. This means that in SA, one in three people drink alcohol, and one in seven report binge drinking.

The levels of so-called 'safe' alcohol consumption are highly contentious, evidenced by the frequent changes to recommended numbers of standard drinks in countries such as the UK, which is also trying to introduce minimum alcohol pricing levels. In resource-rich countries, the main harms of alcohol are seen in rising levels of alcohol-related diseases. I am not going to comment on the clinical side of alcohol harms. However, any one of us who has been in clinical practice, particularly in our provincial hospitals, will have seen the social harms of alcohol misuse in our country. I would be willing to bet that those of you who regularly work in emergency units find that a large percentage of your cases are trauma and injury due to alcohol misuse. I am writing this as we approach the holiday season, when traffic becomes even worse than usual as large numbers of people return to the rural areas or drive to holiday destinations. And every year the dashboard of holiday driving-related deaths and injuries is completely unacceptable - much of it related to alcohol.

As I write we are entering the 16 Days of Activism for No Violence Against Women and Children - which should, of course, not be just for 16 days of the year. Again, alcohol misuse plays a large role in this violence.

As a country, we have done extremely well in stopping advertising for tobacco products, banning smoking in public places and generally reducing the numbers of people smoking. Perhaps it is time to start taking a similar stand against alcohol - another dangerous drug when misused. Anyone who knows me well enough will know that I enjoy a glass or two, so I am no teetotaller with an anti-alcohol agenda. But we need consistency. If we are going to ban advertising and sponsorship by tobacco companies, alcohol should be subject to the same scrutiny. The adverts for alcohol on television, in cinemas and on billboards, like those we used to see for tobacco, equate drinking alcohol with financial and social success - ironical in the face of the effect the substance has on many of those who drink it.

Bridget Farham

Editor

ugqirha@iafrica.com

References

1. Vellios NG, van Walbeek CP. Self-reported alcohol use and binge drinking in South Africa: Evidence from the National Income Dynamics Study, 2014 - 2015. S Afr Med J 2018;108(1):33-39. https://doi.org/10.7196/SAMJ.2018.v108i1.12615        [ Links ]