Alcohol consumption has been increasing across Sri Lanka in unbelievable levels. According to statistics, our per capita alcohol consumption in 2005 was 2.2 litres per annum. It increased to 3.7 in 2010, and by the end of 2015 it reached 4.5. Arithmetically, 204% in 10 years!
The Excise Department reports state that ethanol imports for the manufacture of hard liquor has doubled from 10.4 million litres in 2013 to 20.4 million litres in 2015. The high levels were maintained in 2016 when 18.4 million litres were imported. These are figures for legal imports only.
The excise revenue from liquor production in 2012 was Rs. 60,678 Mn and by 2016 it increased to Rs.120,792 Mn.
The Excise Department website does not present the situation for 2017. However, according to the World Health Organisation our per capita consumption of liquor is quite high when compared with Europe where the average is 0.5 litres.
What do these figures tell us? Before, we answer this question, we need to take a look at the other side of the coin – production of illicit alcohol. In this regard, there are two different views.
The Expert Committee on Tobacco, Alcohol, and Illicit drugs of the Sri Lanka Medical Association (SLMA) says, illicit alcohol production has reduced significantly during the last several years.
The Committee maintains that illicit alcohol is used by less than 10% of alcohol users, often giving a figure between 2.5%-6%.
Some professionals do not agree with these figures. A senior lecturer at the Colombo University’s Economics Department who carried out independent research on the illicit alcohol market in the country said, 49 per cent of the total quantity of alcohol in the market was illicit.
Perhaps, we need a fresh study on this important aspect.
However, it is generally agreed that alcohol consumption is a significant contributor to the burden of disease in Sri Lanka and is a major public health concern.The social and economic changes in the country are paralleled by a steady increase in the production and use of alcohol. Nevertheless, a proportion of the alcohol produced in Sri Lanka is illicit and is a cottage industry outside governmental control.
The low-cost illicit alcohol makes it an attractive option for the poor sections. The lack of regulation and quality control leads to mortality due to methanol poisoning, in addition to physical morbidity.
The pattern of consumption in Sri Lanka has changed from occasional and ritualistic use to social drinking and has become a leisure activity. Years ago, drinking was portrayed as a consequence of poverty, but now it is also associated with relative affluence.
Injuries, suicides and many chronic diseases result from harmful use of alcohol. It also contributes to road traffic injuries and fatalities, occupational problems, domestic violence, marital and social issues, including financial debt. Harmful use results in loss of productivity, income and trained manpower.
On the other hand, the production and sale of alcohol results in substantial taxes and is a major source of revenue for the Government. The industry also provides jobs and large amounts of non-taxed income.
Many election campaigns of political parties often include promises to restrict access to alcohol, a vote-winner among women. However, no government so far has implemented these promises as a complete (or partial) ban due to its impact on revenue. High taxation and the high cost of alcohol result in increasing moonshine markets with their lack of regulation, poor quality and dangers of methanol poisoning, in addition to loss of revenue to the Exchequer.
The organised alcohol industry has its own sophisticated promotion campaigns which project successful lifestyles and aim at recruiting untapped segments of society.
While the alcohol industry is a legitimate operation, the availability of alcohol with minimal checks results in significant health consequences to individuals at risk. The media and mass education campaigns, with their limited budgets, are no match for industry-sponsored advertising and promotion.
There are many laws in statute books related to alcohol. However, many regulations, including those related to drink-driving are observed more in the breach. The strict enforcement of drink-driving laws in Western countries is a main reason for responsible drinking and for responsible driving, and thus it argues the need for similar implementation in Sri Lanka.
While psychiatric treatment and rehabilitation do help individuals to quit the habit, the delay in referral often results in them seeking help at end-stages, when family, social and financial supports are low, and the motivation to quit is limited. Early identification of the problem, e.g. drinking at workplaces, would pay greater dividends in breaking the cycle of poor habits.
We do not have a systematic study done on the expenditure related to alcohol, employing conservative costs, to prove the theory that more money is spent every year to manage the direct and indirect consequences of alcohol use (including health care costs, absenteeism, loss of productivity, premature deaths, loss of trained manpower) than that gained in terms of taxes from the sale of alcohol.
While revenue from alcohol appears to help in social and economic development in the short term, it clearly results in huge costs in the medium and long-term.
To view alcohol-related problems as a personal issue is to fail to understand the complex dynamics related to alcohol policies and their impact on individual health. While holding individuals responsible for their lifestyle choices is crucial, the Government cannot abdicate its responsibility and fail to use public health approaches, which have a greater impact on the use and consequences of excess alcohol consumption.
The enforcement of laws related to alcohol should include a broad range of policies including those related to licence, taxation, restrictions on availability and purchasing, education and media information campaigns, advertising and sponsorship, laws on drink driving and alcohol-related offences and those related to treatment and rehabilitation. The current ad-hoc planning should change to one with long-term inter-sectoral perspectives and policies.