With the stated objective of improving choice and convenience for consumers, the Ontario government is proposing to substantially expand the places and times where alcohol can be purchased and consumed. Certainly, governments consider many factors when developing alcohol policy. There may be a case for alcohol expansion from the standpoint of economic development, for example. But what is lacking from official pronouncements on this topic is an acknowledgement that there is an important tradeoff here: that “choice and convenience” will undoubtedly come at the expense of public health and safety.
This may sound like an overdramatic statement. It is not. The effects of alcohol policy have been studied for decades, and there is no mystery as to what happens when alcohol availability increases. Consumption goes up, and so does a wide range of harms. As pointed out in a recent study, the previous provincial government’s expansion of beer and wine sales to grocery stores has already led to more alcohol-related hospitalizations. Alcohol is directly responsible for about 5% of all deaths in Ontario – more than 5,000 people per year. And based on the experience of other jurisdictions, we know that as alcohol availability increases (whether through more retail locations or lower prices), so does a range of acute and chronic health harms, and even violent crime. Further, people of lower socio-economic status are disproportionately affected by these kinds of policies.
A common counter-argument is that many jurisdictions, including several Canadian provinces, sell alcohol in grocery or convenience stores, with little apparent impact on public health or safety. But here too, the evidence tells a different story. In both Alberta and British Columbia, for example, privatization of alcohol sales and increases in the number of privately owned alcohol retail outlets were associated with increases in alcohol-attributable mortality. This trend has been observed time after time across the world, which is why the World Health Organization (WHO) recommends strong restrictions on alcohol availability, including reduced density of retail outlets and reduced hours of sale.
Viewed this way, the question becomes: what is more important, choice and convenience or public health and safety? We cannot have it both ways. In our view, putting people first involves a commitment to the latter.
We would recommend that Ontario consult widely with its partners, including CAMH, to create a comprehensive alcohol strategy to ensure Ontarians have the information they need to better understand the health harms of alcohol consumption.
Dr. Jürgen Rehm
Senior Scientist, Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health
Dr. Samantha Wells
Senior Director, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health