The COVID-19 pandemic has revealed to us the things we see as essential: vaccines, toilet paper, and booze. When the pandemic first hit rumours spread quickly about the possible closure of liquor stores, which resulted in mass panic and long line ups. Alcohol sales through retail stores spiked during the first wave. According to the Canadian Centre on Substance Use and Addiction (CCSA), one quarter of Canadians say they are drinking more at home because of the pandemic. Their reasons are varied: a lack of a regular schedule, stress and boredom.
Now may be a good opportunity for the federal government to take legislative action in the form of a federal alcohol act to address heavy drinking. This is legislation which could enshrine a harm reduction approach to alcohol that addresses outstanding issues related to advertising and labelling, access to alcohol, the affordability of the product and more.
The consumption of alcohol in moderation in safe social spaces is not the problem. Instead, it is heavy drinking which presents the most significant risks. Heavy drinking is defined by Canada’s low risk drinking guidelines as more than 10 drinks a week for women and 15 for men. A Nova Scotia municipal alcohol report sums up the issue well: “It’s not that we drink, it’s how we drink.” And how we drink is cause for concern.
The CCSA suggests that in Canada, 38 per cent of all healthcare costs in 2014 were attributable to alcohol abuse. The rate of hospitalizations in 2017 were higher for alcohol abuse than for heart attacks. Further, studies suggest alcohol makes us more vulnerable to infectious diseases like COVID-19. In Canada, the financial costs attributable to alcohol use are higher than any other substance. Between 2015-2017, these costs amounted to roughly $16.6 billion dollars.
According to Statistics Canada, during COVID the proportion of Canadians who use cannabis has also increased, but at a much lower rate than alcohol. The use of tobacco products has also increased. But in the case of both tobacco and cannabis products, there is a legislative framework in place to address the public health concerns of these products. For example, there are warning labels on cigarette packages. There is no robust national public health approach concerning alcohol.
Alcohol policy during a pandemic
While Canada’s federal and provincial governments have yet to act, the World Health Organization (WHO) recommends tightening alcohol regulations during COVID-19 – a time when many are stressed, anxious and stretched. Policies such as increasing excise taxes, restricting access and banning advertising, promotions and sponsorships are considered effective in reducing the alcohol-attributable burden as they are cost-effective and easy to implement. As well, organizations concerned with equity and substance use like the CCSA and Homeless Hub advocate for a harm reduction approach, recognizing that abstinence may be neither realistic or desirable for some users.
However, these are not the policies we’ve seen across Canada. During the pandemic, we’ve seen a tremendous effort from alcohol regulators and governments to reduce the spread of the virus. In some provinces there has been the implementation of plexiglass placed at cash registers, changes to hours to limit trips to stores, along with the promotion of social distancing and wearing masks. Policies and practices responding to COVID have been understandably prioritized, whereas the efforts to respond to heavy drinking are non-existent. The message is clear. Governments have an interest in fostering continued economic activity, including the retail sale of alcohol.
To that end, there has been a relaxation of current alcohol policies that have created new industry possibilities. During COVID we’ve seen new regulations that allow restaurants and publicly owned alcohol retailers to deliver alcohol. This was largely not possible before the pandemic. For example, the Nova Scotia Liquor Corporation (NSLC) is hoping to implement a home delivery model akin to other private businesses. We’ve also seen health charities partnering with breweries to raise money for COVID relief funds. While warnings about the health effects of alcohol are few and far between the evidence is clear that Canadians are drinking more than ever at home.
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COVID-19 as a window of opportunity for a Federal Alcohol Act
A federal alcohol act could be modeled after the Tobacco and Vaping Products Act but modified to accommodate alcohol. The main thrust would be threefold. First, this act would address the public health problem of heavy alcohol consumption by reducing the product’s economic availability.
Second, this act would enable a harm reduction approach, which according to the Canadian Mental Health Association “is an evidence-based, client-centred approach that seeks to reduce the health and social harms associated with addiction and substance use, without necessarily requiring people who use substances from abstaining or stopping.”
Third, this act would harmonize and update the patchwork of existing federal alcohol policies to provide legal and regulatory clarity and a reinvigorated public health response. Minimum unit drink prices would be slightly increased, and a there would be a greater commitment to enhancing public knowledge around the harms of heavy drinking – in a way that respects the rights and choices of Canadians to consume alcohol safely.
The act would also include mandatory health warnings on alcohol products, an enhanced volumetric taxation structure with the price based on ethanol content, and targeted restrictions to alcohol advertising with an emphasis on preventing online advertising via social media platforms. The act would fall under the responsibility of the minister of health who is also responsible for administering health legislation and regulation related to tobacco and cannabis and providing support to the development of new Canadian alcohol policies.
The reason why these policies are not widespread may be due to pressure from the alcohol industry. For example, in 2018 the liquor industry threatened to sue the Yukon government for putting alcohol warning labels linking alcohol to cancer. The Yukon Liquor Corporation eventually backed down.
COVID has shown us the impact of a pandemic on Canadians drinking. It has also shone a spotlight on the current state of alcohol policy in Canada. There is a case for federal alcohol legislation, as recommended by countless researchers before us. As we look back on the lessons learned and the lessons learned from other drugs, we should approach alcohol with the same harm reduction approach. This is our policy window to advocate for a federal alcohol act that protects all Canadians.