Turkey needs to act against alcohol abuse

MARCUS GRANT

As in many middle-income countries, Turkey faces growing national problems associated with the harmful use of alcohol, including underage drinking, drink driving and counterfeit alcohol. The Turkish government has sought to reduce alcohol consumption by restricting its availability and use through measures such as advertising bans, restrictions on public consumption and increasing penalties for drink driving. Some of these measures are appropriate, but the government’s strong emphasis on broadly restricting access to alcohol may have unintended consequences and be less effective than an approach that is more targeted toward harmful use, coupled with enforcement, education, and the involvement of a range of stakeholders, including alcohol producers.

Although per capita alcohol consumption in Turkey remains relatively low (and a substantial proportion of the population abstains from any alcohol consumption at all), Turkey exceeds global averages for deaths and disease attributable to alcohol. This seeming paradox can be explained by the fact that the amount of alcohol consumed per person is less important than patterns of alcohol consumption, including how much is consumed at one time and by whom.

Take the issue of drink driving. Turkey is facing a growing problem of fatal road accidents. Turkey’s rate of fatal road accidents had declined from 1998-2003 but it has been on the rise since then. In 2011, there were 2,568 road traffic fatalities in Turkey, with drink driving, reckless driving and speeding cited as the main causes. Prime Minister Recep Tayyip Erdoğan recently warned citizens not to drink alcohol before driving and has approved an action plan to reduce traffic accidents by increasing penalties for drink driving and giving law enforcement additional powers.

Turkey is doing many things right to control drink driving. Its national drink driving law establishes a legal blood alcohol concentration limit of 0.05 grams per deciliter (g/dcl), as recommended by WHO, and Turkey scores a nine out of ten by WHO when it comes to enforcement of its drink driving law. Turkey has also implemented sobriety checkpoints and random breath-testing, which have proven to be effective in reducing alcohol-related crashes.

However, while such laws and enforcement actions are necessary, they are not sufficient for controlling the problem of drink driving. The best approach is one that couples strong enforcement with measures for educating consumers and providing alternatives to drinking and driving, and also engages other important stakeholders, particularly alcohol producers, in fashioning a diverse array of effective and realistic solutions.

The world’s alcohol producers have deep experience in developing programs aimed at discouraging drinking and driving. They have supported numerous public awareness campaigns which have succeeded in changing the culture around the acceptability of drink driving as a behavior. They also have championed the adoption of designated-driver programs in many countries and also worked with governments and other organizations in developing alternative transportation programs to keep people off the road who have had too much to drink. These kinds of programs, which seek to change attitudes toward the harmful use of alcohol and provide mechanisms to break the link between excessive consumption and harmful behavior, are becoming more important in countries like Turkey where recent surveys indicate that people have more tolerant attitudes toward drinking.

Recently, the 13 major international producers of beer, wine and spirits agreed to undertake a series of actions designed to reduce harmful alcohol use. One of the commitments the producers made was to evaluate drink driving pilot programs that are currently being implemented in six countries around the world as part of the WHO 2010 Global Strategy to Reduce Harmful Use of Alcohol, and to replicate the successful strategies in other countries. Many of these pilots work by supplementing government’s enforcement activities with complementary educational and preventive programs. Finally, the producers also have committed to developing symbols on labels that discourage drink driving.

Combining multiple strategies is generally more effective because they target several determinants of behavior and seek to inoculate society from harmful behavior if and when prevention fails.

The problems that Turkey, like many rapidly developing countries, confront with drink driving and other alcohol issues such as underage drinking, can be best addressed by global and local stakeholders working together in developing and implementing evidence-based practices that are sensitive to local cultural norms and beliefs.

Marcus Grant is president of the International Center for Alcohol Policies