What is alcohol policy for? With Dr Katherine Severi

In this episode, I talk to Dr Katherine Severi, Chief Executive of the Institute for Alcohol Studies (IAS), about the importance of alcohol policy. We discuss the evidence, barriers, and debates around alcohol policy and why England is still yet to introduce measures such as minimum unit pricing. We also discuss the recent IAS report on parliamentary alcohol use.

Dr. Katherine Severi is the Chief Executive of the Institute of Alcohol Studies (IAS), an independent charity dedicated to advancing evidence-based policy to reduce alcohol harm. Before joining IAS, Katherine gained valuable experience in the UK Civil Service and the charity sector. 

She holds a Doctorate in Public Health from the London School of Hygiene & Tropical Medicine and a Master’s in Global Health and Public Policy from the University of Edinburgh. Her primary research focuses on the influence of corporations and managing conflicts of interest in public health policy.

Reports and links:

Bhattacharya, A., Angus, C., Pryce, R., Holmes, J., Brennan, A., & Meier, P. S. (2018). How dependent is the alcohol industry on heavy drinking in England? Addiction, 113(12), 2225–2232. 

IAS blog: Two thirds of alcohol sales are to heavy drinkers

Under the influence? Perspectives of alcohol in the parliamentary workplace among UK MPs and staff

Transcript

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 James Morris: So Kathryn, thank you so much for joining me and, , yeah, it's great to have you on the podcast. Uh, I really wanted to do an alcohol policy focused episode. So could you just start off telling me, , a little bit about yourself and, and what you do? 
 
 

Katherine: Well, thanks James. It's a real pleasure to be here. So I'm Katherine Severi. I'm the chief executive at the Institute of Alcohol Studies. So we're a small London-based NGO, and our organizational objective is to inform policy debates with the best available evidence of what works to reduce alcohol harm. 
 
 

Now, those harms can be individual health focused, or they can be broader societal focus, such as alcohol strain on the economy, for example, through lost productivity, et cetera. So we have a relatively broad scope. 
 
 

James Morris: so I guess what I really kind of wanted to get stuck into was, you know, why is alcohol policy so important? Um, we've never really done an episode specifically on the topic, and, uh, , alcohol discussions are [00:01:00] often inevitably focused often around the sort of individual and, , you know, that's an important, uh, sort of perspective to account for. Um, but yeah, maybe in some ways, would you agree the sort of, uh, policy angle is kind of often overlooked or, or it's kind of disadvantaged in terms of at least public discussions? 
 
But yeah, why is it, why is it important to talk about policy and think about it? 
 
 

Katherine: Oh, well, it's absolutely important to think about the environments within which we live because our environments obviously shape our choices and our ability to make choices about our lives and our health. Um, so whilst individual health harms and social harms linked to alcohol is obviously an incredibly important perspective, and we never want to, um, pull down the importance of people's lived experience of harm. 
 
 

But alcohol harm is experienced across society, across communities.- There's a big ripple effect from individuals alcohol harm that does often get neglected. [00:02:00] And I think when we think about the responsibility for the environments that we live in and what shapes those environments, that's when we have to look at what, in public health terms you say, upstream interventions and the more structural drivers that create our environment. 
 
 

So for example, with regards to reducing harm from alcohol, we know that the international evidence tells us that interventions at the policy level that address the price , the availability, and the marketing of alcohol have the biggest impact. They are the most cost-effective policies at the population level, and they have the biggest bang for buck in terms of saving lives, reducing harms to individuals and others from people's drinking. 
 
 

Because we do need to remember that a bit like passive smoking, alcohol harm affects people who aren't the drinkers themselves through crime, antisocial behavior, domestic and child abuse, for example. So these kind of structural policy interventions are incredibly important. And [00:03:00] if we think about within the UK at the moment, we see that Scotland have taken a very evidence-based approach to their alcohol strategy, and they've looked at the World Health Organization recommendations, and they, they were the first UK nation to introduce something called minimum unit pricing for alcohol, which -- was a policy designed to specifically target very cheap alcohol sold in shops and supermarket that was very closely linked to lots of alcohol harm, both to individuals and communities. 
 
 

Now, this pricing intervention has been incredibly effective. After just eighteen months of being in place in Scotland, there was, uh, reported thirteen percent reduction in alcohol-specific deaths and a four percent reduction in alcohol-related hospitalizations in Scotland. So we can see that these national policies can have a really meaningful impact, not only on individuals and their families and their colleagues and friends, but also on [00:04:00] communities and the wider public finances. 
 
 

Because each avoidable death, of course, is somebody who can stay committed in society, stay working, be economically active. Each hospital admission that's avoided, that's, you know, a, a saving for the National Health Service. That means that Granny can go and get their hip replaced or, you know, little Johnny can be seen in A&E with his asthma attack. 
 
 

Um, so these are all, you know, real ripple effects that create a better society for everybody once the more population level structural policies are put in place to reduce harm and, as I said, to make the environments within which we live in more conducive to healthier and better wellbeing. 
 
 

James Morris: Yeah, absolutely. And I think, , you know, it's not just the evidence from Scotland, is it? This builds on, you know, you can go back in history and see many occasions where tax changes or legislation changes have changed the pricing, you know, the market structure or whatever, and alcohol is [00:05:00] essentially, , a price elastic good, you know, that is price sensitive to some degree. 
 
 

But I think, you know, one of the big problems with, , minimum pricing, at least as a policy that we want to see, , implemented in England, is that, you know, just the general public, I think they're kind of, um, split generally on it when, when people do surveys, aren't they? They're, you know, sort of roughly half and half people are opposed to it . But I think, you know, one of the challenges that it just, it sort of goes against the sort of intuition that, um, you know, well, pe- people often say, "Well, I'm not influenced by advertising," and, you know, well, it's not gonna stop the, you know, severely dependent drinker drinking. So there's these kind of intuitive ideas that, that we're kind of working against and obviously, uh, certain sections of the alcohol industry might use to their advantage. So yeah, I think it's, , it's sort of fascinating in a way to, understand when you look at the evidence base historically and internationally, [00:06:00] how clear-cut it is that we should have these policies in place, and yet here we are just still in England, you know, nowhere, nowhere closer to having it. 
 
 

Katherine: Absolutely. We continue to battle on despite the robust, solid evidence base from home and abroad. So it's not just the World Health Organization that recommends pricing interventions, the World Bank, the OECD, um, you know, countries from around the world that have int-implemented price hikes on cheap alcohol. 
 
 

They've all seen the same results, which is a re-reduction in harm and, uh, deaths averted. But I think that what you alluded to there in terms of the narrative around the efficacy of some of these policies is, is really picked up and promoted by industry actors and opponents to these policies because ultimately they have a conflict of interest. 
 
 

A, you know, a big multinational alcohol producer isn't gonna get behind minimum unit pricing because it will affect their sales. [00:07:00] And if I was a shareholder of that said alcohol producer, I wouldn't want them supporting something that was gonna affect my dividends. So we can see that there's, you know, there's a real vested interest here in them trying to delay, weaken, and obstruct the big policy interventions that will ultimately hit their profits. 
 
 

Um, there was some really interesting analysis done a few years ago by one of my former colleagues, Aveek Bhattacharya, and other researchers, who actually looked into what the impact would be on the UK alcohol industry's profits if everybody across the UK drank within the Chief Medical Officer's low-risk drinking guidelines, which is 14 units a week. 
 
 

And it was a pretty phenomenal reduction in their profits. I, I, I wish I knew the statistic off my head. I think it was about a 40% reduction in profits. So there's just this obvious, you know, elephant in the room as to why they're never going to get behind some of these measures that will ultimately be effective. 
 
 

James Morris: . Yeah, and yeah, we can put the, the report in the [00:08:00] show notes so people can kind of, uh, scrutinize that if they, if they want to. Um, but, but yeah, and I think that, um, talking about the sort of industry narratives as well, , again , goes back to that idea of, you know, , what sort of appeals to people and, you know, the narrative of personal responsibility, which is obviously what, many sections of the alcohol industry have deliberately pushed as a way of, , diverting attention from the importance of the structural drivers of, of alcohol harm, particularly price, availability, and marketing. And, you know, that's quite an effective, , narrative in a way because i- in some ways it's hard to disagree with the idea of personal responsibility. Like, no one would say , nobody has any degree of personal responsibility. Like, we still, you know, are responsible ultimately for, for certain choices that we make. 
 
 

But that in turn doesn't then, uh, , mean that that the environment doesn't, doesn't matter at all. And, and conversely, I sometimes say, "Well, [00:09:00] you know, would you want alcohol to be absolutely available and almost given away or whatever," ... so I guess the point I'm trying to make is, you know, it is quite difficult in some ways to really persuade people that, yeah, we're not all just kind of perfectly rational beings making, you know, optimal choices that weigh in, uh, all, all the kind of factors and information available, and that actually we are influenced by the environment, and they wouldn't spend all the money on advertising if it didn't work at all. 
 
 

Katherine: Well, precisely. And, and we need to also remember that we can't be completely rational individuals making perfect choices after we've had a few drinks inside us, because alcohol impairs cognitive function and is an addictive product. So I think that if we're just gonna be placing all of the responsibility on individuals to make their own decisions, that's-- I think that that's quite, um, a, a, a dangerous narrative to adopt because then you're blaming people for poor choices. 
 
And so what does that mean [00:10:00] about the, the socioeconomic gradient when it comes to the proportion of people who are experiencing alcohol harm? Is it poor people making poor choices because they live in poor communities? Of course it's not. Um, it's down to the environments and the exposures, , that we, uh, experience as we, as we walk through life. 
 
And if we, if we need to remember as well that alcohol is a restricted product, you know, there are laws of the land governing when and how it can be sold and, but there are also other restricted products. So if you think of it in comparison to things such as paracetamol, when I do my online shop, if I put more than two packets of paracetamol or paracetamol-containing products into my shopping basket, I get, I get an alert with some health information saying, "You're, you're restricted. 
 
You can't buy any more." Um, no such alert pops up with alcohol. And in fact, if I, um, was a regular drinker and I chose one week not to put alcohol in my shopping basket, the algorithm would pick that up and probably nudge me with some kind of special offer the next time I went to, to [00:11:00] visit. So I think that, you know, there are- Structures in place for other products and goods that are recognized as being damaging to health, and that it's not all about individual agency and individual choices as to how and when you use them. 
 
 

And I think that perhaps as a country, and this does also just not apply to the UK, I think there are many other countries experiencing similar rates of increase of harm, particularly post-pandemic, that need to have a, a relook at how available and accessible alcohol is. So for example, in the UK, a really important debate at the moment is the emergence of rapid home deliveries using apps with very little safeguards in place for people ordering high volumes of alcohol straight to their doorstep, not even having to leave their home, with no restrictions in place. 
 
 Um, these services have been cited in coroner's reports, sadly, as, um, influencing, um, deaths. And we've had many members of the [00:12:00] public speak out about their experiences with family and friends, and how many concerns there are about the lack of safeguarding. Now, these services have been able to emerge because our current alcohol availability regulations, the, the Licensing Act, are all designed around drinking in pubs. 
 
 

They're designed for counter service. They're not designed for where the majority of alcohol is now bought and consumed, which is behind closed doors at home. So whilst in the UK we used to be a nation of pub-goers, now more than three-quarters of all alcohol sold is from a shop or a supermarket or an off license and consumed at home. 
 
 

But the regulations haven't caught up with that change in drinking practices. And this is where alcohol policy is so important because we need decision-makers to improve and update the regulations to ensure that there are appropriate guardrails in place to prevent harms 
 
 

James Morris: Yeah. No, I think there's, [00:13:00] there's several really nice examples there, , I think of how, you know, any, potentially harmful drug, gonna be some kind of balance of regulation and, you know, on one end, you've got , complete prohibition. Uh, and you know, you might argue that, that has costs to it, whether that's driving underground markets and, and kind of criminal activity. And then on the other end, you've got kind of over-liberalization and, you know, heavy marketing and widespread availability and, um, yeah. So I think, you know, alcohol is obviously on that end of the spectrum and, you know, I, 
 
 

I don't think either of us are prohibitionists. We don't wanna say alcohol should not be available at all. That's you know, somewhat unrealistic. But I think we'd probably agree that it's, there's, there's this kind of balance of regulation that you could apply to any drug and sort of, you know, there's a reason why it is in the [00:14:00] place that it's at, which is the sort of long history and culture of alcohol use in society. And, ,, that kind of normalization of alcohol use and often heavy drinking as just, you know, something we do without recognizing, um, actually this is a, you know, a drug that does cause individuals and society a lot of harm. So yeah, I think I often also compare the sort of paracetamol prescribed medication, , example in the context of people, you know, many drinkers, particularly people that , that drink above the recommended guidelines tend to be quite dismissive or, you know, not convinced by them. But would probably read the label and the dosage guidance very carefully for a paracetamol or a prescription medicine, uh, as just as a way of illustrating that kind of cultural normalization, and which in part reflects that, that kind of, uh, mismatch of, of the balance of regulation. I, I guess you, you might agree in general, but have some other [00:15:00] comments. 
 
 

Katherine: No, and I think, I think it's really interesting how you draw upon the fact that in Britain, as a society, we see that alcohol is just integral to our culture and our history, and this is why it's been a neglected issue for so long. But I feel that there are a lot of areas now where things have perhaps come to a bit more of a head. 
 
 

So, for example, um, the government has now committed to introduce mandatory product labeling for alcohol, um, which has never been in place in the past. It's been up to, um, alcohol industry bodies to design their own self-regulatory scheme and voluntary commitments, et cetera. And we've essentially got to a place whereby if you were to buy a zero beer of a leading brand, I shan't name one, um, and you were to buy the, the full-fat alcoholic version of the same brand. 
 
 

On the alcohol-free brand, you have all of the nutrition information and the ingredients and the calorie content, whereas as soon as [00:16:00] alcohol goes into the product, that information gets removed. So consumers in the UK are currently being kept in the dark about the contents of alcoholic beverages because there's no regulation in place to make them aware. 
 
 

And I feel that these anomalies that have been driven by, um, -- very powerful industry bodies that have said, "We don't need policies, we don't need government regulations, we just need voluntary commitments," um, have up, up until now managed to drive an agenda that has excluded alcohol from an awful lot of regulation. 
 
 

So as another example being that, um, in the definition of unhealthy food and drink product in the UK, and that definition is used to apply marketing restrictions to protect young people from seeing adverts for unhealthy food and drink. In the definition, alcohol is excluded. Now, nobody can tell us why alcohol is excluded because there isn't a, a reason, and there certainly isn't a common sense [00:17:00] reason why alcohol should be excluded. 
 
 

Um, but it's just a, almost a historical artifact of a long-standing misperception that alcohol needs to be embedded into our culture and into our daily lives. And I feel that the movement's really shifting away from that perspective. 
  
 

Katherine: and people are becoming a bit more aware of corporate influence on policy and a bit more aware of their own health as well, and the need for healthier environments to live in to ensure that we as a society have better wellbeing and better productivity. 
 
 

James Morris: . Yeah, I'd absolutely agree with, with all of that. But I guess I would also say that I think some of the debate, and particularly around sort of the idea of no safe level of alcohol use, which, you know, is, is technically true. Alcohol is a carcinogen, and from a physiological perspective, any amount is not gonna be good for you in any way and carry some level of risk. But, [00:18:00] um, you know, I still think that the no safe level message can be used sometimes in a way which completely obscures the fact that there are some so largely social benefits or purely social benefits to alcohol and, and its role in society. So I guess I c- I'm still going back to this point about there's a balance somewhere. 
 
 

So I think - many of the movements, positive sobriety, increasing rates of abstinence, um, , increasing market of no low things are all good, and, so, uh, is mandatory legislation and so on. I guess I also feel part of the debate does need to recognize that there are some benefits from alcohol. 
 
 

And I guess, some people might say, "Well, that's playing into the industry arguments and so on." But I feel it's, yeah, um, you know, that these things are complex and do often involve... Like, there's two sides to every coin. I don't know if, if you feel, feel that's kind of, um, yeah, there's a risk of, of, of playing [00:19:00] industry, into industry arguments by acknowledging the, the pleasures or benefits of, of alcohol use? 
 
 

Katherine: I mean, in a way, I think that let's, let's have the debate. 
 

 

Katherine: have the opportunity. Um, and now seems to be the time if we are talking about having mandatory product labeling. Um, I mean, in, in my mind, I think the, the most important thing is that consumers just have a right to know what they're putting in their bodies. 
 
 

So I think that, um, you know, ingredients, calorie information, uh, you know, any health consequences, that should, that should be made, you know, plain and clear to all consumers. What-- how that messaging is framed and whether the no safe level message is included in that kind of communication, we need to have the debate and see, and see what the evidence says, see how the public responds to it. 
 
 

But, um, up until now, we haven't had that opportunity, so it's almost when we are talking about these different narratives about how best to, , communicate health risks linked to drinking, um, we've been talking to each other largely, which is such a pity 'cause really we want to be having a broader national debate and raising awareness of all of these issues. 
 
 

Um, and I really hope that in, in the coming year, we're expecting a public consultation in the UK on mandatory product labeling, and I really hope that that comes out before the end of this year. We're expecting it before Christmas. Um, and I would just-- Yeah, I'd really relish the opportunity to talk through some of these issues because you know, our, our role as an organization, as I said at the start, is to try and inform these debates with the best available evidence. 
 
 

So we just want to know, you know, the evidence of what works when informing the public about health risk drink-- linked to drinking, 'cause the current status quo isn't working because people don't know, and, and that's, for me, that's a real missed opportunity. 
 
 

James Morris: Yeah. Yeah, I mean, I certainly agree that there's, there's definitely a right to know as a sort of fundamental principle and, , the knowledge around, you know, al- alcohol being , , linked to - seven types of cancer [00:21:00] certainly, is still a, a big kind of public health gap. 
 
 

Many people are often still surprised and, and quite shocked to, to kind of find that out. So I do feel there is a, yeah, it's definitely, um, you know, it's an important next step to make, basic information readily available. I guess the sort of psychologist in me still will say, well, we're still gonna have quite a, a long way to go and more, more research and, and, you know, experimental studies testing exactly as you say, how we frame these messages differently because many people are just still gonna be fundamentally resistant and protective of their drinking identity, and aware of the benefits it carries or the threat of, you know, being labeled a problem drinker and so on. 
 
 

So, um, yeah, we've got to run before we can walk, but 
 
 

Katherine: Absolutely. Absolutely. And I don't think that anybody is claiming that labels on products are going to solve the, what is, uh, in my opinion, an alcohol harm crisis overnight. Um, sadly, the evidence is relatively [00:22:00] limited there in terms of, uh, its impact on chronic health harms and ultimate deaths. But this is why, um, going back to the original premise of, um, today's podcast, the whole policy package around reducing harm is so important because there isn't just one intervention that is gonna solve everything overnight. 
 
 

We need this real package, and that must involve the kind of main drivers of harm that I've mentioned, so price, availability, and promotion. But then supporting that, we need to have really good treatment and support, uh, that, you know, good investment in treatment and support, good signposting, so brief interventions and advice and having every healthcare professional and whoever comes in contact with someone who has the opportunity to -- deliver brief advice, being equipped and confident with the right messages to do so. 
 
 

So we need to see this really comprehensive package of policies implemented in order to - have a, you know, a really [00:23:00] meaningful shot at reducing alcohol harm. And it would appear that the, you know, the people that are in charge of those decisions of whether or not those policies get rolled out are at central government at the moment,  um, and especially any of them that involve financing. 
 
 

So we need to, we need to, hopefully, crack through to the new look government here in the UK to urge them to prioritize alcohol harm because it is an issue that has been neglected for too long. 
 
 

James Morris: Yeah, and, um, I mean, I suppose it's quite timely that the IAS just recently r-released a new report on , alcohol use in the parliamentary space, finding it, you know, is quite, quite a unique, , kind of environment and has often kind of been under the media spotlight. 
 
 

But, but can you kind of briefly summarize the key findings of the report in terms of, yeah, the, what, what's going on in Parliament and what we should maybe... they should be thinking about? 
 
 

Katherine: Yeah, sure. So I think that, uh Incentive for exploring how [00:24:00] alcohol is treated in the workplace within Parliament was really trying to unpick where the barriers are to decisions being taken in central government about alcohol policy. Um, we kind of feel like we're hitting a bit of a brick wall sometimes. 
 
 

We've got such clear evidence of what works. Um, we seemingly have good public opinion. Polling data show that the public want alcohol harm to be tackled, but we never, you know, on-once it comes to Westminster and Whitehall, we seem, it seems to get stuck in, stuck in the mud, so to speak. So, um, we've obviously seen plenty of media reports and announcements about alcohol-linked incidents in Parliament and disciplinary actions. 
 
 

Um, there was the incident where, um, somebody's drink got spiked in the Strangers' Bar. Um, so there've been general concerns around the drinking culture in Parliament, but nobody had ever really gone out and investigated the breadth of impact amongst MPs and importantly, the staff that also work there. So we issued a survey to [00:25:00] all parliamentarians and all staff that work both on the parliamentary estate in Westminster, but also work in constituents' office. 
 
 

And we wanted to understand what role alcohol played in the working life, uh, for people that work in Parliament, and also how that compared to other workplaces, and whether they had any recommendations for if things could, um, improve, get better, um, or if things were, if people were happy with the current situation. 
 
 

I think that we were quite surprised by the level of response that we had. So a hundred and ninety people responded to our survey, and we found that roughly about one in ten people had experienced harm from somebody else's drinking. 
 
 

Um, about seventeen percent of people had had their work affected or their productivity had been impaired because of a colleague who'd been hungover from, from the night before. And we also found quite a lot of concerns around, um, safeguarding and vulnerability, particularly [00:26:00] of younger staff members, perhaps impressionable university leavers who have joined Parliament as their first job, um, and this idea of there being quite a lot of peer pressure to drink. 
 
 

Um, in terms of comparison between Westminster and drinking in the Palace of Westminster compared to other workplaces, including constituency offices, we found stark comparisons there with the alcohol environment being so much more prolific on the parliamentary estate compared to all other workplaces. 
 
 

And this was really one of the strongest themes that came across, that people believed that no other workplace would treat alcohol in the way that it's treated within Westminster. And I think part of the, um, issue, and again, when I go back to the environments within which we live and work, one of the m- Main factors in why, um, alcohol is so, , prevalently consumed across Westminster is that a lot of the events and receptions that take place throughout the [00:27:00] working day in Parliament include free alcohol. 
 
 

So if you go along to meet with an organization, a business, or a network, then when you walk in the door for their reception room, you get handed a glass of alcohol. And if you... MPs are saying to us that if you actually don't want to drink and you want a soft drink, you have to fight your way to the back of the room, and you might find a tepid orange juice or a you know, flat fizzy water, um, consuming alcohol was just considered the default. 
 
 

 So I think that from our perspective, um, we feel that this needs to be looked at through a lens of occupational health. I think that we need to be really cognizant of the fact that Parliament is a very unique workplace, and that some of the support structures that might be in place in other workplaces, for example, a centralized human resources department, that doesn't exist in Parliament. 
 
 

Katherine: So... And we've seen, uh, plenty of high-profile politicians and some high-profile special advisors in the past, um, experience alcohol [00:28:00] problems quite publicly. Um, and I think that the, uh, in order to address some of these issues... And we do need to remember that Parliament has modernized in a lot of ways in recent years, and things are looking a lot more positive. 
 
 

But alcohol is something that's lagging a bit, that it's not quite keeping up. Um, so the report recommends that Parliament introduces a alcohol workplace policy, which many large organizations have. and one of the recommendations within that is to limit the provision of free alcohol to evening events only. 
 
 

So once the kind of working hours are done, and you go to receptions, and lobbying events, and networking events, that that's, that's when alcohol can be available for free. Um, and I think crucially as well, better visibility and signposting for support services within the parliamentary estate. Because I think one of the statistics that really stood out for me was that about 70% of respondents to the survey weren't sure or didn't know [00:29:00] how to, um, raise concerns about a colleague's drinking and what to do about it. So how to, how to support a colleague who is experiencing problems with alcohol. And I think that should be a real concern because, you know, these, these are our legislators. These are people that we're entrusting to make really core decisions, so we want to make sure that they're working in an environment that is as conducive to them being productive and healthy and happy as possible. 
 
 

James Morris: Yeah, fascinating. And, um, yeah, really, really good piece of, uh, work, so we'll post a link to that report as well. Um, so yeah, it's been a really great, , discussion around, you know, kind of the importance of alcohol policy and some of the kind of tensions and barriers that exist in, in terms of progress in alcohol policy. 
 
 

Um, maybe just sort of concluding, do you have any sort of final thoughts or comments that you wanna highlight, or even maybe sort of on a more global perspective? I mean, I suppose is Scotland the s- has been the sort of world leader in the sense that, um, you know, it has kind of led [00:30:00] in some of those important, you know, big three: price, availability, and marketing. Um, obviously other countries have tighter regulation, um, and you know, , um, Systembloget in Sweden, the sort of government, , controlled sales, sales of alcohol, but obviously Sweden's, you know, a bit of a different country. But yeah, I don't know, any sort of final comments or thoughts on, on sort of the importance of alcohol policy and possibly from a more kind of global perspective? 
 
 

Katherine: I think um, final thoughts I'd want to center around optimism and hope for the future. I think that we are in a really good position because we've got such a strong evidence base of what works to reduce alcohol harm, and many of the policies, um, that we have this evidence base for around restrictions on price, restrictions on marketing, and restrictions on availability, um, are applicable all over the world in whichever, um, country context, um, you can work within. 
 
 

Um, and I think that, [00:31:00] that, uh, that in itself is, the best starting position to be in if you want to be campaigning for change and you want to see action, you know. I also think that another reason to be optimistic is that, that public opinion does seem to be really shifting around alcohol, and I think in particular, I think the public are starting to get more aware of the role that corporations play in shaping the policy environment, in shaping how governments address decisions, and in just shaping the world in which we live in. 
 
 

So I think that that power imbalance that has been a real uphill struggle until now is starting to shift, and I think that we know that the public have a real mistrust in businesses being involved in health policy decisions. So we hope that governments are listening to that and that they'll be able to take decisions primarily based on evidence of what works, but with the confidence that the general public are behind them. 
 
 

James Morris: Hmm. that's, that's great that you can... That, you know, that, that optimism's there, and I agree that there are [00:32:00] definitely some, some positive attitudinal shifts. I mean, I guess, , when you've been in, in the field for, for several decades and, you know, you still can't see the, the basic , legislative opportunities being, being taken up, it is, you know, there's potential for feeling, um, you know, a little bit frustrated, um, and knowing the weight and power of, of some of the opposing industries. 
 
 

But yeah, I guess these things are slow burners, and it is important to, , to retain a degree of optimism at least. Um, so yeah, Katherine, that's, that's been fantastic. That's a really nice, uh, uh, overview of, of kind of the importance of alcohol policy, and we could probably go on debating for hours some of the, the challenges and nuances, but, but that's, that's been a great summary. 
 
 

Thank you so much for coming on the show. 
 
 

Katherine: Oh, my pleasure. Thank you for having me, James