The Unregulated Drink: Rethinking Alcohol Control in India

Context

• Rising public health concerns due to increasing alcohol consumption in India.
• Policy vacuum at the national level despite the socio-economic and health-related consequences of alcohol use.

Key Highlights

• Alcohol use caused 2.6 million Disability-Adjusted Life Years (DALYs) in India in 2021.
• Per capita alcohol consumption in India increased by 240% over the last two decades.
• Estimated societal cost of alcohol-related health issues is ₹6.24 trillion.
• 23% of men and 1% of women consume alcohol as per NFHS-5.
• India ranks among the highest in heavy episodic drinking globally.

Detailed Insights

1. Health Impact:

• Linked to mental illness, injuries, non-communicable diseases, and cancer.
• Associated with crime, aggression, suicide, and risky behaviour.

2. Determinants of Consumption:

• Biopsychosocial: Includes genetic predisposition, psychological stress relief, and social influence through peer pressure and media.
• Commercial: Includes fruit-flavoured spirits, premixed cocktails, surrogate advertising, happy hours, product placement, and social media amplification.
• Policy: Alcohol laws vary by State; industry uses excise revenue to resist stricter regulation.

3. Policy Variations:

• States like Bihar, Gujarat, Mizoram, and Nagaland enforce prohibition.
• Others like Kerala and Andhra Pradesh actively promote alcohol or subsidise pricing.
• Online alcohol delivery is being piloted in some states via Swiggy, Zomato, Blinkit.
• Legal drinking age varies from 18 to 25 years across States.

4. Current National Policy Gaps:

• No unified national alcohol policy.
• Alcohol excluded from Narcotic Drugs and Psychotropic Substances (NDPS) Policy 2012, but included in National Action Plan for Drug Demand Reduction (NAPDDR) 2021-22 under Nasha Mukta Bharat Abhiyan.
• Role divided among Ministries of Social Justice, Home, Finance, and Health.
• Recognised in NHP 2017, and National Suicide Prevention Strategy (NSPS) as a public health concern.

Recommendations

• Affordability: Set prices high enough to deter overuse without pushing users toward illicit liquor.
• Allocation: Earmark health taxes on alcohol for public health, prevent misuse.
• Accessibility: Reduce retail and visual presence of alcohol in urban and residential spaces.
• Advertisement: Curb social surrogacy, influencer marketing, and algorithmic amplification.
• Attractiveness: Enforce plain packaging, warning labels, and point-of-sale restrictions.