“Dr. Chaturvedi, Deputy Director, Tata Memorial Centre, told The Indian Express that they have written several letters to the Health Ministry to bring out an alcohol-related policy. ‘We are not asking for prohibition but there is an urgent need for limiting the consumption of alcohol. Due to peer pressure the age of drinking is coming down and there are children between 14-16 years who are consuming alcohol,” he said.
The Indian Express, Sunday, August 7, 2022
Having celebrated 75 years of Independence, and soon after Gandhi Jayanti, let’s recall the early spark that lit both our fight against an imperial state and our desire for progress through self-control. The temperance movement that began in the 1880s, especially among the lower castes and tribes of India, became an integral part of progressive reforms to address poverty, untouchability, domestic violence, illiteracy, etc. It faced a formidable counterforce — a revenue-maximising state unanswerable to its subject population. The British aggressively encouraged the production, distribution, and sale of alcohol to exploit its revenue potential. Temperance gave our founders an important political platform in their struggle against the state. We have forgotten that Gandhi’s fight was against state power that leverages alcohol to fill its coffers. And we mistakenly associate Gandhi with a state-led, strong-armed policy of prohibition. As Hansa Mehta, a close confidante of Gandhi, made clear in the 1949 Constituent Assembly debates, Gandhi’s objection was to the state having a role in the production and distribution of alcohol. And he did not support the build-up of a police-state to enforce prohibition. The creation of excise and prohibition police were seen as equally corrupting.
Moreover, Gandhi understood a key requirement for any law — it works best when there is the least need to enforce it. Without wide-spread self-regulation by individuals, prohibition would devolve into corrupting attempts at enforcement. A similar point was made by the doyen of modern Indian liberalism, C Rajagopalachari. Rajaji argued that the presence in India of a cultural proclivity for abstinence would make prohibition less corruptible, relative to other countries. The temperance movement, by leveraging these cultural norms, would prepare the ground for more effective state interventions.
These early temperance lessons along with our struggle against an imperial state remain surprisingly relevant today — more so, given current trends in alcohol consumption and the stalling of reforms by state governments addicted to alcohol revenues. Alcohol continues to engender violence against women, inside our homes and on our streets, and preys on our children. It wreaks havoc with the lives of the poorest among us. It is linked with multimorbidity, lower life expectancy, mental impairment, and loss of productivity. As the scientific consensus on the adverse effects of alcohol has strengthened, public health authorities, including the WHO, have issued stronger warnings while walking back on both the idea of a risk-free level of “responsible drinking” and claims of beneficial health effects. These scientific warnings have also become far more concrete in terms of age, gender, and geography. In one of the most comprehensive global studies on alcohol published this year in The Lancet, researchers flag the under-40 age group as most at-risk at any level of consumption, with no offsetting beneficial effects. A 2019 study in Science Direct estimates that alcohol-related deaths in India — based on just three related harms of liver disease, cancers, and road accidents — would lead to a loss of 258 million life years between 2011 and 2050. And an average annual loss of 1.45 per cent of GDP. In comparison, the government’s total annual expenditure on health amounts to around 1.1 per cent of GDP. With alcohol consumption in India seeing its highest growth in the 15 to 30 age group, and among women, the welfare significance for India cannot be overstated. What is to be done?
Older cultural-religious norms that encouraged abstinence have weakened. The demand for alcohol in India is fuelled by the conspicuous consumption preferences of an aspiring, upwardly mobile middle class. As a result, alcohol is one intoxicant whose consumption by households is being normalised and glamourised to an extent that one does not see with any other drug. While this should be a growing public health concern, state policies have only compounded the problem. Far from fulfilling their primary public health and safety responsibilities, state governments remain addicted to excise tax revenues and licence fees generated by the alcohol industry. Easy access to alcohol revenues has placed state governments under a “resource-curse” that disincentivises them from making the difficult choices needed for the type of reforms that would broaden the long-term tax base. It is no surprise then that states have refused to shift alcohol under the GST reform umbrella.
With growing alcohol consumption, these dynamics are likely to worsen. Corruption remains rampant. Production and consumption of illicit liquor remains widespread, and deaths from alcohol poisonings occur with depressing frequency in all states. These failures have affected poor households the most, creating, in turn, a highly unstable policy environment. The draconian prohibition law introduced by the Bihar CM Nitish Kumar in response to the electoral demands of poor womenfolk measures the extent of desperation felt by the weakest members of our society.
Given the present state of policy dysfunction in face of rapidly growing levels of alcohol consumption the need for a new spirit of temperance cannot be overstated. A study published this year by the US National Bureau of Economic Research used household migration data to confirm what was well-known among the early temperance advocates – that it takes a village to discourage drinking and sustain abstinence. The rapidly changing demographics and socialisation of alcohol consumption in India requires that each of us take seriously the wider impact of our drinking. The potential harm from alcohol radiates outwards – from the individual drinker to the wider community — in ways that are unpredictable. A moderate drinker, without intending to, encourages others who end up drinking immoderately. All drinking risks being socially irresponsible once we consider the wider, negative externalities that are produced.
The good news is that each one of us has the potential to create social good – without waiting for a state that is unable to shake-off its own revenue addictions. There is strong scientific evidence now to convince us that abstinence is in our individual self-interest. Each of us, by simply pursuing our own self-interest, will, at the same time, end up promoting the interests of the most vulnerable amongst us – the poor, women and children. Relatedly, as free citizens we must also recognise the power each of us has to “starve the beast” of its alcohol taxes and force it to reform itself towards a healthier, wider tax base. As our founders understood, we have always had the freedom, as individuals, to pursue our enlightened self-interest and, in doing so, limit the power of the state to harm these interests. The time to exercise this freedom is now.
The writer is professor, Department of Mathematics and Statistics, American University, Washington DC