“In my more optimistic moments, I think that is the way we’re moving,” said Dr Alastair MacGilchrist, a liver specialist and chair of Scottish Health Action on Alcohol Problems (SHAAP).
He believes that it is this fear that is behind the alcohol industry’s “vociferous” pushback against proposals to curb alcohol advertising in Scotland.
“They don’t want alcohol to go in the same direction as tobacco,” said Dr MacGilchrist.
“But if you look at sport, there isn’t as much sponsorship and advertising as there used to be.
“Women’s sport is becoming much more mainstream and Scottish women’s football is a fantastic exemplar of a group who pride themselves in not taking sponsorship from the alcohol or gambling industries, and in doing so they attract other sponsors.”
On Thursday, a Scottish Government consultation on proposals to restrict the “advertising and promotion” of alcohol will close.
Its recommendations are far-reaching, from bans on sports and event sponsorship and outdoor advertising on billboards, bus shelters, and public transport, to retail curbs that could ban window displays and require supermarkets to segregate wines, beers and spirits to a gated area at the back of the shop – separate from other groceries and accessible via a 1.2 metre (4ft) barrier (to reduce visibility to children).
In smaller shops, alcohol may have to go “in a closed cupboard, like tobacco”.
The goal is to cut consumption and, ultimately, harm.
Adults in Scotland consume around 18 units a week on average – nearly 30 per cent more than the maximum guideline amount.
There were more than 35,000 alcohol-related hospital admissions in 2021/22 and 1,245 deaths directly caused by alcohol in 2021.
In most cases, alcohol kills people of working age, in their 40s and 50s, and is estimated to cost the economy somewhere between £5-9.5 billion a year in lost productivity.
“If you’re going to reduce the number of people getting ill through alcohol, then you’re going to have to reduce the amount they drink,” said Dr MacGilchrist.
“It’s consumption that drives harm.
“How do you reduce consumption? At a population level there are only three things that have been shown to be effective: making it less affordable – the huge increase in the 2000s was mainly because of affordability; making it less attractive – that’s about marketing; or making it less available – restrictions on where you sell it, and who you sell it to.”
The lack of advertising restrictions in the UK is highly unusual, by European standards.
In Norway, a blanket ban on all forms of alcohol marketing has been in place since 1975.
The law, introduced in tandem with the same prohibition on tobacco advertising, covers all public spaces as well as television, radio, print publications and social media.
There are even strict limits on how manufacturers can present their product on their own website.
“If the purpose is mass communication to sell alcohol, then it’s banned,” said Stig Erik Sørheim, from ACTIS – the Norwegian Policy Network on Alcohol and Drugs.
What seems extreme from a UK perspective is uncontroversial in Norway, where high taxes also mean that a pint of beer typically costs around £8 and alcohol is only sold through Vinmonopolet, the state-owned liquor stores.
Per head, Norwegians drink roughly the same as Italians – and much less than the European average.
Mr Sørheim credited the regulations as “a big cause of this” because they “help to shape the culture by de-normalising alcohol”.
He added: “You need to see this as a whole, as multiple strategies to achieve the same goal, where advertising is one piece of the puzzle – and quite a crucial piece.
“We actually believe that marketing works, that’s the basic premise of the law.
“That marketing actually achieves what the marketing people say it does – to increase sales.”
There is one form of ‘alcohol’ that the industry is allowed to advertise in Norway, however: the zero-alcohol brands.
Even this is tightly controlled, with breweries required to package their 0% brands with unique logos and labelling to prevent the use of so-called “alibi marketing”.
Such tactics have already drawn criticism from campaigners in Ireland, where alcohol-free Guinness marketing – identical to the standard branding but for the small, blue 0.0 – has been used on the pitch during Six Nations games.
“I think there needs to be very careful consideration given to how to deal with zero-alcohol products,” said Sheila Gilheany, CEO of Alcohol Action Ireland.
Ireland’s Public Health (Alcohol) Act (PHAA), passed in 2018, includes a requirement that alcohol must be restricted to one area of a store – away from checkouts and other groceries, and barriered off behind swing doors.
Those rules do not apply to alcohol-free versions of common brands, however.
“Right now what we see are floor to ceiling displays of no-alcohol products at the front of stores which are using identical branding,” said Ms Gilheany
“I think most people would say these are not suitable products for under-18s and if your overall intent is to avoid advertising alcohol to under-18s – which was the intent of PHAA, because it’s recognised that the more children see of alcohol advertising the more likely they are to start drinking at an early age and at a high level – then you have to consider what restrictions there are around their availability, sale and marketing.”
Calls by SHAAP for Norwegian-style marketing restrictions on zero-alcohol products have been dubbed “simply bonkers” by the Scottish Beer & Pub Association, while the Portman Group – which regulates alcohol labelling and promotion – said concerns that 0% brands could lead to harm by circumventing advertising laws were “unfounded and unhelpful”.
Ireland – whose law also encompasses minimum unit pricing, mandatory calorie labelling and cigarette-style health warnings – appears to be the blueprint for Scotland.
Unlike Ireland, however, Scotland has no control over broadcast advertising.
Nonetheless, even Ireland is struggling to implement its pre-watershed ban on alcohol adverts, including rules that the adverts which do run should be “purely factual” and “stripped of the myths” that glamorise drinking.
For now, this element of the legislation remains in limbo, subject to ongoing consultations between the government and Ireland’s broadcasting authorities on how to monitor it.
“At the moment when you see an alcohol ad, you’re very much sold a dream,” said Ms Gilheany.
“This is an industry that is exceptionally clever at aligning with your aspirations and selling you something you want – fun, a good time.
“But it’s a chemical, not a magic potion.”
For its part, the alcohol industry insists that the purpose of advertising is to help consumers choose between brands, not to increase overall sales.
It is not an argument that Mark Petticrew, a professor of public health evaluation at the London School of Hygiene and Tropical Medicine (LSHTM), finds convincing.
“The evidence shows that that is quite clearly false,” said Prof Petticrew, noting that previous studies have demonstrated clear links between exposure to marketing and youth drinking in particular.
“It’s absolutely clear from their own studies that advertising does much more than affect brand choice, and that they use advertising to target certain markets – particularly heavy drinkers.”
Despite “please drink responsibly messaging”, research shows that if people actually did – by never exceeding guideline consumption – the alcohol industry’s UK sales revenue would drop by 38%, or £13 billion.
Prof Petticrew pointed to research published in 2019, which analyses how alcohol companies evaluated their own advertising campaigns.
In one case study, Famous Grouse noted that whisky brands are “very reliant on a small number of heavy, and increasingly ageing, consumers” and described the goal of its marketing drive being to persuade existing and rival brand customers “to choose Famous Grouse more often”, but “in the longer term we had to attract more younger drinkers – the heavy-using loyalists of tomorrow”.
Similarly, Miller Lite wrote that if it “was to be a large profitable brand we had to attract these young heavy drinkers”, while Foster’s lager couched its campaign in terms of “giving permission for a ‘drinking occasion'”.
Prof Petticrew said: “The advertising encourages you to identify new occasions to drink when you might not normally drink.
“It was a nice example of where, when they talk to each other – the advertising industry and the alcohol industry – are much less guarded about what the purpose of advertising is.”