Why alcohol health literacy awareness matters

A few years back, a video of a drunken driver being pulled out of a regional passenger bus before departure made headlines in Tanzania. Passengers had refused to let the bus depart from the station, fearing for their lives and safety. They proceeded to call authorities to apprehend the reckless driver. Now, this is one of those lucky instances where a potentially fatal situation was averted.

However, it is an open secret that drivers drink and drive with impunity, especially in Africa. Yet, mortality from road traffic collisions disproportionately affects African nations.

Alcohol abuse is increasingly becoming a major public health concern in Tanzania. One of the surveys conducted by the Ministry of Health estimated that about 10 percent of the Tanzanian population indulges in alcohol abuse.

Unfortunately, regulatory frameworks have done little to address the challenge. So what remains a sustainable recourse?

We have Millennium Development Goals and Sustainable Development Goals, but have you ever heard of Global Smart Drinking Goals? Consumers need to understand how and why alcohol should be consumed within limits.

Health experts anywhere in the world can write a book about the health risks associated with alcohol abuse.

In Tanzania, despite the lack of proper data to track the rate of alcohol abuse or even proper equipment at hospitals or police stations to test the level of alcohol in people, it is clear that excessive consumption of alcohol is one of the leading causes of road accidents, mental disorders, and other health risks.

In a span of 12 years (from 2006 to 2017), 2,250 road accidents caused by driving under the influence of alcohol were recorded in Tanzania—one of the highest on record—with a majority of them involving private vehicles.

Driving after substance use, particularly alcohol, is a well-established risk factor for road traffic collisions. However, efforts are ramping up to mitigate and ultimately curb this unsafe and reckless behaviour.

Your Health recently sat down with Mr John Blood, Chief Legal and Corporate Affairs at AB InBev, the parent company of Tanzania Breweries Limited (TBL), for an in-depth conversation on the efforts being made to raise consumer awareness on responsible drinking through a new initiative called global smart drinking goals.

The smart drinking goals involve the display of consumer guidance labels on products aimed at discouraging harmful alcohol consumption or behaviours.

Due to the nature and complexity of the challenge, the brewery firm decided to undertake the herculean task of reducing the harmful use of alcohol globally.

Aside from the glaring numbers of road carnage due to alcohol abuse, there are also other health risks such as mental problems, which could ultimately lead to suicide.

There is also the issue of underage drinking and drinking while pregnant, which have adverse effects on the unborn child and the mother. As such, the efforts to address the scourge go beyond road safety to encompass other risk areas.

“We are trying to change the culture that people have around drinking. We are trying to make sure that every interaction that consumers have with beer is a positive one. We have a number of different pillars. I’m in Tanzania today to talk about our guidance labels. These are labels on beer bottles with some actionable messages and pictographs that remind consumers how to interact with beer,” explains Mr Blood.

But the problem of alcohol abuse is not unique to Tanzania, despite the lack of resources to control it. According to statistics, globally, 107 million people are estimated to have an alcohol use disorder. Of those, 70 percent (75 million) are male and 32 million are female.

Despite the efforts to raise consumer awareness against alcohol abuse, the guidance labels are not compulsory in the African market, something that makes the implementation or adherence rely on volition and not regulatory requirements.

To this, Blood responds, “We made a decision several years ago where we said that regardless of what the governments require, as we interact with consumers, do we think we can do it to the best of our ability?”

AB InBev has to grapple with the fact that there’s no government regulation in 27 countries around the world about having anything on the labels. “What we said was, why shouldn’t those folks in countries where the government doesn’t require labels have the same reminders as in the countries where they do?”

The messages calling for caution may sound basic, but as Blood explains, they are grounded in evidence and were developed alongside health officials. “We collaborated with partners to identify and implement evidence-based ways to increase alcohol literacy among consumers. We worked with academic institutions to look at the best way to talk about smart drinking,” Blood says.

He goes on to add that the road safety AB InBev refers to in the smart drinking initiative goes beyond programs to prevent drunk driving. “It is holistically what we need to do; how are the roads designed? What are the rules for motorbikes in countries where you have lots of them? Can we learn from other parts of the world about the best safety practices—package them up and then make them accessible to a town official or a city official? But we also look at the entire road safety infrastructure that a country may have.”

Apart from working with health organisations, uncovering new ways to reduce the harmful use of alcohol and shift social norms and consumer behaviours requires an evidence-based approach.

“We work with the United Nations Institute of Training and Research (UNITAR) to spread the message on all the evidence-based learning on road safety. The training is translated into multiple languages. The aim is to implement actionable things to reduce accidents and deaths on the highway. What we have seen so far is that people are embracing these toolkits, and we have seen the number of accidents go down,” Blood says.

In terms of chasing the North Star, the goal is to increase alcohol health literacy by 10 percent by the end of 2025, which is in line with the World Health Organization (WHO) and UN Sustainable Development Goals. “We want people to row in the same direction. The goal we have set changes people’s cultures; it changes how people think. For instance, on our label project, Tanzania and Africa are the leaders, so people have started to think about beer a little differently. They notice that there’s something on the beer bottle that educates them and reminds them about how they need to interact. This is a cultural change.”

Through the local tagline mdogo mdogo, people are reminded to drink in moderation. Reaching the consumer is the biggest goal in this endeavour.

TBL is using social marketing campaigns to increase consumer awareness and encourage smart drinking. They also reach all points of consumption (POC) and activate consumer education campaigns.

The new consumer guidance labels address three critical areas of responsible drinking: drinking while pregnant, underage drinking, and drinking and driving.

Mesiya Mwangoka, TBL Director, Greater Africa Corporate Affairs Policy, and LCA Tanzania, talked about what the firm aims to communicate with the smart drinking goal initiative. “We want to cultivate a culture of responsible consumption of alcohol, make every experience with our products a positive one, reduce underage drinking, reduce binge drinking, and reduce drinking and driving,” she said.

According to Dr Nuruel Kitomary, a psychiatrist and mental health specialist from Muhimbili National Hospital’s Department of Psychiatry and Mental Health, even though alcohol is socially acceptable, its abuse can go overboard, resulting in three major challenges: biological, mental, and social.

“Alcohol abuse affects the brain, impairing cognitive ability; it leads to disorientation, depression, irritability, anxiety and mood disorders, psychotic disorders, and memory loss, which causes social impairment,” said Dr Kitomary.

He adds that epilepsy, diabetes, kidney, and liver failure can all be caused by alcohol abuse.

“One is 15 times more at risk of committing suicide as a result of alcohol. They use alcohol to suppress mood disorders, which ultimately lead to depression.”

Beyond smart drinking goals, further steps being taken to address the challenge of alcohol abuse saw TBL launch a pilot project for a road safety app in collaboration with the Tanzania traffic police and UNITAR.

The company’s head of logistics, Nancy Riwa, called on all road users to think and plan their travel carefully. “If you are drinking alcohol, make sure there is a sober person to drive. As a pedestrian, have a sober companion accompany you home. It is our collective responsibility to behave responsibly on the road and be mindful of the rights of others with whom we share the roads,” she said, recognizing that road safety is integral to nearly every aspect of daily life and is essential to building sustainable cities and communities.