Build CAMH: Selling Alcohol in Grocery Stores: Hidden Risks and Alternative Options

Published on March 16th, 2015 | from CAMH

Selling Alcohol in Grocery Stores: Hidden Risks and Alternative Options

By Dr. Norman Giesbrecht, Senior Scientist Emeritus, Public Health and Regulatory Policy Section

In the last few days we have heard about plans to permit the sale of beer and wine in grocery stores in Ontario. For the most part, media reports have made no reference to potential health and safety risks associated with the proposed changes. You would have thought that the reporters were talking about changing the distribution of milk or orange juice in Ontario. What about the possible increase in alcohol-related incidents or negative impact on vulnerable populations – is that not relevant to the discussion? Alcohol is a drug with a long list of well demonstrated harms associated with its use. How it is sold, marketed and priced impacts the rate of alcohol-related problems. International research over many decades has shown repeatedly that if more alcohol is sold and appropriate checks are not in place, then more harm can be expected. These harms include a range of health and social problems impacting not only the drinker, but others in society. They contribute to the already high costs of alcohol-related hospital care (chronic and emergency), criminal justice responses, and productivity losses.

Currently in Ontario there are about 1,800 places where alcohol can be purchased to be consumed elsewhere, so-called ‘off premise’ outlets. This includes LCBO regular stores, LCBO Agency Stores, Ontario Winery, Beer Stores and a few others. According to media reports, the contemplated changes would add about 400 new outlets – 100 new Agency stores and 300 large grocery stores that would sell beer and wine. This is a 22% increase in outlet density.

Canadian and international research has indicated that an increase in alcohol outlet density is associated with a wide range of acute and chronic problems. While there are many international examples to support this conclusion, a recent one from British Columbia is timely: researchers found that after an increase in private liquor stores (higher density) there was an increase in liver cirrhosis cases.

Once 300 grocery stores have a green light, will not the thousand or so others also lobby for the same access? What about convenience stores? We know from the examples of Alberta and BC that privatization of alcohol sales can result in more relaxed enforcement of laws pertaining to underage purchases – as well as higher mortality rates from suicide and other alcohol-related causes. The proposed plan is a very risky one. An alternative strategy should be developed in consultation with public health experts.

The challenges of eliminating Ontario’s deficit are likely substantial and will require innovative approaches and exemplary decision-making. As the provincial government attempts to raise revenues and “modernize” the sale of alcohol, it should focus on strategies that can achieve that aim without increasing the risk of alcohol-related harm. Possibilities include:

  • Minimum prices on alcohol could be raised
  • Product prices could be based on alcohol content, and taxation protocols could be adjusted, so that there is an incentive for production and consumption of lower-strength beverages
  • Marketing expenditures by the LCBO could be reduced
  • Further efficiencies can be introduced to the LCBO, such as using its buying power to get better prices from manufacturers and wholesalers

The course being discussed by decision-makers, in its current form, seems certain to contribute to an increase in alcohol-related harm and costs. We should encourage decision-makers to choose instead a course that fosters greater public awareness of alcohol-related risks and encourages the reduction of those risks.The health of Ontarians should come first.

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5 Responses to Selling Alcohol in Grocery Stores: Hidden Risks and Alternative Options

  1. Dee says:

    Off the top of my head, I know of two states in the USA that have hard liqueur sales in grocery stores. Not only did a bottle of booze go up astronomically (shockingly so), everything else did too. Teen car accidents, teen pregnancy, teen violence, teen drop out rate, lower grades, and sooo much more that you really do not want, all went up.
    It was a mistake for WA State to to follow NV State, but the people who wished it to be legal, tricked the public into thinking it was a good thing. Lots of folks are not happy with the new law. No one seemed to mention the ramifications of making it more available to the public. Privatizing things makes them cost more in all areas.

  2. annick aubert says:

    The picture shows bottles of HARD LIQUOR, the grocery stores would sell only beer and wine, and the choice would be very limited at that…!

  3. carbc says:

    Reblogged this on Matters of Substance and commented:
    While this blog is from Ontario, many of the points are relevant here in BC, now that alcohol sales will soon be permitted in select grocery stores.

  4. Sara Himelstein says:

    I was interested in the post and wondered what is the findings from Quebec over time where wine and beer have been available in most food outlets for many years. Is there data re health issues, differnet incidences of addiction, youth issues etc.? Would love to hear about this as I live in BC and will be experiencing these changes here.
    And is there any information where government puts health before money from sin taxes ?

    • CAMH says:

      Hi Sara,

      Thank you for your comments. Yes Quebec has allowed wine and beer in the corner stores for a number of decades and studies in the 1970s showed an increase in consumption of some beverages. Unfortunately, changes in the other topics that you mentioned have not been examined. In BC there has been partial privatization, as you likely know. A sharp increase in private liquor stores was associated with an increase in alcohol consumption particularly in those areas where their concentration was greatest and also an increase in liver cirrhosis mortality. Please check the Centre for Addictions Research of BC (CARBC) website and publications by Dr. Timothy Stockwell and colleagues, for more information.

      Unfortunately governments typically do not pay much attention to ‘full cost accounting’ of alcohol problems and their costs when making decisions on changes in alcohol retailing. Also, the media tend not to refer to negative consequences when reporting on plans to open new alcohol outlets. Currently in Ontario, potential increased service to minors appears to be the primary problem raised briefly in the media, an important one, but only one among many – some more immediate and others longer-term. The Nordic countries provide some useful lessons on managing alcohol retailing. It would be great if one or more Canadian provinces became world leaders in developing the most effective harm reduction approach in alcohol retailing, that also sustains revenue and reduced alcohol-related costs, but, dramatically adding more alcohol outlets is a step in the wrong direction.

      Norman Giesbrecht

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