Home Page News Opinion Foreign Policy Politics Policy Legislation Lobbying Hill Life & People Hill Climbers Heard On The Hill Calendar Archives Classifieds
Advertising Subscribe Reuse & Permissions
Hill Times Events Hill Times Books Hill Times Careers The Wire Report The Lobby Monitor Parliament Now
Opinion

How should we regulate legally available substances that pose health risks? A lesson from Sweden

By Tim Stockwell      

A free market does not deliver good public health and safety outcomes for psychoactive substances.

Proponents of privatizing Canada's alcohol monopolies usually stress the virtues of consumer choice and convenience.
Photograph courtesy of Pixabay

The regulation of legally available psychoactive substances that pose serious risks to health and safety is a challenge for all modern societies. Should we let the free market decide price, hours of sales, age of purchase, how products are promoted, and how hazardous the products are?

Looking at this coolly and rationally, one might suppose that the degree of control applied in these areas would depend on the potential for risk of the substance in question. In Canada, however, we are fast moving towards a situation in which the reverse is true: the less harm posed, the greater the restrictions applied, and vice versa.

Increasingly, safe vapour devices are becoming available that deliver nicotine (a virtually harmless substance) without the many carcinogens in conventional tobacco. Despite their harm reduction potential, these devices are heavily restricted. The availability of alcohol, on the other hand, is being increasingly liberalised as provinces race to keep up with each other’s bold moves to make its sale possible in more places and at more times than ever before.

Estimates of annual deaths in Canada attributable to alcohol range from 4,000 to 8,000. The World Health Organization recognizes alcohol as a carcinogen implicated in such common conditions as cancer of the breast, oesophagus and colon.

And then we have cannabis: implicated in many fewer deaths than alcohol, but which will likely be more tightly regulated as Canada moves nervously towards legalisation. As lawmakers weigh different models, there are lessons that can be learned from the many successes and failures documented with alcohol and tobacco. One such lesson is Sweden’s handling of alcohol.

Like most of our provinces and territories, Sweden has a distribution and retail alcohol monopoly. Theirs is called Systembolaget. But unlike its Canadian and U.S. counterparts, Systembolaget reports to a health ministry — not a finance ministry — and has a mandate to protect health and safety. It operates 400 retail stores, restricts days and hours of opening, sets prices partly on the basis of alcoholic strength, limits marketing, and sponsors research on how to limit adverse outcomes. Like other monopoly countries, Sweden has relatively low alcohol consumption for a European country and hence lower rates of alcohol-related harm.

Scientists who have studied public health outcomes for legal drugs agree on some fundamental points. First, strong policies on price, availability, and marketing are highly effective for reducing consumption. Second, the less a population consumes, the fewer negative consequences.

A team of international scientists led by the University of Victoria’s Centre for Addictions Research of BC has just released a report applying these lessons to estimate the consequences of privatizing Sweden’s alcohol monopoly. In it, they estimate the extent to which price, availability, marketing and cross-border purchases would change if Systembolaget stores were replaced by 1,200 private liquor stores or if alcohol was sold in grocery stores. Applying the available scientific literature, they estimated alcohol consumption would increase by 20 per cent in the first instance and 31 per cent in the second. Annual alcohol-related deaths were estimated to increase by about 800 in the first scenario and 1,400 in the second. Alcohol-related hospital stays would also increase by about 13,000 and 20,000 in each case.

Perhaps the most important lesson to draw from this is that a free market does not deliver good public health and safety outcomes for psychoactive substances. When more competition is introduced, prices go down, convenience increases, and an intoxicating, addictive carcinogen is delivered more efficiently and in greater quantities to the entire population.

Proponents of privatizing Canada’s alcohol monopolies usually stress the virtues of consumer choice and convenience. But as a society, we can also make choices about how best to regulate substances that alter mood (positively and negatively), impair judgement, and cause health problems.

Alcohol, nicotine, and cannabis can be made available in different strengths and for intake by different means (e.g. vaping versus smoking). Is the best choice to leave decisions about pricing, availability, and marketing to the private sector? Or should we collectively choose to sacrifice a little convenience to protect our overall health and safety, including that of the most vulnerable? Systembolaget provides a model we might emulate in Canada as a way of favouring safer products while raising government revenues to fund treatment, prevention and research.

More in News

Stalled Senate harassment policy review revived

The Senate is buckling down on its review of its harassment policy as the #MeToo movement sweeps through the halls of Parliament—though the head of the group in charge of the overhaul says the timing…

Singh will have to showcase ‘political guts,’ clear progressive message to connect with voters

New leader Jagmeet Singh will have to live up to his promise to boldly dig deeper into social democratic values or he'll risk alienating NDP grassroots as the party tries to create distance from the Liberal…

Military activities, veterans’ support, Phoenix fix big-ticket items in $4B new spending ask

News|By Emily Haws
The Department of National Defence and other departments providing services to active and retired members of the Armed Forces are taking up a sizeable chunk of the $4-billion in extra spending the Liberals have put…

Texting, sit-downs, and lots of waiting in hotel rooms: the ins and outs of NAFTA lobbying

News|By Shruti Shekar
Dozens of industry groups are dispatching executives to every round of the NAFTA renegotiation, and using texts, emails, and phone calls to try to talk to Canada's negotiating leads about what is being discussed with…

Trudeau, Wilson-Raybould justified in speaking out after controversial Stanley verdict, marked a turning point for Canada, say MPs

Prime Minister Justin Trudeau and Justice Minister Jody Wilson-Raybould were right to speak out after the verdict in the Gerald Stanley trial, say Liberal and NDP Parliamentarians, who believe the government and Parliament have to…

What happens if an MP’s found guilty of sexual harassment? No one’s saying

News|By Abbas Rana
All the federal political parties say they take sexual harassment “seriously,” but none will say what disciplinary action they would take against an MP found guilty of it. “We take sexual harassment allegations very seriously,…

Feds’ sweeping, new environmental assessment bill keeps power in ministers’ hands, say observers

The government’s new Impact Assessment Act includes hundreds of pages detailing changes to the environmental assessment process in Canada, but keeps ultimate power over approving natural resource projects in the hands of the federal environment…

NDP reviewing past, present harassment processes amid Stoffer, Weir allegations

The NDP isn’t currently investigating the specific harassment allegations against former NDP MP Peter Stoffer, but it says it's looking into how such complaints were, are now and will be handled, something strategist Robin Sears…

Patrick Brown gaining support since re-emerging to challenge sexual harassment allegations, says adviser, though Conservative MPs largely quiet

Patrick Brown, who in a dramatic move re-entered the Ontario leadership late Friday afternoon, is receiving strong support from all corners of the political world since publicly re-emerging to challenge the sexual harassment allegations that…

WANT MORE EXCLUSIVE HILL TIMES CONTENT?

We’re offering 15% off a year-long subscription to the hill times online content.