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| Journal of the New Zealand Medical Association,
19-May-2006, Vol 119 No 1234
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Regarding New Zealand Medical Association’s position on
the minimum purchase age for alcohol
The New Zealand Medical Association (NZMA) opposed the
lowering of the drinking age in 1999 and until recently supported returning it
to 20 years of age. In their recent written submission to the Select Committee
they concluded:
Although
the NZMA opposed the original decision to lower the purchase age, we are not
convinced that the problems associated with excessive alcohol use by young
people can be curbed simply by re-raising the age to 20 years. Therefore, we do
not support that proposal within the Bill.
This stance simply ignores the research evidence. Four
studies conducted in New Zealand, by independent groups of researchers, using a
variety of methods, showed deleterious health effects of lowering the minimum
purchase age in 1999.1–4 Furthermore, in a meta-analysis of 23 published
studies on the effects of increasing the drinking/purchase age in the USA,
median reductions in the incidence of various traffic crash outcomes were
12%–16%.5
In their submission, the NZMA only refer to one of numerous
published papers on this subject. Could the NZMA explain to readers why their
submission was not based on an adequate review of the public health
evidence?
Dr Boswell in his oral submission to the Select Committee is
reported (Otago Daily Times [ODT] 4 May
2006) as saying “There is no
clinical evidence to suggest alcohol was more harmful to an 18-year-old than a
20-year-old.” Could Dr Boswell advise readers whether this is an
accurate quote and if so: (a) what is meant by ‘clinical evidence?’
and (b) the lengths that NZMA went to verify this statement.
Dr Boswell is reported
(ODT 4 May 2006) as advising the Select
Committee that there had “...been
vigorous debate among NZMA members—many of them medical
students.”
The written submission also states:
“...membership
includes significant numbers of medical students and young
doctors.” Readers could be forgiven for thinking that factors other
than a considered review of the evidence were bought to bear on their
deliberations. Could NZMA advise the relevance of these statements in
undertaking an evidence-based approach to the evidence?
John
Langley
Director Kypros Kypri
Senior Research Fellow Injury Prevention Research
Unit
Department of Preventive and Social Medicine University of Otago, Dunedin References:
ResponseDrs Langley and Kypri are obviously disappointed that the
NZMA does not support their view that New Zealand, having lowered the legal age
for alcohol purchase from 20 to 18 in 1999, should raise it again to 20 in 2006.
NZMA policy is determined by the NZMA Board, on the advice
of elected representatives from committees and views expressed by individual
NZMA members. This issue was debated vigorously and the Board determined by
consensus that as a matter of policy we do not support the raising of the legal
purchase age.
Factors taken into account include the following:
Langley and Kypri quote four
studies conducted in New Zealand by independent groups of researchers, using a
variety of methods which, they say
“showed deleterious health effects of
lowering the minimum purchase age in 1999.” I do not doubt their
sincerity or their accuracy, but I dispute the relevance of these studies.
Evidence that lowering the purchase age was associated with increase in harm is
not evidence that raising it again will decrease harm. Even if it were, we are
aware of other evidence conflicting with their view of the effect of the
reduction in the drinking age: drivers aged 15–19 accounted for 14% of
fatal crashes in 1996—3 years prior to the law change and only 9.1% in
2002, 3 years after it.1
Harm reduction should be the target of any new legislation
in this field, but published evidence that we can find is that where the legal
purchase age has been raised from 18 to 20 reduction in harm was
minimal.2–4 While it is possible, even likely, that raising the legal
purchase age to 20 might have some effect in preventing injury and ill-health,
we have no doubt that raising it to 30, or 40, or 50 would be considerably more
effective. The choice of 20 as a proposed age is entirely arbitrary.
In our view, the proposal to raise the age to 20 is not well
justified, and it falls far short of dealing effectively with the problems that
New Zealanders, and especially young New Zealanders, have with alcohol. For that
reason we do not support it. We have called instead for a comprehensive package
of measures including public education, enforcement of the existing laws, and
controls on advertising.
Ross Boswell
Chairman, NZMA References:
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