Ideas
At the start of the 20th century, temperance ideas grounded in religious morality were dominant and formed the major prism for viewing alcohol control. The non-conformist Protestant churches were the most fervent supporters of temperance ideas as it was consistent with their middle class concerns about moral decline (Lewis 1992, 51). They viewed the poorer classes as the victims of an evil product. Moral views about alcohol remained prevalent well into the 20th century (Fitzgerald and Jordan 2009, 167-9). Although temperance ideas were dominant through much of the early 20th century, the idea gained support that alcoholism was a disease that was best dealt with through treatment of the individual (Fitzgerald and Jordan 2009, 184). An important catalyst was the start of AA in Australia in 1944, which held that alcoholism was a disease that could be treated through the 12 step process of mutual help treatment (Fitzgerald and Jordan 2009, 205 and 212). This coincided with declining support for viewing alcohol as an evil and immoral product that preyed on weaker members of society. Similarly, support for temperance goals like
prohibition and six o’clock closing declined in the post-war era. Alcoholism ideas developed during the 1950s and 1960s and remained influential for much of the period, especially in the treatment sector (Stockwell 1994, 124). The disease model had little interest in availability controls, viewing them as counterproductive and punishing the “normal” majority when measures should target the “diseased” minority (Room 2010, 157). By the early 1970s there was criticism of the disease model, partly because of the rapid growth in treatment centres, clinics, agencies and foundations that were considered both costly and inefficient (Lewis 1992, 147). There was a subtle shift towards considering alcohol as an addictive substance that caused dependence, much like other drugs. This moved ideas away from people having a genetic disease towards one where any person who drank heavily could become dependent and created the concept of alcohol dependence being an illness, an idea that became
The public health approach identified population level issues and advocated population level solutions. The idea that alcohol abuse had public health consequences was not a new one (Fitzgerald and Jordan 2009, 205). However, the move from identifying the private health and public moral/legal consequences to the public health consequences took significantly longer. A public health figure who had a significant influence on ideas about alcohol control was Kettil Bruun. He visited Australia in the early 1970s and outlined his policy messages of raising prices and limiting alcohol supply as the most important measures for reducing
alcohol related harm in the population (Lewis 1992, 182). Public health focused attention on population level responses, less on the individual and more on overall consumption. The National Alcohol Strategy declared that it used a “public health approach” (MCDS 2006, 7).
From the 1980s, harm minimisation ideas became influential in Australian alcohol control. While they had many similarities with public health (the two labels were often used
interchangeably), harm minimisation was less concerned with reducing total consumption, and more concerned with reducing harmful effects from drinking and intoxication. Harm minimisation gained ground and drove the debate towards reducing the social harms from drinking (Fitzgerald and Jordan 2009, 42, 52 and 305). The idea dominated the Australian drug policy debate from the mid-1980s, and alcohol was incorporated to some extent in the wider approach to drug policy (NDS 2001, 17; Loxley et al 2005, 559). Both the National Alcohol Strategy and National Drug Strategy supported a harm minimisation approach, arguing against abstinence or targeting alcoholism, but focusing on intoxication (MCDS 2006, 11 and 21; NDS 2001, 17).
Fitzgerald and Jordan argued that ideas and approaches from overseas were important for naming problems, identifying harms, and looking for causes and possible treatments. They argued that Australian ideas about alcohol and its control tended to follow the rest of the world but with local variations (Fitzgerald and Jordan 2009, 182-6). During the 20th century, there were examples of actors and governments looking to international developments. The Prohibition experiment in the United States (1919-1933) stimulated the temperance
movement to push for its adoption in Australia (Fitzgerald and Jordan 2009, 175-6). It also appeared that Australian politicians were monitoring the effectiveness of Prohibition in the United States (Lewis 1992, 645). The National Alcohol Strategy and National Drug Strategy both referenced international research and experience in comparable countries such as the
United Kingdom, United States, Canada and New Zealand (NDS 2001, 20-2). But the impact that international policies, approaches or ideas had in isolation on Australian alcohol control was unclear. Consistent with the findings of historical institutionalists, it was more likely that their impact was mediated by domestic political institutions and policy legacies (Andersen 2007, Hall 1993).
From the 1980s there was a strong ideological agenda in favour of reducing the level of regulation in Australian society (Craze and Norberry in Stockwell 1994, 35). These neo- liberal ideas were influential on public policies in many countries. The ideas promoted individual freedom and reduced state interference in the activities of individuals, clearly at odds with the public health discourse. These ideas were influential in the establishment of government initiatives such as the NCP. The National Alcohol Strategy identified that the public health approach was often in conflict with modern Australian values of free trade, open markets and individual freedom (MCDS 2006, 7). These values encouraged deregulation, reduced state interference in the economy and social life, and diversity of services (Room 2010, 162).
Socio-economic conditions
Economic conditions had a close relationship throughout with rates of alcohol consumption. During times of economic recession consumption declined and during periods of economic growth it increased (Room 2010, 152; Fitzgerald and Jordan 2009, 7 and 91-2; Lewis, 9). However, there was not any evidence that the state of the economy impacted directly on alcohol regulation, although it was likely that a depressed economy reduced pressure for greater regulation. One element of the socio-economic environment that had an impact on Australian alcohol control policies was war. During the first half of the 20th century Australia was involved in two world wars, both led to increased patriotism, sacrifice and social
regulation. This was demonstrated when six o’clock closing was introduced in South
Australia, NSW, Victoria and Tasmania during World War One (Fitzgerald and Jordan 2009, 174 and 195). This measure was clearly linked to the war effort and it was unlikely it would have occurred had Australia not been involved in war, although the policy remained in place long after the end of World War One. Similarly, World War Two also had an impact on alcohol control, albeit in a less direct way. The Commonwealth Government gained greater control of taxation to fund the war effort which impacted on federal financial relations and,
longer term, taxing powers of the Commonwealth and the States. The post-World War Two environment supported moving away from wartime social and economic controls and allowing Australians to enjoy their new found freedom. This coincided with availability controls gradually being freed up (Lewis 1992, 2).