Total Consumption Model

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The Total Consumption Model is a, now discredited theory, that was devised in the 1950s that stated:

...that the amount of harmful drinking in a population is a fixed percentage of the amount of overall drinking, so if per capita consumption goes up, harm will go up, and if per capita consumption goes down, harm will go down.[1]


While there is a relationship between the two, this is a rather blunt model upon which to base nationwide policy on alcohol. There are two fallacies with Total Consumption Model (as discussed in Punishing The Majority):

  • In line with the Pareto principle, a disproportionate amount of alcohol is drunk by a small percentage of the population, skewing any effect changing the 'average amount' drunk may make:

In Britain, more than 40 per cent of alcohol is consumed by ten per cent of the population. Close to 70 per cent is consumed by one fifth of the population.[1]

  • Those who drink the most, don't cause the most harm:

If you look at drinking patterns within the UK, it is the poorest socio-economic groups that have the lowest average consumption, but it is these groups that have the highest rates of alcohol-related mortality. By contrast, the richest groups drink the most and suffer the least harm.[1]


Despite the fact that this is a discredited theory, (and some people have argued that the Total Consumption Model is attacking a strawman[2]) it is still endorsed, either implicitly or explicitly to defend policy changes:

Population-wide interventions

However, taken together, they [the recommendations of the report] are very likely to improve the health of the population as a whole. As indicated by the Rose hypothesis, a small reduction in risk among a large number of people may prevent many more cases, rather than treating a small number at higher risk.

[..]

In this instance, the number of people who drink a heavy or excessive amount in a given population is related to how much the whole population drinks on average. Thus, reducing the average drinking level, via population interventions, is likely to reduce the number of people with severe problems due to alcohol.[3]


Harmful drinking has become so normal and acceptable that the problems it causes to other people are often overlooked. That’s why we need alcohol policies for the whole population. If we all drink less, then harms will come down across the board. Drinking less is in all our interests.[4]


It is worth noting that total alcohol consumption is a key health indicator in the EU (ECHI 46) as a proxy for the level of alcohol related harm in a Member State.

[...]

The Commission is fully aware of the importance of reduction of alcohol consumption among the population as a whole and in particular among the harmful drinkers.[5]


Of special note from this last citation:

The notification message explains that the minimum pricing aims to reduce alcohol consumption...

[...]

The measure at issue is aimed at reducing alcohol consumption across the Scottish population and thus improving public health and attaining social benefits.

[...]

If the goal is, for health policy reasons, to reduce alcohol consumption via increasing the prices of alcoholic beverages...[5]


The emphasis is on the reduction of alcohol consumption (which in the UK has been decreasing year on year since 2005 without any interference from the state) rather than the reduction of harm, which as stated before has little correlation with the amount of alcohol drunk.


References