Should Alcohol be Banned In India?

Introduction:

To Be: 60 ml of liquor, three times a day, with soda and roasted peanuts! This was the prescription by a Kerala Doctor which became viral in March, 2020. The doctor later clarified and called it a joke. But it could have been very easily a reality as The Kerala government has decided to make alcohol available by issuing special passes for drinkers after at least six alcohol dependent persons committed suicide due to frustration, withdrawal symptoms and a ban on alcohol sale as a direct result of strenuous Lockdown announced on March 25.

Or Not To Be: The story of Bihar alcohol ban is interesting as it was impromptu and unexpected. In late 2015, when chief ministerial candidate Nitish Kumar had just finished a speech at a conventional Hall in Bandol, a woman approached the microphone and urged him to ban alcohol in full public view. For reasons he claimed he did not know then, Nitish Kumar who needed very much to defeat BJP in a bid to save his political career, agreed to ban liquor if he were elected to power. The newspapers around nation front-paged that story and it stuck when Nitish Kumar indeed won the elections. It was the first time that liquor assumed a role in elections which was diametrically opposite to what it has been used historically, i.e., to make voters forget real issues and sway them in favor of whoever is providing more liquor just before polling. The Bihar Excise (Amendment) Act came into effect on April 1, 2016.

In this post, we’ll discuss why alcohol bans are sought, should it be done on a national scale and is it feasible or advisable to do so in India.

Why Alcohol Bans are Sought

Nationwide ban demands are not a new a thing although its reasons & oriented goals can vary over time and region.

Morality
Religion
Crimes
Socio-economic factors
Public Health

[Scientifically speaking, the principles in support of prohibitionist policies are: -

the harm principle (alcohol use harms others),
legal paternalism (alcohol use harms the drinker),
legal moralism (alcohol use is immoral even if it does not harm),
legal perfectionism (ideals of human excellence),
and traditional conservatism (values of the majority).]

The first effective ban in history came into effect by Murad IV of Ottoman Empire who ironically died of alcohol poisoning at the age of 27 in 1640. According to him, people while inebriated were just wasting time and criticizing government in cafes. During 19th and 20th centuries, Temperance Movement, which were social movements to ban alcoholic drinks gained prominence and actually succeeded temporarily in Western World.

In India also, Mahatma Gandhi was a champion of teetotalism and post-Independence, many of Indian States followed prohibition well into 1970s. demands still are made specially by women in several states of India. And in some states, there is already a ban well in place.

Nagaland
Gujarat
Bihar
Lakshadweep

Despite this, when it comes to public health, the situation of India is epidemiological and India is sitting on a public health crisis time-bomb.

In a Lancet study, it was found that alcohol consumption in India increased 38% in 2010-2017. Almost half of them were heavy drinkers meaning susceptible to develop Alcohol Use Disorder (Alcoholism). The reason for this is Indian drinking habits saw a huge jump post 1991 economic reforms as people now have more money to spend.

When it comes to ill effects to health globally, around 50% of the deaths caused by liver cirrhosis, 30% of the deaths because of oral and pharyngeal cancers, 22% of the deaths caused by inter-personal violence, 22% of the deaths because of self-harm, 15% of the deaths caused by traffic injuries, 12% of the deaths because of tuberculosis (TB) and 12% of the deaths caused by liver cancer were attributed to alcohol consumption. Problems related to alcohol consumption made up to 17.6% of psychiatric emergencies in an Indian general hospital. Some Religions such as Islam, Jainism, Buddhism explicitly forbids alcohol. In fact, the countries which still ban alcohol today are only Afro-Asian where major religion is Islam. The countries where prohibition or a nationwide ban failed are

Iceland (1915-1935)
Norway (1916-1927)
Faroe Islands (1907-1992)
Russian Empire/USSR (1914-25; 1929)
Finland (1919-32)
Canada (1918-1920)
USA (1920-1933)

We will take the example of USA here to analyse the feasibility of a possible nationwide ban in India because from this list, USA is the most similar country to India, a federal democracy with vast size and huge diversity.

Results of Ban in America: A Comparative Study

Prohibition in USA was a result of a century-old movement and culminated in National Prohibitional Act or Volstead Act in 1920 through the 18th amendment of the US Constitution. Initially the consumption of liquor dropped but later it came back to its pre-Prohibition Era levels. The reasons of prohibition demand in USA was to reduce the tax burden created by prisons & poorhouses, to improve health and hygiene in America, but the production, importation, and distribution of alcohol was taken over by criminal gangs, which fought each other for market control in violent confrontations resulting in further crime. Prohibition came into force at 12:00:01 a.m. on January 17, 1920, and the first documented infringement of the Volstead Act occurred just 59 minutes later in Chicago. According to police reports, six armed men stole $100,000 worth of "medicinal" whiskey from two freight train cars. This trend in bootlegging liquor created a domino effect with criminals across the United States. Some gang leaders were stashing liquor months before the Volstead Act was enforced.

The state lost immense revenue during the period of 1920-1933 and yet Enforcement became very difficult throughout because some states such as Oklahoma or Kansas had prohibition laws already in the books so they enjoyed a stronghold in maintaining the Volstead Act whereas in some states like New Jersey and Maryland which were very anti-prohibition in nature, the law and order situation was a sudden shift in status quo. This situation can be compared to current Indian situation where states such as Punjab which categorized liquor as essential item during Nationwide Lockdown and Gujarat where modern India’s longest alcohol ban is still in place. The burden of enforcement in the US fell largely on the shoulders of the Federal government to ensure nationwide adherence to the law. As a result, the newly made Bureau of Prohibition in USA assumed the role of chief law enforcement agency for Prohibition. However, funds allocated to the bureau only allowed for approximately 1,500 agents to serve the entire country.

The other reasons for failure of Prohibition in US could be pointed as:

Rise is smuggling, bootlegging,
Complicity/connivance of authorities and police
Making illicit liquor such as Moonshine at home
Extreme nature and sudden implementation of the Act
And adverse Withdrawal Symptoms & Suicides (akin to reports by Indian media during strictest version of Lockdown.)

The Act ultimately caused unforeseen consequences and created newer problems and hence was repealed by, again a Constitutional Amendment.

Why Banning is Not A Solution in India

In Bihar, the major reasons of the plight of women were downward spiral of debt, poverty and violence against women and crime. A study found significant effect of the ban on reducing violent crimes in Bihar (murder, rape, kidnapping, dacoity, robbery, and riots). But a follow-up study in 2018 found that crimes related to alcohol was still rampant in Bihar and the effect has been made minimalistic due to smuggling from neighbouring states. [Also discussed in Soch by Mohak Mangal's video: https://www.youtube.com/watch?v=0lFMXabUWlU ] In fact, it is observed that in all the regions including Muslim majority countries where alcohol is banned, smuggling and black markets of alcohol flourish and the revenue lost by State in Excise Duties is gained by asocial elements which further compounds social problems and result in increase of criminal activities. In India if a nationwide ban takes place, the adverse effect of bans creates two-fold problems for state as well as its citizens.

State	Citizens
Huge Revenue loss Further strain on already burdened law & order machinery to comply the law	Withdrawal symptoms and adverse health effects due to hooch otherwise law-abiding citizens will engage in activity that is now considered criminal

The banning has failed in erstwhile Andhra Pradesh, Kerala, Manipur & Tamil Nadu. It was noticed in TN that, whenever alcohol prohibition was imposed, illegal sales of toddy and arrack and consumption of methanol would rise, resulting in loss of many lives; thus, the ban would be lifted.

The prohibition is clearly mentioned as desirable in in Indian Constitution [Directive Principles of State Policy, Article 47] in which it is the duty of state to prohibit intoxicating substances but with respect to alcohol, the Indian State has always operated within an inherent conflict of interest where, on the one hand it has responsibility for the health of its citizens and on the other hand, it is highly dependent on the revenue from the sale of alcohol and associated industries

Alcohol taxes are the second major revenue-source for a majority of state governments, after sales tax. Further, designing a strong alcohol policy in an economically weakened state has proved to be inefficient and counterproductive by a preliminary study. These are major problems to implement a nationwide ban on alcohol in India. Quite contrary bans usually make people seek the object of their affection or abuse somewhere else as online searches for “how to make alcohol at home” peaked in India during the week of March 22–28, the same week the nationwide lockdown was imposed. Higher tariff for alcohol which worked in USA to reduce consumption wouldn’t work also in India as people would simply find local alternatives to alcohol such as hooch or toddy.

Conclusions & Prevention

Since bans often don’t work, we need other innovative and pragmatic methods to deal with alcoholism and associated problems. Education comes foremost. Myths, such as alcohol is a mood enhancer (it is a depressant), it helps in sleeping (according to National Health Portal of India, it doesn’t), it is a western import (was mentioned in Vedic period) and its supposed health benefits like a cure of kidney stones or even Covid-19 must be disproved with the help of Education and Awareness. Since very young age group (13-17) is falling victim to early alcohol use (Lancet), the social and psychological care must begin in schools. There must be a strong familial, social support for people who wants to seek treatment for their alcoholic nature. The Government has around 100 Deaddiction Centres already in place with centre at AIIMS being the headquarter of the network. In these centres, already 50% patients who seek treatment are alcoholics and these centres must be advised and made available to patients and must be properly maintained. Self-help groups like Alcoholic Anonymous and NGOs networks must be strengthened.

A three-pronged approach can be used to deal with alcohol use disorder menace, similar to the method used by Govt of India to deal with substance use disorders. The three broad category which are to be worked to address the problem are:

Supply reduction (nodal agencies- Ministry of Home Affairs)

Demand reduction (Ministry of Social Justice and Empowerment)

Harm reduction (Ministry of Health & Family Welfare)

Finally, the biggest challenge will be in helping those who wish to not go back to drinking. For those in recovery or wanting to start on that path, it is important that they feel the decision to stop drinking is an autonomous one that is regulated through choice as an expression of oneself and not pressured by environmental forces. Long-term health benefits crucially result from autonomous behavioral decisions and behavioral changes resulting from such decisions that are not externally regulated are more sustainable. Their rehabilitation and constant support without relapse would affirm that alcohol can be defeated in some volume.

Research Articles:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)61939-X/fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014857/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7237931/

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3165159

https://www.cato.org/publications/policy-analysis/alcohol-prohibition-was-failure

https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2005.065409#_i2

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5659092/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470475/?report=reader

https://www.nhp.gov.in/healthlyliving/alcohol-use-disorder

https://www.nhp.gov.in/disease/digestive/liver/alcohol-abuse-and-alcoholism

https://www.nhp.gov.in/quit-alcoholism_pg