Alcohol, age limit and Imran Khan’s PIL: Are we overdoing ‘freedom?’

Maharashtra has raised the legal drinking age to 25. Reactions have ranged from ‘strange’ and ‘absurd’ to downright ‘challenge to individual freedom’. Are these things so black and white? Most countries have used a cut off for legal drinking at around 21. And the advantages and disadvantages of raising it from 21 to 25 needs to be studied and debated. But the current insistence of the critics to lower it to 18 does not have much basis from a public health perspective.

First of all, raising age limit to control alcohol use and the related hazards is a strategy that has strong ‘evidence basis’ to support it. I am not talking ‘what I feel strongly…’ or ‘probably we can infer’ kind of facts seen in columns but hard evidence from methodologically robust studies. What is the nature of hazards  we are talking about?

Alcohol use is the third leading risk factor for poor health globally. It has been estimated in India that while the gains in terms of revenue from alcohol sales are Rs 216 billion every year, losses from adverse effects of alcohol  are estimated to be Rs 244 billion, apart from the immeasurable losses due to multiple and rollover effects of alcohol use. Needless to say, the available estimates are merely the tip of the iceberg. Now coming to youngsters, it has been shown that some one initiating alcohol use after first two decades of life have much lesser chances of developing adverse consequences or pathological patterns of drinking than who starts before. In countries where it has been debated whether drinking age should be lowered from 21, considerable amount of evidence shows that it may not be a good idea (1,2,3,4,5,6,7,8). In fact restrictions at the level of availability of alcohol works better than school based education methods (which doesn’t work despite our common sense inferences). So there is again hard evidence to suggest that ‘just knowing’ the issues related to alcohol use is not enough to deter a teenager from alcohol use. The peer pressure is too strong.

Now coming to ‘it is my freedom of choice’ argument. Basically the argument is that if you can marry and vote at 18, why can’t you decide to drink or not at 18? I am of the opinion that equating all these together is of no value because they are not comparable issues. A teenager at age 16 can give consent to surgery or any other medical procedure. Legal age for sex is 16 years and criminal liability is from 12 years. According to the above said argument, why cant we make the legal age for marriage and voting 12 or 16 years? What we have to understand is that 18 years has been a cutoff for many things due to arbitrary reasons. It doesn’t have to be the absolute benchmark for everything. Now again coming back to the ‘hindrance to freedom’ argument. We have many drugs which are illegal as per law. But isn’t government hampering my freedom to use these drugs by declaring them illegal? What I am trying to say is that our freedom or absence of freedom in society is not a blank cheque but will depend on the effects of that freedom on the society.

I am not saying that legal age for drinking should be 25. But let us have some constructive evaluations regarding the benefits and harms of raising it from 21 to 25. It would be much more worthwhile than this collective chest thumping.

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