In this photo taken on Tuesday, June 7, 2016, cars drive in front of a billboard at the Havana Club on Biscayne Boulevard in downtown Miami.(Photo: Alan Diaz, AP)

When health officials wanted to reduce the number of deaths from tobacco, they spread messages about the proven risks of cancer, pushed the ban on smoking in public places, and worked to raise taxes on tobacco. the cigarettes.

Alcohol, which causes 88,000 deaths a year in the United States, is an equally serious public health problem. But the way forward is less clear.

What worked with smoking may not work with the drink, which still enjoys broad social acceptance. Almost all potential solutions face considerable obstacles.

Studies have shown that the number of alcohol-related deaths has increased between 35 and 50% since 2000, but it has never been cheaper to drink. The Trump Administration's tax cut last year included an 18% reduction in the federal tax on beer, wine and alcoholic beverages.

States with more stringent alcohol control policies had lower rates of alcohol abuse, according to a report 2014 analysis of state laws and taxes.

The excessive occasional consumption of alcohol is responsible for about half of the deaths attributable to alcohol, two-thirds of the years of life lost and three-quarters of the economic costs.

Legislative approaches face the same challenges as tobacco: legislatures support the alcohol industries of their home countries in the same way that they resist political threats to local tobacco interests.

Less than 60% of the American adult population drinks alcohol. But if the goal is to influence lawmakers, says David Jernigan, this population includes the right people.

More: Alcohol kills more people, and younger. The largest increases are for women

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Jernigan, a professor in the faculty of public health at Boston University and specializing in alcohol research for 30 years, says that he does not drink because "I like to keep my head around me ".

Nevertheless, he adds, "it's so socially acceptable, especially among law writers, it's the drug of choice and incredibly standardized for high-income people in the United States."

Among the approaches that yielded results:

Increase taxes: Alcohol is subject to excise taxes, which are based on the volume sold, and sales taxes, which are based on the retail selling price. According to the Centers for Disease Control and Prevention, a 10% increase in taxes leads to a 5-8% drop in alcohol consumption.

For the states, it is good news and bad news. Although reductions in alcohol consumption can save states money on Medicaid for low-income and disabled residents, reduced sales reduce state revenues.

David Jernigan is a professor at the School of Public Health at Boston University. He has been studying alcohol for about 30 years. (Photo: Courtesy of David Jernigan)

Richard Berman is the CEO of Berman & Co., a public affairs company representing the alcohol, tobacco and restaurant industries.

He says higher taxes can encourage people to buy cheaper brands, if they live near a state border, to travel to a neighboring state with lower taxes.

Jernigan is not in agreement.

"The taxes on alcohol are a victory, a victory in the other," he said. "States receive more money and people drink a little less".

Limit sales. State and local governments often limit the number of licensed liquor stores in a region and the number of days and hours they can sell.

The Community Prevention Services Working Group, part of the US Department of Health and Social Services, recommends that states oppose the privatization of alcohol sales, which is linked to a median increase of 44% in sales, which leads to a reduction in alcohol consumption.

States that do not limit or control alcohol sales have 50% more alcohol per capita than those who do, said Marathon Strategies in 2014.

In states with population ceilings, there was one store for 10,204 people. In states that had no ceiling, there was a shop for 5,737 residents.

Improve access to treatment. According to a study from the Administration of Addiction and Mental Health Services reported in 2017, only about one in 10 people requiring treatment for a substance-related disorder receives the care they need.

Psychologist Ben Miller, who is in charge of the strategy for the Well Being Trust, said that dependents need to be identified much earlier and linked to "first stop" treatment, including in emergency rooms and prisons.

The integration of mental health workers into primary care physician offices, he says, could "help countless lives, save millions of dollars and begin to transform the culture of care for that" It is more complete ".

Psychologist Benjamin Miller is the head of strategy for the non-profit advocacy group, the Well Being Trust. (Photo: The confidence of well-being)

Strengthen coping skills. About 15% of deaths attributed to alcohol are suicides. Attacking addiction would also help dispel feelings of hopelessness.

The Well Being Trust called for a "National Resilience Strategy".

The non-profit association says investing in early childhood policies and programs would have the greatest impact.

In his According to this year's Pain in the Nation report, the Well Being Trust calls for better early identification of trauma and mental health issues in school-aged children to help them cope with stress and trauma before they get older. turn to alcohol and drugs.

"The most important substance we should be looking at is alcohol, because it causes a lot of things, including physical violence and rape, that should not happen," said Jernigan. "We must stop accepting that there is nothing we can do about it."

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