First Labour stubbed out smoking. Will it banish booze too?

Inside The Beehive, a barman moves between empty tables, setting out white napkins for the lunchtime trade. It’s midweek, just after midday, and so far only six customers have turned up at the suburban pub: a cheery, grey-haired bunch of a certain age.

While the punters await their meals, they mostly sip wine or beer. Daytime drinking among workers is far less prevalent these days, but perhaps for pensioners the same does not apply – or perhaps not yet.

The Beehive opened on a quiet Enfield street almost a century ago. Landlord Glenn Breslin bought it in 2006. The other local pub he runs, the Grade II-listed, low-beamed Pied Bull, was once owned by King James I.

But today, Breslin is worried. Sir Keir Starmer wants to extend the existing smoking ban to cover outdoor venues such as beer gardens. If this were to happen, he fears the business would be done for.

“We’d all be shut,” he says bluntly. “Half my customers smoke. It will be the nail in the coffin of the pub industry.”

Battlelines have been drawn. On one side, ministers and health experts, who argue that a crackdown would help reduce preventable deaths and the toll tobacco-related disease takes on the NHS. On the other side, members of the hospitality sector are sounding dire warnings about the disastrous effect they feel further restrictions would have on trade.

A public health minister’s remarks this week about tackling excessive drinking did little to calm nerves. Speaking at a fringe meeting at the Labour Party conference in Liverpool, Andrew Gwynne said discussions about the problem were needed, “even if it’s just about tightening up on some of the hours of operation; particularly where there are concerns that people are drinking too much”.

The Department of Health and Social Care quickly denied that the Government was considering closing pubs early. Nevertheless, no-one is denying that the future public health agenda will be focused on preventing, and not merely treating, sickness. In his conference speech on Wednesday, Health Secretary Wes Streeting used the words “prevention” and “preventative” no fewer than five times.

A new health “mission board” chaired by Streeting was said by Gwynne to be working on a five-point plan, with alcohol harm one of the key areas. “The availability of alcohol, the harms that overdrinking does, domestic violence, the licencing laws” were all said to be within its sights.

Alcohol is peculiarly embedded in British history – from the dystopian scene of drunkenness depicted in William Hogarth’s 1751 Gin Lane, to Winston Churchill’s declaration that “I have taken more out of alcohol than alcohol has taken out of me.” In 2007 the removal of the Crown stamp from pint glasses, in favour of the EU’s CE mark, sparked an outcry and became a rallying point for pro-Brexit campaigners.

In 2024 drinking remains a part of British life, and plenty hope to keep it that way. At their own party conference starting this weekend, Conservative leadership candidates will likely attempt to burnish their credentials as libertarian-leaning free market champions, in contrast to Labour’s so-called “nanny state” inclinations (and those of former Tory prime minister Rishi Sunak, who hoped to ban smoking for future generations).

But the Government may be pushing at an open door. One in four young adults aged 18 to 24 is now teetotal, according to a survey published by the charity Drinkaware this week.

This continues a trend that has emerged in recent years, of young people rejecting the boozy ways of older generations (with those aged 55 to 64 now the biggest drinkers).

Could this cultural shift, coupled with a potential new policy drive to reduce consumption further, send alcohol the same way as cigarettes: from the mainstream to the margins?

The demise of smoking

For those who came of age after 2007, it can be hard to believe that until so recently our pubs, bars and nightclubs were thick with cigarette smoke. That the stale stench of it would cling to clothes for days. That even restaurants had an indoor smoking section.

But behaviours and social norms that appear deeply entrenched can change surprisingly quickly. The years following the introduction of the indoor smoking ban by Labour saw a huge shift in behaviours and health outcomes. By 2017, the proportion of smokers in the UK population had fallen from 20 per cent a decade earlier to 15.6 per cent, which translated as 7.9 million fewer smokers.

Today, only 13 per cent of people smoke, and their average daily number of cigarettes has decreased. Average consumption fell from 13.6 per day to 10.6 between January 2008 and October 2019, a 22 per cent reduction, according to researchers at University College London. They note that the trend has stalled since 2019, possibly due to the availability of cheap, hand-rolled tobacco.

In contrast with alcohol, health warnings in the form of graphic pictures have been mandatory on cigarette packets since 2008. Ireland last year introduced regulations to ensure all alcohol labels include warnings about cancer and liver disease, as well as the risk of drinking during pregnancy. In the UK, a pregnancy warning label became mandatory for packaged alcohol products in August 2023. There is no legal requirement for alcohol labels here to display other health warnings, but campaigners are urging ministers to introduce such requirements. A lack of such warnings impedes consumers from making informed choices, and therefore “isn’t liberalism or freedom,” argues Richard Piper, chief executive of Alcohol Change UK. “It’s pernicious.”

If drinkers are given health warnings on labels, they are free to make their own choices, he believes. As it stands, there remains a lack of awareness. “If you ask people, ‘do cigarettes cause cancer?’ yes [they] know this,” he says. “If you ask ‘does alcohol cause cancer?’ they’re not sure. But it’s a group one carcinogen.”

One of the main arguments against the smoking ban in the Noughties was the damage it might do to pubs: what if all the smokers simply stopped visiting their locals?

It’s true that pubs have been struggling since, with another 500-plus closing for good in 2023, according to data from the British Beer & Pub Association. But even those in the industry don’t put it all down to the smoking ban. Such closures have been ongoing for decades, with pub numbers falling by 12,450, or 20 per cent, between 2000 and 2017. A 2014 report by the Institute of Economic Affairs found various reasons for the decline, among them regulations like the smoking ban. Other factors cited in the report included economic conditions, increased taxation and, yes, reduced alcohol consumption. Even a decade ago, the signs that Britain was losing its love of liquor were starting to appear.

“The smoking ban affected a lot of the industry,” says Breslin, although he personally benefited by being able to sell more food. “We did lose a lot of our wet trade,” he adds. “It’s declined over the years with different factors involved: people not going out, buying [alcohol] from supermarkets, lockdown…”

Against this challenging backdrop, an outdoor smoking ban “would finish us all off,” he predicts.

Attitudes to alcohol

On Wednesday night in Marylebone, the Lucky Saint pub is crammed. There are drinkers squeezed onto every available chair; protectively guarding tables to prevent others from swooping.

Outside, young people spill out onto the street. The bartenders are run off their feet.

But this isn’t your average central London boozer. It is a pub “reimagined for the modern drinker”, and offers a wide selection of alcohol-free drinks, as well as alcoholic ones, catering to the growing demographic of those who do not need to get drunk to have a good time.

“I just don’t like the feeling of getting drunk anymore,” says Yueli Ang, a 33-year-old project coordinator sipping an alcohol-free beer. “I don’t need to be intoxicated to have fun. So I just stopped. If there’s a non-alcoholic option, I’ll always pick it.”

The peer pressure to drink has ebbed away, she suggests. Indeed, more than half the drinkers in the pub around her seem to be eschewing alcohol.

Boozing will go the way of smoking, eventually falling out of favour entirely as alternative options take over, believes Alon Miss, a 26-year-old commercial associate. “I think alcohol is going to be one of those things where it’s not cool to do it outside of very specific social situations,” he says. “On a Wednesday night, do you really need that pint? Or can you just get something non-alcoholic?”

Since the answer to the second question is now very much yes, he expects there will eventually be little thirst for alcohol.

“Smoking went through the process of [being recognised as] really bad.

For a long time, people just didn’t have an alternative, and then, unfortunately, the next alternative that came up was vaping, and now that’s not looking cool anymore [and] people are just going straight to nicotine patches,” he says. “I think that same progression will happen with alcohol.”

Uncool or otherwise, three young women stand vaping outside the pub. Plumes of smoke billow into the night, but none of it from cigarettes.

Meanwhile, around the country, universities are welcoming freshers to what is now often rebranded as “welcome week”. Once synonymous with binge drinking, today’s initiation into student life reportedly includes such sober activities as board games and puppy yoga.

If reports of the death of freshers’ week are exaggerated, the data on young people’s drinking habits certainly suggests a shift away from the drunken messiness embraced by Millennials and Generation X.

The reasons are thought to be various. “It seems to be related to greater health consciousness, lack of financial security, social media and a sense that drinking [isn’t] as transgressive when your parents drink quite a lot,” says James Nicholls, a senior lecturer in public health at the University of Stirling.

Class divide

At the same time, alcohol regulation has been gradually tightened (albeit far less than campaigners would like). Changes to alcohol duty introduced last year mean drinks are now taxed more the stronger they are – a move designed in part to help meet public health goals.

Under the Challenge 25 scheme adopted by retailers in 2009, anyone over 18 who looks younger than 25 is encouraged to carry ID if they wish to buy alcohol.

There is no shortage of ideas for further measures. In June, the British Medical Association, supported by at least 17 other organisations, called for England’s legal drink-driving limit to be lowered from 80mg of alcohol per 100ml of blood, to 50mg for most people, and to 20mg for new and commercial drivers.

This month, scientists at the University of Cambridge suggested the pint glass could be swapped for a smaller measure, to improve health.

As for pricing, so far, average alcohol costs have increased much less steeply than those of cigarettes. In 1997, you could buy a 20-pack of cigarettes for £2.92 and a pint for £1.79. Today, the cigarettes would cost you £15.90 (a 445 per cent increase) and the pint £4.80 (a 168 per cent increase), according to Office for National Statistics (ONS) figures.

Yet these relative costs do not appear to influence the demographics of who is most likely to smoke and drink when it comes to social class. According to NHS data published in 2022, the most deprived group of adults contained the highest proportion of non-drinkers (33 per cent), while the lowest proportion of non-drinkers was found in the least deprived, or most well off, social group (18 per cent).

But those from more deprived areas were more likely to smoke, despite the expense (19 per cent did at the time), while the habit was least common among the most well off (just six per cent).

As things stand, the middle-aged middle classes, at least, look wedded to their wine, beer and spirits.

Where we’re heading

The NHS is in trouble. An ageing population with more complex health needs, coupled with outdated systems, has put it under more pressure than ever before. The pandemic hardly helped. Ministers are looking for answers, one of which will be prevention.

By some estimates, 40 per cent of NHS costs go on treating preventable conditions. Before Labour won power, the Conservatives were already arguing in favour of tackling this. “[It’s] the only way we can reduce the demand on the health service, and the state, in the long term,” wrote the then Health Secretary Sajid Javid in the Telegraph in 2022.

Gwynne told his conference audience that Professor Sir Chris Whitty, the Chief Medical Officer, has warned ministers that if current trends continue, 60 per cent of the NHS budget will eventually be spent on preventable illness.

The argument is that tackling drinking – as well as smoking and obesity – will ultimately save public money. Alcohol has been linked to more than 60 medical conditions, including several cancers. In 2022, there were 10,048 deaths from alcohol-specific causes in the UK, the highest number on record, ONS figures show.

“You’ve got changes in culture among younger people but the legacy of heavy drinking among older people,” says Nicholls.

Smoking is estimated to cost the NHS £1.9 billion each year, while drinking costs it £3.5 billion. Although alcohol is taxed at £12.6 billion each year, this apparent high rate of return for the public purse does not reflect the societal costs of drinking. The Government estimates an additional cost of £21 billion in policing and crime, with the ONS estimating that two-thirds of violent crimes involve alcohol.

The near future looks likely to see a more interventionist government nudging people towards healthier choices. “That’s what public health is all about,” says Piper. “It might not be universally accepted, but it’s medical science that health architecture affects health behaviours. If you change those architectures, you improve lives and the economy, because a healthy workforce is a productive one.”

Others, however, have their doubts about the wisdom of further measures targeting smokers and drinkers. “There is a concern around the nanny state,” says Michael Kill, chief executive of the Night Time Industries Association. He worries about the potential impact on an already fragile sector. The potential closure of bars, pubs and clubs as a result of health policies could have a knock-on impact on people’s mental health, he argues. This, in turn, would have an impact on the NHS.

“Are we moving to managing public choices and is it going too far?” he wonders. Are we seeing “the tip of the iceberg”, he asks, of an agenda that could ultimately follow the Scottish system, in which public health must be formally considered in alcohol licensing decisions?

“That would have a considerable impact on our industry, given we’re already in a challenging environment,” he warns.

Much of the consumption of alcohol takes place within the home, outside the licensed environment, points out Kate Nicholls, chief executive of UKHospitality. “You don’t want to have shifts of behaviour from consumption in a supervised, regulated environment to an in-home environment where you may have worse health consequences,” she says.

Public health “nudges” can deliver unforeseen consequences, she says.

Glass half empty

Back inside Lucky Saint, the health-conscious youth wear devices on their wrists. These WHOOP fitness trackers, which several drinkers are sporting, record personal health data and measure sleep.

“I started drinking non-alcoholic beers because after drinking even just one beer, my sleep is messed up that night,” explains Hiroki Hirayama, a 28-year-old financial modeller enjoying a sober evening. “Health trackers like this tell me that alcohol is just not good for you.”

The kids are alright, then; but what about everyone else? Is alcohol really on what we might call the cigarette pathway? Probably not quite. “Different substances or behaviours require different approaches,” says Piper. “We’re not for a society that has no alcohol drinks in it. We want to see an end to the harm that comes with that and completely believe that’s achievable.”

Nicholls likewise points to the obvious differences between tobacco and alcohol. “It became widely accepted that even being in the same room as someone smoking was a health risk,” he says. “Someone could have a drink on a plane and you wouldn’t know it.”

Although we are in the middle of a “social shift”, he says he would be surprised if the cultural status of alcohol in Britain became comparable to that of cigarettes.

Even some of the young and sober crowd seem to feel there will always be a place for it. “I think that reducing how much alcohol you’re drinking will increase,” says Beth Marchant, 27. “But I don’t think it will disappear entirely.”