SIZE matters.

That is the message behind a well-timed alcohol awareness campaign launched by the Scottish Government yesterday and aimed principally at women. Two generations ago women barely featured in statistics for alcohol-related disease and mortality. Historically, there was a greater sense of shame about women drinking and getting drunk but, as that stigma has faded, the numbers of women suffering serious health consequences from over-indulgence, including liver disease and breast cancer, have ballooned alarmingly.

This is not just because far more women are drinking far more alcohol far more often but also because, unfair as it may be, women tend to develop alcohol-related diseases and other consequences more quickly than men. Several biological factors make women more vulnerable to the effects of alcohol than men. This is particularly worrying in Scotland, where women drink more on average than their English counterparts. The 2010 Scottish Health Survey showed nearly four in ten women in Scotland drinking more per day and/or per week than recommended guidelines (a maximum of two to three units a day or 14 units a week, with at least two days alcohol free).

Loading article content

The "drop a glass size" campaign adopts a common sense approach that borrows its methodology from the world of dieting and exploits personal vanity. By drinking wine from a 125ml glass, rather than the so-called standard 175ml size or the 250ml "goldfish bowls" offered by many restaurants and bars, it is easier to moderate drinking, just as smaller plates are regarded as an aid to dieting. By echoing campaigns that encourage women to "drop a dress size", it also makes the often-overlooked link between alcohol and calorie intake. An accompanying smart phone app, showing how the ageing process is reduced along with reductions in alcohol intake, may be something of a gimmick but it has the advantage of nudging drinkers in the right direction without finger-wagging.

Scotland's dysfunctional relationship with alcohol is a complex one and nobody is suggesting that campaigns like this one can have an impact without a broad range of other measures to support it. The historically low price and widespread availability of alcohol play a part, which is why the Scottish Government's minimum alcohol pricing strategy deserves public support.

The licensed trade should contribute by ensuring that a 125ml glass always features among the choices on offer. The free distribution of 125ml measures would facilitate measuring alcohol units at home, where consumption is often dramatically underestimated.

Also there must be better recognition of the links between alcohol and poverty and the degree of self-medication with alcohol by women suffering from depression, stress and anxiety or struggling to cope with emotional problems. Is the Scottish story about women and alcohol not merely part of a broader cavalier disregard for personal health and an unwillingness to face up to the long-term personal and societal impact of unhealthy behaviour?