Philip Hensher: Bullying us won't change our behaviour

No one can deny that there is a problem with drinking in this country. But what is needed is less of a punitive approach and more of a nudge

About 10 years ago, the authorities at Schiphol airport decided to address a problem.

Their men's lavatories needed cleaning, they believed, much too often. It's obvious, psychologically, why this might be. Most visitors to an airport are not going to come back very soon. They might simply be passing through Schiphol with no connection to the place. The sort of small civilities that come naturally in a home setting or a familiar place – tidiness, politeness, cleanliness – fall by the wayside.

Since it was a psychological problem, the Schiphol authorities tried a psychological approach. They etched a fly into the urinals. It worked perfectly. Male readers will recognise that, standing in front of a urinal with a fly on it, it is almost impossible not to aim directly at the fly rather than spatter all over the place. The cleaning bills resulting from the men's urinals fell dramatically. Nobody hectored anyone; no threat of fines; no instructions, even. A perfect example of "nudging" people into socially constructive behaviour.

A small example. There are other, much larger examples of socially destructive behaviour to hand. Take, for instance, drinking. Everyone knows that the drinking of alcohol in this country is out of hand. Everyone understands that the social burden of alcoholism and mere drunkenness is approaching epidemic levels. On the other hand, most people acknowledge that alcohol is a great pleasure in many people's lives, and that social bonds of a very useful type often involve the drinking of alcohol at some point.

It ought to be possible to distinguish between the sort of behaviour that involves a pleasant few drinks with friends at a party, in a pub or in a restaurant, and the sort that ends in casualty, in chronic illness, in the loss of job, home and family. It ought to be the job of government to guide us towards the first sort of behaviour, and away from the second. Is it possible to do this through "nudging" – of the sort of incentives which actually co-opt our instincts?

It is fair to say that, if the medical authorities in this country were in charge of the men's toilets at Schiphol airport, it would not have occurred to them to paint flies on the porcelain. Instead, they would have decided to close down all but one toilet in the airport. They would have erected huge notices by the urinals instructing us exactly where to widdle. They would have mounted surveillance operations noticing exactly who went into the toilet to pee. And finally, they would probably have persuaded the airport to forbid all pissing altogether.

That, more or less, seems to be the approach of much of the medical establishment to drinking. This week, the Royal College of Psychiatrists addressed the problem of drinking in the over-65s, in a report sensationally entitled "Our Invisible Addicts". Their conclusions were that many elderly people are drinking too much. Depressed, bereaved or isolated, they may drink to pass the time. Their bodies are less able to metabolise alcohol, and if they are taking medicine, it may not mix well with alcohol. Therefore, the RCPs recommended that GPs regularly screen patients for signs of alcohol dependency, and that the recommended daily limit of three units for men, two for women, be reduced for the over 65s to 1.5, or 12g, or a half pint of beer.

Yeah, that'll work.

As far as I know, no sane person gives any kind of credence to these safe drinking limits. When you look at the wide variation in limits across the world, it does seem as if few authorities have been able to agree on an accurate answer. Looking at different advice from European authorities, a 75kg man of retirement age can drink between a small glass and a bottle of wine a day.

Resistance to this sort of medical advice on the drinking of alcohol is quite high. In part, it seems down to the splendid comment of Emma Soames, editor of Saga magazine, on hearing about this report: "The right to get quietly sozzled in your armchair is sacrosanct." In part, it defies common sense and experience to think that a man of 65 would invariably endanger his health by drinking a pint of beer a day. But mostly, it is just a dislike of being told what to do, often expressed in no uncertain terms.

No one can deny that there is a problem with drinking in this country. A minority of people of all ages drink to excess, and their behaviour affects not just themselves, but those around them, and society as a whole. Take a trip down Clapham High Street on a Saturday night, or to your local A and E department around one in the morning. Evidently, the problem isn't one of stepping over official limits.

What is needed, clearly, is less of a punitive approach, less of the traditional GPs' route of leaflet-and-lecture, and more of a nudge. What is needed is the fly in the porcelain, the small intervention which will make drinkers themselves think "Do you know what – I don't think I will tonight", or just "OK, just the one", and mean it. What is that nudge? Perhaps it is in setting a minimum price for alcohol. Perhaps, like Sweden, it may lie in stopping supermarkets selling alcohol, and limiting retail to specialist outlets.

Perhaps one could leave it to the discouraging sight of elderly pissheads lying about the streets at 11 o'clock in the morning.

What that nudge is I don't think we know yet. But it seems absolutely clear that it doesn't lie in prescriptions and units. I know what many readers over 65 who like a drink will have done on reading these new limits. They'll have poured themselves another stiff one.