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Controversy is brewing over the proposed expansion of alcohol sales outlets in Nova Scotia. The proposal would make alcohol available at retail locations like grocery and corner stores. Its advocates assert that consumers, retailers, and alcohol producers would benefit from the new retail framework, while health experts strongly oppose the move.

The Canadian Federation of Independent Business (CFIB) is lobbying for increased retail access points for alcohol purchases, asserting that Ontario, British Columbia (BC), and Quebec have already made the move with successful results.

“The government is looking to modernize how alcohol is sold interprovincially, and they’re reviewing direct-to-consumer trade,” Duncan Robertson, director of legislative affairs (Nova Scotia) for the CFIB, told Medscape Medical News, describing what prompted the proposed policy change. “Nova Scotia is really a laggard compared with many other Canadian provinces.”

Convenience stores argue that the proposal would ensure that consumers can choose where they spend their dollar. “Rather than [supporting] a faceless government monopoly, they can support a small business owned by members of their community,” said Robertson. In a recent survey sent to CFIB members in all Atlantic provinces, out of a sample size of 390, including 130 from Nova Scotia, 78% of respondents either strongly supported or somewhat supported the idea that some private retail sales points, such as convenience stores, grocery stores, and large retailers, should be permitted to sell alcohol.

“For consumers, having greater choice is important, but the possible impact on local producers is important as well,” said Robertson. He noted that the success of craft breweries, cideries, and wineries depends on their ability to get their product on Nova Scotia liquor corporations’ shelves. “When we look at agency stores, if a local brewer wants to sell at an agency store down the street, if their product isn’t on the predetermined local product list, they can’t sell at that agency store.” With expanded access, private retailers would be able to provide these products directly to the community.

The CFIB isn’t advocating for hard alcohol because that’s not in the works in other provinces. Ontario, for example, caps what can be sold at corner stores based on the amount of alcohol by volume, which is 7.1% in that province.

Experts’ Opposition Mounting

The proposal is facing strong resistance from public health organizations and doctors, who cite a potential increase in disease and mortality rates, along with the overloading of hospital emergency rooms, which already are overtaxed.

In Ontario and BC, after alcohol sales were expanded to grocery stores in 2015, an additional 24,000 hospital visits were attributed to alcohol annually, according to Brandon Purcell, advocacy manager for prevention and early detection at the Canadian Cancer Society. “In BC, a study found that for every 20% increase in privately owned stores selling alcohol, deaths caused by alcohol increased by 3.25%. Nova Scotia is proposing changes that would likely double the number of outlets where alcohol is sold, which likely means even greater public health risks,” Purcell explained.

Alcohol is a group 1 carcinogen, on a par with tobacco and asbestos, he added. “We know from Canadian research that greater availability of alcohol leads to higher consumption and more harm. At a time when provinces, including Nova Scotia, are seeing shutdowns of hospital emergency rooms, expanding access to alcohol is a policy that will predictably result in more emergency visits, hospitalizations, and preventable deaths.”

Increased Disease and Death

Ian Culbert, executive director of the Canadian Public Health Association, noted that in BC, a 20% increase in private liquor outlets was associated with a 3% rise in per capita consumption. A similar impact was seen in Ontario. “You’re increasing consumption of a product linked to more than 200 health conditions, including multiple cancers and liver disease,” said Culbert. “We’re dealing with emergency rooms across the country that are already overwhelmed, and emergency care is the most expensive hospital care sector. 

“The government has an addiction to the revenue from the sale of tobacco and alcohol, both of which kill people,” Culbert continued. “We’ve had warning labels on tobacco for decades, and we should have the same for alcohol.” Alcohol’s effect on public revenue is negative when one considers its cost to health systems and society, he added. “The proposed change isn’t a good deal for anybody except shareholders of distilleries, breweries, and wineries.”

In May, Nova Scotia announced that it was launching a monthlong public survey of 1500 Nova Scotians older than 19 years to assess public opinion on retail options for alcohol sales and the health impact of possible changes.

Robertson, Purcell, and Culbert reported having no relevant financial relationships. 

Evra Taylor is a widely published freelance medical writer and reporter with 20 years’ experience covering a broad range of therapeutic sectors, including family health, cardiology, psychiatry, ophthalmology, and dermatology.