How to reduce fetal alcohol spectrum disorder

1 News reports:

An alcohol harm prevention expert is calling for change after a damning report estimated the cost of alcohol harm to be at $9.1 billion dollars. 

The report was commissioned by the Ministry of Health in an attempt to estimate the cost of alcohol harm in New Zealand. 

It found the cost of fetal alcohol spectrum disorder at $4.8 billion, $4 billion in loss of productivity, and $2.1 billion in the societal cost of road crashes.

So half the cost is FASD. Reducing that will have huge benefits both economically and quality of life for those affected.

He said there was “really good strong evidence” and “international consensus” that the price, availability, and marketing of alcohol were “the most effective” things that New Zealand could change to reduce harm.

Not if we’re talking about FASD. FASD is not caused by me drinking. It is not caused me most people drinking. It is caused by moderate to heavy drinking by pregnant women in later stages of pregnancy. Eric Crampton tweets relevant stats here. Basically around 1% of pregnant women (who themselves are 1% of the population) drink heavily after the first trimester. Those pregnant women tend to be younger, lower income Maori or Pacific, smokers, have had previous children, pregnancies were unplanned and have no secondary qualifications.

Their heavy drinking during pregnancy does impose huge costs on society, and on the kids born with FASD who often go on to have wretched lives.

So how do you best make change here? You need to target 1 in every 10,000 New Zealanders. Do you do that with measures that impact everyone such as trading hours, price or do you look to do interventions aimed at a very small group of New Zealanders who can fairly easily be identified as likely to drink heavily in pregnancy?