It was hard not to feel sorry for Liam Donaldson on Monday morning. Arriving at a press conference to announce his latest strategies for improving the public’s health 24 hours after the most controversial of his plans was splashed across the Sunday papers, he had the right to feel ruffled and angry. But he showed no signs of being crestfallen and when asked if he was annoyed – perhaps just a little bit? – about the breaking of the embargo on his 2008 annual report he answered slowly and calmly that he was not. And you had to believe him. England’s chief medical officer had been through this before after all, he told journalists. About to announce his plans for a ban on smoking in public places he was getting ready in his hotel room when he saw on the TV news a government minister reject the idea outright. “It will never happen,” the minister had said. But the idea was hatched, debated, and became law within a couple of years.

Gordon Brown slapped down the proposal for a minimum tariff of 50 pence on a unit of alcohol even before the idea left Donaldson’s lips. The PM called it unfair to punish the sensible majority who drink responsibly. While there might be some truth in what Brown says, it is hard to do nothing about the victims of excessive drinking. Donaldson wants to introduce us to the idea of passive drinking and the damage irresponsible drinking has on other people. There are the 1.3 million children whose lives are blighted by excessive drinking, the 6000 babies born every year with fetal alcohol syndrome, the 7000 people injured annually by drink driving and the 560 who die from it. Then there are the 125,000 instances of alcohol induced domestic violence every year, the 39,000 alcohol fuelled sexual assaults that get reported, the vandalism and the aggression.

The government has tried promoting responsible drinking by highlighting the personal damage it can cause. So why not try the approach of making drunken behaviour no longer unacceptable? Donaldson asked us to imagine a country where no child has to cower in the corner while its mother is beaten by a drunken partner, where nobody has to see a relative die young from drinking too much alcohol, and where the streets are free of urine and vomit on Sunday morning. Sounds good to me.

So it’s strange that a proposal which is backed by evidence – the levy will hit the heaviest drinkers hardest and those who drink moderately less so – has been received so coolly. The BMA might be the one body that you would expect to put its weight behind Donaldson’s levy. But its response – given out only on request rather than the more usual press release – lacked lustre. The organisation, which blazed the campaign for banning smoking in public places, admitted that the policy was backed by evidence – that pricing did indeed affect alcohol consumption – and that the idea should be “considered”. But it fell short of endorsing it.

Donaldson is the first to admit that raising the price of alcohol is going to be controversial. We have all got used to drinking from a nice bottle of red and still have change from a tenner. Raising the price of a bottle of wine to at least £4.50 and bottle of whisky to at least £14 might hit the middle classes more than the law that makes smokers leave a public building every time they want to light up. But as Donaldson said, who has a plan B? Too many lives are being shattered by excessive drinking, and the conversation about how to tackle it needs to be spoken out loud.

Zosia Kmietowicz is a freelance journalist.