Alcohol Policy UK

King's Fund report explores drinking, smoking, diet and exercise links and impacts

The King's Fund has published research on the clustering of lifestyle behaviours, which explores the inter-linked relationships of smoking, drinking, diet and exercise across the population.

Many adults engage in more than one unhealthy behaviour, which can result in a potential 14 year gap in life expectancy if all 4 unhealthy behaviours are followed. The research found that the overall percentage of individuals engaging in 3 or 4 unhealthy behaviours had fallen from 33% in 2003 to 25% in 2008.

However the fall in numbers seems to be amongst those people from higher socioeconomic and educational groups. People with no qualifications were 5 times more likely to engage in more than 3 unhealthy behaviours in 2008 compared to 3 times more likely in 2003. Yet although lifestyle behaviours impact strongly on mortality risk, the impact on quality of life is not so evident. This may be interpreted as people not fully understanding the impact of adopting multiple unhealthy behaviours until it is too late.

These findings suggest the gap in health inequalities is still widening, with implications for policy and strategy development. How do we best motivate and support people to climb down the "risk ladder"? Should future policies and strategies focus on multiple behaviours rather than single issues? Which single issues should be prioritised?

The King's Fund does recommend that the NHS follows through the Making Every Contact Count agenda, and that there appears to be a need for health trainers and for commmunity champion roles to be further developed.

For alcohol behaviour change, IBA is known to be highly effective and should arguably be prioritised as having the greatest benefit of all lifeltysle brief interventions. However discussion has agreed that IBA must not exclude other lifestyle conversations as alcohol use, smoking and diet can be inextricably linked.

SIPS Junior trial underway; sessional researchers sought for London

The SIPS Junior research trial is underway, and the team are seeking to recruit sessional workers for part of the study.

The SIPS Junior research programme will provide estimates of the level of alcohol consumption and alcohol-related problems in adolescents attending Emergency Departments (EDs). It will also develop, implement and evaluate screening and alcohol interventions for adolescents in the ED setting. Funding was awarded by the Department of Health National Institute for Health Research (NIHR) to a consortium of research centres led by the Institute of Psychiatry (IoP), King's College London.

As part of the programme, 10 sessional Research Workers are needed to work in London Emergency Departments (King’s College Hospital, St George’s Hospital, Lewisham Hospital, St Thomas’ Hospital) between 8am until 4pm or 4pm until midnight recruiting 10 to 17 year olds into the study for the period of three months (September-November 2012).

Download the SIPS jr researchers advert here. To obtain further particulars, an application form and further information about the Institute, please email Paolo.Deluca@kcl.ac.uk.

Results of the adult SIPS trial are soon to be published following peer review. A post on IBA for children and young people: evidence, guidance and resources is available on the IBA blog.

Findings alcohol bulletins: Innovation in the South East; preventing youth drinking; changing the Welsh drinking culture? & more

Recent bulletins from the drug and alcohol Bank:

Lessons of test bed for alcohol harm reduction innovations
In the south east of England a bidding exercise generated a spate of short-term innovative projects to reduce alcohol-related harm. Five models including outreach and brief intervention were assessed as most promising and taken forward for further implementation and assessment the following year - an unusually intensive test bed from which others can learn valuable implementation lessons.

More does not always mean better in preventing youth drinking
Implementing alcohol use prevention tactics in a coordinated manner on several fronts at once - school, family and the broader community - ought to maximise impacts compared more limited programmes, but this authoritative review found no convincing evidence that this was the case. Even the evidence for any impact was patchy. Our analysis focuses on whether adding extra components adds extra value.

How to achieve positive change in Welsh drinking culture
What will it take for Wales (and by extension, the UK as a whole) to adopt safer drinking practices which cut the national burden of drink-related harm? This research report thoughtfully reflects evidence from reviews and recent and seminal studies, offering guidance not just on each intervention type, but on what the most effective mix might be.

Working with families helps prevent adolescent drinking
Authoritative review finds that offering families of school-age children help to curb or prevent their drinking usually works - but typically effects are modest and may apply only to a minority of compliant and keen families. Our analysis pays particular attention to whether it is worth adding work with the parents to school substance use education, or best instead to focus resources on directly working with the young people.

Whole team training may counter detox ward staff burn-out
Even more so than in a typical psychiatric ward, staff at a London inpatient alcohol treatment ward experienced high levels of stress and other indicators of potential burn-out. Whole-team training seemed to help, reflected especially in feelings of greater competence in working with sometimes challenging and complex patients.

Recent Findings hot topics include:

• Brief alcohol interventions: can they deliver population-wide health gains?
• Alcohol licensing, price and taxation

JRF report: local variations in young people's drinking cultures

A new study published by the Joseph Rowntree Foundation examines the lives of young people in relation to alcohol across 2 major regions in England.

Download 'Local variations in youth drinking cultures' or the summary report.

Key findings from the report include:

• the north has a higher degree of reported indicators of alcohol-related harms than the south-east and the south-west, but despite this young people’s drinking behaviour in these areas followed similar patterns;
• young people rarely drank on their own;
• young people actively sought out clusters of youth-orientated bars, and sometimes these clusters encouraged young people to drink more than they intended;
• planning authorities had often been unable to resist commercial pressures to allow clubs and bars to fill units that would otherwise be vacant, despite a wish to limit the number of licensed premises.

The study, conducted by Westminster University, shows that the "Big Night Out" remains a common activity for young people both in the North and South. Young people report that they like to plan a night out where sociability is the prime motive. This they view as key to a successful night of laughter and fun, often including some element of spontaneity.

Drinking on the "Big Night Out" tends to happen in a cluster of youth-orientated bars. This factor may also encourage drinking beyond limits intended by the young people at the beginning of the evening. The idea of limiting the amount of licensed premises in any area does not seem to have come to fruition, largely because of commercial pressures.

Interestingly, despite alcohol use being a distinctly social activity, there seems little evidence of "peer pressure" to drink excessively in any of the regions studied.

However, there is likely to be more "pre-loading" activity in the North east. Generally in the North there are more instances of young people and adults drinking alongside one another, with high visibility of adult drinking. In the South, there is more likely to be drinking inside (at parties and social events) than in the North, where drinking occurs both inside and outside.

This report follows publication of research on young people who choose to drink little or no alcohol. Further alcohol-related reports and guidance related to children and young people can be found here on the Alcohol Learning Centre, including the CMO guidance or see the Drinkaware web-page for parents. See here a post on IBA for young people.

News & updates August 2012: Adults drinking to deal with stress; alcohol problems often 'missed'; less young pub goers & more

Alcohol has had a busy few months in the media, not least on minimum pricing which we'll cover soon. Here's a snapshot of some of the recent stories relevant to the field:

Most adults using alcohol to deal with with stress - three in five (62%) Brits use alcohol to relax and unwind in the evenings according to research commissioned by Drinkaware. People were more likely to have a drink if they had a stressful day (44%) or a bad day at work (29%). The survey also revealed 71% buy alcohol with their regular grocery shop. See a a BBC report.

Alcohol Concern's Emily Robinson said: "Many people use alcohol to relax but this can lead to more problems. Alcohol is also a depressant so feelings of anxiety may get worse by drinking and causing someone to feel more stressed." Earlier this year the Don't let the drink sneak up on you campaign was launched by the Department of Health.

Clinicians overlook many alcohol problems unless a patient is visibly drunk, a new study by the University of Leicester reports. The report suggests clinicians are not aware of what tools or questions to use to identify problematic or risky drinking. Yet GPs say tough times mean 'middle class' patients are drinking more, according to a survey reported in the Daily Mail. They also believe people are exercising less and suffering more anxiety. However research indicates although moderate drinkers could drink more in recessions, heavier drinkers are more likely to be forced to cut down.

The NHS needs support from local authorities to tackle alcohol problems says a recent Guardian report. It says hospitals are too often responding and reacting to alcohol abuse, when more investment in prevention is needed. It reiterates similar conclusions from the recent Health Committee report on the Government's Alcohol Strategy.

More than 77,000 people receive benefits because alcohol or drug dependency which renders them unable to work according to new figures from the Department for Work and Pensions - The Telegraph. Meanwhile poor areas 'hit harder' by alcohol, reports The Express. Health inequalities are known to play a significant role in alcohol problems.

A tipple at dinner 'could turn children into binge drinkers' the Telegraph reports. New research adds to the evidence that earlier drinking can lead to an increased likelihood of later alcohol problems, hence medical guidance encouraging an alcohol free childhood.

Trade and industry

The numbers of young pub visitors are falling - young pub goers (18-24 year olds) visiting the pub regularly – once a week or more – has fallen from 38% to 16% since 2005 - new research from CAMRA (Campaign for Real Ale) has revealed. See Morning Advertiser (MA) report.

A petition to scrap the Beer Duty Escalator is closing in on 100k signatures. The 2012 budget continued the alcohol duty escalator of 2% above inflation (RPI), first started in 2008.

The London borough of Islington plans to introduce the Late Night Levy reports the MA. The Home Office recently confirmed details on the levy. Stores won go-ahead for display of alcohol - two major supermarkets in Edinburgh have been granted approval to display large boxes of alcohol despite objections from health chiefs.

Stickers are being placed on bottles as part of an underage crackdown in Newcastle reports the BBC. When police seize alcohol or the discarded containers with the stickers on they can trace them back to the shops and take action. Cardiff binge-drinkers who need medical treatment are to be filmed and given the option to watch the video once they have sobered up - BBC report.

Other news

One in 10 children in Scotland is at risk because of parental drinking, reports the Herald. The charity Children 1st said new figures collated from analysis of Scottish Health Surveys  showed that up to 93,000 youngsters are adversely affected by their parents' alcohol misuse.

A piece in the Guardian looks at the history and questioned value of some alcohol research in studies on alcohol so often involve going to the pub.

JRF report: 'A positive choice: Young people who drink little or no alcohol'

A new report into the influences on non or light drinking young people in the UK has been released by the Joseph Rowntree Foundation.

Download the full report 'A positive choice: Young people who drink little or no alcohol' or summary here.

The study examined the lives and choices of young people (aged 16-25) who drink little or no alcohol. It explores the influences that shape their decisions and how their choices and patterns of consumption affect their lives.

Some summary findings include:

• getting drunk is not an automatic rite of passage for young people;
• young people who drink little or no alcohol tend to prefer activities where drinking alcohol rarely plays a role;
• the immediate effects of drinking alcohol (e.g. hangovers) concern young people more than longer-term health effects; and
• young people believe alcohol education is based on the assumption that young people drink. They want 'not drinking' to be presented as a legitimate option.

• getting drunk is not an automatic rite of passage for young people;
• young people who drink little or no alcohol tend to prefer activities where drinking alcohol rarely plays a role;
• the immediate effects of drinking alcohol (e.g. hangovers) concern young people more than longer-term health effects;
• young people believe alcohol education is based on the assumption that young people drink. They want 'not drinking' to be presented as a legitimate option.

Writing on the JRF blog one of the report's authors, Mariana Bayley, reflects on the findings and its implications. Bayley highlights the disparity between many young people not drinking and some of the media depictions of young binge drinking women especially. But whilst some non-drinking young people are comfortable stating their choice, others have strategies to avoid standing out as non-drinkers - not drinking therefore needs to be seen as a legitimate choice.

The study also featured in a Huffington Post report. Last year the JRF published the report Young people, alcohol and the media. It found young people's estimates of their friends’ drinking and the perceived acceptability of drinking by friends were key influences on their drinking.

Alcohol Concern last year called for more protection of children from alcohol advertising and Balance North East are calling for people to sign a petition to protect children and young people. Last year Turning Point called for more action to protect children from parental alcohol misuse.

The Department of Health is currently planning social marketing activity to target young people and alcohol.

Further alcohol-related reports and guidance related to children and young people can be found here on the Alcohol Learning Centre, including the CMO guidance or see the Drinkaware web-page for parents. See here a post on IBA for young people.

New research highlights risks from regular alcohol use in pregnancy

Research from Harvard Medical School recently reported highlights the risks of regular alcohol use in pregnancy. 

The research found that regularly drinking 3 units each day during pregnancy could lead to lower height, weight and head circumference in babies at birth. Moreover, the restriction in growth seems to persist well into childhood - up until the age of 9 years in some cases. 3 units a day would however be above the current guidelines for non-pregnent females of 2-3 units per day plus at least 2 alcohol-free days per week.

The findings will add to the debate regarding messages relating to the risks of drinking in pregnancy. Previous reports have suggested that drinking occasionally, in very small amounts (1 or 2 units per week), would appear not to lead to lasting damage. However such reserch has appeared to lead to gross misrepresentation in the media.

Alcohol use can cause harm to the unborn child and the breastfeeding child, with regular or daily drinking presenting serious risks. The chief researcher at Harvard Medical School, Dr Colin Carter, added "The overall message is not to drink in pregnancy." Current guidance in the UK echoes this message.

Last year Diageo funding was announced for training midwives as part of the controversial responsibility deal.

For further information on alcohol, pregnancy and the breastfeeding child see NHS Choices or the Drinkaware.

Briefing released to support Police and Crime Commissioners with election campaign policies on alcohol

Alcohol Concern have released a briefing for Police and Crime Commissioners (PCCs) candidates to help them form policies on alcohol-related issues in their election campaigns.

From November 2012 PCCs will be elected in each of the 41 police force area in England and Wales, and will be responsible for local police and crime plans as well as rewarding grants to organisations that reduce local crime. They have previously been highlighted as having an important role to play in alcohol-related crime and influencing wider alcohol issues and partnerships.

The briefing includes a summary of policy recommendations for PCC candidates including:

• Take an active role in licensing decisions
• Ensure tougher enforcement of alcohol free zones, under age sales, serving people when drunk
• Prioritise drink driving campaigns and clampdowns
• Use budgets to invest in alcohol treatment services and signpost offenders (e.g. cautioned) to alcohol treatment services
• Liaise effectively with A&E
• Campaign for minimum pricing

It also highlights the imapct of alcohol on crime, particualy violent crime and domestic violence.

A recent Drugscope briefing also assessed the role of PCCs for the field.

The Home Office has produced guidance to support interested parties. The Local Government Association (LGA) have also highlighted a list of useful publications relevant to the PCCs and local partnerships.

Alcohol Awareness Week 2012: 19-25 November "It’s time to talk about drinking"

Alcohol Concern, the national charity for alcohol misuse, have announced Alcohol Awareness Week (AAW) 2012 on the theme of "It’s time to talk about drinking". 

Alcohol Concern hopes it will help trigger all kinds of conversations about the health risks, social problems, stigmas and taboos associated with talking about the dangers of alcohol. A set of conversation starter cards are available to download.

The release also states:

'One of the main ways we’re going to start the conversation is by challenging people to give up alcohol for a month in January. From AAW people will be able to sign up either as an individual or a team to give up drinking for a month. We’re going to ask people to pledge money or get sponsored to motivate them to stick at the challenge. We’ll also be providing people with tips and information on cutting down and how this will help their health, sleeping patterns and general wellbeing.'

For Alcohol Awareness Week 2011Alcohol Concern launched a Charter for a world free of alcohol harm. See here for Alcohol Concern's latest supporters' campaign bulletin.

'Part of the Picture': binge drinking over twice as common amongst lesbian, gay and bisexual people

The Lesbian & Gay Foundation have released the Part of the Picture 2009-2011 report exploring substance use amongst lesbian, gay and bisexual people in England.

Download Part of the Picture: Lesbian, gay and bisexual people’s alcohol and drug use in England (2009-2011) [pdf]

Key findings include:

• 34% of gay and bisexual males, and 29% of lesbian and bisexual females, reported binge drinking at least once or twice a week
• Binge drinking is more than twice as common amongst lesbian, gay and bisexual people when compared with the wider population
• Lesbian, gay and bisexual people demonstrate a higher likelihood of being substance dependent
• Significant barriers exist to seeking information, advice or help about substance use issues amongst lesbian, gay or bisexual people

In highlighting the high prevalence of binge drinking the report uses the definition of drinking more than twice the recommended guidelines in one session, though the term has often been contested.

The Part of the Picture (POTP) research project is a five-year partnership between The Lesbian & Gay Foundation (LGF) and the University of Central Lancashire (UCLan). It aims to establish a national database of lesbian, gay and bisexual (LGB) people’s drug and alcohol use; to use the database to inform local and national policy and practice in addressing the drug and alcohol use of LGB people; and to improve knowledge and understanding of the needs of LGB people amongst drug and alcohol agencies through dissemination of the research findings.