Alcohol Policy UK

'Don't let drink sneak up on you' - new Change4Life alcohol campaign launched

A new Change 4 Life alcohol campaign, 'Don't let the drinks sneak up on you', has been launched - see the press release, TV advert and Change4Life alcohol pages including a new tool to check your drinking.

The campaign warns against drinking above lower risk guidelines, highlighting the potential impacts on long term health. A TV advert warns that regularly drinking just 2 large glasses of wine or 2 strong pints of lager a day can triple the risk of developing mouth cancer and double the risk of getting high blood pressure. A supporting leaflet [pdf] is also available to order.

A survey as part of the campaign revealed that most people are unaware of the serious illnesses caused by regularly drinking above the guidelines. For example 85% of people did not realise it increases the risk of developing breast cancer and 59% did not realise it increases the risk of mouth, throat and neck cancer (see press release for more). The campaign follows a recent call for recognition of the need for at least 2 alcohol-free days per week.

Secretary of State, Andrew Lansley said: 

 “It’s crucial we support people to know about how drinking too much poses risks to their health and how they can take control of their drinking. It can be easy to slip into the habit of having a few extra drinks each day, especially when drinking at home. But there can be serious health risks. Don't let drinking sneak up on you.”

Chief Medical Officer Professor Dame Sally Davis said:

"Drinking too much is a major public health issue. This campaign highlights how easy it can be to use a glass of wine or beer to unwind at the end of a busy day but these drinks stack up and can increase your risk of high blood pressure, cancer or liver disease.”

See reports in the Guardian, BBC and The Telegraph.

The campaign follows previous Government-led activity such as the alcohol effects, Know Your Limits (materials here) and support for areas to develop local social marketing activity. Existing alcohol communications are also run through NHS Choices and the industry funded Drinkaware trust.

The campaign had been previously announced as part of the Government's new alcohol strategy to be released later this year. But may health policy groups have expressed concern over an excessive focus on on 'nudge' or 'personal responsibility' approaches delivered in part through the Responsibility Deal. They warn that to significantly reduce alcohol misuse multi-strand action that includes addressing price, availability and marketing must also take place. 

DH streamlines public health social marketing for 2012

The Department of Health (DH) will shortly launch public health communications for 2012, taking a 'linked behaviours' approach. It will tailor social marketing operations to follow the life course, instead of focusing on individual behaviour issues.

The strategy, Changing behaviour, Improving outcomes, was published in April 2011 and aims to increase effective communication of public health issues. It was followed by the Change4Life Three Year Social Marketing Strategy which stated the 'alcohol harm reduction campaign will be brought more fully under the Change4Life umbrella, embracing not only the calorific content of alcohol but also the wider health harms of alcohol for adults in mid-life.'

Operations will be supported by two agencies from this month - Freud Communications will manage creative PR for all public health campaigns and MEC will manage media planning. Freud Communications, who already handle PR for the Change4Life campaign, may prove a controversial choice as they also manage PR for Walkers Crisps and KFC.

There are four strands to the strategy, two of which are directly linked with reducing alcohol related harms. Change4Life will focus on diet and exercise issues concerning families and middle aged adults, and from February 2012 it will also include drinking. The Young People strand will focus on 'binge drinking', smoking and risky sexual behaviours.

Alcohol-related hospital admissions up 9%, doubling over a decade

The latest data for alcohol-attributable conditions has shown a 9% rise on the previous year, resulting in a doubling over the decade. For 2010/11 the figure was 1,898 alcohol-related hospital admissions per 100,000 population in England, up from 926 admissions per 100,000 in 2002/03.

The LAPE figures are produced by the North West Public Health Observatory, based on calculations which reflect the role alcohol misuse plays in conditions such as high blood pressure, heart disease and cancers (by calculating 'attributable fractions' - details here). The figures also include alcohol-only conditions, such as alcoholic liver disease, also increasing.

The rising trend in alcohol-related admissions is thought to reflect decades of rising alcohol consumption up until 2004, when consumption began to fall. Since many alcohol-related conditions develop over time, a significant lag means admissions look likely to continue rising. London saw the biggest jump in the last year, at 14%, followed by the East of England with a 10% increase. See here for a previous exploration of alcohol trends and consumption.

Alcohol-related hospital admissions passed the one million per year mark in 2010, drawing criticism from health groups on inadequate Government policy. The latest figures have prompted similar calls, with Shadow public health minister Diane Abbott swiping at the controversial Responsibility Deal, stating: "It is clear that for Andrew Lansley, the be-all and end-all is whether his friends in big business are happy, and, unfortunately, it is costing our NHS and British families an absolute fortune."

However the Health Secretary reportedly placed blame on Labour's so-called '24 hour drinking' 2003 Licensing Act, though a full-fact analysis had previously contested the theory following similar claims from the Home Secretary Theresa May. Speaking on the hospital figures, Lansley said "Our alcohol strategy, which we will set out in the new year, will outline what further steps we are taking to tackle this growing problem."

See reports from The Guardian, Telegraph and Press Association.

'From one to many: The risks of frequent excessive drinking' - report calls for understanding of 'risky drinking'

A report from 2020health, a health and technology policy body, has emphasised the importance of addressing 'risky drinking' as a key part of public health policy. The report highlights the importance of brief interventions [or IBA] for risky drinkers, the need to promote alcohol-free days, and Government action including minimum pricing.

Download From one to many: The risks of frequent excessive drinking [pdf]

A foreword by Dr Clare Gerada, Chair of Royal College of General Practitioners, states:

"This report focuses on what we term ‘risky drinking’, where a person drinks often, perhaps even every day, but does not necessarily get drunk or display dependence on alcohol. It is these people, a million miles away from the classic image of the teenage binge drinker, who may not even realise they are drinking above the recommended amounts, and are quietly, slowly paving the way to serious health problems in the future."

The report re-emphasises many recent recommendations from health bodies over recent years, including NICE public health alcohol guidance, Alcohol Concern reports, Department of Health commissioning guidance and calls to mainstream brief intervertions.

It specifically calls on the use of new technologies to deliver brief interventions, which should also be included in a 'universal alcohol assessment' offered at age 30. Brief interventions should be included in all NHS health checks, integrated within the QOF and delivered by dentists.

Further information on alcohol and 'risky drinking' can be found from NHS Choices alcohol pages, Drinkaware, and resources and guidance are available from the Alcohol Learning Centre.

Report says alcohol enforcement laws are not fully used, but enforcement alone is not the solution

A new report explores whether UK laws relating to the sale and consumption of alcohol are 'fit for purpose' and are being effectively enforced. The report finds that many laws are not being fully utilised, although a variety of measures are still required to achieve alcohol harm reduction.

Download ‘Lost Orders?: Law Enforcement and Alcohol in England and Wales’ or download the Executive Summary.

The report, commissioned by the Portman Group, was authored by Dr Fiona Measham of Lancaster University and research consultant Dr Phil Hadfield. It finds that laws designed to tackle underage drinking are not being used to their maximum effect, and that enforcement is rarely actioned against consumers rather than suppliers.

In a press release, Dr Measham said that prosecuting individuals for offences such as underage drinking, proxy sales and the serving of alcohol to intoxicated persons were regarded as too expensive and time consuming to pursue. The findings appear to re-iterate past messages that the 2003 Licensing Act powers have not been fully utilised - 2009 Home Office alcohol guidance referenced evidence that crime and disorder had remained stable but powers were underused.

Dr Phil Hadfield said: “One of the main messages of our findings is that there seems little point in Government introducing new tough sounding measures to tackle alcohol-related harms in the community if these laws are not actually enforced in practice. The rush to introduce new legislation has occurred at the expense of ensuring that the laws we already have are being implemented and effectively used.”

The report emphasises the importance of partnership working, local innovation and a greater recognition of health priorities. It also highlights that "regulation works best when embedded within community focused multi-component programmes (MCPs) that encompass broader approaches to harm reduction". A comprehensive report on multi-component pogrammes to reduce alcohol-related harm was published by the Joseph Rowntree Foundation in 2007.

A factsheet on Alcohol, crime and disorder in the Night Time Economy was published last year, and a recent London event explored some current initiaives including Licensing reform.

News & updates Oct 11: Alcohol-free days; Don Shenker to leave Alcohol Concern; Facebook-Diageo deal; ‘drunkorexia’ - skipping meals to save calories?; trade & industry news

Advice for three alcohol-free days per week has been in the news following evidence given at the inquiry into alcohol consumption guidelines. See reports from the Daily Mail, BBC and The Telegraph.

Sir Ian Gilmore of Royal College of Physicians (RCP) emphasised the need for drinkers to consider the risks of daily alcohol consumption, even in moderate amounts. Gilmore said: ‘In addition to quantity, safe alcohol limits must also take into account frequency. There is an increased risk of liver disease for those who drink daily or near daily compared with those who drink periodically or intermittently." A possible 'binge drinking guideline' of 8 units had also been raised in an earlier session.

Don Shenker is to leave Alcohol Concern, a press release today announced. He had spent six years with the organisation with over three years as Chief Executive (CE). Eric Appleby is returning to act as a part-time Interim CE, alongside the recruitment of a full time Director of Fundraising and Campaigning.

Last month a multimillion-dollar deal agreed between Facebook and Diageo was announced. A Guardian report highlighted concerns over a deliberate strategy to target a younger audience - half of Facebook users are under the age of 24 and many under 18 years old. 

Diageo's US brands had reportedly seen a 20% increase in sales as a result of Facebook activity this year. Alcohol Concern recently released a report on children's exposure to advertising via social networking. Facebook said all its alcohol advertising was 'age-gated' - not allowing under 18s onto alcohol brand pages. Diageo said it complied with 'all applicable laws, regulations and industry codes'.

Young women who 'binge drink' are skipping meals to reduce their calorie intake according to the Daily Mail. The practice termed ‘drunkorexia’ is reportedly affecting young British women, particularly students, following U.S. research that found 16% of students reported restricting calories to 'save them' for drinking. Women were apparently three times more likely to do so, citing wanting to lose weight and spend less money getting drunk as reasons.

Pub, trade and industry

The controversial below cost ban may yet still include production costs, according to the Morning Advertiser. However a source said the Home Office were finding it "increasingly difficult to come up with something that includes the cost of production. Legally it’s a minefield". At present the 'below cost ban' only identifies cost as duty+VAT; ASDA recently came under fire for selling Budweiser for around 16 pence per unit despite committing to the ban.

Community Alcohol Partnerships (CAPs) - local partnership projects which work with retailers to reduce underage drinking - are planning wider roll out following further industry funding. Brighton Council is seeking a VAT rise for off-licence sales according to the MA. More Government action needed to earn its 'pub friendly' claim says CAMRA. The Northern Ireland Health Secretary is intent on minimum pricing according to the BBC.

Alcohol... all in the mind? BBC news piece challenges the 'alcohol message'

A recent BBC news magazine article, Is the alcohol message all wrong?, has challenged the validity of current alcohol education campaigns. Social anthropologist Kate Fox posed the provocative question... Is it alcohol that causes the nation's problems - binge drinking, promiscuity, violence - or are these effects actually determined by our cultural values and norms?

Fox describes two alternative cultures: so called "ambivalent" cultures such as the UK, where alcohol is strongly associated with dis-inhibition and anti-social behaviour. Secondly "integrated" cultures, such as Mediterranean countries where drinking alcohol is viewed much more as "morally neutral" and is normalised as such.

She insists that these variations in attitude and subsequent behaviour cannot be explained away by consumption rates - people behave as their cultural beliefs would predict, and we get the problems we are primed to anticipate. For instance, we get disinhibiting behaviour when intoxicated because that's in part what we expect.

Fox cites experiments which demonstrate that people can remain in control of themselves under certain situations, for example when incentivised to do so. Ergo, we are not the slaves of ethanol but of our own beliefs about what it will make us do. Tackling alcohol education campaigns from this perspective would mean promoting an attitude shift in our population; indeed in the very beliefs and expectations that we hold about alcohol in the UK. Fox states in the article:

"...we need a complete and radical re-think of the aims and messages of all alcohol-education campaigns. So far, these efforts have perpetuated or even exacerbated the problem, because almost all of them simply reinforce our beliefs about the magical disinhibiting powers of alcohol."

Others might agree on this point, such as Don Shenker who has previously suggested in a DDN article that the industry may construct messages that serve its own interests. Other health interests might argue that it is not alcohol messages that can 'change the culture' of problem drinking, which can only be achieved with action on price, availability and marketing.

Regardless, responsible drinking messages or 'educational approaches' will continue to be a popular response to alcohol problems. But are we ready for such a "radical re-think" on these messages... or will we continue to just get what we expect?

ASDA under fire for selling Budweiser for under 50p per bottle

Supermarket giant ASDA hit the news after launching a new deal offering 24 bottles of Budweiser for £11 - around 46 pence a bottle or 15 pence per unit. ASDA are part of the Government's Responsibility Deal having signed up to pledges on alcohol, including on its advertising and marketing. 

The supermarket had previously received attention for voluntarily introducing a 'below cost ban' before it was brought in by the Government. However news that 'cost' would be defined as duty + VAT appeared to confirm accusations that the ban would have little effect on the actual price alcohol could be sold for, and was widely confused with minimum pricing.

Outspoken MP Sarah Wollaston recently called for tougher Government alcohol policy, including a 50 pence minimum price - a policy widely supported by health groups by largely opposed by producers and retailers. Wollaston said "There is nothing particularly responsible about our "new responsibility deal". Of course it is good to have the drinks industry's co-operation but we should be setting the standards, rather than them."

Professor Ian Gilmore Prof Ian Gilmore, a liver specialist, condemned the ASDA deal in a Metro report: ‘Again this is another example of a retailer on the one hand pledging to act responsibly while at the same time offering ridiculously cheap offers when buying in bulk.' A Daily Mail article said even pubs or retailers would not be able to purchase drinks so cheaply when buying wholesale.

ASDA defended the deal stating 'We are as committed to our role as a responsible alcohol retailer as we are to providing affordable deals for our customers.’ The major supermarkets are reportedly embroiled in a major 'price war'.

Scotland ban on 'irresponsible promotions' as England introduce 'schooners'

New licensing laws came into force on 1st October 2011 for Scotland, including a mandatory challenge 25 scheme and a ban on irresponsible promotions. The changes are part of the Alcohol etc Scotland Act 2010 and are expected to be followed by plans for a minimum price.

However the changes have been attracting media attention as some retailers could change offers to apply to single drinks - for instance instead of three bottles of wine for £10 retailers may sell one bottle for £3.33. Tesco have reportedly advised Scottish customers that they can still benefit from cut-price deals if they shop online as it will be transported from England.

The Scottish Health Secretary, Nicola Sturgeon, expressed disappointment that some retailers would not be respecting the spirit of the law, but emphaised future plans for a minimum price. In the meantime, she believed the measures would still have some effect, stating: "...if somebody is going to buy one bottle of wine, as they intended to do when they went into the supermarket, instead of three bottles, that they are tempted to buy because it is on offer, then that is helping us reduce alcohol over-consumption."

The changes also pave the way for a social responsibilty levy, which aims to ensure retailers and licensed premises contribute to the wider cost of their activities on the community. Restrictions on the location of drinks promotions are also set out, and the Challenge 25 scheme means all licensed premises must have an age verification policy in place, including anyone appearing under the age of 25 being required to prove their age.

In England, a mandatory code was introduced last year to ban certain irresponsible promotions, such as banning ''all you can drink" deals. A new licensing amendment also came into force this month, allowing premises to now sell 'two-third' pint sizes, known as a 'schooner'. Some have suggested it may encourage responsible drinking, though bodies such as CAMRA have criticised it as unnecessary. Heineken have produced 500,000 branded schooner glasses for pubs across the country.

'Mixed messages': Alcohol Concern warning over alcohol and energy drinks

A new briefing paper from Alcohol Concern Wales has warned of possible dangers of mixing highly caffeinated drinks with alcohol. In particular it suggests caffeine in energy drinks can mask the effects of alcohol, meaning that drinkers may be less aware of how drunk they are, and more likely to put themselves in danger.  

Download the Mixed messages briefing paper or see the press release.

An Alcohol Concern spokesperson highlighted a rising trend in energy drink sales and an overall lack of awareness about caffeine content. A 500ml energy drink may contain 160mg of caffeine - the equivalent of a double espresso or five cans of Coca-Cola. Andrew Misell warned:

“Both caffeine and alcohol are diuretics – they cause the body to pass water – so mixing energy drinks with alcohol can leave drinkers badly dehydrated, possibly leading to vomiting, nausea, and other health problems in the long term.
 
“What’s more dangerous, perhaps, is that the stimulant effect of so much caffeine can mask the depressant effect of the alcohol. People drinking energy drinks with alcohol may feel very alert and not realise how drunk they are. One possible result of this is that drinkers will take more risks.
 
“A study in the USA found that students drinking alcohol mixed with energy drinks were four times more likely to intend to drive compared with drinkers who had consumed alcohol without energy drinks.”
 
Alcohol Concern Wales’s Drink Wise Wales website contains an alcohol and energy drink counter outlining the amount of alcohol, caffeine and sugar in common energy drink cocktails.