Alcohol Policy UK

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.

Managing the Night Time Economy: LDAPF & GLA 2011 event presentations

A Managing the Night Time Economy event was held last month, hosted by the London Drug and Alcohol Policy Forum (LDAPF) and Greater London Authority (GLA). 

Presentations [pdf] from the day included:

• Overhauling the Licensing Act Mark Halton, Home Office
• Camden's NTE Jon Paris and Michael Hrycak, London Borough of Camden
• Havering NTE Deborah Houston-McBean, Havering London Borough
• Newham's Total Enforcement Sheila Roberts, London Borough of Newham
• TfL and the NTE Graham Daly, Transport for London
• Islington Community Alcohol Partnership John Hart, Islington Coucil
• LAS Soho Alcohol Recovery Pilot Brian Hayes, London Ambulance Service

See here for presentations from a previous London NTE event. An Alcohol Concern NTE factsheet is also available, or see the Alcohol Policy UK NTE category.  

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.

Findings alcohol research: alcohol-related offending measures do work

Recent research from the drug and alcohol Effectiveness Bank:

Probation and NHS alcohol team working well in West Yorkshire
In northern England the probation and NHS alcohol team were working well together to deliver alcohol treatment requirements, and most of the problem-drinking offenders on the orders engaged with treatment and stopped drinking or cut back.

Better lives for problem-drinking offenders in Lancashire
Problem-drinking offenders in the north of England who agreed to be ordered in to alcohol treatment by the courts substantially cut their drinking and offending and experienced improved health and wellbeing.

Crime cut and drinking less but still too much in the Midlands
In the English Midlands, problem-drinking offenders who agreed to be ordered in to alcohol treatment by the courts started with a worse prognosis than comparable previous offenders but still slightly fewer reoffended; also their drinking was reduced, though for many it remained excessive.

Also previously from Findings: Probation resources too stretched to adequately tackle huge drink problem

See here for further alcohol-related offender health guidance and resources from the Alcohol Learning Centre, and here for a recent alcohol diversion scheme report.

Alcohol Diversion Scheme reports: Herts and Derbyshire

Reports on Alcohol Diversion Schemes (ADS) in Herts and Derbyshire have been released by Druglink. 

The schemes were set up to reduce alcohol-related crime and disorder by offering those fined for alcohol-related offences the chance of a reduced payment by attending a 3 hour course. Individuals given Penalty Notices for drunk & disorderly, drunk & incapable or Section 5 Public Order offences were offered the option of halving the £80 fine to a £40 course attendance fee.

Druglink says the course encourages 'offenders to face up to the reality' of their behaviour in terms of personal health risks, whilst also being 'encouraged to think of the consequences of alcohol fuelled violent behaviour to others around them.' The reports provide further details of the project including feedback from participants and course outcomes based on surveys.

The Derbyshire report states:

"Post course interviews saw a significant reduction in unit intake; the average units per person had decreased from 36 units to 15 units per week... 11% were still drinking above the safe guidelines falling within the 25-35 units per week, however this represented an overall reduction of 60% who were previously drinking at [hazardous or harmful] levels."

"Pre course interviewees were drinking on average 4 days a week, this was reduced post course by 50% to 2 days a week... Attendees reported actively managing and reducing frequency of consumption; they considered this a key element of managing their drinking and reducing the incidents of binge drinking."

Further alcohol-related Offender Health projects and reports are available on the Alcohol Learning Centre. A Home Office guide to Alcohol Arrest Referral schemes is also available.

News and updates April 2011: Alcohol and cancer risk; move to restrict advertising; alcohol's cost to Wales; Royal Wedding licensing hours

Increased cancer risk with alcohol consumption

Research published in the BMJ has highlighted that around 10% of all cancers in men and 3% in women are attributable to alcohol consumption. Although the media reported increased risk of cancer even when drinking within the recommended guidelines, the BMJ highlighted risk to be proportionately greater on exceeding the guidelines. See an NHS Choices summary on the topic and reports from the Guardian, BBC, Telegraph and Cancer Research UK.

Calls to protect children from alcohol advertising

A call for a tougher stance on alcohol advertising in the UK has been given the backing of health experts. Dr Sarah Wollaston, a Conservative MP who has also called for minimum pricing, put forward a private members bill to limit the exposure of children to alcohol marketing. It calls for statutory regulation that outlaws marketing to children and ensures that information in ads is factual and verifiable, similar to laws passed in France. The move was backed by health experts writing in the BMJ, but drinks producer Diageo spoke out and claimed the evidence was unsubstantiated.

Obesity and alcohol misuse costs NHS £140m in Wales reports the BBC. The research put the cost of obesity to the NHS in Wales at £73m and excessive alcohol consumption at between £69.9m and £73.3m. See here for Independant report.

Relaxation of licensing hours for the Royal Wedding have been confirmed. An order allows licensed premises in England and Wales to stay open between 11pm on Friday 29 April and 1am on Saturday 30 April, and between 11pm on Saturday 30 April and 1am on Sunday 1 May. More here.

Responses to the 'Healthy Lives, Healthy People' consultation on the public health White Paper are available from Drugscope, The King's Fund, Faculty of Public Health and the BMA.

Other news

The LGA has called for clarification on how the below cost ban is to be implemented. Whilst welcoming the measures and wider licensing act changes, it warns of already under-resourced Trading Standard teams. The FullFact website scrutinized Home Office claims that the ban “will reduce crime by 7,000 incidents a year 2,000 of which are violent crimes”.

Soaring numbers of women are drinking hazardous amounts of alcohol - a quarter in under-24s, the Daily Mail reports. Revellers in Hull city centre who drink so much they cannot look after themselves are being threatened with fines, the BBC reports. A Telegraph report on the recent drink-drive changes looks at motorists set to lose the right to demand a blood test.

A Guardian comment explores the current alcohol policy and the responsibility deal. See our recent guest post analysis for an insight into determinants and influences on alcohol policy.

'A Label for Exclusion: Support for alcohol-misusing offenders'

A policy paper from the Centre for Mental Health has made recommendations to improve the development of alcohol interventions for offenders:

A Label for Exclusion: Support for alcohol-misusing offenders

The report identifies areas and practical examples of how, in a changing and uncertain policy and commissioning landscape, the joint commissioning and delivery of alcohol interventions for offenders in the community might be productively developed. A press release states:

Offenders who misuse alcohol do not get enough support to turn their lives around, according to research published by Centre for Mental Health. A Label for Exclusion finds that offenders who drink harmfully are not offered as much support as those who use illegal drugs even though alcohol misuse is a bigger cause of crime and ill health.

Six out of ten male and four out of ten female sentenced prisoners in England are harmful or hazardous drinkers. Yet there is inadequate support for offenders who misuse alcohol at all levels, from basic screening and advice to specialist counselling and treatment programmes.

A Label for Exclusion calls for commissioners of health and justice services to come together to pool their limited resources for offenders who misuse alcohol and involve service users in planning the support they offer. It says all front line workers, such as police officers and GPs, should have basic skills in recognising alcohol misuse and referring people on to specialist services if they need them. And it calls for good quality alcohol support to be available to people at any point in the criminal justice system, from first contact with the police to courts, prisons and probation services.

See here for further Offender Health publications and links on the Alcohol Learning Centre.

Drug strategy 2010 outlines joint drug and alcohol treatment objectives

The 2010 drugs strategy Reducing demand, restricting supply, building recovery: supporting people to live a drug-free life has been released by the Home Office. It outlines that "severe alcohol dependence raises similar issues [to drug dependence] and that treatment providers are often one and the same. Therefore, where appropriate, this strategy will also consider severe alcohol dependency."

An alcohol chapter on page 7 states:

'Alcohol plays an important part in the cultural life of this country, with large numbers employed in production, retail and the hospitality industry. Pubs, bars and clubs contribute to community and family life and also generate valuable revenue to the economy. However, alcohol is a regulated product. Some individuals misuse it, contributing to crime and anti-social behaviour, preventable illness and early death.

The estimated £18-25 billion a year cost of alcohol misuse spans alcohol related disorders and diseases, crime, loss of productivity in the workplace and health and social problems experienced by those who misuse alcohol and the impact this has on their families14. For the NHS alone, the estimated financial burden of the harmful use of alcohol (regularly drinking at increasing or higher risk levels) is around £2.7 billion.

The evidence suggests that a dependent drinker costs the NHS twice as much as other alcohol misusers and that the largest and most immediate reduction in alcohol-related admissions can be delivered by intervening with this group through the provision of specialist treatment.

It is estimated that 1.6 million people have mild, moderate or severe alcohol dependence. About a third of these will face some challenges that are similar to those dependent on drugs in needing support to help them recover. It is specialist alcohol treatment, for those in this group who would benefit from treatment, that this strategy aims to improve.'

Also released this week was the Ministry of Justice Green Paper and consultation Breaking the cycle: effective punishment, rehabilitation and sentencing of offenders. Last week the public health White Paper was released, outlining the new Public Health England service and ring-fenced budget for local authorities.

Licensing act 2010 reform: no 'below cost ban' but late night levy and say for health boards

The Home Office has published its plans for re-balancing the Licensing Act which aims to give more power to local communities. However recent speculation that a below cost ban was soon to be introduced was proven false, though the Government have stated they remain committed to bringing in the ban. Plans to give health bodies powers as responsible authorities and the introduction of a late night levy look set to go ahead. See the Home Office press release.

The changes are to be brought in through the Police Reform and Social Responsibility Bill and also outline a commitment to review the mandatory code. The fine for persistent underage sales is to be doubled whilst the unused Alcohol Disorder Zones are to be scrapped (not to be confused with popular controlled drinking areas).

The Home Office have released a Government response to the consultation and made factsheets available on the main proposals, including:

• applications to give greater consideration to the local area 
• late night levy
• making health bodies responsible authorities
• making relevant licensing authorities responsible authorities
• persistent sales of alcohol to children
• reducing the burden of proof
• cumulative impact policies

The Independent reported that as much as half of all pubs and clubs with late night licenses could cut their licensing hours to avoid an annual levy of up to £4,480, based on information from an impact assessment (parts one and two). See reports from the Publican and Morning Advertiser.

BBC home affairs editor Mark Easton looks back on the recent era of licensing in The myths of 24 hour drinking.

FASE: Preventing alcohol-related harm in drinking environments

The FASE (Focus on Alcohol Safe Environments) project is co-funded by the European Commission to develop a better understanding of what works to reduce alcohol-related harm in drinking environments. The project is collecting research from across the world and focuses on interventions that can be implemented at local level, covering five key areas:

1. Responsible server/staff training interventions
2. Interventions to reduce underage access to alcohol
3. Policing and enforcement approaches
4. Interventions delivered in drinking establishments
5. Multi-component community interventions

An outline paper Preventing alcohol-related harm in drinking environments is available as is a presentation by UK partners the Liverpool John Moores University (JMU). The paper says:

'The best evidence of effectiveness available is for multi-component community interventions – schemes that bring together local agencies in a partnership to plan and deliver a combination of strategies to prevent irresponsible alcohol sales, address risky drinking and enforce licensing legislation at a community level.

Despite programmes such as designated driver schemes and educational campaigns frequently being used in Europe, the study found little evidence to support their effectiveness. It also found that staff training programmes and test purchasing operations often have little effects when implemented as standalone measures. However these measures can be important components within broader multi-component community interventions.'

The study reports further research is needed, particularly within the UK context. A study by Dr Simon Moore of Cardiff University will shortly be published in the Addiction journal; 'Interventions for disorder and severe intoxication in and around licensed premises' - see draft proof version.