Alcohol Policy UK

Monitoring and Evaluating Scotland’s Alcohol Strategy (MESAS): 2nd Annual report

The Monitoring and Evaluating Scotland’s Alcohol Strategy (MESAS) 2nd annual report has been released.

The MESAS provides an update of Scotland’s alcohol strategy, the evaluation plan and the analyses of price, consumption, affordability and alcohol-related harms. Additionally, this report presents findings from the Alcohol Brief Interventions (ABIs) evaluation - ABIs are commonly known as Identification and Brief Advice (IBA) in England.

The report identifies alcohol sales in Scotland decreased by 5% between 2009 and 2011. However consumption in Scotland remains a fifth higher than in England & Wales, largely attributable to higher sales of lower priced spirits (particularly vodka) through the off-trade. Affordability of alcohol has increased by 45% since 1980, largely due to rising disposable incomes.

Mortality rates in Scotland are over two and a half times higher than they were in the early 1980s and remain nearly twice as high as those in England & Wales. However in recent years indicators of alcohol-related morbidity and mortality have begun to show falls, but these need to be interpreted with caution given variations within population groups.

On Alcohol Brief Interventions (ABIs), the report states:

Although NHS annual performance targets for ABI delivery were met consistently, the overall reach of the programme to hazardous and harmful drinkers is likely to be limited. Due to a lack of outcome monitoring data, the impacts of the ABI programme were unable to be assessed, resulting in a need for modelling to measure the impact of ABIs on alcohol consumption and alcohol-related harm. Findings from exploratory modelling analysis suggest that potential benefits could exist, particularly in relation to recent reductions in alcohol-related harm. These potential benefits from ABIs are modest, however, when compared to the total burden of alcohol-related harm in Scotland.

In the executive summary conclusion the report states:

Until further work is completed on the wide range of possible explanations, it is not appropriate to draw conclusions as to what factors, or combination of factors, are responsible for the recent improvements identified in alcohol consumption and alcohol-related harms in Scotland.

See here for a recent Scotland update on test purchasing as key to Licensing Act and alcohol sales data.

Alcohol and Cancer Risks: a Guide for Health Professionals

Scottish Health Action on Alcohol Problems (SHAAP) have released a report Alcohol and Cancer Risks: a Guide for Health Professionals [pdf].

The guide was produced to help Health Professionals understand and communicate the links between alcohol and consumption and cancers.

The report aims to highlight that many cancers are preventable, and identifies some key facts as: 

• One third of cancers are linked to a number of lifestyle risk factors – smoking, alcohol, diet, overweight/obesity, and physical inactivity
• Half of the Scottish population have three or more of these lifestyle risk factors
• Forty-six per cent of [Scottish] men and 38% of women drink alcohol at levels higher than current guidelines for sensible alcohol consumption
• Drinking alcohol increases the risk of cancer of the breast, head and neck, the oesophagus, bowel and liver
• Each year, approximately 6% of new cancer cases are estimated to be attributable to alcohol consumption
• Drinking alcohol, even within the limits of current advice on sensible drinking, may increase the risks of alcohol-attributable oral and pharyngeal as well as breast cancer
• Reducing alcohol consumption to levels within the current guidance for sensible drinking will reduce the risk of developing an alcohol-attributable cancer

The guide calls on health proffessionals to make use of opportunities to raise awareness of the risks of alcohol and cancer through the delivery of brief intervention.

Earlier this year the European Alcohol Policy Alliance has launched a new website to flag up the risks associated with alcohol consumption and cancer.

Last year Cancer Research UK suggested as many as 40% of cancers could be preventable through improved lifestyle choices including smoking, unhealthy diets, alcohol and excess weight. A recent King's Fund report explored the close links of these behaviours, with many adults in England engaging in at least one unhealthy lifestyle behaviour. 

Scotland update Sep 2012: test purchasing key to Licensing Act; alcohol sales data

An evaluation of the implementation of the objectives of the Scottish Licensing Act has been released by NHS Health Scotland. It reviews the effectiveness of various interventions including test purchasing, Challenge 25 and proof of age schemes. The report finds that test purchasing is seen as the most useful way to influence licensed trade staff practice, especially when combined with robust proof of age schemes.

A recent Scotland MESAS update analysing alcohol sales, revealed that the amount of pure alcohol drunk by Scottish adults has risen from an average of 10.2L per adult in 1994 to 11.2L per adult in 2011. However, since 2005 sales of pure alcohol show a fall from 2010-2011 of 4%. This equates to 21.6 units per week on average. This remains significantly higher than approximately 20% higher than current sales in England and Wales of 2.3L per adult (equating to 17.9 units per week).

Reacting to the report, the former Health Secretary Nicola Sturgeon admitted there was no single answer to the Scottish relationship with alcohol, and that the current Scottish Government Alcohol Framework included 40 separate measures to tackle alcohol harms. The BBC reported that Alcohol Focus Scotland have estimated that alcohol harms cost the 32 Local Authorities in Scotland £2bn each year. Dr Evelyn Gillan, CE of Alcohol Focus Scotland stated that Scotland needs to "shift the focus of licencing away from individual on-sales premises to managing the overall availability of alcohol".

The new Scottish Health Secretary Alex Neil agreed that more needs to be done to tackle Scotland's problems with alcohol misuse, which currently cost the country £3.6bn per annum. He warned of a "nightmare problem with booze" that threatens to overwhelm the NHS. Scotland plan to bring in minimum pricing following the passing of a new bill this year.

See here for other earlier news from Scotland on hospital statistics, lowering of the drink drive limit and alcohol retail and pricing reports.

Latest Findings bulletins: Single alcohol question effective but routine screening low across offender settings

Recent bulletins from the drug and alcohol Bank:

Single question enough to identify most heavy drinking offenders         At English prisons, police stations and probation offices, offenders and arrestees in this study usually scored as at least hazardous drinkers and over half as problematic on the AUDIT drink problem questionnaire; nearly all would have been identified by a much briefer screening method usually requiring just a single question.

Despite senior support most detainees not screened for risky drinking  Risky drinking was widespread among the disorder and assault suspects screened for alcohol problems and (as indicated) offered brief advice by civilian staff at a police station in north east England, but despite senior officer support, they constituted just a quarter of the arrestees intended to have been screened.

Screening offenders for risky drinking not a priority in Scotland      Though drinking problems were widespread, Scottish probation and community service staff were unconvinced of the appropriateness of screening their offender clients for risky drinking and (if indicated) offering brief advice. Not a priority, was the common feeling.

Previous Findings bulletins suggested alcohol-related offending measures do work, but also that Probation resources too stretched to adequately tackle huge drink problem.

Last year the Centre for Mental Health called for more support for offenders with alcohol problems.See here for further Offender Health publications and links on the Alcohol Learning Centre.

Scotland reports and news: latest hospital statistics, drink drive limit to be lowered; alcohol retail and pricing reports

Alcohol Related Hospital Statistics 2012

Scotland's Information Services Division (ISD) has published alcohol-related hospital discharge statistics in the latest Alcohol-related Hospital Statistics report (full pdf report here). Key findings include:

• In 2010/11, there were 38,825 alcohol-related discharges from a general acute hospital in Scotland (a rate of 695 discharges per 100,000 population).
• In 2010/11, the rate of alcohol-related discharges from general acute hospitals was 7.6 times greater from patients living in the most deprived areas (category 1), compared to those living in the least deprived areas (category 5).
• Rates of alcohol-related discharge were highest in the 50 to 54 years age group with a rate of 1,319 discharges per 100,000 population.
• The rate of alcohol-related discharges from a general acute hospital decreased by over 2% between 2009/10 and 2010/11.
• Alcohol dependence was recorded in 69% (2,807) of all alcohol-related discharges from psychiatric hospitals

Statistics for England can be found here.

Scottish Drink Drive limit to be lowered

The drink-drive limit in Scotland will be lowered "as a priority", according to the BBC. Justice Secretary Kenny MacAskill said plans to lower the limit from 80mg of alcohol per 100ml of blood to 50mg will be brought forward later this year. Doctors welcomed plans according to The Herald.

Last year in England the Government decided to keep the 80mg legal limit despite a report advising it to be lowered in line with most of Europe.

Retail sales data and discount ban impact reports

Two reports have been recently released as part of the Monitoring and Evaluating Scotland’s Alcohol Strategy:

• A review of the validity and reliability of alcohol retail sales data
• Preliminary descriptive analysis of the impact of the quantity discount ban on off trade alcohol sales in Scotland

Scotland's Alcohol Minimum Pricing Bill was passed last month, meaning a 50 pence minimum unit price (MUP) could be in place north of the border by April next year.

Scotland passes minimum pricing bill; Irish health minister announces ban on alcohol sports sponsorship

The Scottish Government has passed the Alcohol Minimum Pricing Bill, meaning a 50 pence minimum unit price (MUP) could be in place north of the border by April next year. The Bill requires Royal Assent and still faces the threat of potential legal challenges as warned of by sections of the alcohol industry.

A 50 pence MUP would set a minimum floor price for an average strength bottle of wine at £4.69, vodka at £13.13 a bottle (70cl) and a standard four-pack of lager would need to cost at least £3.52. The Bill sets a minimum price for a unit of alcohol as a condition of licence.

However most drinks would be unaffected, especially those sold in pubs and restaurants. The minimum price would not be raised for at least two years and is reported to include a "sunset clause". The move is expected to save lives and reduce crime based on evidence linking price and consumption and modelling work by the University of Sheffield.

See reports from the BBC, Telegraph, Guardian and the Herald.

Irish health minister announces ban on alcohol sports sponsorship

Roisin Shortfall, Irish Minister of State for Health, has announced that alcohol sponsorship of sports will soon end. The announcement was prompted by calls from Fianna Fail to address alcohol issues in the wake of a worrying report on young people's mental health in Ireland.

Recent research by Headstrong/UCD found that young people who drink excessively were at risk of depression, severe anxiety and stress. The survey found that 38% of 12-25 year olds had problem or harmful drinking, and 7% showed signs of dependence. There was also a particular risk of suicide with young people who drank excessively.

Ms Shortfall said emphatically that there was "no room for ambivalence" on the issue. She said that although currently there were still contractual agreements in place, she would seek to phase out alcohol sports sponsorship as soon as possible.

The full recommendations of the National Substance Misuse Steering Group include a ban on all alcohol sponsorship of sporting activities and large outdoor events, outdoor advertising of alcohol, higher excise duties on some alcohol products and the introduction of minimum pricing.

Scotland sets sights on 50 pence per unit minimum price & agrees 'sunset clause'

The Scottish Health Secretary Nicola Sturgeon has announced a 50 pence per unit target minimum through the Minimum Pricing Scotland Bill. See BBC and Telegraph reports and a Guardian Data blog interactive graphic on its impact.

Announcing the decision, Nicola Sturgeon said:

"Too many Scots are drinking themselves to death. The problem affects people of all walks of life. It’s no coincidence that as affordability has increased, alcohol-related hospital admissions have quadrupled, and it is shocking that half of our prisoners now say they were drunk when they committed the offence... Introducing a minimum price per unit will enable us to tackle these problems, given the clear link between affordability and consumption."

The Scottish government were recently reported to have agreed to a "sunset clause" in the planned legislation, under a deal to win Conservative support. Minimum pricing will be ditched after six years if it fails to have an impact, which Sturgeon deemed "a perfectly reasonable and legitimate position to take."

The SNP's previous attempt at a 45 pence minimum price in 2010 was blocked by opposition parties when the SNP had a smaller majority. The Health Secretary defended the 50 pence unit price stating the price was equivalent to the 2010 aim of 45p after taking account of 5% annual inflation.

In England David Cameron recently confirmed plans for minimum pricing in the new Government Alcohol Strategy. The price is yet to be set though and is unlikely to come in until 2015. Recently a Channel 4 factcheck blog was published on the supposed legal risks of Cameron's minimum pricing plans, although its legality may only be possible to test once implemented.

Events and updates: Alcohol Research UK 72nd symposium & studentships; rolling out brief inteventions in Scotland; last call for New Directions 2012 bursary; Adfam family survey; MA in Comparative Drug and Alcohol studies

Forthcoming events

The 72nd Alcohol Problems Research Symposium is calling for abstracts or other presentation suggestions for the Spring 2012 meeting to take place Stonecross Manor Hotel in Cumbria on the 14th and 15th March. The meeting is part of a long-running series of friendly events in which Alcohol Research UK is helping to organise with Professor Moira Plant, Emerita Professor of Alcohol Studies at the University of the West of England. See here for more information.

Alcohol Research UK have also opened the annual Studentship Scheme. The deadline for the academic year 2012/13 is 10th May 2012. See here for full details.

On Tuesday 27th March 2012, Edinburgh Cyrenians will be holding a one day conference at Murrayfield Stadium: Can Brief Interventions change Scotland's relationship with alcohol? Developing the model for community settings. The event will offer practical support on introducing alcohol brief interventions to new settings and provide opportunities to discuss and share experiences in workshop sessions. For more information see here or contact jenny@cyrenians.org.uk 0131 475 2354.

The New Directions in the Study of Alcohol Group (NDSAG) 2012 conference, exploring '21 years of experience and the future for motivational interviewing' takes place from Thursday 24th May 2012 to Sunday 27th May 2012, in Llandindrod Wells, Wales. The conference will include a keynote from Professor Stephen Rollnick. Submissions for the The Ron McKechnie Prize close this Sunday 29th Feb!

A free workshop on working with 'Frequent Fliers', those with the highest levels of alcohol-related hospital admissions takes place Friday, 23rd March 2012, London. See here for the flyer.  

Further updates:

The Charity Adfam is conducting a short survey for family members affected by problem alcohol use. If you are a family member please complete the short anonymous survey. If you are a practitioner who works with family members please pass the link on: http://www.surveymonkey.com/s/JCDS9LR

Middlesex University has opened a new MA course Comparative Drug and Alcohol Studies. It is designed to develop knowledge and understanding of drugs and alcohol issues, policies and interventions within a comparative context. It is relevant to policy makers and practitioners, and to students and researchers associated with the drug and alcohol field. Full info here.

News & updates Dec 2011: Scotland's multi-buy ban 'working'; minimum pricing; British Liver Trust's anger over policy; 313 DBOs so far; 'Dry bars' and 'Booze Buses'

Scotland's ban on multi-buy deals has reduced sales according to figures from retail analysts Nielsen. Sales of wine fell 5%, spirits by 3% and beer by 8% during the first eight weeks of the ban compared to 2010. See reports from the BBC and the Herald. The ban was introduced as part of The Alcohol Scotland Act which introduced new licensing laws from 1st October 2011. Measures also include a ban of multi-buy deals, alcohol advertising restrictions, Challenge 25 scheme, and a new tax on some licence holders.

Minimum pricing, also on the cards for Scotland, is explored in a recent Economist feature 'The battle of the booze', which suggest legal challenges could await both national efforts in Scotland or local approaches in England. Scottish industry figures have been speaking out on minimum pricing as 'certainly misguided, and most probably illegal'. But the Scottish Government have said its "probably not illegal", though can only be truly tested in court once enacted.

Meanwhile a national summit to build support for minimum pricing in England will take place at Manchester town hall next year. The Association of Greater Manchester Authorities (AGMA) are drafting a bylaw to stop the sale of alcohol below 50p a unit in local shops and businesses, but want to build a 'coalition of support' for a national approach.

Trade leaders have continued to call for a cut in VAT and also called for production costs to be included in the forthcoming 'below cost ban', which the IFS recently desribed as likely to only impact 1% of off-license units. However the IFS also advised lobbying on EU legislation to allow the re-structuring of alcohol taxation over minimum pricing.

England's Government-led policies on alcohol and public health have been branded 'a joke' by the British Liver Trust. Commenting on figures showing a 74% rise in liver cancer deaths since 1997, Chief Executive Andrew Langford said there are only "weak policies or no action at all... Almost all liver disease is preventable yet we are met with a sheer resistance to tackle it." Liver disease is the only health problem out of "the big five" - cardiovascular, respiratory, circulatory and cancers - showing an increasing trend. Alison Rogers, before leaving the British Liver Trust, also spoke out saying the Responsibility Deal was "fundamental conflict of interest".

The Home Office has reported 313 Drinking Banning Orders (DBOs) have been issued on conviction since they became available to local authorities last year - see MA report. DBOs can be put in place to stop an individual convicted on an alcohol-related offence from entering licensed premises or ban them from entering pubs in a specific area. See Home Office DBO pages for more.

Five men behind a counterfeit vodka manufacturing and bottling plant in Leicestershire were sentenced to 17 years reports the MA. One in 5 off-licenses were thought to be selling counterfeit alcohol a Staffordshire sting found. Suspected criminals were arrested after they were tricked by police who lured them in with a hoax offer of free beer - The Guardian.

Liverpool's first dry bar has opened reports the Guardian. Owners say 'Brink' is a social enterprise which actively promotes itself as a 'dry bar', not simply a cafe, and will appeal to people in recovery or simply those that want to avoid the "testosterone, drunk and drug-fuelled club and bar scene". 'Violence, abuse and vomit' was the headline for a night with the 'booze bus' medics in a recent Observer feature. 

Scotland's minimum pricing plans outlined

The Scottish National Party (SNP) has outlined its plans to introduce a minimum price per unit of alcohol. The Minimum Pricing Bill has not yet set out the proposed price but has commissioned further work by the University of Sheffield to model its likely impact. The SNP's previous attempt at a 45 pence minimum price was blocked by opposition parties when the SNP had a smaller majority.  

The Scottish Cabinet Secretary for Health and Wellbeing Nicola Sturgeon said: 

"We have had a wide ranging debate on alcohol pricing and there is now widespread recognition across the country of the need to tackle pricing... By setting a minimum price for a unit of alcohol, we can raise the price of the cheap supermarket white ciders, lager and value spirits sought out by problem drinkers."

The Government say the cost of alcohol consumption in Scotland is estimated to cost £3.56 billion each year, equivalent to £900 for every adult. Sturgeon said a minimum price was "not a magic bullet", but believes it will save hundreds of lives and millions of pounds over a number of years. The SNP has produced information on the effects of minimum pricing on common drinks and highlighted wide support from health groups.

But certain industry and retail bodies continued to speak out against the proposals, claiming they would breach EU competition law, increase illegal activity or trigger cross-border shopping. Opponents also repeated claims that a minimum price "would punish the responsible majority" - a line a health select committe report has said was a deliberate manipulation of the public's interpretation of the measure.

Speaking to the BBC, Sturgeon rejected claims that minimum pricing would affect responsible drinkers. She said the SNP were not "anti-alcohol", but it was wrong that a teenager could buy a potentially fatal amount of alcohol for less than £5. Brewer and trade body Greene King have also supported the move in expectation that it would help pubs who have lost out to cheap supermarket sales. See a selection of responses for and against the proposals here.

See further news reports including a BBC analysis, a Q&A on the proposals, and BBC news feature.

In England a minimum price is not supported by the Coalition Government who have emphasised voluntary action through the Responsibility Deal, but have committed to a 'below cost ban'. However the ban is not expected to affect prices under a 'Duty + VAT' definition of cost - ASDA who claimed to not to sell at below 'cost' recently came under fire for selling Budweiser at around 16 pence per unit. Manchester is attempting to bring in a regional minimum price via a local bye-law.