Alcohol Policy UK

General Lifestyle Survey 2011 confirms drop in risky drinking - but causes and long term trend unclear

The 2011 General Lifestyle Survey has been released, including Chapter 2: drinking (pdf). The GLS 2011 explores trends in reported alcohol consumption since 2005 and confirms a fall in frequency of drinking above the guidelines amongst men and women. However health groups are keen to emphasise a significant longer trend rise in alcohol misuse and harms since the 1950s. 

Respondents to the 2011 GLF were asked questions relating to average weekly alcohol consumption and the maximum amount drunk on any day in the last week. Key findings included:

• The proportion of men drinking on five or more days a week fell from 23% in 1998 to 16% in 2011, and for women from 13% to 9%.
• The proportion reporting drinking alcohol in the last seven days fell from 72% in 2005 to 66% in 2011 for men, and from 57% to 54% for women.
• The proportion of men exceeding four units (daily guideline) on their heaviest drinking day was 41% in 2005 and 34% in 2011. The proportion of women exceeding three units was 34% in 2005 and 28% in 2011.

It is unclear to what extent various factors account for falls in reported consumption. Lower disposable income since the recession; national and local action to reduce alcohol misuse; or a general 'peaking' of consumption in 2004 may all play significant roles.

Clare Gerada, chair of the Royal College of GPs, suggested "It may be linked to income – as we have less disposable income, we drink less," she said. Others have previously warned that consumption and harms may begin to rise again as or when the economy picks up, as heavier drinker's income are disproportionately squeezed in harder times.

Extensive media coverage was recently given to the issue of 'under-reporting' following a UCL study. However media reports generated some particularly sensationalised interpretations, as explored in this behind the headlines report. More to come on this.

Earlier this year findings from the the Health Survey for England (HSE) 2011 were released, comprehensively exploring consumption patterns. See the HSE chapter 6: drinking patterns and chapter 7: drink diary. Also earlier this year the ONS released the latest Statistical bulletin for alcohol-related deaths in the UK (2011).

See here for the NHS Statistics on Alcohol 2012 report.

Health Survey for England 2011: latest figures on reported consumption

Findings from the the Health Survey for England 2011 have been released, including chapter 6: drinking patterns and chapter 7: drink diary. See here for the trend tables, trend commentary and press release.

The report broadly reflects known general consumption patterns. Young adults are more likely to drink heavily (binge) on a single occasion, but drink on fewer days in the week. Adults over 45 are more likely to drink on most days, but tend to drink less per day. Those from higher socio-economic groups are more likely to drink above the guidelines and do so more regularly. Men drink significantly more than women across most age groups.

The drink diary chapter is a new addition to test how reported consumption matches up when recorded by the drinker. Although reported frequency of drinking tended to match, consumption levels tended to be under-estimated when compared with a drinks diary. The survey data is still considered reliable in determining consumption patterns and variations across age, sex, region and income groups.

Some specific findings include:

• Focusing only on those who drank alcohol in the last week, over half exceeded recommended limits on at least one day in the previous week (56% of men, 52% of women), while over a quarter drank more than twice the recommended limit (31% of men, 25% of women). Men drank an average of 7.7 units, and women an average of 5.0 units on the day they drank the most in the last week.
• Younger people were the most likely to drink heavily on a single occasion: 67% of men and 68% of women aged 16-24 drank above the recommended level, and 45% and 46% respectively drank more than twice the recommended amount.
• The proportion of men consuming more than four units on the heaviest day’s drinking in the last week did not show substantial change between 2006 and 2011 (39 per cent in 2011), and similarly the proportion of men that drank more than twice the recommended amount showed little change over the period (22 per cent in 2011).
• The picture was different among women: there was a decrease between 2006 and 2011 both in the proportion consuming more than three units on the heaviest day’s drinking last week (from 33 per cent to 28 per cent), and in the proportion drinking more than twice the recommended amount (from 16 per cent to 13 per cent).

The figures prove interesting given indications that overall alcohol consumption has been falling since 2004. However consumption it still significantly higher as a longer term trend, and it has been suggested that consumption may have dipped in part due to the recession. A continuing rise in alcohol-related and primary alcohol attributable hospital conditions is also set to continue for sometime.

See here for the comprehensive statistics on alcohol for England 2012.

BBC Timeshift explores the social and cultural history of drinking in Britain

BBC Four's Timeshift, a documentary series into Britain's social and cultural history, featured episode 11 on 'The Rules of Drinking' this week and is available for a further 5 days on BBC iplayer.

The Rules of Drinking synopsis:

In the pubs and working men's clubs of the forties and fifties there were strict customs governing who stood where. To be invited to sup at the bar was a rite of passage for many young men, and it took years for women to be accepted into these bastions of masculinity. As the country prospered and foreign travel became widely available, so new drinking habits were introduced as we discovered wine and, even more exotically, cocktails.

People began to drink at home as well as at work, where journalists typified a tradition of the liquid lunch. Advertising played its part as lager was first sold as a woman's drink and then the drink of choice for young men with a bit of disposable income. The rules changed and changed again, but they were always there - unwritten and unspoken, yet underwriting our complicated relationship with drinking.

Another BBC feature 'Inside Out London' also featured alcohol this week - available on iplayer until 16th January. In it Wendy Hurrell goes attempts to 'go dry' in December whilst also talking to people who've experienced alcohol problems - and professionals trying to address alcohol misuse.

Report: Contributions of Alcohol Use to Teenage Pregnancy and Sexually Transmitted Infection Rates

A report from the Centre for Public Health found expected higher alcohol related hosptial admissions amongst areas with higher teenage pregancy and STI rates:

Contributions of Alcohol Use to Teenage Pregnancy and Sexually Transmitted Infection Rates [pdf]

However the report also finds some variations, suggesting further research and monitoring. Findings and recommendations include:

• The relationship between alcohol misuse and poor sexual health outcomes means there is an urgent need for the integration of health services for young people. It should be routine for professionals to address sexual health and alcohol issues simultaneously.
• Campaigns/services that aim to address teenage conception should include alcohol consumption in young men as well as young women, since alcohol misuse in both sexes independently predicts teenage pregnancy and sexual infections
• Attention needs to be paid to local factors that may play a role in enhancing risk of conception among groups of young people

ONS data: fall in alcohol related deaths; lifestyle survey highlights drinking differences

The Office for National Statistics (ONS) has released data showing alcohol-related deaths have fallen since 2008, but remain significantly higher than the the early 1990s. Results from the General LiFestyle Survey (GLF), formerly the General Household Survey (GHS), were also released highlighting drinking and smoking differences between between socio-economic groups.

Don Shenker, Chief Executive of Alcohol Concern stated: "The slight fall in 2009 in alcohol-related deaths mirrors a slight drop in alcohol consumption, and while this is positive, it is wholly due to a drop in consumer spending as a result of the recession." Figures from the BBPA have shown a downward trend in consumption since 2004. Shenker warned "It is very likely that alcohol consumption will rise again once the economy picks up" and called for government alcohol policy to go further in addressing affordability.

The ONS statistical bulletin highlights:

• In 2009 there were 8,664 alcohol-related deaths in the UK, 367 fewer than the number recorded in 2008 (9,031)
• Males accounted for approximately two-thirds of the total number of alcohol-related deaths in 2009.
• Across the 2000–09 period, rates were highest amongst those aged 55–74

An ONS release on the GLS survey highlighted:

• In contrast to smoking, managers and professionals have a higher weekly alcohol intake than routine and manual workers. Average weekly consumption was 13.5 units for adults in households managerial and professional household and 10.7 units for adults in routine and manual households.
• In managerial and professional households, 23 per cent of men and 15 per cent of women drank heavily (more than 8 units for men, more than 6 units for women) on at least one day in the previous week, compared to 19 per cent of men and 11 per cent of women in routine and manual households

See media reports from the The Independent, The Guardian , the BBC, and the Daily Mail.

See here for further alcohol related information and reports, the NHS Statistics on Alcohol 2010 report and factsheets from the Institute of Alcohol Studies.

'Light' drinking during pregnancy does not increase risk says research

New research by University College London (UCL) says 'light' drinking during pregnancy does not harm a young child’s behavioural or intellectual development. However 'light' drinking meant only 1 or 2 units a week or at any one time; less than 'moderate' drinking which was classed as 3 to 6 units a week or 3 to 5 at any one time.

See the report 'Light drinking during pregnancy: still no increased risk for socioemotional difficulties or cognitive deficits at 5 years of age?' [pdf]

Advice over drinking when pregant has been somewhat controversial, with official NHS advice advocating a message of avoiding alcohol altogether. A spokesperson for the Department of Health said that its advice would remain unchanged to avoid confusion among pregnant women:

"After assessing the available evidence, we cannot say with confidence that drinking during pregnancy is safe and will not harm your baby...Therefore, as a precautionary measure, our advice to pregnant women and women trying to conceive is to avoid alcohol."

Chris Sorek, the chief executive of alcohol awareness charity Drinkaware, also urged caution stating:

"Despite these findings, it is important to remember that 'light drinking' can mean different things to different people.

"Excessive drinking during pregnancy can carry serious consequences and lifelong damage to children and should be avoided."

NICE advises women to avoid drinking in the first three months of pregnancy especially, due to increased risk of miscarriage.

See news stories here from the BBC, The Guardian and a Radio 4 report.

Alcohol segmentation reports

A series of four reports utilising segmentation tools to discuss alcohol have been produced by the Liverpool John Moores University (JMU) Centre for Public Health.

The reports aim to synthesise the different data sources that identify at-risk groups as well as to provide an insight into related motivations and attitudes.

Alcohol pen portraits: segmentation series report 4

This report is a summary document, bringing together the intelligence gathered to provide an in-depth understanding of the groups. The report provides suggestions for the nest steps in developing a truly insightful understanding of the groups through qualitative research.

Alcohol-attributable hospital admissions: segmentation series report 3

This report concentrates on hospital admission relating to alcohol in order to highlight which groups and types of populations are most at risk.

Alcohol consumption: segmentation series report 2

This report concentrates on consumption, highlighting which groups and types of groups are most likely to drink in certain patterns.

Attitudes towards alcohol: segmentation series report 1

This report concentrates on attitudes and motivations in relation to alcohol, highlighting which groups and types of groups are most likely to have specific attitudes and/or motivations.

A national social marketing toolkit is available from the Alcohol Learning Centre's Social Marketing pages as well as segmentation tools for your local area.

Latest HubCAPP projects: May 2010

Latest projects added to the Hub of Commissioned Alcohol Projects and Policy (HubCAPP) database:

Addenbrooke's Hospital | Fetal Alcohol Syndrome (FAS) Research Study and Pocket Guide

The Addenbrooke's Hospital | Fetal Alcohol Syndrome (FAS) Research Study and Pocket Guide project was undertaken to establish what antenatal advice was given to expectant mothers about FAS and alcohol intake in pregnancy. Subsequently, a pocket guide was produced and sent to midwives, accompanied by a letter discussing the principal research findings. See Addenbooke's Hospital project here.

Manchester Comprehensive Care Pathway Development

NHS Manchester used additional funding through itsits Early Implementer status to develop a comprehensive alcohol care pathway across three Acute Hospital Trusts to address the full range of problem drinking and ensure rapid access to community based advice and treatment. See Manchester Care Pathways project here.

Wigan Mainstreaming Identification and Brief Advice Project

Ashton, Leigh and Wigan Primary Care Trust are aiming to mainstream and embed alcohol identification and brief advice into routine practice in a variety of health and allied health settings. See Wigan IBA project here.

European seminar explores alcohol's harm to others

A seminar 'The Cost of Alcohol: Passive drinking' organised by Eurocare  to discuss the harm caused to others took place on the 2nd February 2010. See here for the seminar report.

Presentations included:

“Passive drinking” the collateral damage from alcohol by Hans Olav Fekjær (Actis) (PowerPoint) (Audio)

EU action to reduce alcohol related harm by Ceri Thompson (DG SANCO- EU Commission) (PowerPoint) (Audio)

Alcohol and Interpersonal Violence - Domestic violence: Xavier Ferrer (Fundación Salud y Comunidad) (PowerPoint) (Audio)

Alcohol and traffic accidents - Antonio Avenoso (ETSC: European Transport Safety Council) (PowerPoint) (Audio)

Children living in families with alcohol problems: the invisible victims - Mira Roine (ENCARE: European Network for Children for Children affected by Risky Environments within the family) (PowerPoint) (Audio)

Harm to the unborn child - Dr Rudi Kohl (FAS Policlinic. The Netherlands) (PowerPoint) (Audio)

Closing remarks by Cliona Murphy (Alcohol Action Ireland - Eurocare) (Audio)

Health practitioners' guide on Foetal Alcohol Syndrome

An Australian children's health research organisation has released 'Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder: a Resource for Health Professionals'. The guidance aims to provide practitioners with information and guidance for identifying and providing support relating alcohol use and pregnancy and preventing Foetal Alcohol Syndrome.

Currently the Department of Health recommends that 'Pregnant women or those trying to conceive are being advised to avoid drinking alcohol, and not to get drunk.'  (see more here).

The UK organisation Foetal Aware Syndrome UK also provides a range of resources and information.