Alcohol Policy UK

Safe. Sensible. Social. Selling Alcohol Responsibly - consultation events

The Home Office are running a series of ten events around England and Wales in July and August 2009 as part of the consultation on the code of practice for alcohol retailers.  They want participants from the alcohol retail industry, licensing authorities, health bodies or enforcement agencies.

These events "will inform the future development of this policy in order to ensure that it gets the balance right by achieving reductions in alcohol related harms such as nuisance, crime and disorder, public safety, protection of children and the health impact, in a targeted and proportionate way that does not harm businesses that are behaving responsibly."

The dates are:

• Newcastle 7 July
• Hull 9 July
• Liverpool 14 July
• Nottingham 16 July
• Birmingham 21 July
• Cambridge 23 July
• Portsmouth 28 July
• Cardiff 30 July
• Weymouth 4 August
• London 6 August

Details and registration here.

Parliamentary review body highlights continuing gaps in alcohol treatment

The All Party Parliamentary Group (APPG) for alcohol misuse has released its first report 'The Future of Alcohol Treatment Services'. The review examines whether recent policy developments have made an impact on treatment delivery and considers what needs to be done to increase longer term access and provision of alcohol treatment.

The APPG report largely considers the ongoing challenges for alcohol treatment as it continues to be under-resourced to varying degrees across the country. This comes despite the increased profile of alcohol-related harm though does recognise some gains for alcohol provision. However the report estimates that on average only 0.1% of Primary Care Trusts' total annual expenditure is spent on alcohol services.

Last year the National Audit Office produced an extensive review of alcohol treatment services with similar findings and recommendations to improve strategic planning and resourcing for alcohol services.

Key recommendations of the All Party Parliamentary Group:

• Government needs clear cross-departmental leadership to tackle England's growing alcohol problem.
• Government needs to measure alcohol harms differently, by targeting a reduction in heavy drinking amongst all age groups and a reduction in alcohol-related crime as well as hospital-related admissions. All primary health care services should understand and be able to deliver Screening and Brief Interventions (SBI).
•  All PCT areas should have effective specialist alcohol services which are accessible to local communities.
• Specialist alcohol treatment must meet the needs of all those affected by alcohol misuse.
• There needs to be clear protocols and pathways in place to tackle alcohol misusers with more complex needs.
• In order to tackle alcohol harms, PCTs must understand the scale of the problem they are facing and share data as required.
• The Department of Health should update and reissue existing guidance and support implementation with regional training.
• There needs to be an ongoing training programme for alcohol commissioners.
• Strategic Health Authorities must ensure that PCTs are assessing need in their area and commissioning alcohol treatment commensurate with that need.
• Clear guidelines are required about how different parts of the alcohol treatment sector are to work effectively together.
• The National Institute for Health and Clinical Excellence (NICE) should look at how the Quality and Outcome Framework (QOF) for GPs can be amended to help tackle alcohol misuse.
• Access to accurate alcohol misuse and dependency data must become a priority for the Department of Health.

North East launches Big Drink Debate as North West reports successes

The North East Big Drink Debate has been launched, encouraging the region to consider the impact of alcohol and report their views and consumption via this questionnaire. Local press coverage here.

North West Big Drink Debate findings
In 2008 the neighbouring North West region carried out a Big Drink Debate and claimed its success prompted the Chief Medical Officer to encourage other regions to deliver their own Big Drink debates (see 'Key achievements of the Big Drink Debate'). Findings of the evaluation showed:

• 80% of NW respondents said they thought low price and discounts increased people’s drinking;
• 75% of NW respondents believe large measures are key to increased drinking;
• 68% of NW respondents say allowing street drinking increases alcohol use;
• Over half of NW respondents believe advertising (56%) and extended drinking hours (54%) are factors that increase drinking;
• Nearly half the NW respondents avoid town centres because of the drunken behaviour of others

Big Drink Debates are being rolled out as Social Marketing projects that are recommended as one of the Department of Health High Impact Changes for reducing alcohol-related harm. See the National Social Marketing Centre for guidance.

A new Home Office binge drinking campaign is also running this summer as part of the national Know Your Limits social marketing campaign.

Too much too young? Alcohol misuse amongst young Londoners

The London Assembly has published Too much too young? Alcohol misuse amongst young Londoners. The report reviews evidence of alcohol use in London amongst 11-21 year olds and makes a number of policy recommendations across all levels.

The key findings of the report include:

• Young people in the capital are less likely to drink, and less likely to get drunk than young people elsewhere in the country.
• More than a third (35 per cent) of Londoners aged 11-21 drank regularly in 2005-06.
• Londoners aged 11-15 now drink around 307,391 units of alcohol a week
• 11-15 year old women now have similar drinking habits to young men of the same age.
• Around 80 to 90 per cent of 17-21 year olds have ever had an alcoholic drink, compared to 15 per cent of 11 year olds and 60 per cent of 15 year olds.
• In 2005-07, ten per cent of Pakistani and 12 per cent of Bangladeshi young people drank at least once a year (up from 4% and 2% respectively in 2001-04).
• Alcohol-specific hospital admissions for 11-21 year old Londoners have almost doubled in recent years. In 2006, there were 1315 hospital admissions for 11-21 year olds, compared to 690 in 2002 – an increase of 91 per cent.
• The alcohol-specific hospital admission rate for young women (at 14.0 admissions per 10,000) was almost twice as high as the rate for young men of the same age (at 7.4 admissions per 10,000).
• In 2003, there were 1,272 incidents where 11-21 year olds were accused of alcohol–related offences, compared to 2,370 in 2007; nearly double.
• Underage drinking was the least frequently reported issue in a survey on alcohol-related disorder conducted with community safety staff in London boroughs.

Recommendations (summary):

1. The Greater London Alcohol and Drugs Alliance (GLADA) should monitor the alcohol consumption of young Londoners between 2009 and 2012 to assess whether recent increases in drinking among young women and among young Pakistani and Bangladeshi Londoners are part of ongoing trends.
2. The Mayor should commission an immediate review of GLADA’s membership, resourcing and remit to ensure it can effectively implement the Regional Statement of Priorities for Alcohol and provide strong regional leadership on alcohol misuse.
3. The Mayor should outline initiatives to tackle the disproportionate impact of alcohol on the health of people from deprived communities in his upcoming Health Inequalities Strategy.
4. By March 2010, London boroughs where alcohol-specific hospital admissions for under-18s are higher than the national average (currently Kingston and Sutton) should appoint an alcohol harm reduction champion.
5. A London borough and local police service working with the Retail of Alcohol Standards Group should pilot the St Neots community alcohol partnership model to reduce alcohol misuse by under 18s during 2009/10. Representatives of both the on- and off-licence trade should be engaged in this partnership.
6. The Department for Children, Schools and Families and the Qualifications and Curriculum Authority should ensure that alcohol education is effectively covered in the mandatory PSHE curriculum, currently under development. Alcohol should be given the same prominence in this curriculum as drugs, and the focus should be on how to reduce alcohol harm. The curriculum should cover how and why alcohol tolerance varies between men and women. It should also include first aid techniques, so that young people know how to help in emergencies such as a friend collapsing because of alcohol.
7. By June 2010, The Department for Children, Schools and Families and the Home Office should run a national FRANK campaign around alcohol that focuses on the consequences of drinking, and also promotes the information FRANK can provide about alcohol and local services.
8. By December 2010, GLADA should co-ordinate a London wide social marketing campaign that aims to reduce alcohol harm, in association with external partners. The campaign should target groups including parents and carers, young women aged 11-15 and young Pakistani and Bangladeshi Londoners.
9. By March 2012, NHS London should ensure that Screening and Brief Intervention Initiatives are in place at every London Accident and Emergency Department, and available to adults and to young people. A detailed evaluation of the impact of Screening and Brief Interventions on young Londoners’ drinking behaviour should be conducted by March 2014.

Interestingly the report does not extensively refer to the draft guidance from the Chief Medical Officer (CMO) issued earlier this year, though it does claim to support it: "The Committee welcomes [the CMO] guidance, but believes that once the guidance has been finalised, it should be disseminated together with information about alcohol treatment and support services for young people and for their parents and carers."

The Youth Alcohol Action Plan was released as the government's national strategy for young people in 2008.

Tools released to assess local impact of increasing alcohol treatment and interventions

A number of tools and documents have been released by the Department of Health's Alcohol Learning Centre (ALC) to assist commissioners predict the likely impact of increasing alcohol interventions and treatment. The tools 'can be used by commissioners as an aid for needs assessment, treatment capacity, service impact and planning your responses in local alcohol service delivery.'

The main tool is the Ready Reckoner v1 which generates data to identify the potential impact of increasing alcohol interventions and treatment for local PCTs. By selecting your PCT and entering possible increased provision (in the yellow boxes), the tool will calculate the costs, potential cost savings and predicted impact on hospital admissions. The ready reckoner calculates the possible impact of increasing High Impact Change interventions of A&E nurse specialists, hospital ward Alcohol Health Workers, Primary Care brief interventions and psychosocial interventions for dependent drinkers. A guidance document for using the tool is available.

The ALC have also highlighted the Rush report as a resource to assist commissioners in assessing the need for treatment capacity.

Information on the Purple Report is also available, whereby commissioners can access alcohol data collected from local treatment services via NDTMS.

Home Office binge drinking summer campaign

The Home Office will be running advertising for the Know your Limits binge campaign this summer, starting on Monday 8th June. The latest Know Your Limits bulletin from Forster reminds us that in June last year the Home Office launched a new campaign which posed the question to the 18-24 year-old target audience ‘You wouldn’t start a night like this so why end it this way?’. The campaign seeks to challenge attitudes around the acceptability of drunken behaviour amongst 18-24 year olds. The long term aim is to the change drinking behaviour amongst this audience thereby reducing alcohol related harm and anti social behaviour.

Advertising launched last year included TV, radio, online and print advertising. According to Forster campaign awareness is very high at 96% of 18-24 year olds; of those, 67% agreed the TV advertising made them think more carefully about their drinking behaviour and 65% agreed the campaign is making them think about how much they drink on a night out.

TV, radio, print and online advertising will be running as follows:

• TV advertising – male and female versions of the TV ad will be aired from 8th June - 27th July
• Press advertising – 15th June - 27th July
• Radio advertising – 13th July - 3rd August
• Online advertising – 8th June - 27th July

The Home Office has produced two new print adverts and one new radio advert aimed primarily at 18-24 year old women. There is also a new online viral targeting 18-24 year olds which will be available on YouTube from Saturday 6th June and officially launched on Monday 8th June.

The Home Office are also partnering with Hollyoaks this summer on twelve spin off online episodes which will be shown online in July. These episodes bring to life some of the consequences of binge drinking such as aggression and violence and vulnerability. They follow on from an independently planned storyline on binge drinking in the TV soap. The spin off episodes will be shown here.

The stakeholder website  will be updated on Saturday 6th June to include the new print adverts and the viral. The new radio advert will be added at the end of June, prior to its launch in July.

Efficacy of A&E brief interventions for injury; targeted vs universal approaches

The Drug and Alcohol Findings policy and research site has published two new bulletins reviewing key alcohol-related studies:

• A systematic review of emergency care brief alcohol interventions for injury patients.

The review found confirmation that brief advice to risky drinkers identified in accident and emergency departments can cut drinking and reduce the chance of further injuries and readmissions; the issue now is why this happens sometimes but not always.

• A preliminary study of the population-adjusted effectiveness of substance abuse prevention programming: towards making IOM program types comparable.

One of the biggest strategic decisions facing prevention planners is whether to target high-risk groups or to prioritise universal programmes. This analysis won't decide the issue, but it does create an important new tool for comparing these strategies.


The report examines the efficacy of universal or targeted interventions against different substances