Alcohol Policy UK

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.

PhD Research place: Gendered Identities and Alcohol Consumption Among Young Adults

A PhD Research Studentship opportunity has arisen to address the subject of Gendered Identities and Alcohol Consumption Among Young Adults: A Qualitative Study.

Led by the MRC Social & Public Health Sciences Unit, Glasgow, the project will explore:

• How do young women and men in Scotland perceive (excessive) drinking?
• How are young adults’ gendered identities related to, and constructed by, alcohol consumption?

Closing date: 16 February 2011. Stipend £13,590 per annum. The successful student will be supervised by Dr Carol Emslie and Dr Helen Sweeting.

Further details can be found here on the MRC website.

JRF report on the influence of family and friends on young people’s drinking

Family and friends are key to shaping young people’s drinking culture, says a round-up report from the Joseph Rowntree Foundation (JRF). The findings of the featured projects suggest that family or friends may be more or less influential at different times, but these influences interconnect, with family influence continuing as children grow up.

The authors conclude that:

• prevention and harm reduction approaches need to take into account how family circumstances vary;
• public health messages need to connect more with the realities of parents’ attitudes and practices;
• interventions should consider group behaviour, not just individuals’ behaviour;
• the potential for using price as a harm reduction measure and the need for more appealing spaces for young people to socialise require further consideration.

Other recent reports from the JRF explored family life and alcohol. See here on the Alcohol Learning Centre for a list of alcohol-related documents and resources on children and young people.

'Below cost' ban announced as duty + VAT re-opens pricing debate

The Government has announced the 'below cost ban' will be defined as the rate of duty + VAT, despite concerns from critics that few drinks are sold below this level. A Home Office press release said "This is an important first step in delivering the government's commitment to ban the sale of alcohol 'below cost' price."

However some media reports described the measures as 'minimum pricing', a different approach based on cost per unit. See here for the differences between a below cost ban and minimum pricing. The ban on sales below a duty + VAT rate has been calculated as preventing retailers from selling:

• a litre of vodka for less than £10.71
• 440ml lager for less than 38p
• a litre of cider for less than 40p
• 700ml whiskey for less than £8

There has been ongoing controversy over how a 'below cost ban' could be defined since the Coalition first pledged to crackdown on cheap alcohol. The on-trade had previously warned that supermarkets would 'beat a below cost ban' under a duty + VAT definition, arguing production and distribution costs should be factored in. A press release from the Association of Licensed Multiple Retailers’(ALMR) today said it would “make no difference to pocket money prices on the high street nor the irresponsible retailing practices of Britain’s supermarkets”.

However retailers and supporting bodies have called for a duty + VAT definition, with Asda already adopting the approach last year. A press release from the Wine and Trade Spirit Association (WTSA) welcomed the move as the "practical way to implement the policy", adding that "alcohol pricing and taxation cannot provide the solution to alcohol misuse". Drinks producer Diageo said the proposal was "the least distorting option".

The announcement of the below cost ban appears to have re-opened the pricing debate, first ignited in 2009 when the former Chief Medical Officer called for a 50 pence per unit minimum price. Speaking on BBC Radio 4 feature, Professor Ian Gilmore said of the measures: "It's a step in the right direction but I have to say, it's an extremely small step." Gilmore and other health interests including Alcohol Concern have continued to call for a 50p minimum price. Professor Nutt argues the harm caused by 'super strength' lagers also supports the case. See here for a Channel 4 news report.

As it announced the measures, the Home Office published a review assessing the potential impacts of pricing measures:

The likely impacts of increasing alcohol price: a summary review of the evidence base [pdf]

The Home Office said options for implementation of the measures were still being considered.

Only 2 in 5 adults correctly identify unit content, finds Drinkaware survey

Only two in five adults (42%) recognise how many alcohol units are in common drinks, according to research by Drinkaware. The survey also found that less than a third of adults (29% of women and 32% of men) can correctly state the recommended daily unit guidelines for their respective gender.

The survey of over 4,000 UK adults found whilst 85% of adults had heard of 'alcohol units', only 30% of women and 46% of men could correctly identify which drinks roughly equate to one unit of alcohol when given a list of drinks. See the press release here.

To raise awareness of units, Drinkaware recently posted 2.3 million unit and calorie calculators to households across the UK. The unit wheels and other resources are available to order from the Drinkaware site. Chris Sorek, Chief Executive of Drinkaware, said:

“It’s great to see most people have heard of the term ‘alcohol units’, but we want to help them understand the unit equivalents of their favourite drinks and relate those to the recommended daily guidelines."

“Changing the UK’s drinking culture won’t happen overnight but providing consumers with useful tools such as the unit calculator can help them understand what a unit is and how many are in the nation’s most popular drinks."

As well as Drinkaware activities, the NHS and Home Office have also funded alcohol awareness campaigns in recent years. Currently the NHS Choices website has alcohol pages and a 'Drinkswap' campaign has been developed as part of Change4life.

News and updates Jan 2011: Pubs & licensing reform; Nutt speaks out; blogs and reports

Plans to allow more freedom for pubs to serve smaller measures have been confirmed. A Guardian article highlighted premises will be able to sell wine in measures of under 75ml, while beers can be sold in Australian-style "schooners" which hold two-thirds of a pint. A consultation is also currently open on the relaxation of licensing laws for the royal wedding.

Industry trade groups will give evidence to a committee of MPs examining the licensing reforms later this month, reports The Publican. The controversial overhaul of the Licensing Act, which plans to give greater power to communities, is currently going through parliament. Written evidence can be submitted here. The Publican has also reported on pubs and government policy following comments from the Pubs Minister and a piece from the BII chief exec on pubs and Coalition policy.

The British Beer and Pub Association (BBPA) though has warned over a beer tax "double whammy", claiming the rise in VAT combined with the planned rise in duty will push the typical pub pint over the £3 mark. The BBPA called for a re-think claiming the changes will result in job losses and reduced revenue. Last year a leading doctor suggested reducing the VAT rate for pubs as part of wider alcohol policy and tax measures.

Professor David Nutt talks on the harms of alcohol in a Guardian video blog, including a short explanation of the recent harm rankings study. Nutt established the Independent Scientific Committee on Drugs following his sacking from the Government's advisory group the ACMD. "It used to be that to drink you went to the pub and there were social constraints on how much we drunk" Nutt says. "A lot of people are inadvertently drinking more than is good for them and they're ending up in [their] middle age with alcohol-related damage." Nutt said policy is not facing up to the challenge of alcohol harm.

The drinks industry watchdog the Portman Group is advertising for new members to join its independent panel that rules on breaches of the code for responsible drinks marketing, reports the Morning Advertiser.

A 'no-wine' trial version of the hugely successful M&S 'dine in for two for £10' has flopped according to the Daily Mail. Despite higher quality food offered as part of the deal, one customer was reported as saying "No wine, no deal. Think again M&S!".

The Beyond the Silo blog explores Is Cardiff’s binge drinking reputation deserved?. A blog from the Centre for Policy Studies has called for better monitoring of addiction and dependence rates as part of improving mental health. Currently the main indicators for alcohol dependency include the Adult Psychiatric Morbidity Survey (APMS). Manchester hospitals treat 186 drinkers every day, says the Manchester Evening News.

'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.

Consultation open on Public Health proposals; NHS Operating Framework

Consultation and further details on the new proposals for Public Health have been released by the Department of Health:

Healthy lives, healthy people: consultation on the funding and commissioning routes for public health

The consultation seeks views on the proposed delivery and funding arrangements for public health services as outlined in the recent Public Health White Paper. As part of the wider NHS reform plans, the proposals include the creation of Public Health England to oversee a ring-fenced budget. Locally, public health responsibility will be transferred to local authorities to deliver through Health and Well being boards, including responsibilty for drug and alcohol treatment provision.

The consultation closes on 31 March 2011 and responses can be submitted online here.

Also recently released was the The Operating Framework for the NHS in England 2011/12 which sets out the next steps for NHS reform. A new national drugs strategy also recently outlined implciations for alcohol treatment.

Latest Findings alcohol research & topics Jan 2011: Motivational Interviewing 'what to say'

Recent research from the drug and alcohol Bank:

Findings research bulletins

Clues to what to say and not to say in motivational interviewing sessions This substudy from the seminal US Project MATCH alcohol treatment trial found evidence for the appealingly simple conclusions that selectively reflecting back to the client their own pro-change statements promotes further change talk, which in turn promotes the desired drinking reductions themselves.

Findings Hot Topics

Relieving the population-wide burden of alcohol-related harm At 2001 rates alcohol-related death, illness and crime cost England about 20 billion pounds and at 2006/7 rates, Scotland 2.25 billion. This public health burden both reflects and calls in to question the embededness of drinking in British society, making how to reduce the burden a highly contested issue. In the mix are universal prevention programmes, price rises, widespread screening and brief advice in surgeries and hospitals, and treating the worst cases. Each has enthusiasts and sceptics.

Controlling alcohol-related crime, nuisance and disorder Another major theme, this time in British national alcohol policies, as town centres count the costs of an alcohol-based nighttime economy and street drinking is increasingly treated as anti-social and sometimes simply banned. Policy prominence has yet to be matched by UK-based research, but we can still learn potentially important lessons from the UK and from abroad.

Further alcohol research abstracts as highlighted from the Findings team:

• Spirituality in Recovery: A Lagged Mediational Analysis of Alcoholics Anonymous' Principal Theoretical Mechanism of Behavior Change
• Stigma and Treatment for Alcohol Disorders in the United States
• Alcohol-Use Disorders and Depression: Results from Individual Patient Data Meta-Analysis of the Acamprosate-Controlled Studies
• Barriers to Implementing Screening and Brief Interventions in General Practice: Findings from a Qualitative Study in Norway

Further research can be found from the Findings bank, the AERC library, and a links page on the Alcohol Learning Centre.