Alcohol Policy UK

Drinkaware release 'In:tuition' life-skills based teaching resource and parents section

The industry funded body Drinkaware has released a 'life-skills based interactive teaching resource' called In:tuition, which includes a series of lesson plans and supporting resources.

A press release said the "cross-curricular programme builds the esteem, confidence and decision-making skills of students aged 9 to 14 so they can make more informed decisions about a range of issues – including alcohol, sex and relationships, personal finance, health and civic responsibility." The resource itself says: "The programme aims to build young people's confidence, personal and social skills and help them explore how they make decisions and what might influence them".

Drinkaware say the average age of first unsupervised drink is just under 14 years old so ensuring young people have life-skills from an early age can help them make responsible choices. It claims 'life-skilled' based approaches are effective based on a Cochrane review of school-based alcohol misuse prevention programmes. A recent Findings bulletin assessed the evidence that schools-based prevention worked best when it didn't target alcohol.

Drinkaware have also released a parents section, which "will help explain why, when and how to start talking to your child about alcohol, whatever their age. It will also give you the facts you need to feel more confident in keeping up an ongoing dialogue about responsible drinking throughout your child’s teenage years." It also says "the more information your child has, and the earlier they get it, the better." See reports from the BBC and The Sun.

The NHS had previously ran a campaign called 'Why let drink decide?' to encourage parents to talk to their children about alcohol, but the webpages have been closed. NHS Choices offers some guidlines and FAQs for parents. CMO guidance advises an alcohol-free childhood as best.

Alcohol Concern calls for restrictions on alcohol advertising affecting children and young people

A survey of 2,300 young people published by Alcohol Concern said most respondents wanted more protection from alcohol advertising. Alcohol Concern said there is recognition of a need to protect under-18s from exposure to alcohol promotion, although children and young people as young as 11 are regularly exposed to alcohol advertising. 

See here for the report 'Overexposed and overlooked'

Alcohol Concern says that the government needs to reduce the "cumulative exposure" of young people to "positive drinking messages". Don Shenker of Alcohol Concern said:

"If one of the aims of alcohol marketing regulations is to protect children and young people from exposure to advertising then government needs to ask itself whether the current framework is fit for purpose."

Young people said they recognised the influence of cinema and TV advertising, asking for better restrictions, such as no alcohol advertising before the 9pm TV watershed. They also wanted a reduction in positive imagery related to alcohol and clearer labelling on drinks which highlighted the risks. Few of those surveyed said they recognised so-called "below the line" advertising such as alcohol advertising on football shirts.

The report also looks at social network sites and internet accessibility of alcohol sites for under 18s. Alcohol Concern also recently produced a report highlighting the realm of new social media in advertising in its report New media, new problem?. A recent JRF report also explores the influence of media on young people.

However, calls to protect young people from alcohol harms are not new nor restricted to advertising influence. Demos recently called upon parents to protect their children through good parenting, stating that "bad parenting" of young people up to the age of 10 years led to an increased risk of excessive drinking when these youngsters reached their 30s. Amongst requests to parents to encourage "sensible and responsible expectations" towards alcohol, they also called on the Government to make it harder for children to obtain alcohol.

In 2007 Martin Plant and the ESPAD survey reported that the UK had some of the highest levels of teen binge drinkers in Europe and highlighted some of the risks they were facing. But earlier this year a survey suggested fewer 11-15 year olds were drinking, although the trend for those that do drink is unclear.

The Alcohol Learning Centre has a Children and Young People section including a 2010 DCSF report and the CMO guidance advising an alcohol-free childhood. Search the Findings bank here for research bulletins.

News & updates Oct 11: Alcohol-free days; Don Shenker to leave Alcohol Concern; Facebook-Diageo deal; ‘drunkorexia’ - skipping meals to save calories?; trade & industry news

Advice for three alcohol-free days per week has been in the news following evidence given at the inquiry into alcohol consumption guidelines. See reports from the Daily Mail, BBC and The Telegraph.

Sir Ian Gilmore of Royal College of Physicians (RCP) emphasised the need for drinkers to consider the risks of daily alcohol consumption, even in moderate amounts. Gilmore said: ‘In addition to quantity, safe alcohol limits must also take into account frequency. There is an increased risk of liver disease for those who drink daily or near daily compared with those who drink periodically or intermittently." A possible 'binge drinking guideline' of 8 units had also been raised in an earlier session.

Don Shenker is to leave Alcohol Concern, a press release today announced. He had spent six years with the organisation with over three years as Chief Executive (CE). Eric Appleby is returning to act as a part-time Interim CE, alongside the recruitment of a full time Director of Fundraising and Campaigning.

Last month a multimillion-dollar deal agreed between Facebook and Diageo was announced. A Guardian report highlighted concerns over a deliberate strategy to target a younger audience - half of Facebook users are under the age of 24 and many under 18 years old. 

Diageo's US brands had reportedly seen a 20% increase in sales as a result of Facebook activity this year. Alcohol Concern recently released a report on children's exposure to advertising via social networking. Facebook said all its alcohol advertising was 'age-gated' - not allowing under 18s onto alcohol brand pages. Diageo said it complied with 'all applicable laws, regulations and industry codes'.

Young women who 'binge drink' are skipping meals to reduce their calorie intake according to the Daily Mail. The practice termed ‘drunkorexia’ is reportedly affecting young British women, particularly students, following U.S. research that found 16% of students reported restricting calories to 'save them' for drinking. Women were apparently three times more likely to do so, citing wanting to lose weight and spend less money getting drunk as reasons.

Pub, trade and industry

The controversial below cost ban may yet still include production costs, according to the Morning Advertiser. However a source said the Home Office were finding it "increasingly difficult to come up with something that includes the cost of production. Legally it’s a minefield". At present the 'below cost ban' only identifies cost as duty+VAT; ASDA recently came under fire for selling Budweiser for around 16 pence per unit despite committing to the ban.

Community Alcohol Partnerships (CAPs) - local partnership projects which work with retailers to reduce underage drinking - are planning wider roll out following further industry funding. Brighton Council is seeking a VAT rise for off-licence sales according to the MA. More Government action needed to earn its 'pub friendly' claim says CAMRA. The Northern Ireland Health Secretary is intent on minimum pricing according to the BBC.

Portman Group: consultation on alcohol marketing code; annual Annual Alcohol Responsibility Report 2011 and panel members sought

The Portman Group, the industry's social responsibility body, has made the following recent announcements:

Consultation on alcohol marketing code

The Portman Group has announced it will review the alcohol industry’s Code of Practice on the responsible marketing of alcohol. The Group states "It is now the right time to conduct another comprehensive review to make sure there are no regulatory gaps and that the rules which govern alcohol marketing will be robust and fit for purpose going forward." Consultation documents are available here in PDF or Word formats.

Annual Alcohol Responsibility Report 2011

A press release states 'The aim of the Annual Alcohol Responsibility Report 2011 is to show how the industry regulates its marketing and the measures it takes to help reduce alcohol misuse. The report also shows the latest trends in alcohol consumption and alcohol-related harm to show alcohol and its role in society in context.'

Independent Complaints Panel members sought

The Portman Group is also seeking two members to join the Independent Complaints Panel which considers complaints about alcohol marketing under the Portman Group’s Code. The site states they "particualrly welcome applications from those with a health or alcohol services background" for one of the postions.
 
However not long left to apply - applications must be received by 5pm on Monday 31 October 2011. To apply see here or download the PDF information pack.

Alcohol... all in the mind? BBC news piece challenges the 'alcohol message'

A recent BBC news magazine article, Is the alcohol message all wrong?, has challenged the validity of current alcohol education campaigns. Social anthropologist Kate Fox posed the provocative question... Is it alcohol that causes the nation's problems - binge drinking, promiscuity, violence - or are these effects actually determined by our cultural values and norms?

Fox describes two alternative cultures: so called "ambivalent" cultures such as the UK, where alcohol is strongly associated with dis-inhibition and anti-social behaviour. Secondly "integrated" cultures, such as Mediterranean countries where drinking alcohol is viewed much more as "morally neutral" and is normalised as such.

She insists that these variations in attitude and subsequent behaviour cannot be explained away by consumption rates - people behave as their cultural beliefs would predict, and we get the problems we are primed to anticipate. For instance, we get disinhibiting behaviour when intoxicated because that's in part what we expect.

Fox cites experiments which demonstrate that people can remain in control of themselves under certain situations, for example when incentivised to do so. Ergo, we are not the slaves of ethanol but of our own beliefs about what it will make us do. Tackling alcohol education campaigns from this perspective would mean promoting an attitude shift in our population; indeed in the very beliefs and expectations that we hold about alcohol in the UK. Fox states in the article:

"...we need a complete and radical re-think of the aims and messages of all alcohol-education campaigns. So far, these efforts have perpetuated or even exacerbated the problem, because almost all of them simply reinforce our beliefs about the magical disinhibiting powers of alcohol."

Others might agree on this point, such as Don Shenker who has previously suggested in a DDN article that the industry may construct messages that serve its own interests. Other health interests might argue that it is not alcohol messages that can 'change the culture' of problem drinking, which can only be achieved with action on price, availability and marketing.

Regardless, responsible drinking messages or 'educational approaches' will continue to be a popular response to alcohol problems. But are we ready for such a "radical re-think" on these messages... or will we continue to just get what we expect?

ASDA under fire for selling Budweiser for under 50p per bottle

Supermarket giant ASDA hit the news after launching a new deal offering 24 bottles of Budweiser for £11 - around 46 pence a bottle or 15 pence per unit. ASDA are part of the Government's Responsibility Deal having signed up to pledges on alcohol, including on its advertising and marketing. 

The supermarket had previously received attention for voluntarily introducing a 'below cost ban' before it was brought in by the Government. However news that 'cost' would be defined as duty + VAT appeared to confirm accusations that the ban would have little effect on the actual price alcohol could be sold for, and was widely confused with minimum pricing.

Outspoken MP Sarah Wollaston recently called for tougher Government alcohol policy, including a 50 pence minimum price - a policy widely supported by health groups by largely opposed by producers and retailers. Wollaston said "There is nothing particularly responsible about our "new responsibility deal". Of course it is good to have the drinks industry's co-operation but we should be setting the standards, rather than them."

Professor Ian Gilmore Prof Ian Gilmore, a liver specialist, condemned the ASDA deal in a Metro report: ‘Again this is another example of a retailer on the one hand pledging to act responsibly while at the same time offering ridiculously cheap offers when buying in bulk.' A Daily Mail article said even pubs or retailers would not be able to purchase drinks so cheaply when buying wholesale.

ASDA defended the deal stating 'We are as committed to our role as a responsible alcohol retailer as we are to providing affordable deals for our customers.’ The major supermarkets are reportedly embroiled in a major 'price war'.

Change4Life Three Year Social Marketing Strategy: alcohol to be brought within Change4life campaign

The Department of Health has released the 'Change4Life Three Year Social Marketing Strategy' which includes commitments to new alcohol messages. The strategy describes how the Change4Life social marketing programme will support national obesity ambitions as well as promoting other lifestyle changes. 

'The alcohol harm reduction campaign will be brought more fully under the Change4Life umbrella, embracing not only the calorific content of alcohol but also the wider health harms of alcohol for adults in mid-life.'

The strategy cites 'a programme of qualitative proposition research' with adults who were drinking to increasing or higher risk levels. The key insights to emerge were:

• These adults do not think their drinking habits are an issue – it’s just something they do at the end of the day to help them relax, de-stress and unwind.
• They believe they are in control of their drinking – they believe they do not binge drink, they are not dependent and they believe they know their individual limits.
• Currently, this audience think the only people who really suffer poor health as a result of drinking are dependent drinkers.
• Proposition research demonstrated that the only way to encourage behaviour change was to raise the issue of long-term health harms.'

From page 39, the document has a section on 'Alcohol health harms', which includes forthcoming proposals including stepping up the alcohol-related communications by:

• re-running the ‘Alfie’ commercial (to reintroduce the alcohol subject matter)
• introducing new communication that focuses on the health harms of alcohol
• encouraging parents to talk to their children about alcohol and alcohol health harms and to delay initiating their children into alcohol consumption until they are 15 (as recommended by the Chief Medical Officer for England)

Beyond what is covered by Change4Life, marketing will support the alcohol health harms strategy by:

• including messaging on binge drinking within the youth programme
• providing bespoke information for people living with conditions (as part of the activity targeting older people)'

General alcohol information for the public is available from alcohol pages on the NHS Choices and Change4Life websites, whilst the Alcohol Learning Centre provides information for proffessionals.

The Cost of Alcohol: The Advocacy for a Minimum Price per Unit in the UK

A new Alcohol Insight exploring the public's perceptions and attitudes to a minimum unit price for alcohol has been published by Alcohol Research UK. The insight, The Cost of Alcohol: The Advocacy for a Minimum Price per Unit in the UK, assessed findings from 28 focus groups on their views towards minimum pricing, its possible outcomes, and how its introduction might be made more acceptable. 

The insight's conclusion states:

'Current findings indicate that participants were largely sceptical of the introduction of a minimum price per unit alcohol-pricing policy and expressed doubts regarding its effectiveness. Participants did, however, suggest that the policy could be made more acceptable if introduced as part of a wider strategy to curb alcohol consumption. Present findings suggest that participants’ objections to a minimum price per unit were the result of three main issues:

1. a misunderstanding of the minimum price per unit policy itself;
2. the failure to recognise the significance of small incremental reductions in alcohol consumption; and
3. a preoccupation with the effects of a minimum price on heavy and dependent drinkers.

Policymakers looking to introduce a minimum price policy should focus on dispelling the misconceptions regarding an alcohol-pricing policy and on highlighting the key features of the policy to counter the misunderstandings expressed by participants in the present research.'

A YouGov survey earlier this year indicated British opinion is split over whether the Government should introduce minimum pricing; 47% were reportedly in favour with 44% against. Full survey results here.

Minimum pricing refers to legislation that would set a minimum price per unit of alcohol, potentially affecting 'loss-leading' or 'high alcohol low cost' drinks sold through off-licensed premises including supermarkets. The likely impact of minimum pricing has been modeled by the University of Sheffield and has been widely called for by health groups, but strongly opposed by sections of the drinks and retail industries.

Minimum pricing has been commonly misinterpreted in England following the introduction of a 'below cost ban' defined as duty + VAT, which is thought to have had no impact on prices. Scotland are however seeking a minimum unit price and have set out information here.

World Mental Health day raises profile of mental health and related issues

October 10th was World Mental Health Day, the World Health Organization's (WHO) annual focus on mental health issues. This year's theme was "investing in health", highlighting the need for further research, treatment and acceptability of mental health problems. #Worldmentalhealthday was trending on Twitter, with hundreds of people leaving messages and comments.

Alcohol is known to play a significant role in mental health and wellbeing - the Mental Health Foundation say alcohol can both provoke and intensify existing mental health problems and those with mental health problems more at risk of alcohol misuse and vice versa. 

Alcohol and mental health factsheets are available here from the Mental Health Foundation, the Institute of Alcohol Studies and Alcohol Concern.

Alcohol is often used as a coping mechanism for many people - a major survey by the Samaritans showed that half of its respondents used alcohol for stress relief. Bridget O'Connell from MIND states:"Some people who experience mental health disorders may turn to alcohol as a form of self-medicating, and this can result in dependency and may worsen symptoms."

Risk of alcohol dependence in people diagnosed with schizophrenia is three times the average population risk; for people diagnosed with depression and affective disorders 1.9 times the average risk; and in people diagnosed with anxiety the risk of alcohol dependence is 1.5 times higher. As many as 70% of successful male suicides are alcohol related.

England's mental health strategy, No health without mental health, states that alcohol problems often go unrecognised, and that there is good evidence that brief interventions are effective those with mental health problems post-discharge or in general medical settings.

For further information on mental health see NHS Choices mental health pages, MIND, the Mental Health Foundation or Centre for Mental Health. The Samaritans offer a 24/7 confidental support service for anyone experiencing feelings of distress or despair.

Scotland's Alcohol and Offenders Criminal Justice Research Programme: prison health needs and brief interventions reports

The Alcohol and Offenders Criminal Justice Research Programme is a portfolio of three studies led by NHS Health Scotland on behalf of the Scottish Government (2009-2011). The overarching aim is to understand better the extent and nature of alcohol problems in offenders and which effective interventions can address them, recognising that the criminal justice setting is an opportunity to detect and intervene in an often ‘hard to reach’ population. 

This year the research programme has released 3 reports:

• Prison health needs assessment for alcohol problems
• Interventions for offenders with alcohol problems in community justice settings
• Delivery of alcohol brief interventions in the criminal justice system: evaluation of a pilot project 

In England the Alcohol Learning Centre hosts Offender Health pages, including links to the Offender Health IBA pilot.