Alcohol Policy UK

Alcohol Concern urges action on minimum pricing ahead of new national alcohol strategy

Alcohol Concern are calling on the public to urge MPs to push for minimum pricing ahead of the forthcoming national alcohol strategy. Alcohol Concern state:

The next few weeks will be our last chance to influence the shape of the alcohol strategy, which will shape public policy on reducing alcohol harm for years to come. We must act now to counteract the lobbying power of the drinks industry and major retailers.

The Prime Minister has come out in support of minimum pricing, but the Secretary of State for Health has not- this is the moment when we need MPs to call for minimum pricing and help ensure that it becomes government policy.

Up until now, the government has relied largely on voluntary measures by the drinks industry to reduce consumption. Given that the turnover and profitability of the drinks industry is entirely reliant on maintaining or increasing alcohol consumption, there is a clear conflict of interest involved in this approach.

Alcohol Concern are urging people to write to their MP to call for minimum pricing, stating the business case for action. The charity have provided a list of key facts and possible questions to include and a minimum pricing briefing paper. They are also promoting a Twitter hashtag #ActNowOnAlcohol

The Prime Minister David Cameron recently instructed Whitehall officials to look at minimum pricing options according to a Daily Telegraph report. Cameron has repeatedly spoken out on the issue of cheap alcohol, but the Health Secretary Andrew Lansley prefers voluntary action through the controversial Responsibility Deal. The public appear divided on the subject.

Minimum pricing has been at the forefront of the national alcohol policy debate, particularly since the release of research from the University of Sheffield modelling the likely benefits. Supporters cite the link between rising consumption with the falling relative price of alcohol.

However opponents of minimum pricing, such as sections of the alcohol industry and retailers, argue minimum pricing is a blunt measure and could contravene EU legislation. Scotland is currently seeking to introduce a minimum price and so could soon test this, whilst the IFS advise lobbying for EU law changes to allow tax restructuring to achieve a minimum pricing effect.

A 'below cost ban' is due to come in under forthcoming Licensing changes, but  the ban is not expected to not expected to affect prices under a 'Duty + VAT' definition of cost. See here for information on why a below cost ban is not minimum pricing and further reports.

Small rise in alcohol-related deaths in 2010

A slight rise in alcohol-related deaths has been reported for 2010, according to the ONS (bulletin here). Figures show a rise of 126 to 8,790 from 8,664 in 2009. Last year a slight fall was reported, though Alcohol Concern Chief Executive Don Shenker attributed the drop to a fall in consumption triggered by the recession. See BBC and Press Association reports.

Key points from the bulletin include:

• In 2010 there were 8,790 alcohol-related deaths in the UK, 126 more than in 2009 (8,664)
• There are more alcohol-related deaths in males than in females, with 67 per cent of all alcohol-related deaths in the UK in 2010 being male
• Alcohol-related death rates were highest for those aged 55-74 and lowest for those aged under 35 over the last ten years
• UK males aged 55-74 years showed a sharp and statistically signficant increase in alcohol-related death rate from 41.8 per 100,000 in 2009 to 45.2 per 100,000 in 2010
• Alcohol-related death rates varied between the regions of England and tended to be highest in the North and lowest in the East of England over the last ten years

Last year alcohol-related hospital admissions passed the one million per year mark and are still rising. However the definition maybe reviewed following news of the changes to the public health outcomes framework. See the Statistics on Alcohol: England, 2011 report for wider data on alcohol-related consumption trends and harm.

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 [email protected] 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.

Lower strength drinks heralded as Stella Artois, Becks and Budweiser switch to 4.8% & 'mid-strength' 2.8% Guinness announced

Brewing giants AB InBev will reduce the strength of popular lagers in the UK from the end of this month to keep line with "evolving UK category trends". The world's largest brewer will reduce the % Alcohol By Volume (ABV) of Stella Artois, Budweiser and Becks from 5% ABV to 4.8% ABV. See Daily Mail report.

The move will reportedly save AB inBev up to £8.6 million a year in duty on off-trade sales alone, but follows an £11.6 million decline in Stella Artois sales. Sales of 'triple filtered' 4% ABV Stella have also suffered after an initial good start. The news comes after the All Party Parliamentary Beer Group recently enjoyed a tasting session of lower strength drinks. But brewers have been suffering from the effects of rising costs, with off-trade beer sales reportedly plummeting faster than on-trade sales for the first time in 15 years.

Daigeo has also just announced a 2.8% mid-strength Guinness to be released for the off-trade. By dropping from the standard 4.1%, the new line will take advantage of the 50% duty discount on beers with an abv of 2.8% or below, introduced in October last year. High-strength beers of 7.5% abv and above must now pay an additional 25% tax. Under the Responsibility Deal, Heineken is expected to reduce the alcohol content of Strongbow by 1% (currently 5.3%) by 2013.

Whether or not such changes in the strength of drinks can have significant impacts on public health, the structure of taxation and pricing levers will remain central to alcohol policy debates. Recently the IFS called for taxation over minimum pricing approaches, and "to tax all alcohols at an equivalent rate per unit" which "would require policy action at the EU level which the Government should pursue."

The British Beer and Pub Association (BBPA) however have continued to speak out against the the alcohol duty escalator after the 2011 budget confirmed the Government would continue with alcohol taxed at 2% above the rate of inflation (RPI). The BBPA highlight duty on beer has increased by 60% since 1995, compared with a 15% increase in duty on spirits, and instead call for a tax system which encourages consumption of lower strength drinks in pubs as supervised environments.

Alcohol research updates - web based reviews: online peer support; web-based self-help; online feedback to students

The role of online peer-support?

A new Insight from Alcohol Research UK has explored the value of alcohol-related online support groups to their users. The Insight Problem Drinking and Peer Support in Cyberspace looked at the experiences and motives in using online support groups. Reasons included dissatisfaction with AA, accessibility & convenience, anonymity and the ability to connect to others. Positives were also cited as ready access to connect with others and find information. However disadvantages were also identified, including misunderstandings, lack of social contact, group dynamics, a lack of response and dis-inhibited behaviour.

Given the growth in online resources and groups, the Insight emphasises the importance of sites maintaining up to date, accurate and reliable information. Moderators play an important role in providing good online peer support, whilst users ought to be made aware of the pros and cons.

Best evidence yet for web-based alcohol self-help

Also highlighted on the Alcohol Research UK blog, the Findings review of the potential effectiveness of web-based self-help resources. Given the rise and rise of the web, it explores the significance and potential effectiveness of online self-help and who may benefit most.

Providing web-based feedback and social norms information to reduce student alcohol intake

A further Insight has explored the feasibility and effectiveness of a web-based intervention including feedback on consumption and social norms. It indicated some small reduction in drinking and concluded that monitoring alone is likely to reduce weekly consumption. However keeping students engaged in online programmes required further work.

Public Health Outcomes Framework released: spend should reflect local needs; alcohol admissions data to be reviewed

The NHS Public Health Outcomes Framework has been published, aiming to tackle public health challenges through moving public health back into local government. It outlines 'a shift away from the focus of process targets' to a framework that describes two 'high level' outcomes: an increase in healthy life expectancy and a reduction in life expectancy gaps across communities.

A DH press release, states:

'Public health will be measured against a framework which sets out 66 health measures so councils and the Government are able to see real improvements being made and take any action needed.

From April next year, councils will be given a ring-fenced budget – a share of around £5.2 billion based on 2012/13 funding – and will be able to choose how they spend it according to the needs of their population. Those who make the most improvements will be rewarded with a cash incentive.'

Investment in alcohol treatment and prevention will be locally determined, and should be reflected in each area's Joint Strategic Needs Assessment and Joint Health and Well-being Strategy.

The 66 indicators will be grouped into four main domains: 'Improving the wider determinants of health'; 'Health Improvement'; 'Health Protection' and lastly, 'Healthcare public health and preventing premature mortality'. Alcohol is addressed within the Health Improvement domain, alongside other lifestyles factors. A set of indicators on premature mortality includes preventable mortality from liver disease.

A specific alcohol indicator will remain for alcohol-related hospital admissions, though the indicator definition is due to be reviewed by NWPHO - 2.18 of the technical specifications states: 'the preferred option is for an indicator based on just alcohol-related primary diagnoses, to minimise the risk of perverse consequences from any changes in coding practice so the indicator rewards local areas for good performance.'

Recently the Health Committee warned over risks to public health budgets within the changes, concerns echoed by the Shadow Health Minister Diane Abbott - see a Press Association release. The Responsibility Deal, a key strand of Lansley's public health strategy, has also been heavily controversial and the 'nudge' focus has been criticised by a Lord's committee.

Last month the DH released a series of factsheets about the new public health system. See news reports in the Daily Mail and Daily Telegraph.

Scientists gleam further insight into alcohol's effect on brain reward system

Further insight into the effect of alcohol on the brain's reward system has been reported in the journal of Science Translational Medicine. It found alcohol effects the orbitofrontal cortex and results in a release of endorphins, previously only proven in animal studies. These naturally produced pain relieving proteins have an action akin to morphine, leading to drinkers experiencing pleasurable feelings.

The study found that heavier drinkers found alcohol more pleasant than non-drinkers. It also describes how the endogenous opioid function in the brains of chronic drinkers appears to change, in a sense 'over-learning' problem drinking behaviours. See reports in the Telegraph and Daily Mail.

The study may help to explain the mechanism by which antagonists such as Naltrexone work successfully, which could lead to the further development of pharmacological treatment approaches. Nonetheless, from the position that environment and learned behaviours also contribute to the development of problem drinking, successful alcohol treatment approaches emphasise the role of psychosocial as well as medical interventions. See here for the review into the effectiveness of alcohol treatment and NICE guidance.

Recently the message of a little but not often came out for preventing the development of alcohol problems. Sir Iain Gilmore, Chair of the Alcohol Health Alliance stated that having at least 2 alcohol free days each week was "a very good indicator of not being addicted". He emphasised the key is not to let regular consumption and rising tolerance end up as daily dependence, as experienced by as many as 1.6 million people in England.

This echoes calls from the Science and Technology Committee of MPs recently to urgently review alcohol guidelines and help the public to understand units better. The Change4Life website now contains public health messages about alcohol use within the context of a healthy lifestyle, and NHS Choices has useful tips for cutting down.

Home Office consultation on late night levy & restriction orders as trade warns of on-trade burden

The Home Office have opened a consultation on new powers due to be brought in under Licensing Act reforms. The consultation is seeking specific responses on the late night levy and Early Morning Restriction Orders (EMROs) as measures to help curb late night drinking problems. See the press release here. 

The consultation asks which types of premises should be covered by Early Morning Restriction Orders, a measure which will allow authorities to restrict the sale of alcohol to any time between midnight and 6am. It also ask which services a licensing authority may fund with the 30 per cent of levy revenue it will retain. The rest of the levy will go to funding police activity.

However BBPA Chief Executive Brigid Simmonds warned the Government against excessive action on the on-trade: “More and more alcohol is drunk at home, yet more and more red tape is heaped on pubs." Concern about the level of regulation being imposed on the pub trade were also raised during pubco debate in the House of Commons last week. 

Health Minister Anne Milton however defended Government action at an event in Parliament where brewers showcased a range of 2.8% ABV beers. Milton said “As a government we do not want to be killjoys but we do have some health problems. We do have a problem with alcohol but it is complicated." Milton said “We are supportive of the pub industry, we are supportive of people having a good time", and expressed hope that the forthcoming alcohol strategy will strike the right balance.

A list of Home Office factsheets on the full licensing changes due are available.

Alcohol Policy Comment: The Grocer-isation of Alcohol Brands & policy contradictions

In this guest post, Chris Hackley, a Professor of Marketing at the University of London discusses 'The Grocer-isation of Alcohol Brands and the Contradictions of Alcohol Policy in the UK':

In the UK, the government first issued ‘safe’ alcohol consumption guidelines in 1987. Coincidentally, the 1980s also saw the first UK advertising campaign for alcohol to use imagery previously only seen in pre-school TV programming. The bar-cruising, wise-cracking, girl-chasing Hofmeister Bear (an actor in a trilby-wearing bear suit) became an icon of the times and a symbol of the lager-isation of Britain’s nightlife. Some 24 years later, doctors in the North East recently reported a 400% rise in hospital admissions for advanced liver disease among people in their early thirties, against a UK rise of 61%. 

Coincidence? Clearly, it would be going too far to blame the UK’s alcohol problem on John Webster, advertising agency BMP DDB’s resident creative genius. For Webster, it was simply the case that his Honey Monster sold a lot of Sugar Puffs, so why not do it with beer? What is more, today, the UK advertising regulator, the Advertising Standards Authority, would probably disallow the campaign on the grounds that the imagery appeals to children.

But the juxtaposition of the two events, the Hofmeister Bear campaign and the UK government issuing drinking guidelines, neatly illustrates a contradiction in UK alcohol policy we are yet to resolve. That is, the intensification of alcohol marketing has grown hand-in-hand with the intensification of government-led initiatives to persuade people to drink less. While government convenes committees to ‘look into’ alcohol, children and young people have to negotiate a culture in which alcohol is celebrated as never before. Alcohol brands adorn major sports events and team strips; mixer drinks, which boomed in the 1980s as the notorious ‘alco-pops’, sell 40% proof vodka that tastes like fruit juice; while the country’s leading supermarket chains all treat alcohol brands as if they are normal grocery items, discounting them, promoting them heavily and stacking them in pyramids by the checkouts.     

Alcohol industry lobbyists such as the Portman Group will point to the relatively small numbers of alcohol-related deaths in the UK relative to other countries. As a nation, we do not have a generalised alcohol problem in terms of consumption per capita. But we do have unusual rates of alcohol-related disease and disorder in certain socio-demographic and age groups. The rising numbers and falling age of liver disease victims seems particularly shocking, and hints at worse to come. Under current policy, they bear the whole responsibility for their predicament. They were told to drink ‘sensibly’. They didn’t. They are, in effect, collateral damage in a battle for higher profits from alcohol sales.

Over the past three decades our policy makers have assisted the alcohol industry in shifting the emphasis from steady but unexciting pub on-sales to huge volume, highly profitable, powerfully branded, 24/7, retail off-sales. This grocer-isation of alcohol brands is the elephant in the room in UK alcohol policy debates. The paralysing policy contradiction this creates needs to be acknowledged.

Chris Hackley is Professor Marketing at the School of Management, Royal Holloway University of London. He recently appeared on Channel 4 news discussing the call to review alcohol guidelines. See here for a round up on media and policy engagement in alcohol policy issues and a collection of papers here.

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.