Alcohol Policy UK

Latest Findings bulletins: Single alcohol question effective but routine screening low across offender settings

Recent bulletins from the drug and alcohol Bank:

Single question enough to identify most heavy drinking offenders         At English prisons, police stations and probation offices, offenders and arrestees in this study usually scored as at least hazardous drinkers and over half as problematic on the AUDIT drink problem questionnaire; nearly all would have been identified by a much briefer screening method usually requiring just a single question.

Despite senior support most detainees not screened for risky drinking  Risky drinking was widespread among the disorder and assault suspects screened for alcohol problems and (as indicated) offered brief advice by civilian staff at a police station in north east England, but despite senior officer support, they constituted just a quarter of the arrestees intended to have been screened.

Screening offenders for risky drinking not a priority in Scotland      Though drinking problems were widespread, Scottish probation and community service staff were unconvinced of the appropriateness of screening their offender clients for risky drinking and (if indicated) offering brief advice. Not a priority, was the common feeling.

Previous Findings bulletins suggested alcohol-related offending measures do work, but also that Probation resources too stretched to adequately tackle huge drink problem.

Last year the Centre for Mental Health called for more support for offenders with alcohol problems.See here for further Offender Health publications and links on the Alcohol Learning Centre.

Drink driving figures not achieving desired reduction says ACPO

The proportion of those failing a breath test has not fallen significantly, figures from the latest police drink and drug campaign and enforcement drive show.

The Association of Chief Police Officers (ACPO) announced that 4,857 (5.8%) of the 83,224 drivers tested during the month long campaign in June 2012 tested positive, refused or failed a breath test. Although a slight improvement on the 6% rate the previous year, ACPO said they are "disappointed" that a small proportion are refusing to the get the message about the dangers of drink and drug driving.

Although drink driving levels are reported to have fallen significantly since the 1970s, the figures could be evidence of a resilient rate of drink driving that will be much harder to reduce. The figures show there are more under 25’s drink driving than over 25’s: 6.7% compared with 5.5%. Regional variations and trends are also evident - in the West Midlands an increase of 18.7% in the number of drivers who tested positive or failed the breath test was recorded against the previous year.

Last year it was announced the legal drink-drive limit would remain at 80mg per 100ml of blood despite an independent report calling for it to be reduced to bring it in line wth most European countries. Instead the Government said it would focus on "improving enforcement and education to tackle the drink and drug drivers who put lives at risk."

See here for the Think! road safety website, including facts and advice on drink-driving.

Drinkaware 'in:tuition' schools programme pilot update - an effective educational approach?

In 2011 Drinkaware launched an interactive life-skills programme in:tuition to support school-aged children, their teachers and parents.

The on-line resource was designed to support 9-14 year olds develop a range of skills to deal with responding to alcohol. It encourages young people to explore their attitudes, behaviour and decision-making by looking at issues such as peer pressure, self-confidence and goal setting.

The resource aims to support Personal, Social, Health and Economic (PHSE) education in schools. It aims to equip teachers, parents and young people with the knowledge and skills to help delay the age at which young people have their first drink. It also encourages parents to join in with home learning and reinforce the messages that their children have learned at school about how to deal responsibly with alcohol. It claims it is based on best-evidence life-skills approaches, which can reportedly reduce the risk of alcohol misuse by up to 30%.

An effective approach?

The effectiveness of schools-based programmes to reduce substance use has been the subject of hot debate. Critics argue that industry backed initatives focus on educational approaches precisely because these don't significantly result in reduced consumption.

In 2011 a review Investigating the effectiveness of education in relation to alcohol noted that whilst there was a range of educational approaches and delivery methods which made a small but positive contribution to alcohol harm reduction, some indeed may even be counter-productive. It cited that knowledge and attitude change alone were not predictive of positive behaviour change, and that combined school and family approaches were most effective when integrated with environmental interventions. This would include interventions such as limiting young people's access to alcohol and changing community tolerance to alcohol misuse.

Research previously indicated that that there may not be a proven significant difference between interactive and non-interactive methods. This suggests life skills may be no more important than a more narrowed focus of helping school children counter social influences. Findings has also published articles showcasing the debate on whether interactive programmes are effective accounting for research which suggested such programmes had a small but significant effect in delaying the onset of substance use - but subsequently contested.

In:tuition is currently being evaluated through Alcohol Research UK.

Health Select Committee report delivers verdict on Government alcohol strategy

A Health Committee report has given a mixed, if not critical, verdict on the Government's Alcohol Strategy published earlier this year.

Download the 3rd report into the Government's alcohol strategy (pdf), chapter index, written evidence and the Commons press release.

Although supportive of some aspects of the strategy, including the headline announcement of minimum pricing, the report is critical of an excessive focus on binge drinking over health issues and the lack of a delivery framework in the strategy. It also speaks out on alcohol industry denial over alcohol advertising effects on consumption. Although not against the principle of the controversial responsibility deal, it warns it should not be a substitute for government policy and should be regarded as standard corporate responsibility, rather than something to be praised for.

Launching the Committee's report, the Chair, Rt Hon Stephen Dorrell MP, said:

"The main focus of the strategy is binge drinking and its consequences for anti-social behaviour and public disorder. Those are important issues, but the health impact of chronic alcohol misuse is in our view also significant and greater emphasis needs to be placed on addressing that impact."

Dorrell said the industry should not receive credit for the responsibility deal for this as it was their "civic duty" to act responsibly, but claimed the industry does not have a "sufficiently well-developed sense of what it takes to trade responsibly". The report calls for an evaluation of the responsibility deal by Public Health England PHE, the new body establsihed by the Department of Health to lead on alcohol and other public health areas.

The report also wants Government to look into the possibility of introducing a version of the Loi Évin, a tougher regulation approach to advertising passed in France in 1991. Loi Évin bans alcohol advertising on TV and in cinemas, and prohibits alcohol sponsorship of cultural or sporting events. PHE are also called upon to evaluate the possible impact of introducing Loi Évin type measures .

Sir Ian Gilmore, the Royal College of Physicians' adviser on alcohol, said more action was needed to "tackle the growing problem of marketing through digital, online and social media, to reduce children and young people's exposure". Last year Alcohol Concern produced a report on the threat on of online alcohol marketing and an attempt was made to introduce advertising curbs through a private members bill.

The Portman Group welcomed some aspects of the report but Chief Executive Henry Ashworth said it was "deeply disappointing that they have failed to understand the significance of the innovative unit reduction pledge".

See reports from the BBC, Guardian, Telegraph and Daily Mail. A Guardian editorial comment also covered the report.

See here for a range of responses to the alcohol strategy released earlier this year.

News & updates July 2012: minimum pricing by 2014; call for health warnings on alcohol labels; MPs report to call for more action

Minimum pricing by 2014

The Home Office has set a target of implementing a minimum unit pricing (MUP) for alcohol by October 2014 in its Business Plan 2012-2015. However according sections of the alcohol industry, the plans are ambitious due to the potential legal challenges, according to a Morning Advertiser report.

The government will be conducting an impact assessment of MUP and will launch a consultation on it and other measures in the strategy in the autumn.

'Health warnings' should be included on alcohol labels

"No nonsense" health warnings on alcohol products would help inform people about the risks, says the Faculty of Public Health. According to a Guardian report warnings were suggested such as "Alcohol increases risks of violence and abuse", "Alcohol causes over 15,000 deaths a year in the UK" and "Alcohol increases risks of mouth, throat and other cancers".

Currently a voluntary labelling pledge expects more alcohol products to list unit content and guidelines, but only a warning message around pregnancy risks. Professor Mark Bellis, FPH’s spokesperson on alcohol, says: "At the moment, when people think about the dangers associated with alcohol, they are more likely to think of the problems caused by binge drinking rather than breast cancer. These health warnings would help educate the public...".

Report into alcohol strategy will want more from industry

An Health Select Committee on the Government Alcohol Strategy will publish a final report this week. The Telegraph has claimed it will warn the alcohol industry it is in the 'last chance saloon' and will face tougher regulation if it does not deliver more significant actions through the controversial responsibility deal.

Doctors called for tougher action on advertising on alcohol as part of evidence given to the committee - see Alcohol Research UK report. Alcohol Concern highlighted a recent Lords debate on the successes and failures of the Responsibility Deal and developments with the Alcohol Strategy.

Other news

Membership of Drinkaware's independent review panel has been announced - see here for details. Membership includes Sir Ian Gilmore, chair of the Alcohol Health Alliance, and Chris Heffer, Deputy Director Alcohol and Drugs at the Department of Health.

Daily drinking in pregnancy 'not safe' says an NHS report after contradictory headlines based on research suggesting drinking a low or moderate level of alcohol in early pregnancy is not linked to developmental problems.

David Nutt has told MPs cannabis 'coffee shops' would cut alcohol consumption by 25% in a Guardian report. A David Nutt Science weekly podcast is also available.

Pubs will have to pay up to £4,400 per year towards the late-night levy, as confirmed by the draft regulations on the measure published by the Government, reports the Morning Advertiser.

Fake alcohol products are on the rise, reports the Grocer, who said fake alcohol accounted for almost half (45%) of the 170 cases reported to the FSA’s Food Fraud Database, against 23% of the 238 reported in the same period last year.

Charities are providing drugs and alcohol services in place of the NHS, says a Guardian report. A BMJ study found that 14% of presentations at the Bristol Royal Infirmary A&E felt their attendance was related to alcohol. A Daily Mail report used the study to estimate 'Two million trips to A&E every year blamed on alcohol-related illness and injury'.

Irish health experts intend to cut the weekly recommended guidelines of alcohol to 17 units for men and 11 units for women - reports the Herald. The current lower risk drinking levels in Ireland are 21 units per week for men and 14 units per week for women. In the UK Government announced that there will be a review of current alcohol guidelines.

'Checked out: the role of ID checks in controlling underage drinking' - report warns of underage drinking from online sales

A new report warns that online alcohol sales and purchasing by friends and family are creating a significant and emerging battleground in the fight against underage drinking. The report was published last month by ‘test purchasing’ company Serve Legal and Plymouth University. 

Download Checked Out: the role of ID checks in controlling underage drinking [pdf]

A University of Plymouth press release highlighted:

High street retailers have become significantly better at checking the age of potential underage drinker in recent years. In 2007 the ID of teenage mystery shoppers attempting to buy alcohol from retailers or pubs was checked just over half of the time (55%). By 2010, ID was checked in more than seven in ten cases (71%).

However, the report warns that while greater vigilance by retailers has helped reduce alcohol consumption among young people, it has also prompted a shift in the way underage drinkers are getting hold of booze. Online retailers are identified as a key potential source of alcohol for underage drinkers, presenting a window of opportunity for under-age drinkers looking to circumvent the stricter alcohol policies now in place in many high street retailers.

Researchers uncovered a number of websites that sold alcohol where there was either no discernible age-check policy or a simple disclaimer noting that the consumer needed to be over 18 to complete the purchase. Even major retailers, many of which have age-related policies in place regarding on-line alcohol purchases, mainly relied on an ID check at the point of delivery, placing delivery workers in potentially confrontational situations. 

The report also identifies ‘proxy-purchasing’ as a growing trend with 42% of underage drinkers claiming to have bought alcohol from friends, relatives or “someone else”. Data contained in the report found that while just 4% of underage consumers would try to buy alcohol at the till in a large supermarket, 74% would attempt to obtain alcohol from parents and 86% from older siblings or friends.

Ed Heaver, Director of Serve Legal who commissioned the report, said:  “The battleground is changing in the fight against underage drinking – online retailers need to take heed of this warning and improve their age-checking procedures. Meanwhile parents and friends also need to understand the harm their proxy purchasing is doing.”

It was also reported in The Telegraph. In 2009 Alcohol Policy UK published a guest post on Alcohol home delivery services: a liberalisation too far?

NICE Guidance on diabetes prevention: no recommendations on alcohol?

New NICE Guidance PH38 on the Risk Identification and Interventions for Individuals at High Risk of developing Diabetes has been published.

Although there are clear recommendations to address lifestyle issues as one of the ways to prevent people at risk from going on to develop diabetes, there are no recommendations regarding alcohol consumption.

The guidance reports that evaluation of diabetes prevention trials found that there is no evidence regarding the value of excluding or including alcohol as part of dietary interventions to reduce the risk of development of diabetes. However, the report does go on to state that there is an acknowledgement that alcohol does contribute to calorie intake.

The Guidance is published at the same time that Pulse reports that GPs have been asked to screen all patients over 40yrs for diabetes. The NHS Health Checks, however, do commonly screen for alcohol use and offer an opportunity to give brief advice on lower risk drinking. Nevertheless, hopes that alcohol screening on a national scale would be included in the Quality Outcomes Framework (QOF) were dashed when the QOF Advisory Committee blocked the roll out of targeted screening for alcohol abuse.

For more information on Lower Risk drinking visit NHS Choices or Change4Life.

Alcohol Research UK reports: shop servers' experiences across Glasgow; Option 2 family intervention service; community gardening as effective rehab?

Reports recently published from Alcohol Research UK include:

Shop servers’ experience of alcohol-related issues and interventions in socially contrasting neighbourhoods

Alcohol problems are concentrated in disadvantaged neighbourhoods. Recently there has been a shift in alcohol consumer patterns across the UK away from the on-trade (pubs) towards the off-trade sector (licensed shops). Off-trade purchase is cheaper (incurring more health problems, especially amongst disadvantaged groups), and its consumption is largely unsupervised (risking more serious disorder). 

This study by Glasgow Caledonian University and the University of Glasgow addressed these issues via an overlooked group of experts/stakeholders, namely off-sales servers (shopkeepers) working in local licensed stores in socially contrasting neighbourhoods (deprived and non-deprived areas).

An Evaluation of the Option 2 Intensive Family Preservation Service

Option 2 is based on a crisis intervention model named “Homebuilders”. It works in a very intensive way with families referred by child and family social workers where the child is at risk of being taken into care.

Option 2 reduces the use of care system in families where parental alcohol misuse is a factor, but what impact does it have on parental substance use, child welfare and family functioning?

Investigating community gardening as a form of rehabilitation for people with alcohol misuse problems in Northern Ireland

 

Report from a pilot study into the use of eco-therapies for the treatment of alcohol problems, undertaken by Queen’s University Belfast.

Home Office decisions on EMROs and Late Night Levy following consultation

The government has published its response to the consultation Dealing with the Problems of Late Night Drinking [pdf]. Draft legislation has been laid in parliament so that later this year local councils will be able to:

• use early morning alcohol restriction orders (EMROs) to restrict the sale of alcohol in all or part of their areas between midnight and 6am
• charge a levy for late-night licences to contribute to the cost of extra policing, and other costs linked to late-night drinking like street cleaning 

The consultation response outlines the following decisions:

EMROS

• Persons that may be affected by an EMRO will have 42 days to make relevant representations for, or against, a proposed EMRO. (Paragraph 2.06)
• Licensing authorities will be required to notify licensed premises that would be included in the scope of a proposed EMRO, rather than all licensed premises in the licensing authority area. (Paragraph 2.07)
• A proposal to introduce an EMRO should be publicised on the licensing authority’s website and in their local newspaper. (Paragraph 2.07)
• EMROs will not apply on New Year’s Eve. (Paragraph 2.10)
• There will be no exemptions from EMROs. There will be provision to ensure that premises with overnight accommodation can still provide room service and mini-bars, if they are included in the scope of an EMRO. (Paragraph 2.17-2.18)

LATE NIGHT LEVY 

• Local residents can use their existing rights to make representations and other channels of communication to call for the implementation of the levy in their area. (Paragraph 3.04)
• Premises with overnight accommodation (Paragraph 3.09), theatres, cinemas (Paragraph 3.12), bingo halls (Paragraph 3.14), CASCs (Paragraph 3.16), community premises (Paragraph 3.17), country village pubs (Paragraph 3.18) and BIDs (Paragraph 3.20) will be available as a discretionary local exemption from the levy.
• Restaurants (Paragraph 3.11), casinos (Paragraph 3.14) and private member’s clubs (Paragraph 3.26) will not be available as a discretionary local exemption from the levy.
• The levy will not apply on New Year’s Eve. (Paragraph 3.29)
• Licensing authorities will be able to offer a 30% reduction from the levy for best practice schemes that meet relevant criteria (Paragraph 3.34) and pubs that are in receipt of Small Business Rate Relief and have a rateable value below £12,000 (Paragraph 3.45).
• There will be no cumulative discounts from the levy. (Paragraph 3.40)
• Licensing authorities will be able to fund services that are connected to the management of the night-time economy and services that prevent and tackle alcohol-related crime and disorder with their revenue from the levy. (Paragraph 3.56)

The late-night levy and early morning alcohol restriction orders (EMROs) were set out in the Police Reform and Social Responsibility Act 2011. The full consultation details are set out here.

See here for a series of factsheets on the licensing changes.

Voluntary alcohol labelling pledge on track says Portman Group

The Portman Group, the alcohol industry's social responsibility body, has said alcohol producers are on track to deliver their pledge to provide health information on 80% of alcohol labels by the end of December 2013.

As part of the Government’s responsibility deal, alcohol producers have committed that three core labelling elements - clear unit content, NHS guidelines and a warning about drinking when pregnant - will appear on 80% of drinks. A Drinkaware link and responsibility statement are optional.

The Portman Group, who were given responsibility for monitoring the pledge, say current compliance is over 60%, with 18 months still remaining. More companies are expected to confirm their pledges in the coming months. 

The industry has attempted voluntary agreements to improve alcohol labelling in the past, but failed to make real progress. A 2010 independent report said just 15 per cent of drinks give consumers sufficient information as per the voluntary code, whereas an Alcohol Concern report Message on a Bottle put the figure at only 4% of the products reviewed.

See here for the alcohol network's full alcohol pledges, which include commitment to the removal of a billion units, preventing under-age sales, the development of a new sponsorship code requiring the promotion of responsible drinking, and support for schemes such as Best Bar None and Community Alcohol Partnerships.