Alcohol Policy UK

Alcohol strategy consultation proposes 45 pence minimum unit price

The much anticipated consultation on the Government alcohol strategy has been released, proposing a 45 pence Minimum Unit Price (MUP). The consultation is seeking views on five key measures identified by the release:

• a ban on multi-buy promotions in shops and off-licences to reduce excessive alcohol consumption
• a review of the mandatory licensing conditions, to ensure that they are sufficiently targeting problems such as irresponsible promotions in pubs and clubs
• health as a new alcohol licensing objective for cumulative impacts so that licensing authorities can consider alcohol-related health harms when managing the problems relating to the number of premises in their area
• cutting red tape for responsible businesses to reduce the burden of regulation while maintaining the integrity of the licensing system
• minimum unit pricing, ensuring for the first time that alcohol can only be sold at a sensible and appropriate price

Minimum pricing has arguably been the most high profile and politically sensitive aspect of alcohol policy over recent years. Health groups almost universally support the implementation of minimum pricing based on the link between affordability and consumption and Sheffield modelling. However sections of the alcohol industry and those opposed to such Government intervention have fiercely contested the evidence base and repeatedly asserted that it would 'punish the sensible majority', or could even 'backfire' - notions equally disputed by supporters.

Earlier this year the Scottish Government passed the Alcohol Minimum Pricing Bill, meaning a 50 pence minimum unit price (MUP) could be in place north of the border by April next year. However, the Scotch Whisky Association (SWA), supported by major drinks companies, have been seeking to challenge the move in the European courts. 

The surprise announcement that the Coalition's new alcohol strategy would seek to implement minimum pricing came earlier this year - politically MUP policies are not generally considered a vote winner. Last year a YouGov survey indicated British opinion is split with 47% reportedly in favour and 44% against (full survey results here and a research insight here).

Selected coverage of the announcement includes reports from the BBC, The Guardian, The Telegraph. See here for a Morning Advertiser summary of 'the industry responds', a This is Money feature on 'an industry divided'.

The consultation runs for 10 weeks from 28 November 2012 until 6 February 2013. See here for the online response form or download the consultation pdf.

Alcohol Awareness Week 2012 in review

Last week, 19-25 November was designated Alcohol Awareness Week (AAW) 2012 by Alcohol Concern. The theme of "It’s time to talk about drinking" aimed to stimulate discussion and local activity to promote understanding of alcohol misuse. Here's a round up of some of the things that went on.

A Twitter hashtag of #alcoholaware2012 generated close to one thousand tweets over the week. However tweets were largely divided between those supporting or promoting the week, and those against or mocking it.

As reported, national and regional bodies released reports and campaigns. Drinkwise launched a 'discussion kit' to support public-initiated conversations, whilst Balance aimed to generate support for a 50 pence minimum unit price (MUP). A Government consultation is expected to announce the options of a 40, 45 or 50 pence MUP this week.

Alcohol Concern and Balance, both advocating 50 pence MUP, jointly released a report stating 15 and 16 year olds in the UK are more likely than those in almost any other European country to have been drunk in the last month.

However the report attracted criticism given significant falls in the overall proportion of pupils aged 11 to 15 who drank in the last week. There were other critiques of the use of stats by those opposing health calls for action. Perhaps the most prolific self-proclaimed 'anti-nanny stater' Christopher Snowden compiled a blog of various alcohol harm stats going down.

A comprehensive official analysis of alcohol stats (going up and down) can be found in the annual national statistics for alcohol reports.

Local activity snapshot

Searching online for 'Alcohol Awareness Week' shows many local authorities, health bodies and voluntary sector organisations carried out activities. Whilst some appeared to carry out only traditional 'health advice' approaches, many seem to be integrating 'Identifcation and Brief Advice' (IBA) which has been increasingly recognised as an effective intervention for at-risk drinkers.

A couple of examples of local area activities are highlighted to list but a few. Reigate & Banstead Borough Council used a double decker bus to promote activity and the Change4Life drinks tracker app. In Bradford district-wide activity including a clampdown on illegal sales generated local press coverage, whilst others directly promoted Alcohol Concern's Dry January. In Cumbria more than 160 people took part in a live webchat hosted by NHS Cumbria and the Police.

Others chose the week to promote various new initiatives or reports, ranging from NICE tweeting its new briefing for local authorities, to a new online peer support website 'Soberistas' for women wanting to quit or cut back their drinking. That's all we can cover for now, but expect we'll see you for AAW next year!

Alcohol 'discussion kit' aims to encourage citizen-led conversations

An 'alcohol discussion kit' has been released during Alcohol Awareness Week 2012 to encourage citizen-led discussions about alcohol use and risks. Under the Influence? was developed by Our Life, in partnership with NHS North West and NHS Western Cheshire.

The discussion kit aims to get people thinking more about alcohol and some of the factors that influence people's relationship with alcohol. The kit is made up of four main sections; an instruction booklet, a set of story cards, a set of influencer cards and a planning grid. Through the use of a set of cards, groups can consider a range of opinions before suggesting what they think is the best course of action.

The components of the discussion kits can be downloaded below:

Black & white copy

• Instruction Booklet
• Story Cards
• Influencer Cards
• Planning Grid

Colour copy

• Instruction Booklet
• Story Cards
• Influencer Cards
• Planning Grid

The kit was based on the findings of the ‘Talking Drink: Taking Action' Ellesmere Port Alcohol Inquiry.

Binge drinking influences on young people: Alcohol Concern & Balance report calls for action

A new Alcohol Concern and Balance North East report explores binge drinking, attitudes and influences amongst young people and argues a 50 pence minimum price is needed.

Download 'Binge – Drinking to get drunk: Influences on young adult drinking behaviours' [pdf]

An Alcohol Concern press release reported that the UK’s young people say it is cheaper to get drunk than go to the cinema. One thousand 16-24 year olds were asked about their views and experiences by a specialist survey research agency. Those surveyed agreed that 'drinking to get drunk' is the defining feature of how young people relate to alcohol. 

The report also states young people aged 15 and 16 years in the UK are more likely than those in almost any other European country to have been drunk at least once in the last month; are more likely to have experienced being drunk by the age of 13; and have by far the most positive expectations of drinking. See coverage from the Daily Mail and Sky news.

Balance, the North East Alcohol Office, have run previous activity to raise awareness of the impact of alcohol on young people, including a campaign against marketing targetting youngsters. Balance are calling for members of the public to sign a petition for a minimum unit price of at least 50p per unit.

Recently a JRF report explored regional variations in young people's drinking. NHS statistics produce annual data in Smoking, drinking and drug use among young people in England.

Further alcohol-related reports and guidance related to children and young people can be found here on the Alcohol Learning Centre, including the CMO guidance or see the Drinkaware web-page for parents.See here a post on IBA for young people our see all Alcohol Policy UK young people tagged reports.

Change 4 Life release 'drinks checker' app

Change4Life have launched a new drinks checker app available to download for smartphones, offering a mobile equivalent to the web page drinks checker.

The app follows previous alcohol activities including 'Don't let the drink sneak up on you' TV ad and alcohol leaflet [pdf] which is available to order. The campaign warns against drinking above lower risk guidelines, highlighting the potential impacts on long term health - for instance regularly drinking 2 large glasses of wine or 2 strong pints of lager a day can triple the risk of developing mouth cancer and double the risk of getting high blood pressure. 

Last year the alcohol industry funded organisation Drinkaware launched 'My Drinkaware', which also offers online tools, an app and guidance to help people keep track of units and understand the risks.

NHS Choices also offer comprehensive alcohol pages, including how to find local services. Drinkline can also be contacted 24 hours a day for advice and support on 0800 917 8282.

Individuals can also access online IBA tools such as www.dontbottleitup.org.uk and www.downyourdrink.org.uk/. Proffessionals can visit www.alcohollearningcentre.org.uk or www.alcoholiba.com for guidance and resources.

Alcohol Awareness Week 2012 kicks off with 'time to talk about drinking' theme

The week of 19-25 November has been designated Alcohol Awareness Week (AAW) 2012 by Alcohol Concern.

The theme of "It’s time to talk about drinking" is intended to stimulate discussion and local activity to promote understanding of the risks and problems associated with alcohol misuse. 

A Twitter hashtag of #alcoholaware2012 has been picking up and a set of conversation starter cards and a poster are available to download. Alcohol Concern have also been promoting 'Dry January', an initiative challenging social drinkers to stay booze free for the month - see press release.

AAW is also prompting further debate around minimum unit pricing (MUP) called on by many health groups as an important step to help reduce alcohol misuse - see recent Telegraph report. The Government will shortly consult on a MUP following a pledge in the national alcohol strategy.

Regional and local activity

Many areas will be carrying out activity as part of the week, just a few highlighted below.

DrinkWise North West have produced a YouTube video 'I've paid the price for alcohol' to raise awareness of alcohol misuse and its impacts in the North West.

A series of events and activities will be taking place in Haringey led by HAGA, including a local service user activity fundraiser, awareness raising stalls and more as outlined in the press release.

In Southwark, activity will be focusing on increasing awareness of alcohol and older people. At the Yalding Day Centre, London Fire Brigade will host discussion around safety at home while drinking, supported by local health checks and care. In neighbouring Lambeth, three public events will offer interactive activities, information and IBA.

In Nottinghamshire, a special screening of The Lost Weekend, the 1945 Academy Award winning film which follows the life of a dependent drinker, will be shown at The Broadway Cinema on Monday 19 November, 5.30pm. An expert led panel discussion will follow. Contact for more info.

If you have any any Alcohol Awareness Week activity you would like us to highlight this week please drop us a short summary.

LHIB action on early intervention: London IBA reviews; IBA Practitioners' Network & 2013 Leadership Summit

The shadow London Health Improvement Board (LHIB) alcohol programme has announced a number of projects and events as part of its aim to promote alcohol early intervention across the capital.

The LHIB alcohol priority is committed to ensuring that Identification and Brief Advice (IBA) is delivered effectively across a wide range of key settings in London including criminal justice, acute and primary care. It will also be engaging with senior leaders to develop a shared vision and partnership framework, and supporting local licensing and enforcement teams.

As part of the early intervention programme, the LHIB commissioned two key reports to assess the extent of IBA delivery across the capital and challenges and opportunities for moving forward - see summary reports here:

• IBA Interventions across London - Executive Summary.pdf
• Systematic Review of Alcohol Early Intervention in Criminal Justice Sector - Executive Summary.pdf

An IBA Practitioner Network has also been established, aiming to bring together a practitioners from health, social care and criminal justice sectors to promote and lead on IBA delivery. The Network is currently recruiting practitioners from a range of key settings, though is not intended for drug and alcohol roles - see here for more information.

An IBA leadership Summit will also take place in January 2013 with the intention of securing senior level buy-in to embedding IBA delivery across London.

Alcohol and Cancer Risks: a Guide for Health Professionals

Scottish Health Action on Alcohol Problems (SHAAP) have released a report Alcohol and Cancer Risks: a Guide for Health Professionals [pdf].

The guide was produced to help Health Professionals understand and communicate the links between alcohol and consumption and cancers.

The report aims to highlight that many cancers are preventable, and identifies some key facts as: 

• One third of cancers are linked to a number of lifestyle risk factors – smoking, alcohol, diet, overweight/obesity, and physical inactivity
• Half of the Scottish population have three or more of these lifestyle risk factors
• Forty-six per cent of [Scottish] men and 38% of women drink alcohol at levels higher than current guidelines for sensible alcohol consumption
• Drinking alcohol increases the risk of cancer of the breast, head and neck, the oesophagus, bowel and liver
• Each year, approximately 6% of new cancer cases are estimated to be attributable to alcohol consumption
• Drinking alcohol, even within the limits of current advice on sensible drinking, may increase the risks of alcohol-attributable oral and pharyngeal as well as breast cancer
• Reducing alcohol consumption to levels within the current guidance for sensible drinking will reduce the risk of developing an alcohol-attributable cancer

The guide calls on health proffessionals to make use of opportunities to raise awareness of the risks of alcohol and cancer through the delivery of brief intervention.

Earlier this year the European Alcohol Policy Alliance has launched a new website to flag up the risks associated with alcohol consumption and cancer.

Last year Cancer Research UK suggested as many as 40% of cancers could be preventable through improved lifestyle choices including smoking, unhealthy diets, alcohol and excess weight. A recent King's Fund report explored the close links of these behaviours, with many adults in England engaging in at least one unhealthy lifestyle behaviour. 

Findings alcohol bulletins: preventing underage sales; fewer under-18s needing treatment; health promotion gains limited; alcohol testing lorry drivers?

Recent bulletins from the drug and alcohol bank:

Road-tested good ideas to prevent underage alcohol sales 

No controlled studies, but lots of ideas which seem to have worked from case study areas across the UK featuring innovation and cooperation in promoting compliance with laws banning sale of alcohol to under-18s and in reducing related public nuisance.

Fewer under-18s need specialist treatment in England 

National Treatment Agency for Substance Misuse documents increasingly successful specialist treatment of children with alcohol and drug problems in England. Patient numbers have fallen in line with falls among young adult patients and the general population, a sign of fewer drug problems generally, though cannabis bucked the downward trend.

Few sustained gains from health promotion session with college students

US university students at first cut back their drinking and cannabis use in response to a brief face-to-face contrast of their desired image versus their health-related behaviour, but the gains were no longer apparent a year later. Yet still at that time they had at least experienced more positive trends in how well they felt than students who had just read a fitness brochure.

Too little evidence to recommend drug/alcohol testing lorry drivers 

Exhaustive search finds just two rigorous studies of workplace testing for alcohol and/or drug use of people employed as drivers. For drugs there was some evidence of a long-term effect averting injuries and deaths, but in respect of both drugs and alcohol the evidence was too thin to support any particular policy.

NICE release 'alcohol public health' briefing to assist local authorities

The National Institute for Clinical Excellence (NICE) have released an alcohol briefing (PHB6) as part of its suite of public health briefings for local government - see NICE press release.

NICE have based the guidance on its comprehensive set of resources, guidance and quality standards for the prevention and treatment of alcohol problems. NICE reccomond a two-pronged approach to alcohol misuse, with a combination of interventions aimed at the whole population and individuals.

The briefing aims to support local government in its public health role, including its leadership of Health and Wellbeing boards forthcoming duty to commission alcohol misuse prevention and treatment interventions. As of April 2013 public health functions will be formally transferred from Primary Care Trusts to local authorities, some challenges explored in a recent Guardian public health article.

The briefing summarises evidence, actions and recommendations covering key areas:

• What can local authorities achieve by tackling alcohol misuse?
• What NICE says
• Developing an action plan
• Costs and savings
• Facts and figures
• Support for planning, review and scrutiny
• Other useful resources and advice
• About the briefing

The briefing may be regarded as a strategy template for Health & Wellbeing boards who will have overall responsibility for local level alcohol harm reduction. Of course many areas already have local alcohol strategies in place - examples of which can be found on the Alcohol Learning Centre. See here for the recent National Alcohol Strategy.