Alcohol Policy UK

Last chance for minimum pricing consultation as arguments over evidence escalate

As the Government's consultation on Minimum Unit Pricing (MUP) and other measures draws to a close next week (6th February), various industry and health groups are making their cases for and against. See here for the online response form.

Leading the pro-MUP arguments, Alcohol Concern and the Alcohol Health Alliance
have challenged anti-MUP messages from sections of the alcohol industry. Alcohol Concern have stated "parts of the alcohol industry are currently trying to discredit the research on minimum unit pricing and are attempting to sway the public by putting out misleading information", and encouraging people to respond to the consultation. See Alcohol Concern's consultation response.

The AHA have said the drinks industry is now using tactics of Big Tobacco against minimum unit pricing. Dr Nick Sheron said the industry is "trying to undermine evidence-based alcohol policy measures which would save lives" and that MUP is "a targeted policy that will impact heavy drinkers whilst leaving the majority of moderate drinkers unaffected, and the international evidence (from Canada) shows that it works." See here for the full AHA response.

Sections of the industry and other bodies have been re-iterating various arguments against MUP, largely questioning the evidence base, predicted impacts, EU legal issues or suggesting it as an unfair measure that will 'penalise poorer drinkers' or a 'responsible majority'. The Adam Smith Institute (ASI) ,a free-market think tank, released a report refuting MUP and in particular the statistical modelling done by the University of Sheffield as "entirely speculative and do not deserve the exalted status they have been afforded". Sheffield have published a response to the claims here.

Bodies such as the IFS suggest using tax should be the preferred lever, though may have a less direct effect on prices on the floor. Other groups within the alcohol or retail industry also support MUP such as Greene King who see cheap alcohol as behind the decline in the pub trade.

A recent BBC report looked at the battle over minimum pricing. Other analysis includes an Information Daily feature and a selection of other recent MUP news and updates we recently featured. See here for a previous recent round up of MUP news and developments or the intial responses to MUP and the Government Alcohol Strategy released last year.

Both for and agiainst MUP websites are availabe:

• The pro-MUP www.minimumpricing.info website is supported by various alcohol organisations including Drinkwise Noth West
• The anti-MUP www.whyshouldwepaymore.co.uk is spear-headed by WTSA  

The consultation closes on 6 February 2013. See here for the online response form or download the consultation pdf.

Alcohol Learning Centre update: merge to Public Health England; user survey; 'beginners toolkit'

The Alcohol Learning Centre (ALC) will become part of the forthcoming Public Health England (PHE) web portal from April 2013. Although its functions may remain the same, an ALC user consultation survey is currently seeking views on use and content of the ALC.

According to the most recent ALC Newsletter there are broadly three major functions of the ALC:

• Providing information - guidance, tools, data, case studies
• Providing [accredited] training
• Providing a vehicle for discussion and interaction

A new 'begginers toolkit' section of the ALC is now available that is designed to provide access to the key documents and resources for those who may be new to the topic of alcohol harm reduction.

A useful websites page is also listed.

Latest from the IBA blog: SIPS - not just a leaflet; IBA in a nutshell; IBA should do it? INEBRIA 2012 presentations and more

A selection of recent posts from the IBA blog, which aims to promote news, links and ideas relating to alcohol brief interventions are included below: 

• SIPS Primary Care research: not just a leaflet
• Step-by-step IBA (in a nutshell)
• New look to the blog…
• IBA – who should do it and how do we convince them?
• INEBRIA 2012 presentations
• IBA – are all settings equal? Presentations and experiences
• INEBRIA 2012: research into practice?
• IBA ‘mystery shopping’ experiences: the good, the bad and the…

The blog also has dedicated 'About IBA' and 'IBA tools' pages. See here for the Alcohol IBA Twitter Updates (@Alcohol_IBA).

The IBA blog was set up to promote learning, understanding and the delivery of IBA through news, links and ideas on IBA from a range of contributors. It also aims to highlight other resources and links such as INEBRIA and the Alcohol Learning Centre IBA pages.

'Alcohol problems in the criminal justice system' WHO guidance released

The World Health Organization (WHO) have released a document outlining the scale of the link between alcohol and offending, and the missed opportunities to address alcohol misuse within the Criminal Justice System and prisons in particular.

Download 'Alcohol problems in the criminal justice system: an opportunity for
intervention' [pdf]

The document describes an integrated model of care for alcohol problems in prisoners, with elements for best practice. The model starts with assessment of prisoners’ alcohol problems, using a validated screening tool, the WHO Alcohol Use Disorders Identification Test (AUDIT), and calls for interventions tailored to prisoners’ specific needs.

Other reports have previously made calls for further attention and action to address alcohol-related offending needs. In 2011 the Centre for Mental Health published the report A Label for Exclusion: Support for alcohol-misusing offenders

In 2010 the National Offender Management Service (NOMS) published comprehensive Alcohol Interventions Guidance for probation staff on the effective commissioning, management and delivery of a range of interventions for alcohol misusing offenders.

See here for relevant bulletins from Findings bank and here for further Offender Health publications and links on the Alcohol Learning Centre.

Latest Findings alcohol bulletings: brief interventions findings including SIPS review

Recent bulletins from the drug and alcohol bank:

First major report from crucial English alcohol screening and brief intervention trials

Confirming preliminary releases, the first major formal account of findings from the SIPS trials reports no benefits from adding 20 minutes of theory-based counselling to a straightforward few sentences warning primary care patients they are drinking too much. 'Do just the minimum' is the message austerity-hit commissioners might take from the studies, but that would be to over-read their implications.

See here for the BMJ SIPS Primary Care results.

Single question identifies most problem drinkers

Can you get away with asking just a single question to identify risky and even dependent drinkers? When the thresholds are suitably adjusted, asking either about frequency of heavy drinking or maximum single-occasion consumption worked remarkably well in the US general population. Results could help extend screening to more venues and more patients.

Half-hour of advice may cut drinking in repeat drink-driving offenders

Can repeat drink-driving offenders be swayed by just 30 minutes with a therapist, and would those minutes best be spent in motivational interviewing or providing information on alcohol? This Canadian study hints that 'Yes' is the answer to both questions – but only hints.

See the Alcohol IBA blog or Alcohol Learning Centre for brief interventions news and resources.

NTA release national alcohol treatment statistics 2011-2012

The National Treatment Agency for Substance Misuse (NTA) have published national alcohol statistics for 2011 - 31 March 2012: 

• Alcohol treatment in England 2011-12 (NTA commentary report)
• Alcohol treatment 2011-12 Statistical release
• NTA press release

The figures are taken from the National Drug Treatment Monitoring System (NDTMS) and show:

• 108,906 people received alcohol treatment in 2011-12, down 2% from the year before. This includes 74,353 new entrants to treatment during the year, a rise of 1% compared to 2010-11.
• 38,174 people successfully completed their treatment, 6% more than the previous year.
• Most people (38%) referred themselves into treatment, 19% were referred by their GP
• 70% of all those in alcohol treatment were concentrated in the 30 to 54 age range and the average age of a person in treatment was 42. Men accounted for nearly two thirds of the treatment population during the year. By far the biggest ethnic group was white British (88%).

The NTA has been working to support local areas to develop effective alcohol treatment to meet local needs. In April 2013 the NTA will become part of Public Health England (PHE) which will have responsibility for national action on preventing and tackling alcohol misuse. PHE will focus on work to progress the wider development of two key elements of the Alcohol Strategy: Identification and Brief Advice (IBA) and hospital based provision.

See here for a recent report on changes to alcohol treatment recording and alcohol PbR update.

See here for NICE alcohol guidance on treatment and commissioning.

Minimum pricing: consultation deadline approaches; Scottish legal challenge; Newcastle try 'MUP' on bars; news and views

There are less than 3 weeks left to respond to the Government's consultation on Minimum Unit Pricing (MUP) and other measures set out in the strategy. See here for the online response form. A selection of MUP reaction and news is highlighted below.

Alcohol Research UK have said they support the Government MUP proposals but warn of cross-border purchasing if a 45 pence MUP is adopted in England and a 50 pence MUP in Scotland. Alcohol Concern are calling for a 50 pence MUP, though only a 45 pence option is proposed in the consultation.

In Scotland a legal challenge against the SNP's minimum pricing is underway, headed by the Scotch Whisky Association (SWA). The SWA says MUP would be “in breach of the UK’s European Union Treaty obligations as it would restrain trade”. However there is much uncertainty over the legal position, with the Office of Fair Trading (OFT) previously stating that in its view "UK competition law does not prevent legislation to set a statutory minimum price for alcohol".

The Information Daily recently published a feature 'Minimum pricing is not what it seems' which seeks to dispel public mis-conceptions about how MUP would be expected to work. It followed an earlier anti-MUP piece by the Wine and Trade Spirit Association claiming it would hit 'responsible consumers'.

David Cameron last month claimed that responsible families are “actually subsidising the binge drinker” because supermarkets increase the price of food to fund loss-leading on wine, beer and cider. Supermarkets have previously been accused of such strategies but the British Retail Consortium said the remarks were “nonsense”.

MUP plans were reportedly under threat due to opposition from a number of Cabinet members, the Telegraph also reported last month. It claims an alliance of senior Ministers, including the current Home Secretary who is responsible for the strategy, are opposed to MUP.

The boss of the pub and brewer giant Greene King has backed minimum pricing citing home drinking as a driver for binge drinking. However in a Telegraph report Carlsberg chief executive Jorgen Buhl Rasmussen said he is strongly against MUP.

Meanwhile Newcastle City Council have applied a novel but controversial local 'minimum pricing' approach to two bars in the city centre. A press release states the £1.25 minimum price has been "agreed as a license condition in order to maintain standards and to keep the street as the city’s premier street". A Morning Advertiser piece suggest the move is legally "questionable".

See below for other key MUP reports and research:

• University of Sheffield modelling on pricing impacts for England and Scotland
• Home Office report on The likely impacts of increasing alcohol price: a summary review of the evidence base [pdf]
• Could minimum pricing "backfire" as claimed?
• A SABMiller commissioned report by the CEBR outlining arguments against minimum pricing
• An Alcohol Insight into 'The Cost of Alcohol: The Advocacy for a Minimum Price per Unit in the UK'
• SNP pages on minimum pricing and the Scottish Alcohol Bill.
• An interim report on Manchester's proposed local minimum pricing
• BMJ report urging a VAT reduction for the on-trade 
• Aberdeen University research arguing minum pricing does not target lower income groups

'Public health and alcohol licensing in England' LGA briefing

The Local Government Association (LGA) have published guidance on Public health and alcohol licensing in England.

Under new licensing measures councils have greater powers in relation to licensing decisions, and health bodies are now a 'responsible authority'. The briefing aims to place health bodies' new role in alcohol licensing in a strategic context, and to provide guidance to those who will be delivering the responsible authority role.

The guidance outlines how health authorities can consider playing an active part in licensing decisions, despite not being able to influence licensing based on health grounds. However health-related data, such as A&E or ambulance collected data may be useful under the existing licensing objectives such as the prevention of crime and disorder. It also outlines the potential for health based decisions in 'cumulative impact' areas as proposed in the current alcohol strategy consultation.

See here for an e-learning course on A&E data sharing and data sharing guidance. The National Institute for Clinical Excellence (NICE) recently released an alcohol public health briefing for local authorities.

The LGA have also published recent guidance including:

• Police Crime Commissioner (PCC) NTE Briefing
• LGA Licensing Policy Statement Template
• Blackpool council and Police partnership case study for PCCs

The LGA are also hosting a series of events including: Councils role in tackling drugs and alcohol harm (17th January), Late-night levy workshop (22 January - LGA members only planning on introducing a levy) and a Licensing Conference (5 February).

News & updates: Dry January; alcohol guidelines still questioned; press snapshots

Dry January? Thousands opt for month off the booze

Both Alcohol Concern and Cancer Research UK have promoted alcohol-free January challenges, attracting a fair bit of media attention. Alcohol Concern's Dry January site reports 4,306 people signed up who could expect to "feel better... ditch the hangover, reduce the waistline, and save the pennies." Cancer Research UK also promoted a Dryathlon, claiming 35,000 have signed up to help raise money for the charity.

In response, the Independent's Jamie Merrill, having undertaken a dry January in 2012, explores Is there any point in giving up booze for January?. The Telegraph's well known columnist Peter Oborne wrote a frank piece, admitting "A month without alcohol - the thought fills me with terror" as he fears he is 'in danger of becoming alcohol-dependent'.

The Guardian have two features, Should I stop drinking in January? briefly assesses the impact on the liver and the importance of moderating use throughout the year. A Guardian Science blog asks Alcohol: friend of Foe?, arguing the importance of the many social and economic benefits.

Drinkaware have a feature 'De-toxing for January? We have a better idea', which suggests and explores "the problem with so called “detoxing” is that it can imply it’s okay to regularly drink too much at all other times and undo the damage with a month-long break – which is not true."

Alcohol limits: a place for tailored recommended guidelines?

A BBC article suggests the alcohol message 'is confused' following a Dr Michael Mosley Radio 4 programme You and Yours on the alcohol guidelines. It explores the problems of one size fits all 'low risk' guideline for all adults considering genetic and individual differences, and low unit awareness. Last year MPs on the Science and Technology Committee called for greater efforts to help the public understand alcohol guidelines and for a further scientific review to build public confidence.

Other news and reports

A recent Economist feature, Their cup runneth over, explores Britain's alcohol problem and it's history. Despite dipping consumption since 2004, the piece suggests "Britons manage to combine Scandinavian bingeing with liver-pickling Mediterranean levels of consumption." See here for latest alcohol consumption data from the Health Survey England.

Alcohol contributes to at least 38% of pedestrians killed in London road accidents, reports the Evening Standard. Nearly half of pedestrian fatalities aged 30 to 49 and 38% of those aged 16 to 59, being under the influence was idntified as a “contributory factor” in their death.

A Conservative MP has proposed preventing benefits being spent on alcohol by creating a welfare cash card that can be used on "essential" items only. See BBC Democracy report and clip. Alec Shelbrooke said the card could be provided to out-of-work people on benefits to pay for travel, food, clothing, energy and housing but could not be spend on alcohol, cigarettes or luxury items.

Young Britons cut back on drink and drugs, an Observer report argues. Another Guardian piece explores Boozy Britain – why do we drink so much?. Amy Winehouse was killed by too much alcohol, a second inquest has confirmed.

A Mentor UK blog post has highlighted research identifying early drunkenness as a key predictor of problem drinking, urging a further Government policy focus. Research on stress and risk of dependence has been covered in a Daily Mail article Peril of drinking to relax. New blog posts by home drinking researcher John Foster cover reflections on alcohol and culture and the role of eduction.

A minimum pricing update will be coming shorty.

Demos re-iterates importance of parenting style in preventing problem drinking

The think-tank Demos has produced a follow up report further emphasising the influence of parenting style on children’s drinking as teenagers and later in life. Demos claim that ‘tough love’ parenting – a parenting style that combines warmth with consistent discipline – is the best protection against young people developing later life alcohol problems.

Download Feeling the Effects and see a summary blog piece by one of the authors. An NHS Choices review of the report is also available.

In 2011 Demos produced a report based on a study of over 15,000 children stating parenting style is one of the most important and statistically reliable influences on children's later life alcohol use.The findings appeared to be corroborated by a JRF report that emphasised the importance of parents in influencing teenager's drinking, and research reviews assessing parenting interventions.

However a critical blog post by Phil Mellows suggests 'blaming the parents' is a poor policy approach, which neglects to consider wider environmental factors. Mellows questions the analysis and points out the report was sponsored by SABMiller who wish to scupper the Government's minimum pricing plans.

Demos' latest report nonetheless claims that parenting-focused initiatives should be the central tenet of alcohol harm reduction policy. The report's recommendations include:

• Information campaigns targeted at parents to increase understanding of alcohol misuse and the benefits of a 'tough love' parenting style
• Identification and brief advice (IBA) to help parents reduce alcohol misuse
• Early identification of and support for parents who may have a drinking problem, while their children are still young
• Alcohol support initiatives to include ‘parent-child engagement sessions’ to give children a voice.
• Alcohol support programmes to focus on parenting and advise on parenting techniques

Drinkaware has a web-page for parents aimed at promoting earlier conversations about alcohol. Further reports and guidance related to children and young people can be found here on the Alcohol Learning Centre, including the CMO guidance. Last year two reports called for the protection of children from alcohol harm.