Alcohol Policy UK

What's the picture with underage sales? 'Challenge 25' claims big impact but concerns over pubs, online and proxy sales

Alcohol consumption may be falling amongst children, but there is still a long way to go before CMO guidance of an alcohol free childhood for all seems remotely realistic. Whilst most children reportedly get their alcohol from friends or family, what's the current picture with underage sales?

Pubs under more pressure?

Firstly, no national data is collected on underage sales, with enforcement likely to be varied across local Trading Standards teams. However recent figures reported in the Morning Advertiser say that while the off-trade has continued to improve, more pubs are serving underage drinkers. The figures come from ‘test purchasing’ company Serve Legal who say only 66% of pubs were passing test purchases in 2013, down 4% from 2012 and down 8% on peak figures in 2010.

In contrast, off-sales via high street retailers have continued to improve, with pass rates now at 83% - up 3% on the previous year. However bad figures for the on-trade were not evenly distributed: notably the worst performance was found in the leased and tenanted pub sector with only a 46% pass rate. Managed pub premises did better at 66%, but late night venues performed best of all retailers at 85%.

Regional differences were also significant, with pubs in Scotland and London reportedly performing worst. Licensees however would like more action against underage drinkers. A subsequent case study report by the Morning Advertiser found a number of test purchase fails with pubs.

The role of Challenge 25?

A report on the impact of the Challenge 25, a voluntary retailer scheme reportedly now involving all major supermarkets, was recently released. The report says 75% of 18-24 year olds report having been challenged to provide ID as a result of Challenge 25. The scheme has been led by Retail of Alcohol Standards Group (RASG), who state underage sales are down, but highlight 'the emergence of worrying new trends outside of retailers’ control, including an increase in ‘proxy purchasing’.'

What about online & home delivery sales?

Last year a report by Alcohol Concern Cymru said children are often able to access alcohol via home delivery services. It found 15% of the young people surveyed stated they had successfully bought alcohol online, and over two thirds found it “easy” to do so. The report also covered a South Wales Police test purchase operation, in which 15 year olds attempted to buy alcohol from major supermarket grocery websites. In 44% of the test cases, alcohol was delivered to the test purchasers in person with no proof of age requested. However no further information in this area seems to be available since the report.

In 2012 Serve Legal and Plymouth University jointly published a report warning against both online and proxy sales as the emerging battleground for underage sales. Yet over the last five years, prosecutions for both underage sales and proxy purchases have been falling. Could it be time for more action in these areas?

'Smoking, Drinking and Drug Use Among Young People in England 2013' - drinking falling but still above European average

The latest report from the Health & Social Care Information Centre shows the number of pupils who have smoked, tried alcohol or taken drugs, suggesting a continued decline in drinking since 2003. Nonetheless young people's drinking reportedly remains above the European average for prevalence and likelihood of binge drinking.

The report gives results from an annual survey of secondary school pupils mostly aged 11-15 in England, showing 9% of pupils had drunk alcohol in the last week in 2013, compared to 25% in 2003.

Key findings on pupil's drinking from the summary report include:

• In 2013, around two-fifths of pupils (39%) had drunk alcohol at least once. Boys and girls were equally likely to have done so.
• The proportion of pupils who have had an alcoholic drink increased with age from 6% of 11 year olds to 72% of 15 year olds.
• Less than one in ten pupils (9%) had drunk alcohol in the last week. This continues the downward trend since 2003, when a quarter (25%) of pupils had drunk alcohol in the last week.
• Older pupils were more likely to have drunk alcohol in the last week: the proportion increased from 1% of 11 year olds to 22% of 15 year olds.
• Pupils who had drunk in the last week had drunk an average (mean) of 8.2 units, less than in recent years.
• Boys and girls drank similar amounts. Most pupils who had drunk alcohol in the last week had consumed more than one type of drink.
• Beer, lager and cider accounted for the majority of the alcohol boys drank (63%). Among girls, less than a third of the alcohol was drunk as beer, lager or cider (30%). The remainder was likely to be in the form of wine (25%), spirits (22%), or alcopops (20%).

However the full report highlights higher reported consumption and binge drinking than most European countries according to ESPAD data:

'Although the proportion of young people in England who drink is steadily reducing, it remains well above the European average. Furthermore, the UK continues to rank amongst countries with the highest levels of alcohol consumption by those who do drink, and British children are more likely to have ‘binge drunk’ or been drunk compared to children in most other European countries.'

The report suggests that median consumption is the best consumption indicator for those pupils who drank in the last week. For 11 to 13 year olds who had drank in the last week the median was 2.5 units, 5.0 units for 14 year olds and 6.5 units for 15 year olds. 18% of pupils who drank in the last week had consumed 15 or more units of alcohol; concerning since drinking among this age group is most likely to fall on one occasion in the last week (74%).

The issue of alcohol and young people remains a high profile policy area. Last year Drinkaware warned against parents being drunk in front of their children and Alcohol Concern and others have been campaigning for tougher regulation on alcohol advertising. See here for a Joseph Rowntree Foundation report Young People, Alcohol and Influences.

The Crime Survey for England and Wales, also released last week, showed adult's drug use appeared to be back on the rise following a longer downward trend, but the rise included the use cocaine and ecstasy among young people aged between 16 and 24. See a Guardian Datablog analysis here.

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. See here a post on IBA for young people.

Event presentations: Skills Consortium 'From Alcohol.. Medicines: Are we competent' & Exploring Effectiveness in Alcohol Treatment

Substance Misuse Skills Consortium conference slides

The Substance Misuse Skills Consortium recently held its annual conference on the theme of 'From Alcohol... Medicines: Are we competent?'

Presentations on the day included:

• Emily Robinson (Alcohol Concern) - Alcohol strategies (PPT)

• Emily Finch (South London and Maudsley NHS Trust) - Skills for the future (PPT)

• Lauren Booker (Alcohol Concern) - Alcohol media campaigns (PPT)

• Marcus Roberts (Drugscope) - Drug and alcohol policy trends and developments (PPT)

• Mike Ashton (Findings) - Drug and alcohol findings (PPT)

• Gemma Lousley (Drugscope) - Tackling substance misuse in older people  (PPT)

• Steve Brinksman - Addiction to medicines (PPT)

Evidence for effectiveness and local innovation in alcohol treatment delivery?

Earlier this year the Alcohol Academy and Public Health England held two workshops exploring alcohol treatment in relation to seeking NICE guidance and lessons learned. Speakers are each event covered one of key three areas: 

• NICE alcohol guidance: what it says
• Packages of Care (post PbR)
• Local examples

Download the event summaries and presentations here.

Some forthcoming alcohol events and dates are outlined here.

Below cost ban in effect; tightening of mandatory licensing conditions lined up

Below cost ban in place

You could be forgiven for not noticing, but the Government's ban on below cost sales is in effect. The legislation came into force on the 28th May 2014 as a new Mandatory Condition of the 2003 Licensing Act.

The below cost ban prohibits the sale of alcohol below 'cost', defined as the level of duty plus value added tax (‘VAT’) payable on the duty element of the product price. Typical 'cost' prices are:

• Can of 440ml beer at 4% ABV =  40 pence
• 750ml bottle of 12.5% ABV wine = £2.46
• 70cl bottle of 37.5% ABV spirits = £8.89

However it has been estimated the ban will affect only 0.7% of alcohol units sold, according to research by Sheffield University. A recent Dispatches documentary however said it had analysed thousands of supermarket prices from the last five years but could not find any drinks below cost. However a Home Office statement to the programme said it was the "first ever [UK] Government intervention to set a floor price for alcohol and its significance should not be underestimated."

The below cost ban has of course been amidst the Coalition Government's controversial alcohol policy dramas since the start. First announced as a Conservative Manifesto pledge in 2010, it was then superseded by the infamous 2012 Minimum Unit Pricing (MUP) commitment. The below cost ban was resurrected last year following the MUP u-turn - though of course officially MUP has not been 'ruled out'.

Generally there appears to have been little opposition to the below cost ban - unlike MUP - although Sainsbury's have said customers will no longer receive Nectar points on spirits or liquers. Sainsbury's say this is in the "interests of simplicity" in response to "complex laws", but a Home Office spokesperson said Sainsbury’s had “gone above” what was required by the law.

Further changes to the Mandatory Code on 'irresponsible drinking'

The current Mandatory Code conditions are being tightened up through a legal order due to come into force on the 1st October 2014. Currently the Mandatory Code legislates for on-trade premises:

• an age verification policy must be in place
• a ban on dispensing alcohol directly into customers’ mouths
• mandatory provision of free tap water
• the mandatory provision of smaller measures such as 125ml wine measures

A useful detailing of the expected revisions to the legislation is available here from licensing solicitors John Gaunt & Partners, and a commentary also available from PopplestonAllen.

The Government recently announced further pledges as part of the Responsibility Deal with alcohol industry partners, including some pubs and bars agreeing to have house wines below 12.5% ABV on offer and actively promoting lower-alcohol products.

All Home Office licensing guidance can be accessed here, including revised guidance issued under section 182 of the Licensing Act 2003.

Public Health England Marketing Strategy sets out limited alcohol 'social marketing' plans

Public Health England (PHE) has published its 2014-17 marketing strategy, outlining plans for campaign related activity around alcohol and other lifestyle behaviours.

However PHE says its plans for alcohol-related communications are limited for a number of reasons. Namely, budget limitations and recognition of the limited evidence base for alcohol campaigns in changing behaviour, alongside the awaited revisions to the Chief Medical Officer (CMO) drinking guidelines. The strategy says the CMO's review will "involve appropriate consultation and so is unlikely to report before the end of the year".

What the strategy sets out

Under the alcohol chapter, 7.4 Making it easier for adults to drink at lower-risk levels, PHE says it has developed an evidence-based model for which:

'alcohol is reported as low priority in the model, due principally to the paucity of evidence (nationally and internationally) of success in marketing-based interventions around alcohol. Given the low prioritisation we could not support a recommendation to develop a significant national campaign in 2014. This is further argument for taking a test-learn-refine approach.'

PHE have therefore outlined plans for two regional pilots and are also currently developing a wider Health and Wellbeing Framework to identify the key interventions for improving health and reducing inequalities.

The strategy identifies a number of possible areas for 'social marketing' based activity including binge drinking and preventing early age drinking. However it states 'since industry-derived funding (via Drinkaware) will continue around young people and resume shortly around young adults, we recommend focusing PHE’s funds on increasing and higher risk drinking in middle-aged and/or older adults.'

The strategy says most increasing and high-risk drinkers underestimate their level of risk and are happy with their consumption levels. This is in contrast to other areas such as diet where target populations 'readily accept that they need to change and are keen to eat more healthily and be more active.' The strategy also says that PHE and a small number of other organisations have made attempts to change at-risk drinkers’ beliefs and behaviours regarding alcohol. However it says:

'while the evidence is patchy, the emerging picture is that attempts to change attitudes generally fail (although possibly because no one has ever spent enough to impact on the counterweight of industry spend); however, providing people with tools to assess and record their drinking has had some success in reducing consumption. While people repeatedly tell us that they have no intention to change how they drink, it seems they do change in response to price, availability and strength, but also to identification and brief advice.'

Previous Campaigns: 'Alcohol Effects' & Change4Life 

In 2009 a number of alcohol 'social marketing' resources and activities were launched to support local areas deliver activity and target the public directly. Then in 2011 the Government announced future alcohol messages were to be brought within the Change4Life campaign.

The new PHE strategy says the Change4Life Drinks Checker app received over 50,000 downloads and generated over 130,000 visits to the Drinks Checker page. It says 79% of Drinks Checker users were increasing and higher risk (IHR) drinkers and 75% of those IHR drinkers agreed that “it will encourage me to drink less alcohol” and 81% agreed that “I plan to use the tips it suggested”.

Future plans

The strategy says it will deliver two regional pilots:

Pilot 1. A participative abstinence event

PHE says it will be looking at the role of promoting temporary periods of abstinence from alcohol to 'prompt reassessment of its role and benefits'. This follows the percieved success of recent Dry January and  Dryathlon challenge campaigns. PHE say:

We are evaluating the impact of Dry January 2014 on consumption, in both the short and long term. The initial data is promising, and we explore the potential to use Dry January or a similar initiative as a pilot for other employers and communities (and indeed to repeat or enlarge temporary abstinence outside of January).

Pilot 2. Promoting irregular drinking

The strategy also commits to 'explore new strategies to help people remain within the guidelines'. It states:

This project will start with research into people who already drink within guidelines, to understand the strategies they currently deploy to drink at lower risk levels. From this phase, we will develop articulations of strategies for maintaining low consumption and, via an experimental methodology, assess the ability of increasing and higher risk drinkers to adopt and follow the strategies. For example, daily drinking is a key contributor to increased risk, so it is possible that promoting a simple approach such as never drinking two days in a row would have a positive impact.

The strategy's alcohol section concludes by stating "Finally, in addition to the social marketing approach described above there is evidence that changes in price, availability and strength are more likely to have immediate positive impacts and the broader PHE alcohol team will continue to look at those areas." A position many in the public health community will be pleased to hear.

Events, dates & jobs: Alcohol Awareness Week 14-24 Nov, Alcohol Concern annual conference, Alcohol Policy in Scotland, SHAAP Policy Officer

Alcohol Awareness Week 17-23 November & Alcohol Concern conferences

This year's Alcohol Awareness Week (AAW) will run from 17-23 November. Alcohol Concern say the theme is 'Facing our alcohol problem: Taking back our health and high streets', which will be the theme of its annual conference on 19 November in London.

During the week Alcohol Concern encourage people, organisations and local areas to promote alcohol awareness and related activities - see our review of 2013 AAW activity.

Alcohol Concern Wales' annual conference will take place on 16 September 2014 in Newport, on the theme of 'Under control? Alcohol licensing and creating safer communities'.

Scotland the Brave! Alcohol Policy in Scotland 

A seminar on the 5 September in Brussels will explore Scotland's alcohol policy including its ongoing battle to implement alcohol Minimum Unit Pricing (MUP). The event is being organised by the Scottish Health Action on Alcohol Problems (SHAAP) and Eurocare. Registration here.

SHAAP Policy Officer sought

Scottish Health Action on Alcohol Problems are also seeking a Policy Officer for 28 hours per week. The key focus of the work will be to support SHAAP alcohol-related advocacy and educational activities through carrying out research, drafting briefing papers, monitoring media and policy activity, providing administrative support and organising events. More here.

Also..

The 11th INEBRIA conference exploring international research and developments on brief interventions takes place in Warsaw, Poland on 18 - 19 September 2014.

An Alcohol Policy in Practice CPD course run by UKCTAS, the UK Centre for Tobacco and Alcohol Studies will take place in Edinburgh from 22nd to 25th September 2014. The course covers key issues for alcohol policy and practice led by some of the leading academics and policy-makers. Further info here including the flyer or programme.

News & updates June 2014: local minimum pricing sought, counterfeit alcohol, alcohol industry updates, drink-driving, holiday drinking, foetal alcohol syndrome & more

Selected media stories since the May round-up: 

Councils seek local minimum pricing and strength controls

Nine councils are considering implementing local alcohol minimum pricing via local licensing policy statements, reports the Morning Advertiser. Research by Poppleston Allen also found that 10 licensing authorities have confirmed they are planning to ban sales of high strength alcohol as part of the revision of their statement of licensing policy.

In addition, five councils have confirmed interest in introducing a “Reduce the Strength Campaign”, following the introduction of the scheme in Ipswich, which sees outlets agree to remove ‘super strength’ (6.5% ABV+) alcohol from their shelves.

Should Charities receive industry money?

Alcohol charities should be made to declare funding that comes from the alcohol industry in order to improve transparency, according to The Alcohol Industry, Charities and Policy Influence in the UK published by the London School of Hygiene & Tropical Medicine. The report caused consternation because two beneficiaries of industry funding, Addaction and Mentor UK, are the only health groups that remain involved in the coalition's public health responsibility deal. See Mentor's response here.

Nurses debate treating drunks in A&Es

A recent debate at the Royal College of Nursing conference on how to respond to intoxicated patients hit the headlines. The Daily Mail suggested senior nurses called for drunks to be banned, but a Telegraph report reflected some of the views from nurses not wanting to exclude patients. See our exploration of 'Drunk Tanks' following last year's call for measures to relieve police pressures.

Counterfeit alcohol

Seizures of counterfeit alcohol by UK trading standards authorities have soared fivefold over five years, reports the Guardian. Statistics from Interpol's Operation Opson III show that international criminal gangs are helping to fuel consumer demand for cheap drink. Last year HMRC consulted on actions to help prevent and tackle alcohol fraud after it came under fire from MPs, but no further news yet it seems. You can report fraud to HMRC here.

Alcohol industry news

• In a move welcomed by Alcohol Focus Scotland, C&C Group, owner of Tennent's Lager, has quit the Portman Group, claiming it is dominated by the interests of multi-national companies, reports the HeraldScotland.

• Diageo has hired Vickie Sheriff, the Department for Transport's director of communications and former deputy spokeswoman to the Prime Minister, as global communications director, reports PR Week.

• A report by the Retail of Alcohol Standards Group, Rising to the Challenge found that around 850,000 shop workers per year are now given training in how to apply the Challenge 25 initiative, leading to ID requests for around 11 million people, 75% of whom are 18-24 year olds.

• Research by Off Licence News suggests proxy purchasing has almost trebled in the past 12 years. Retailers have called on authorities to overhaul proxy purchasing laws and start a public awareness campaign to teach adults that buying alcohol for children can cost store owners their livelihoods.  

Holiday drinking

Half of British holidaymakers drink alcohol every day on summer breaks - and one in three of us admit to drinking in the departure lounge, says the Daily Mail, reporting on research by Alcohol Concern Wales.

Foetal alcohol syndrome

The number of diagnosed cases of foetal alcohol syndrome in those born to women who drink during pregnancy has tripled since records of the debilitating condition were first kept 16 years ago, reports the Guardian. Shadow public health minister, Luciana Berger, who uncovered the new figures, said: "The government must ensure that expectant mums have the information they need to make informed choices during their pregnancy. Instead, ministers have relied too heavily on the drinks industry to do it for them."

Drink driving news

The Ford Motor Company has created a suit that simulates the impact of alcohol on a motorist. The manufacturer is now – courtesy of its Driving Skills For Life courses – encouraging younger drivers to access its impact, reports motoring.co.uk.  

A new laser-based device that detects alcohol vapour inside a moving car by detecting tiny changes in the laser beam as it passes through vapour has been reported by the Daily Mail reports on. Just as well, since more than a third of British passengers would turn a blind eye to if a driver was drinking alcohol at the wheel, according to new research reported by the Daily Mail.

Meanwhile, the British Touring Car Championship has become the first motor racing series in the UK to introduce mandatory alcohol testing and a ‘zero tolerance’ policy to driving with any alcohol in the bloodstream, reports motorsport.com.

Supermarkets hinder efforts to reduce harmful drinking says Sheffield; Channel 4's Dispatches on 'The Cost of Cheap Alcohol'

Research indicates supermarkets 'under-shifting' cheap drink

Supermarkets subsidise tax increases on the cheapest drinks according to research by the University of Sheffield recently published in the journal Addiction. It suggests the impact of price rises on harmful drinkers - those most sensitive to price changes - have been undermined by supermarket tactics to keep customers attracted in store.

The press release says "retailers appear to respond to increases in alcohol taxes by ‘under-shifting’ their cheaper products (raising prices below the level implied by the tax increase) and ‘over-shifting’ their more expensive products (raising prices beyond the level implied by the tax increase)." According to the research, under-shifting affects a large proportion of total sales: approximately 68% of beer, 38% of spirits and 31% of cider sales.

However this year the Chancellor ended the the alcohol duty escalator, which had seen duty rise 2% above inflation since 2008 until last year. Professor Petra Meier, of the Sheffield Alcohol Research Group (SARG) said "alcohol duty increases can be part of a mix of measures" to address alcohol misuse since the "ready availability of cheap alcohol" is a "key influence" on alcohol-related harm. Sheffield have of course worked extensively on Minimum Unit Pricing which is seen as necessary to prevent 'loss leading' or 'under-shifting' against tax rises.

Professor Paul Dobson at the University of East Anglia, also involved in the research, said: “Subsidising cheap alcohol might be attractive to supermarkets in their efforts to increase the number and frequency of store visits that shoppers make" but it was "imperative that the Government take a much closer look at how taxes and duty are applied on alcohol".

Earlier this year University of Cambridge research on the impact of end of aisle displays found that for a 1% decrease in the price (per volume) of alcohol there was approximately a 5% increase in sales volume. A below cost ban is expected to be introduced in law shortly, though the impact of a below cost ban is expected to be "approximately 40 to 50 times smaller than the estimated impact of a 45p MUP".

Channel 4's Dispatches airs 'The Cost of Cheap Alcohol' 

Channel 4's investigative programme Dispatches explored recent events in relation to minimum pricing and the Government's U-turn amidst accusations of industry lobbying. The show is available to watch via 4oD for another 15 days. 

New 'Responsibility Deal' alcohol pledges on strength, school education and shop displays; 80% labelling pledge 'met'

The Government has announced further pledges as part of the Responsibility Deal with alcohol industry partners, despite various controversy over the initiative since its 2011 launch.

The new pledges include agreements for some producers to stop super-strength drinks being available in large cans, and further actions on responsible display and promotion of alcohol for off-sales.

For the on-trade, some pubs and bars will agree to have house wines below 12.5% ABV on offer and actively promote lower-alcohol products to customers. Funding is also been made available to train 10,000 servers on responsible retailing focused under-age drinking and anti-social behaviour. A pledge to support a new schools alcohol and life skills education programme is also included.

However some critics have continued to argue the Responsibility Deal is a smokescreen for evidence based policies such as Minimum Unit Pricing (MUP). When first announced, six health groups walked out of the deal in protest of the pledges and process, with more reportedly quitting after the Government's MUP u-turn. Indeed health based effectiveness rankings for alcohol initiatives tend to assess alcohol education in schools and voluntary led initiatives as low impact compared to action on price, availability or marketing. Last year Asda pulled its pledge to stop promoting alcohol in its foyers after other supermarkets had not followed suit.

Nonetheless, Ministers are standing fast on what they see as a key role for the industry in addressing alcohol misuse. Health Secretary Jeremy Hunt said the deal had "made real progress" and the new pledges "will help people to drink responsibly and make healthier choices". Local partnership action with retailers is also central to the Home Office's 20 'Local Alcohol Action Areas' initiative.

Labelling pledge met?

The first word on the labelling pledge of unit and health information on 80% of alcohol containers by 2013 has also appeared, with the Portman Group website stating "Minister for Public Health, Jane Ellison has also confirmed that industry has met its target by achieving 79.3% on its pledge to feature important health information on 80% of labels on shelf by the end of 2013." A public report is expected from the Portman Group who agreed to monitor the labelling pledge.

The Government also recently said the pledge to remove one billion units by 2015 is 'on track', although question marks and the issue of significant producer tax benefits from the pledge have been raised. The announcement of the new pledges were also reported by the Guardian as subject to politics, saying the Home Office had been ordered to hold off on news of the deal as part of the Government's strategy of avoiding news not focussed on the central issue of the economy.

Alcohol through the life course: Alcohol Research UK 2014 conference & postgraduate symposium videos from FEAD

Videos of presentations at the recent Alcohol Research UK 2014 annual conference are now available from the Film Exchange on Alcohol and Drugs (FEAD). Also available are videos from the first postgraduate and early career symposium. Selected presentations are also available to download here.

As well as leading figures such as Professor Robin Room and Tim Stockwell, a retiring Professor Ray Hodgson gave his reflections on alcohol through the life course.

Selected videos from the annual conference include:

• Professor Robin Room: Thinking about the interplay between drinking cultures and drinking policies

• Professor Robin Room: Wet and Dry Generations: What happens with social change in drinking

• Professor Harry Sumnall: Intoxicated Identity: Young people's online behaviour

• Professor Ray Hodgson: Alcohol Research: Through its Life Course

• Dr Sarah Wadd: Tackling Alcohol Misuse in Older Adults: A public health approach

• Professor Tim Stockwell: Moderate Alcohol Use in Older Years: A sign or cause of good health?

See here for further videos including the postgraduate and early career symposium.