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.
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