Alcohol Policy UK

Special occasion drinking responsible for 120 million unreported units per week

A new study has identified 'special' and 'atypical' drinking occasions are responsible for a significant amount of alcohol under-reported in national surveys.

The research, published in the BioMed Central journal, attracted national headlines, despite it already known that self-reported consumption typically gives a figure 40% lower than HMRC sales data. However the new study still only accounts for some of the under-reporting, with a number of possible factors for further 'missing' units. The role of storage, spillage, under 16's consumption and tourist consumption are hard to gauge for example.

The study highlights a number of flaws with current national survey approaches which focus on typical or average drinking in the last week. As one of the authors, James Nicholls from Alcohol Research UK, highlights in a supporting BioMed blog: 'drinking, while often routine, is more usually a matter of peaks and troughs, in which periods of fairly low consumption are interspersed with episodes – Christmas, for example – where our drinking shoots up.'

Differences between groups were also found, for instance the most missed units were found amongst 25 to 34 year-olds who have the highest typical consumption; atypical or special occasions added approximately 18 units a week (144g) for men and women of this age. A BBC report said the amount under-reported across all groups was equivalent to more than three-quarters of a bottle of wine per drinker every week

In a Guardian report, lead author Mark Bellis of Bangor and John Moores universities, highlighted that 'summer holidays, bank holidays, weddings and many other special occasions' as times where true alcohol consumption is overlooked in most survey data. See the behind the headlines analysis here.

The research team conclude that 'the additional units are inevitably linked to increases in lifetime risk of alcohol-related disease and injury, particularly as special occasions often constitute heavy drinking episodes.' Critics may argue - perhaps simplistically - tell us what we don't already know; researchers say further understanding of true consumption and associated patterns help better inform public health interventions.

Further calls to lower drink-drive limit as women 'not getting message'

Fresh calls for the drink-drive limit to be lowered have been made by the Police Federation, alongside a warning over women 'not getting the message'.

Last year Scotland changed the legal blood alcohol limit for driving from 80mg to 50mg in every 100ml of blood, bringing it in line with most of Europe.

Victoria Martin, of the Police Federation, said Scotland had seen a marked reduction in failed breathalyser tests as soon as the law was changed. Martin however warned: “We’ve seen a steep decline in men drink-driving over the years, with targeted advertising campaigns, which is great, but women don’t seem to be getting the same message".

Only England, Wales, Northern Ireland and Malta have an 80mg limit, with most of Europe having a 50mg limit and some having lower or zero limits. Strong evidence for a reduced limit is claimed, however in 2011 it was announced England's limit would remain at 80mg despite an independent report calling for it to be reduced. Instead the Government said it would focus on "improving enforcement and education to tackle the drink and drug drivers who put lives at risk."

However whilst the longer term trend in drink-driving is one of significant decline, concerns over an increasing proportion of women failing breath tests are being raised. According to a report by Social Research Associates (SRA), women now account for 17 per cent of convictions, compared with nine per cent in 1998, as reported in the Telegraph.

Kris Beuret OBE, director of SRA and author of the study, said there were a number of gender specific reasons for women's drink driving:

"These include the effects of different metabolism on men and women’s bodies, confusion about how many units are in alcoholic drinks – especially wine – and thinking that the police would be less likely to stop them.

The study also found that several important messages aren’t getting across to women – and this is reinforced by the generally male dominated imagery of anti-drink driving campaigns. Some women in the study even admitted trying to drive ‘extra carefully’ but this is no solution..."

Last year a campaign was based around 50 years of drink-drive messages, celebrating the steady decline. However drink-drive incidents account for 13% of all road fatalities - about 230 each year. 

In 2013 a warning that 'morning after’ drink driving was on the increase was reported, with 46% of drivers having no idea or underestimated how long it took for alcohol to leave the body. Typically a healthy body will process around 1 unit per hour, but a wide range of variables such as body size, gender, age and other factors come into play - read more here or see www.morning-after.org.uk.

The 'Think!' campaign aims to highlight the dangers, as well as a fine of up to £5,000, a minimum 12-month driving ban and a criminal record if caught.

Alcohol Research UK reports: 2014 review, Online Health Check for Employees, AUDIT accuracy tested

Recent Alcohol Research UK funded reports, and a review of their 2014 activity have been released:

Alcohol Research UK: Spotlight 2014

This review describes Alcohol Research UK's recent research, achievements, events and initiatives and also looks to the year ahead. It includes an overview of the key flagship grant projects as well as PhD and small grants support. Download here [pdf].

Online health check for reducing alcohol intake among employees

New research funded by Alcohol Research UK and Balance North East suggests workplace health screening and feedback is feasible. The conclusion states challenges include low participation rates, potentially attracting ‘worried well’ employees rather than those at greatest health risk, and less acceptance of the approach among older employees and those from ethnic minority backgrounds and routine or manual occupations.'

Accuracy of Alcohol Use Disorders Identification Test (AUDIT) for detecting problem drinking in 18 to 35 year olds

'The use of AUDIT in primary care screening is widespread. This report analyses how AUDIT scores can be used most effectively to identify a range of alcohol problems, taking into consideration gender differences. It identifies a number of optimal scores at which patients might be considered for further interventions, while recommending that doctors consider approaching such scores less as absolute ‘cut-points’ than as a starting point for patient dialogue.'

Assessing the role that entertainers play in alcohol marketing and the maintenance of good order within on-trade licensed premises

'This study suggests that the relationship between alcohol and live entertainment is culturally embedded in the UK. When combined, alcohol and entertainment (e.g. music) can alter moods, of crowds and individuals, often in a pleasurable direction, for example the idea that drinking and dancing go in tandem... Thus, on-trade entertainment provision could provide an alternative attraction for nightlife patrons instead of mere intoxication, and alternative income for venues (e.g. entry fees or more attendance, a selling-point over the off-trade) as opposed reliance on alcohol provision alone.'

Lead author of the report Dr Alasdair Forsyth, Glasgow Caledonian University, will be discussing the findings at various forthcoming events - contact for more information.

A Measure of Change: The impact of the public health transfer on local alcohol provision

Alcohol appears increasingly to be a public health priority and in many local areas the new structures are facilitating joined-up working. However, treatment providers are concerned about future funding. Alcohol Concern previously released the report.

See here for all Alcohol Research UK publications.

'Drink responsibly (but please keep drinking)': Alcohol Concern briefing critiques industry messages

A new briefing from Alcohol Concern, 'Drink responsibly (but please keep drinking)' [pdf], says that alcohol industry 'responsible drinking' messages do little or nothing to help reduce alcohol harms, and may be used to further promotion of brands, or give the impression of corporate social responsibility.

Alcohol Concern Cymru studied a sample of supermarket magazines and found that although 90% of alcohol promotional material included mention of Drinkaware, only 36% included any specific 'drink responsibly' message.

Even then, Alcohol Concern say 'drink responsibly' messages are dubious, for instance are open to wide interpretation and have no clear bearing to the recommended guidelines. Messages or Drinkaware links were typically small and sometimes appeared to contradict the main message of the advert.

The briefing states:

Rather than promote moderation, then, it is argued that responsible drinking messages in alcohol advertising are used by the industry for three main purposes: a means to frame the debate around alcohol-related problems, an opportunity to promote their brands, and a chance to create a socially responsible image.

The briefing is also critical of wider policies over alcohol advertising regulation and industry practices, as well Government failure to implement "evidence-based policies around price and availability" instead of promoting "education and personal responsibility as the solution to alcohol problems in society." It argues that the industry deliberatly frame alcohol problems around a minority of irresponsible drinkers, rather than the role of the products or environment in which they are available.

Questioning the current focus of industry activity, it states:

It may be that the inclusion of the Drinkaware website address, recommended as best practice by the Portman Group and which was present in 90% of the total alcohol adverts and advertorials analysed, is viewed by alcohol companies as sufficient to fulfil their voluntary obligations to promote responsible consumption. However, one can argue that referencing an educational website hardly constitutes pulling out all the stops to make, as one leading drinks company ABInBev puts it, responsible drinking “a fundamental part of our dream to be the Best Beer Company bringing people together for a Better World.”

Alcohol Concern have frequently campaigned for more protection of children from alcohol advertising and availability. However the Portman Group continue to highlight voluntary regulation and claimed successes through and the Responsibility Deal, such as the unit reduction pledge. Meanwhile Drinkaware have been seeking to convince the public health community that its activities are effective following a 'mixed' independent review in 2012.

Alcohol Concern's report makes 3 recommendations:

• Current “drink responsibly” messages found in alcohol advertising should be replaced with factual health warnings appropriate to the product being advertised and/or the publication or platform in which it will most frequently appear
• These health warnings must appear in larger type and be placed in a more central position than the drink responsibly messages found in the alcohol advertising reviewed in this study
• There needs to be a fundamental shift in how alcohol is advertised, whereby images appearing in alcohol advertising should refer only to the characteristics of the product’s strength, origin, composition and means of production; promotion of ‘lifestyle’ images of drinkers should be prohibited

IAS Alcohol Alert May 2015: Irish alcohol policy, drinking in films influences teens, pregnancy, pricing & more

The latest Institute of Alcohol Studies (IAS) Alcohol Alert: May 2015 is now available (here for PDF version). Read the editorial here and articles below:

• OECD report gives damning assessment of UK drinking habits

• Action on Alcohol Week in Ireland: Women drink as much as men

• Stop Out of Control Drinking scheme under fire over its position on Irish Public Health Bill

• What does the future hold for alcohol policy under a Tory government?

• Movie drinking linked to alcohol-related problems in teens

• Poll: one-in-five women drink while pregnant

• “Good week” Guinness tweet escapes ad ban

• Poll: price top factor for supermarket beer drinkers

• Lines blurred as industry mixes sport and alcohol cocktail

• Supreme Court foetal alcohol damage appeal rejected

• CAMRA votes to end LNLs

• Court ruling: Reducing the Strength scheme still valid

• European Parliament passes resolution for a new EU Alcohol Strategy

OECD report warns over rise in young people and women's drinking

Harmful drinking is on the rise among young people and women in many OECD countries, partly due to alcohol becoming more available, more affordable and more effectively advertised, according to a report from the OECD. See the press release and Policy Brief.

Although consumption in OECD countries has declined slightly over the last 20 years, it highlights the average adult consumption of 10 pure litres of alcohol per year, equivalent to to 100 bottles of wine, is well above the world average (6.2 litres). Alcohol abuse ranks as one of the leading causes of death and disability, killing more people worldwide than HIV/AIDS, violence and tuberculosis combined.

The report highlights that most alcohol is consumed by 20% of the population, though approximately four in five drinkers would still decrease their risk of death by cutting their alcohol intake by just one unit per week.

Most of the headline figures are based on the overall picture of the 34 member countries, where of course the UK does not exactly mirror this trend. In the UK declines in 'binge drinking' amongst younger people appear to have led recent falls in consumption, although levels are still above the EU average. The UK is also above the OECD average for adult consumption, with possible indications that the downward trend since 2004 could soon end.

A call for policy action 

The OECD state that taking action can reduce rates of heavy drinking and alcohol dependence by between 5 to 10 per cent.

It advises that 'policies should target heavy drinkers first', although broader approaches such as minimum pricing, taxing and tighter regulation 'may also sometimes be needed to complement these measures'. Alcohol industry initiatives 'may also have a role to play but more independent evidence of their impact is needed'.

The report reviewed alcohol policy approaches, including modelling analysis for several countries. It says many alcohol policies 'pay for themselves and 'even the most expensive alcohol policies have very favourable cost-effectiveness profiles in health terms'.

 

News & updates April 2015: booze buses, alcohol with marijuana, is alcohol a 'gateway' drug?, memory, movies and pop music

Selected media stories since the March roundup

Mobile “booze buses” to treat drunken revellers could soon become a common sight in towns and cities across England, after a pilot project led to dramatic decreases in A&E admissions and saved the NHS hundreds of thousands of pounds, reported the Independent.

Personnel Today discussed drug and alcohol testing in the workplace. It suggests a sensible way forward for employers is to remove the stigma surrounding drug and alcohol abuse and get to the root of the problem, taking a health-led, rather than disciplinary-led, approach.

Binge drinking is costing UK taxpayers £4.9bn a year as we analysed here or see BBC report and the Telegraph recently asked "Do you know how much alcohol you are drinking?" explaining units and NHS risk levels to readers.

Crime, drink-drug driving & violence

Thermal cameras could be used to catch drink drivers, using an algorithm that spots changes in the face caused by an 'alcohol flush' said the Daily Mail.

People who smoke cannabis while consuming alcohol are twice as likely to drink-drive, says new research reported in the Daily Mail.

People needing medical treatment due to violence dropped by nearly 23,000 between 2013 and 2014, according to Cardiff University researchers as previously reported here or see Wales Online.

Women

272 children left disabled by foetal alcohol syndrome were hospitalised in England over the past 12 months, according to data from the official Health and Social Care Information Centre reported the Daily Mail and Mirror, but the actual number affected by their mother's drinking could be far greater.

A child born with foetal alcohol syndrome has been refused permission to take her case for criminal injuries compensation to the UK Supreme Court said the BBC.

Alcohol policy

Health bosses in Scotland are considering raising the legal age for buying alcohol to 21 to tackle binge drinking, reported the Daily Mail.

Alcohol Concern Cymru has called for tailored health warnings to be included on drinks advertisements, publishing research showing more than half of adverts and advertorials in supermarket magazines do not contain a specific ‘drink responsibly’ message. Wales Online.

More than 100 people have died because of a legal challenge to minimum alcohol pricing by Scotland’s whisky industry, health secretary Shona Robinson has claimed. The Courier 

Treatment 

The NHS could save £27m a year by changing the way it deals with alcoholic patients, reported the BBC after a week at Manchester's Chapman Barker detox unit.

Two key drugs recommended in international guidelines and used to treat alcoholic hepatitis are failing to increase patients' survival and leave death rates among patients "alarmingly high", reported the Mail Online. 

Young people

Marijuana isn’t a gateway drug – alcohol is, said Metro, reporting on research by Treatment4Addiction.

Binge drinking as a teenager causes long-lasting changes to the regions of the brain that control learning and memory, said the Daily Mail, reporting on new research from Duke University.

In a study of 15-year-olds in the UK, those who had been most exposed to alcohol use in films were also most likely to have tried alcohol, and about twice as likely as the least exposed to have been binge drinking, reported the Huffington Post.

Psychologists have documented a striking increase in references to alcohol and heavy drinking in the lyrics of UK chart music. They warn this could mean that attempts to control the direct advertising of alcohol to young people will be in vain, as pop music is effectively spreading a positive message on the drinks companies' behalf.

24 per cent of young professionals in the UK would consider themselves to have a “drinking problem” according to a recent survey reported the Independent.

A new event, Shaken Not Slurred — a pop-up night on the first Thursday of the month has been launched for people to enjoy a drug and alcohol free night out in Bolton without alcohol or drugs. Bolton News

Trade news

Local councils are the real driving force between prohibitionist alcohol policies - and the trade should devote more attention to them, according to the Wine and Spirit Trade Association, reported Harpers.

This Is Money said local councils could be made to pay thousands of pounds in compensation to retailers who say they were pressured into stopping selling strong lagers and ciders, following a legal ruling in Newcastle.

Drinks industry leaders will resist plans for compulsory labeling of calories on alcohol products, by arguing that information would be better used online or on smartphone apps rather than on bottles and cans, said the Grocer.

Starbucks has opened a cafe at Edinburgh Airport which is only its second in the UK to offer dinner and alcohol, reported the Scotsman.

Meanwhile the Grocer says UK consumers have almost no interest in using lower-strength drinks to cut down on alcohol consumption, according to a major new study.

the Telegraph recently asked "Do you know how much alcohol you are drinking?" explaining units and NHS risk levels to readers.

Jobs & events: IAS policy analyst, IBA role, New Directions 2015 approaches & more

IAS Policy Analyst role

The Institute of Alcohol Studies (IAS) is looking to recruit a Policy Analyst to join their small team in Central London. The purpose of the role is to support IAS work in promoting public policies to reduce alcohol harm by ensuring information provided to external audiences includes up to date, accurate evidence on financial impact and cost-effectiveness.

• Salary: £34,000-£36,000 per annum, depending on experience
• Location: Alliance House, 12 Caxton Street, London, SW1H 0QS
• For more information email Kellie Donaldson ([email protected]).
• Click here to download the full job description
• Deadline for applications is 1 June 2015.

HAGA Brief Interventions Team Leader

Haringey Advisory Group on Alcohol (HAGA) are seeking a position to lead HAGA’s alcohol awareness campaigns, events, project and training across Haringey, Islington and other areas. 

• Salary: NJC SP 29 (£27,304)
• Location: Neighbourhood Resource Centre, 177 Park Lane, London, N17 0HJ
• See the Application Form and Job supporting document
• Closing date 19th May 2015

New Directions 2015: Addicted to Recovery?

The New Directions in the Study of Alcohol Group (NDSAG) 39th Annual Conference 2015 takes place in London this month on 21st and 22nd of May - see here for the conference programme [pdf].

The event explores the key theme of 'Addicted to Recovery?', looking at addiction concepts, 'brain science', pharmacology and other issues crucial to the treatment field. The second day focuses on a range of other issues including gambling, the changing policy and commissioning landscape, lessons from the field and more. A range of leading high profile speakers include Professor Keith Humphreys, former adviser to the Obama administration, Professor Marc Lewis and many more.

A number of registration options are available starting £250 for full conference attendance - see here for the booking form [doc] or New Directions website for more details.

Later this year...

Drinking for two? Alcohol and pregnancy

On 21 September in Cardiff Alcohol Concern Wales are holding a conference on alcohol and pregnancy. See here for the conference agenda or register here at a £60+VAT early bird rate.

Global Alcohol Policy Conference 2015 

The Global Alcohol Policy Alliance (GAPA) and Alcohol Focus Scotland are to co-host the next Global Alcohol Policy Conference which will be held in Edinburgh from 7-9 October 2015.

EU minimum pricing decision edges closer as calorie labelling finds favour

Another hurdle for Scotland's MUP

This week the European Court of Justice in Luxembourg is hearing evidence from the Scottish Government in relation to its attempts to bring in Minimum Unit Pricing (MUP) - BBC news.

Although the hearing will allow the court to produce its preliminary ruling, the decision will not be issued until later this year, and the case will then be referred back to the Court of Session for a final decision. EU member states will also have the opportunity to make representations on the Scottish Government’s proposal. See the Government press release here.

Scotland first passed legislation to implement a 50 pence MUP in 2012, but a number of industry bodies represented by the Scotch Whisky Association (SWA) mounted a legal challenge. Although the Scottish Judiciary found that MUP did not breach EU competition law, Dr Evelyn Gillan, Chief Executive of Alcohol Focus Scotland said "The SWA has mirrored the tactics of the tobacco industry in delaying life saving legislation."

SHAAP (Scottish Health Action on Alcohol Problems) recently published an MUP briefing [pdf] and are campaigning for people to sign in support of MUP.

Wales and Northern Ireland also plan to implement MUP. However in England it has not received attention from the main parties since 2012 plans for a minimum pricing were shelved amidst accusations of industry lobbying. As an alternative, a 'below cost ban' has since been implemented, but its effect has been suggested to be minimal, if any. However Public Health England have committed to "continue to set out the evidence base for the introduction of a minimum unit price for alcohol", and rumours that Labour would seek MUP surfaced last year.

Calorie labelling on the cards? 

Members of the European Parliament recently backed calls for compulsory calorie labelling on alcoholic drinks following a vote at the European Parliament. However according to the BBC, the MEPs' vote is not binding so it is not certain if or when the proposals could become law.

Last year a report from the Royal Society for Public Health (RSPH) called for legislation to require calorie labelling on drinks, with the majority of the being public unaware of the calorie content but wanting more information. However the report suggests the likely impact of increased awareness of alcohol calories on drinking habits is largely unknown.

The Portman Group have highlighted some producers are reportedly taking voluntary labeling action; Diageo became the first drinks producer to commit to calorie labelling according a Drinks Business report. Of course voluntary action has been a highly controversial alcohol policy area so its future is uncertain for now...

Changing drug, alcohol and smoking behaviours: report from ESRC Behaviour Change Seminar Series

Earlier this year a seminar on 'Changing drug, alcohol and smoking behaviours' took place as part of the Economic and Social Research Council (ESRC) programme on policy and research in behaviour change.

See here for the short synthesis report [pdf] or some of the presentations here.

The seminar included a number of 'position statement' presentations from academics including Professor Jim McCambridge, Professor Gerard Hastings, Dr James Nicholls, Professor Christine Griffin and others, with each followed by audience discussion.

The synthesis report identifies three main themes which cut across much of the discussion; 'engaging with industry' (or not as some views suggested), 'harnessing citizen power' and 'social media'.

Following from the event, the report suggests key objectives for the future of behaviour change can be summarised as:

• To understand corporate behaviour better; in terms of its activities to engage with consumers (e.g. through social media platforms), its influence on policy and its research and development strategies for future profit making.
• To regulate industry as an essential pillar of behaviour change activity.
• To understand better the influence of policy and corporate behaviour on population-level behavioural trends.
• To continue to include brief, personalised and individualised interventions as part of a behaviour change approach where appropriate and effective.
• To better understand the relationship between people’s capacity for agency amidst the powerful cultural forces shaped in part by industries whose ‘bottom line’ will always be more important than the public health agenda.
• To explore mechanisms for engagement which have the goal of raising the critical consciousness of populations.
• To embrace a multi-­level behaviour change approach which includes critical capacity building, containment of industry and the countering of harmful corporate marketing with public health messaging.
• To better understand the actual subjects of the intended behaviour change; people with their own existing critical capacities, desires, pleasures and agencies; as people who might actually like vaping, or drinking, or for whom health and longevity are just one good among many others.
• To consider, as behaviour-­change proponents, how we know our goals are ‘right’? To consider the limitations of our own understanding of the social groups we are seeking to influence and to seek to understand change that happens in spite of our efforts?