Alcohol's harm to others: PHE evidence review

Public Health England (PHE) have released an evidence review of the harm caused by alcohol to the people around those who are drinking in the UK.

The review examines alcohol’s harm to others (AHTO) based on six surveys across the  UK and Republic of Ireland, including a recent study published in the BMJ which attracted widespread media coverage. The findings indicate one in five people have been harmed by others drinking over the past year, though did not cover all AHTO, for example Foetal Alcohol Syndrome was not included.

Whilst the majority of harms were less serious issues such as sleep disruption or feeling threatened, these issues can have significant impacts including financial costs to the economy. More serious harms were largely associated with the burden of violence due to other’s drinking: 3.4% of respondents said they had felt physically threatened, 1.9% said they had been physically assaulted and 0.7% said they had been forced or pressurised into something sexual.

In terms of responses to address AHTO, the review states:

Given that alcohol consumption both causes harm and puts drinkers and non-drinkers at risk from experiencing harm from others, evidence-based policies that reduce alcohol use across society (for example duty increases, a minimum unit price, restrictions on the availability of alcohol, and marketing regulation) are likely to be most effective at reducing the total burden of alcohol-related harm and also AHTO. Targeted interventions aimed at specific issues such as parenting programmes or advice to pregnant women, could also be used to good effect.

A PHE Health Matters blog on the review also stated:

Finding ways to reduce the levels of unmet need for treatment amongst alcohol dependent adults, and in particular parents, is likely to impact on violent crime, including intimate partner violence; while programmes that reduce sales to intoxicated adults in the night time economy may also have an important role to play in that setting.

Harm to others - an appeal to policy makers?

The PHE review follows a number of previous reports attempting to highlight the scale of the problem and instigate further alcohol policy measures. In 2015 a report released by the Institute of Alcohol Studies (IAS) said the extent of alcohol harms experienced as a result of other people's drinking costs the UK economy more than £15bn each year.

In 2009 then Chief Medical Officer Liam Donaldson called for minimum pricing by highlighting alcohol's harms to others, which he termed 'passive drinking', whilst alcohol's harm to others earned it the title of most harmful drug in the 2010 drug rankings by harm.

Highlighting harm to others though may raise important questions in the context of policy making. Whilst opponents of further alcohol control measures often argue against by emphasising the role of 'personal responsibility' rather than population level policy levers, such arguments may have less public traction in the context of harm to others versus harms to self.

Indeed, attention to the issue of children of dependent drinkers has notably resulted in targeted action, albeit spearheaded by a number of influential MPs. Meanwhile, hopes for action on policy issues via a new national alcohol strategy appear to have been quelled, though further data on the impact of Scotland's MUP policy is likely to be seen as critical in the coming years.