The recent release of the Prevention Green Paper consultation for England has prompted has a series of criticisms over a lack of effective actions to address alcohol harms.
Whilst the Green Paper claims to set out a 'new approach to public health that involves a new personalised, prevention model', alcohol and heath groups have spoken out over the absence of any commitments that reflect Public Health England's (PHE) own evidence review.
The Green Paper details little about future alcohol policy, though says 'making alcohol-free and low-alcohol products more available would help to nudge the general drinking population towards lower strength alternatives'. To do this it says the Government 'will work with industry to deliver a significant increase in the availability of alcohol-free and low low-alcohol products by 2025' and review the alcohol alcohol-free descriptor threshold in consideration of changing it from 0.05% abv up to 0.5% abv.
It also states the commitment to more Alcohol Care Teams (ACTs) as identified in the Long Term Plan (LTP), and highlights the innovation fund to work with families affected by alcohol dependence.
Groups however highlighted the absence of a range of measures seen as central to large scale prevention efforts, notably minimum unit pricing (MUP) as adopted in Scotland, with Wales and Ireland seeking to follow suit. In comparison, focusing on issues such as definitions of low or no alcohol drinks may seem rather odd, whilst concerns have been raised over the exact role of such drinks in supporting public health goals. A recent Institute of Alcohol Studies (IAS) post set out a series of arguments highlighting potential reasons for caution, for example, how such products may be perceived by sections of the industry as 'extensions to regular strength alcoholic drinks rather than as substitutes for them’.
Alcohol & health groups respond
A response from Collective Voice highlights recognition of the value of treatment for substance misuse problems in the Green Paper, but says 'we are unsure though, as to why this recognition of the power of treatment has not been extended to problematic alcohol use.' Recognising the commitment to identify the challenges facing the treatment sector, Collective Voice warn that 'without sufficient resource, though, the green paper’s ambitions will remain just that — ambitions. Funding is needed to turn them into reality.'
Others highlight the disparity between seemingly more evidence-based led approaches to other areas such as smoking. A response from Alcohol Change UK describes actions to address alcohol as a preventable cause of harm are 'near absent' from the Green Paper, and that 'at its heart, there is a denial about the scale of the problem'. They argue this reflects a misconception that alcohol problems are confined to those with more severe levels of alcohol dependency, whilst in reality 'alcohol harm happens on a spectrum, and millions of us – in England alone 1.9 million at higher risk and 8.5 million at increasing risk'.
In response, Alcohol Change UK call for 'a sustainable long-term plan which addresses alcohol in all its complexity, including its intersections with other causes of harm like poverty, social isolation and homelessness, which the existing small pockets of money and piloting do not provide.' Balance North East echoed calls for an evidence led approach covering pricing, taxation, marketing and funding for treatment, as did Sir Ian Gilmore, Chair of the Alcohol Health Alliance UK, who said such measures would be 'saving taxpayers’ money in the long run'. Alcohol industry body The Portman Group 'welcomed and supported' the Green Paper's approach.
For now, it seems England's approach to alcohol policy continues to be at odds with what the majority of health and academic groups see as necessary. Hopes for a new national alcohol strategy expected this year appear to have been dashed, and with it a commitment to review the emerging evidence of MUP in Scotland. A Government response to the consultation, setting out further details, is expected by spring 2020.
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