alcohol policy what’s happening in england? professor colin drummond st george’s university of...
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ALCOHOL POLICYWHAT’S HAPPENING IN
ENGLAND?
Professor Colin DrummondSt George’s
University of London
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Alcohol is a big problem• 90% males, 80% females drink alcohol (16 and over)• 30% males, 19% females drink above “safe” level (ONS,
2002) • 32% males, 15% females “hazardous/harmful drinkers”
AUDIT 8-15 (Drummond et al., 2005) 7M• 7% males, 3% females drink above 50/35 units/wk (ONS,
2003)• 6% males, 2% females “alcohol dependent” 16+ AUDIT
(Drummond et al., 2005) 1M
• Compared to 0.5% “problem drug misusers”
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Binge-drinking in last monthAverage number of occasions
2.1 to 2.6 (4)1.6 to 2.1 (2)1.1 to 1.6 (5)0.6 to 1.1 (4)
Source: Anderson et al., forthcoming
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Alcohol problems are increasing
• Alcohol misuse in 18-24 yr old men increased by 32% in last 12 years
• In women (all age groups) increase of 70% over same period
• In 65 years + increase of 31% in men and 75% in women
• Increase in alcohol related mortality of 25% in last 10 years (women>men)
• 23% increase in alcohol related road injuries 1993-2001
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NATIONAL A&E STUDY, 2003Hourly attendance at A&E for alcohol positive and negative attendees - proportions
0%
20%
40%
60%
80%
100%
Hour
%
ETOH-
ETOH+
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Source: ONS 2001
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“Rising consumption over the last 25 years have been accompanied by an increase in availability”
• 68% increase in licensed hotels and restaurants
• 100% increase in off licences• 145% increase in on licence applications• Increased capacity of on licenses:
“Super pubs” are now 20 times bigger than typical pubs
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Student monthly binge-drinking% bingeing 3+ times / month
24 to 32 (6)18 to 24 (6)13 to 18 (6)8 to 13 (6)
Source: Anderson et al., forthcoming
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What is planned?
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The Licensing Act 2003
explained:
“Flexible opening hours for premises,
with the potential for up
to 24 hour opening, seven days a week.”
“This will help to minimise public
disorder resulting from fixed closing
times.”Source: DCMS, 2004
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DISCLAIMER:DISCLAIMER:NO EFFECTIVE STRATEGIES HAVE BEEN NO EFFECTIVE STRATEGIES HAVE BEEN
USED IN THE MAKING OF THIS DOCUMENTUSED IN THE MAKING OF THIS DOCUMENT
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Content of the strategy
• Better education and communication
• Improving health and treatment services
• Combating alcohol-related crime and disorder
• Working with the alcohol industry
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STRATEGY IMPACT NAHRSE & LA Taxation & pricing High "more complex than price" Restricting availability High 24 hour availability Limiting density of outlets High “Local planning” Lower BAC driving limits High No change Graduated licensing for young drivers
High No
Minimum drinking age High More enforcement Brief interventions/ treatment Medium "Lack of evidence" -->
Needs assessment; evidence review; MOCA
Safer drinking environment Medium Voluntary codes: change glasses Heavier policing Medium 1902 Act, ASBOs, on the spot
fines Public education campaigns Low Change safe drinking message,
unit labelling School based education Low More education Voluntary advertising restrictions Low Yes please!
National Alcohol Strategy mapped against Babor et al., 2003 Alcohol: No Ordinary Commodity
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Some major problems
• No money• No targets• No high impact strategies• Licensing relaxation• Voluntary codes for alcohol industry• Less effective controls on alcohol
consumption• Increased criminalisation
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Policy score
Less than 9½
9½ to 10½
10½ to 12½
More than 12½
Source: Anderson et al., forthcoming
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CONCLUSIONS• Sharp increase in alcohol consumption in UK has led to
dramatic increase in alcohol misuse and alcohol related problems
• This has occurred in an alcohol policy vacuum• Government appears more persuaded by the alcohol
industry and their lobbyists than public health experts• Hence alcohol strategy designed to be acceptable to
industry and to have minimal impact on whole population alcohol consumption
• Strategy unlikely to reduce or even stem increase in alcohol misuse and alcohol related harm
• There is a need for close monitoring of indicators of alcohol-related harm
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