Download - VicHealth Innovation Challenge - Alcohol: Dr Michael Livingston, University of New South Wales
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Alcohol in Australia: Key trends and recent developments
Michael Livingston
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Background – why alcohol?
Contributes to an array of health and social problems – Liver disease, heart disease, cancers, etc etc – Injuries from accidents (e.g. falls, traffic), violence – Mental health (e.g. Suicide, depression)
But: widely enjoyed, moderate consumption associated with improved health outcomes and psychological wellbeing
Societal ambivalence
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Historical consump/on data
0
2
4
6
8
10
12
14 Alcohol Spirits
Wine Beer
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Interna/onal consump/on data
0
4
8
12
16
20
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Interna/onal consump/on data
0
4
8
12
16
20
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Recent trends in consumption
Perception that alcohol is an increasing problem in Australia society – “Epidemic of binge drinking” (Rudd) – “Drink until you drop culture” (Scippione) – “Binge drinking out of control” (AMA)
Per-capita consumption is at its lowest level since the mid 1990s
Distinct shifts in drinking behaviour among young people
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Consumption
Underage drinking
0%
10%
20%
30%
40%
50%
60%
70%
80%
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
NDSHS (14-17) ASSAD (12-15) ASSAD (16-17)
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Consumption
Age at first drink (of current drinkers aged 18-24)
12.0
12.5
13.0
13.5
14.0
14.5
15.0
15.5
16.0
2001 2004 2007 2010
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Consumption
Risky drinking by young adults
0
10
20
30
40
50
60
2001 2004 2007 2010 2013
18-24 year olds 25-29 year olds
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Consumption
But...
0
10
20
30
40
50
60
2001 2004 2007 2010 2013
18-24 year olds 25-29 year olds 40-49 year olds 50-59 year olds 60-69 year olds
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Consumption trends Drinking among young people steadily declining
– Particularly those under the age of 18 – Trends appear to be consistent across an array of population
sub-groups (e.g. rich and poor, urban and rural) and not due to increasing cultural diversity
– Not offset by illicit drug use
Drinking among older cohorts is steady or potentially increasing – Some evidence that very heavy or ‘binge’ drinking is
extending into later adulthood – E.g. 5% of 30-39 year olds drink 20+ drinks at least monthly,
up from ~2% 10 years ago
Source: National Drug Strategy Household Survey, 2001-2010, pop aged 14+
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Attitude shifts
Clear evidence that public attitudes towards alcohol are shifting – Greater media concern – More worry about alcohol as a problem – Increased support for restrictions – Attitude changes not limited to particular subgroups of the
population
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Drug of ‘most concern’ for the general community
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
2001 2004 2007 2010
Alcohol Tobacco Meth/Amphetamines Heroin
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Drug causes the most deaths
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
2001 2004 2007 2010
Alcohol Tobacco
Meth/Amphetamines Heroin
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Support for restrictive policies
0
0.5
1
1.5
2
2.5
3
3.5
4
1995 1998 2001 2004 2007 2010
Price Outlets Trading hours
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Media focus of alcohol stories
Azar, White, Bland, Livingston, Room, Chikritzhs, Durkin, Wakefield (submitted) Something’s brewing: changing trends in alcohol coverage in Australian newspapers 2000-2011
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Harm trends
Generally increasing harm rates over the past decade (although road injuries and deaths are steady)
0
10
20
30
40
50
60
70
2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13
Hospital admissions Ambulance attendances Treatment episodes
Assault Family incidents Emergency Department
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Harm trends In spite of promising data on consumption, rates of
problems are high and increasing – Recent research estimates that >5,000 die each year due to
alcohol, and more than 150,000 are hospitalised – Harms are spread fairly evenly across the age spectrum
– Higher rates of injuries among young people
– Higher rates of chronic disease in older groups
– Men generally experience higher rates of harm
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Conclusions
Victorian and Australian alcohol trend data provides a confusing picture – Reasonable evidence of harm increases
– Generally stable levels of consumption, which obscure: • Major reductions in teenage drinking • Declines in risky drinking, particularly among young adults • Some slight increases in drinking among older people
– Big shifts in attitudes towards alcohol
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Conclusions
Little evidence to explain these changes – Increased public health presence in media coverage of
alcohol may be driving or reflecting changes in public attitudes
– Declines in youth consumption may represent a reaction against heavier drinking cohorts
• Reasonably good evidence that teenage consumption predicts future drinking behaviours, so current reductions are promising for ongoing gains
• Alcopops tax and secondary supply may have contributed, but can’t explain the degree of change observed
• The success of FebFast and Hello Sunday Morning may be a cause of or a reflection of changes in attitudes to drinking among young people