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Archive for the ‘Alcohol’ Category

If home is an English(wo)man’s castle, it seems it’s now also his and her local. Until now homes have been uncharted territory for studies of where, why and how people drink. But at the Royal Geographical Society’s ‘Drinking Spaces and Places’ seminar on Britons’ drinking habits in town centres and rural communities, parks and pubs, London and the regions, it was the home that took centre stage.

One of the single biggest factors in how our drinking habits and tastes have changed in the last 100 years or so has been the creation and growth of supermarkets, according to Dr James Kneale from University College London. His presentation on the history of drinking patterns in Britain also showed that the rise of the now ubiquitous stores has been phenomenal in the modern times: the number of off-licences rose by 40% in five years (1996-2001). A lot faster than on-licences. And apparently one of the fastest growing groups of ‘home-drinkers’ is women – they choose to drink at home more and more often, perhaps because alcohol harm is less visible there.

What are the reasons for drinking at home? As well as being more affordable than going down to the pub, Professor Gill Valentine from Leeds University and Dr Sarah Holloway from University of Loughborough found that their study respondents drank to relax, to entertain friends, to lift their mood and even to treat depression. Some people were also ‘aspirational’ in their drinking: having a glass of wine with a meal every night was likened to cultures in the Mediterranean. Their study also found alarming ignorance of what constitutes harmful drinking. Many respondents thought, for instance, that if they took exercise and ate a healthy diet, drinking to harmful levels wouldn’t put them at any risk.

According to Elizabeth Fuller from the National Centre for Social Research families have a significant influence over the way in which young people drink. She looked at the drinking habits of 11 to 15 year olds – the age group when most young people try alcohol – and linked them to their home environment. Apparently, children of parents who were tolerant towards their drinking are more likely to drink than children whose parents weren’t. However, if the latter did drink, they were more likely to drink outdoors, to hide their drinking, and take part in other risk-taking behaviour such as drug-taking, smoking and truancy. It could be suggested then that drinking in the home environment might lead to a more balanced and healthier relationship with alcohol – assuming of course that the parents provide their children with a responsible role model.

There’s no question, however, that drinking is a huge problem. Eric Stark from the Government Office for London highlighted that drinking behind closed doors at home can exacerbate domestic violence, another significant public health issue.

There was a clear consensus at the event that a behaviour change is necessary and the most effective intervention would be to make alcohol less available. Emilia Crighton, the Faculty’s Scottish Convenor, presented strong evidence on how alcohol minimum pricing would help curb drinking in Scotland, a particular problem spot in the UK.  But it was also agreed that minimum pricing alone wouldn’t solve everything. What is needed is for public health campaigns to challenge the image of binge drinking. The issue is, as Professor Valentine and Dr Holloway pointed out, that drinking to a harmful level in a rural community in Cumbria doesn’t match the unruly and chaotic scenes in town centres all around the country on a Friday night. The majority of people do not relate to images like this and therefore do not realise that the way they drink might be putting them and people around them at risk.

Enjoying a drink at home in front of the telly or with friends at dinner doesn’t have to be a guilty pleasure. But the rise and rise of home drinking does pose a tricky challenge to policy makers and public health practitioners alike, and needs to be looked into more if we’re to understand the nature of Britain’s booze culture.

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By Dr Emilia Crighton, chair of the Scottish committee of the Faculty of Public Health.

So the government has decided to bring in a ban on pub and club drinking promotions that encourage people to drink fast and furiously. Licensees will face fines of up to £20,000 or face a prison sentence, under this new tougher code of practice.

This is definitely a step forward in attempting to tackle a British drinking culture that encourages people to see drinking large volumes of alcohol as an achievement to crow about to friends, rather than a threat to their health.

The introduction of the mandatory code of practice banning irresponsible promotions; the need for age verification policies; and ensuring smaller measures are available, acknowledges the failure of the voluntary arrangements that have been in place until now.

Making pub and clubs offer free tap water to customers, from April, should also be welcomed. Drinking water could help drinkers slow their consumption of alcohol and tackle dehydration.

As the FPH has regularly argued, alcohol consumption in the UK has doubled over the last 40 years and the average consumption of alcohol in the population is directly linked to the amount of harm. Increases in alcohol consumption have been driven by an increase in off sales, which now represents around 51% of alcohol volume sales, up from 24% in 1980. Consumption is strongly linked to affordability: as price has fallen, consumption has risen. Alcohol is now 69% more affordable than thirty years ago. The increased affordability of alcohol has been driven by the off sales sector.

Tackling price and availability are the most effective alcohol policies aimed at reducing alcohol related harm. Research produced by the team at Sheffield University which modelled the effect of different levels of minimum pricing on alcohol consumption indicates increasing impact on consumption with increases in price. For example the introduction of a minimum price of 40 pence per unit in Scotland would have a very small effect on consumption (-2.7 per cent), while at 50 pence and 60 pence, there would be significant changes in consumption (-7.2 per cent and 12.9 per cent respectively). The higher the price, the lower the consumption, and the lower the harm caused by drinking.

However, the government needs to go further. The introduction of a minimum price per unit of alcohol sold will have the highest financial impact on harmful drinkers.  People who drink within the sensible drinking guidelines will hardly be financially affected.   For example, if a 40p minimum price was introduced, it is estimated that a moderate drinker’s spend on alcohol would go up by £11 per year (21p per week), but that of a harmful drinker, who tends to buy more, cheap alcohol, would go up by £137. The increased prices in alcohol could be offset by lower prices for food and non alcoholic drinks by the supermarkets.

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The Faculty of Public Health today publishes our joint manifesto on public health, alongside the Royal Society of Public Health. 12 Steps to Better Public Health offers a dozen practical recommendations that, if adopted by the next government, will improve the UK’s health and well-being for the new decade.

The joint public health manifesto calls for:

  1. A minimum price of 50p per unit of alcohol sold
  2. No junk food advertising in pre-watershed television
  3. Ban smoking in cars with children
  4. Chlamydia screening for university and college freshers
  5. 20 mph limit in built up areas
  6. A dedicated school nurse for every secondary school
  7. 25% increase in cycle lanes and cycle racks by 2015
  8. Compulsory and standardised front-of-pack labelling for all pre-packaged food
  9. Olympic legacy to include commitment to expand and upgrade school sports facilities and playing fields across the UK
  10. Introduce presumed consent for organ donation
  11. Free school meals for all children under 16
  12. Stop the use of transfats

The full manifesto is available to read here, and the front-page Guardian story, with an accompanying podcast from our President Alan Maryon-Davis, is available to read here.

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In the last couple of months, alcohol minimum pricing has been widely, and often fiercely, debated. To add to the discussion, the Faculty of Public Health decided to conduct a survey of its 3,000 public health specialist members to see what they thought.

Out of the 274 Faculty respondents the vast majority (87%) supported the policy of a mandatory minimum price for alcohol.

59% were in favour of raising the alcohol price to 60p per unit.  A level of 50p per unit was voted for by 35%, and only 5% thought 40p per unit was sufficient.

Professor Alan Maryon-Davis commented: “There’s a lot of evidence showing that cheap drink is fuelling Britain’s booze culture and ruining so many lives.  We need to set a minimum unit price that’s high enough to deter heavy binge drinkers without hitting too hard the much greater number of people who drink sensibly and moderately.”

The noughties saw the ban on smoking in public places.   Perhaps the next decade will witness the introduction of minimum pricing for alcohol.

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It could have been a big day for public health in Scotland. It could have been the day when notice was served on Scotland’s ugliest health blight – its rising tide of binge drinking, drunkenness and alcohol-related illness and injury.

On Thursday this week, Health Secretary Nicola Sturgeon introduced the Alcohol etc (Scotland) Bill – a raft of proposals including further restrictions on drink promotions, powers to raise the legal purchasing age to 21 and, most controversially, mandatory minimum pricing to banish all those special offers of ultra-cheap drink at ‘pocket-money prices’ lining supermarket shelves

Everyone knows Scotland has the worst alcohol problem in the UK, indeed in most of Europe. We’ve seen its alcohol-related death rates doubling in the last 15 years, and alcohol-related liver disease rising faster than almost anywhere in the world.

Drink now kills about one person in 20 in Scotland and costs the country at least £2.25 billion in extra services and lost productivity. This toll is nothing less than shocking and amounts to a huge public health crisis that demands to be tackled with steady determination.

The SNP-led Scottish Government’s Alcohol Bill looked set to do just that until it came up against the combined machinations of party politics and the drinks trade.

Just hours before the Bill was launched, the Scottish Labour Party finally decided to join the Tories and Lib-Dems in declaring themselves opposed to the minimum pricing proposal. Unless deals can be done and sensible compromises reached, this element of the Bill will fail, knocking a great hole in the new legislation.

Needless to say this is all a massive disappointment to the supporters of minimum pricing, including all four UK Chief Medical Officers, the Royal Colleges of Nursing, Physicians, Surgeons and GPs, the UK Faculty of Public Health, the BMA, the Association of Chief Police Officers in Scotland and even the Scottish Licensed Trade Association.

We at the FPH have done all we can to bring the arguments to bear, and at our recent Scottish conference have pointed out the potential gains in health, wellbeing and lives saved if the minimum price were set at various levels. Alcohol consumption is closely associated with price – and the higher the minimum is set, the more it would deter heavy drinking. But too high a price would be punitive for the great majority who drink moderately and sensibly – and could encourage crime and smuggling – so a compromise would have to be reached through rational, informed debate.

I hope that the Scottish Parliamentary process will allow such debate to take place. I hope that Labour’s newly declared position is tactical and that they will at least offer enough support to the minority SNP government to permit proper discussion. Their current argument that minority pricing is ‘probably illegal’ under EU law seems very weak when stacked up against the hugely pressing social and humanitarian issue that heavy drinking in Scotland has undoubtedly become.

This week could have seen a major step being taken on the way to better health for the people of Scotland. Despite the latest setback, perhaps it still can be.

Let us have the debate – and let us see if, once again, Scotland can set an example to the rest of the UK by taking a strong, brave and decisive step for public health.

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One in 20 deaths in Scotland is linked to alcohol, said Dr Lesley Graham at the Scottish FPH conference.

Scotland has the fastest growing rate of liver disease in the world, said Graham, public health lead for alcohol and on the policy team for alcohol in the Scottish government.

The estimated cost to Scottish society was £2.25m per year, she added.

Price and consumption were linked, she argued. “Tackling price is so important,” she said.

Education is not powerful enough on its own, she said, putting the argument for minimum alcohol pricing.

Graham’s speech at the annual FPH Scottish conference, being held in Peebles, caused a call for a vote from the floor in support of minimum pricing.

The ad hoc vote was massively in favour of the proposal.

 

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Before you put that glass to your lips, just remember that this is Alcohol Awareness Week. Just stop and think about the huge impact alcohol is having on the health and wellbeing of the nation – and perhaps on you too. Some good, some bad, some ugly.

Most of us enjoy a drink from time to time. It helps us unwind. It breaks down barriers. It helps things go with a swing. Trouble is, all too often, what unwinds is someone’s life. What breaks down is their relationships. What swings is a right hook to the jaw.

The personal, social and economic cost of alcohol-related injuries, illness and general mayhem is mounting by the minute. As our consumption rises, so does the casualty rate. About 9,000 deaths a year, tens of thousands of hospital admissions, countless A&E and GP attendances. According to Government estimates, the NHS bill was £2.7 billion at 2006-07 prices, and in 2008 the total cost of harm from alcohol across the whole UK economy was between £17.7 and £25.1 billion per year. That’s mega.

Everyone knows there’s a booze culture in Britain – not just among our young people. In fact the UK, led by Scotland, is rapidly becoming the booze capital of Europe.

But it’s only relatively recently that the real cost of booze has begun to impinge on the public consciousness. We’ve all seen the CCTV footage of staggering, threatening, puking young revellers trashing our city centres. We all know about the horrific toll of drink-drive accidents and alcohol-related domestic violence. But perhaps we’re less aware of the rising tide of alcohol-related liver disease, such as cirrhosis, affecting younger and younger drinkers. Or the links between alcohol and unwanted pregnancy. Or  the increase in alcohol-linked depression and dementia.

Much of Britain’s booze culture has been driven by an unholy alliance of the drinks industry, with its sophisticated marketing techniques, and the ‘off-trade’ (mainly supermarkets), with its deeply discounted ultra-cheap loss-leader drinks. Up till now, the ‘alcohol lobby’, which wields considerable power with HM Treasury and influential politicians of all parties, has managed to fend off attempts to use legislation to clip its wings. They argue that self-imposed voluntary codes to restrict the way drinks are advertised and marketed are working well. They say young people are not being specifically targeted, and that the industry is no longer using cool, sexy, potent or otherwise glamorous images to promote drink. And they say the issue of cheap offers should be taken up with the retailers, not with them. The retailers in turn say they are just responding to public demand.

But attitudes are beginning to shift, and I believe we are reaching the same sort of tipping point that we did a few years ago with the issue of smoke-free legislation. Of course, unlike smoking, alcohol isn’t all bad. But the public and the politicians are hardening their views and talking more about tougher action – like mandatory restrictions on advertising and marketing and banning the easy availability of ultra-cheap drink.

And as with the smoking ban Scotland is leading the way. A government-sponsored bill is currently going through the Scottish Parliament that would bring in a minimum price per unit of alcohol, together with a range of other restrictions. I don’t think England will be far behind once the election is out of the way.

Like fire, alcohol is a good servant but bad master. It is available far too cheaply. For too long we have let its promotion and marketing run virtually unfettered.  Drinking excessively is now an almost essential part of being young. The burden of ill-health this leads to is horrific. As a society, it’s time to call time on our booze culture and the drinks trade. We must bring in clear standardised labelling of alcohol content, mandatory restrictions on promotion and marketing, and a minimum price per unit to do away with ultra-cheap deals once and for all.

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