Alcohol Alert Podcast
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In this month’s podcast we spoke to John Holmes, Professor of Alcohol Policy at the University of Sheffield, about no and low alcohol products. We discussed the project the Sheffield Alcohol Research Group is running on the topic, why these products are gaining attention, who consumes them, the concerns among public health groups, and what the market for such products will look like in the coming years. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
In February's podcast we spoke to Dr James Morris, Research Fellow at London South Bank University, about how the model of ‘alcoholism’ evolved and led to beliefs about alcohol problems being heavily focused on the severe end of the spectrum. Dr Morris discusses how Alcoholics Anonymous, despite helping a great many people in their recovery, reinforces this model and leads to people failing to recognise their own issues with alcohol. Discussing why this model can cause harm, Dr Morris stated: “I think the main way it prevents progress is through ‘othering’, essentially the process of classifying alcohol problems as belonging to an ‘other’. The alcoholic stereotype is drawn on heavily for that. We see lots of heavy drinking groups point to the ‘alcoholic other’ to distance their own drinking and protect their own drinking identify." This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
In our first podcast of 2024, we spoke to Nicola Merrin, Alcohol Focus Scotland's (AFS) Policy & Research Manager, about the Scottish Government's consideration of reintroducing a Public Health Supplement (or levy). We discussed what the previous levy raised and why it was implemented, AFS's support for a new levy, and why it's so important to introduce one now, when alcohol deaths are at record highs. Listen to the end to hear from Dr Alastair Macgilchrist, who explains next steps for minimum unit pricing in Scotland. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
In this month's podcast, we spoke to Dr Aalaa Jawad about a new report by the AHA, OHA and ASH that found that alcohol, tobacco, and junk food industries make £53 billion a year from harmful consumption. We also spoke to Susan Taylor of Balance North East, about their hard-hitting new campaign, which aims to raise awareness in the region of alcohol as a cause of cancer. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
In this month's podcast we spoke to a number of the attendees at the 7th Global Alcohol Policy Conference in Cape Town, including Prof David Jernigan of Boston University, Prof Charles Parry of the SAMRC https://www.samrc.ac.za/research/intramural-research-units/MASTRU-charles-parry, Alison Douglas and Nicola Merrin of Alcohol Focus Scotland, Chris Smith of Open Philanthropy, and Juan Tello of the World Health Organization. We asked them what they had found most enlightening during the three days, as well as what they hoped people would take away from the conference. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
In this month's podcast we spoke to economist Nicholas Woolley about a new report by Frontier Economics, which found that 184,000 preventable cancers diagnosed in 2023 will cost the UK economy £78 billion. We also spoke to Robert Stebbings of Adfam, about their new report: State of the Family Support Sector. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
In this month's podcast we spoke to Lucy Bryant of IAS and Dr Carly Lightowlers of the University of Liverpool, about their new study that found that off-trade alcohol availability is a crucial driver of alcohol-related violence. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
In our latest podcast we spoke to Anu Rumm of the Alcohol Health Alliance, about new polling data which suggests there is significant public support for political action on reducing alcohol harm. We also spoke to Ailar Hashemzadeh of Alcohol Change UK about Alcohol Awareness Week 2023. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
In our latest podcast, we spoke to Professor John Holmes, Director of the Sheffield Alcohol Research Group, about Public Health Scotland's new report which concludes that minimum unit pricing has been effective in reducing health harms and should continue. Also on our podcast, IAS's head of research Dr Sadie Boniface explains the findings of a new IAS study which highlights the inconsistency of government messaging around changes to alcohol duty over the past 15 years. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. On the podcast this month, we are joined by our chief executive, Dr Katherine Severi, to discuss her proudest moments of the last three years, our new strategy, why we are focusing on inequalities, and what she’s most looking forward to. Dr Courtney McNamara, a lecturer in public health at Newcastle University, also joined our podcast, to discuss her new analysis of the CPTPP trade deal, and why it could be a threat to public health. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. Joining our podcast this week is Susan Taylor, Head of Alcohol Policy for Fresh and Balance in the northeast. We discussed the burden of alcohol-related harm in the northeast of England, and how the region still experiences disproportionate harm compared to other English regions. Taylor explained that alcohol harm doesn’t need to be a political issue, and that whatever happens in the next General Election, any government should look at the evidence base and commit to policies to prevent further harm. Listen to the end of our podcast, where you can hear from Dr Harriet Rumgay about her recent study on the economic cost of deaths from alcohol-related cancer in Europe. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. On this month’s podcast, we spoke to Dr Peter Rice, an addiction psychiatrist and IAS's chair, about changes to alcohol duty made in the Spring Budget. Before that, we hear from Dr Sadie Boniface about a recent study that found minimum unit pricing reduced alcohol deaths in Scotland by 13.4%. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. On this month’s podcast, we spoke to Nicola Merrin, Policy and Research Manager at Alcohol Focus Scotland. We discussed the proposals within Scotland’s alcohol marketing consultation, how Nicola Sturgeon’s resignation could affect the proposals, and tactics the alcohol industry are using to fight against the proposals. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. IN THIS MONTH'S PODCAST: WHAT ARE THE COMMERCIAL DETERMINANTS OF HEALTH? The phrase ‘commercial determinants of health’ is being increasingly used in the public health sphere. But what does it mean, how does it relate to the alcohol industry, and what should our listeners reflect on? We spoke to Jeff Collin, Professor of Global Health Policy at the University of Edinburgh, about the issue. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this podcast: People, planet, or profit: Alcohol’s impact on a sustainable future. We’re pleased to announce the launch of our new report: People, planet, or profit: Alcohol’s impact on a sustainable future https://www.ias.org.uk/wp-content/uploads/2022/11/People-Planet-or-Profit-alcohols-impact-on-a-sustainable-future-IAS.pdf. On our podcast this month we discussed the most interesting findings. The report brings together the learnings from our sustainability webinar series and provides insight into: Discussing the report, IAS’ Head of Policy Jennifer Keen said: “As a society we know that we need to reduce our consumption across products generally, due to the burden on natural resources and biodiversity. “However alcohol has a dual harm, as not only does it negatively impact the environment, but also kills millions of people around the world every year. “So reducing alcohol consumption, through known, evidence-based population measures - such as reducing alcohol's affordability through an increase in duty - will improve both the health of people and also the planet.” This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this podcast: HOW ALCOHOL COMPANIES USE GENDERED NORMS TO SELL MORE PRODUCT In our podcast this month we spoke to Dr Amanda Atkinson of Liverpool John Moores University about gendered alcohol marketing. Among other things, we discussed: * The gendered tactics alcohol companies use to promote their products * Why this is worse than other product-based companies using similar tactics * And what Dr Atkinson would do if she had control over the UK’s alcohol marketing regulations This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
HOW FAR CAN WE TRUST THE LATEST GLOBAL BURDEN OF DISEASE STUDY? 🎵 PODCAST FEATURE 🎵 In the summer, the Global Burden of Disease (GBD) group published a study https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00847-9/fulltext that looked at alcohol consumption and harm, and suggested older people may benefit from drinking, while people under 40 should not drink. This conclusion was lambasted by a number of alcohol researchers, including Colin Angus in an IAS blog https://www.ias.org.uk/2022/07/15/should-we-have-lower-drinking-guidelines-for-younger-people/ and Professor Tim Stockwell in a Movendi blog https://movendi.ngo/blog/2022/08/04/how-several-hundred-lancet-co-authors-lost-a-million-global-alcohol-caused-deaths/, who criticised the study’s analysis and the data the conclusions were based on. In our podcast we spoke to Professor Stockwell about the major issues of the study, including: - Why the study has reported 1 million fewer alcohol deaths compared to its 2018 publication, despite no fall in global alcohol consumption - How various biases throw off studies and suggest health benefits of alcohol - Whether we should now distrust the GBD group - The difficulties of understanding risk This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
WHY THE ALCOHOL INDUSTRY CAN’T AFFORD TO LET US KICK OUR DRINKING PROBLEM 🎵 PODCAST FEATURE 🎵 James Wilt, PhD candidate and author of ‘Drinking Up the Revolution’ https://repeaterbooks.com/product/drinking-up-the-revolution-how-to-smash-big-alcohol-and-reclaim-working-class-joy/, writes https://www.theguardian.com/commentisfree/2022/jul/31/britain-unhealthy-drinkers-alcohol-industry?CMP=Share_iOSApp_Other that we aren’t talking enough about the influence of the alcohol industry on Britain’s unhealthy drinking habits and how alcohol’s ubiquity is largely due to “its commodification and deregulation by Big Alcohol”. Wilt states that the industry has successfully maintained self-regulation and offloaded responsibility for harm on ‘problem’ users “especially through the discourse of ‘responsible drinking’”. He argues that: “The crisis of alcohol-related harms is principally caused by the fact that the profit-motivated alcohol industry structurally incentivises higher-risk drinking”, highlighting that their profits would fall by £13 billion a year if drinkers consumed within the guidelines. As well as limiting the alcohol lobby’s power – through advertising restrictions and restrictions on density and hours of sale – Wilt argues that there also “needs to be a massive expansion of free and public alcohol-specific healthcare for higher-risk drinkers that doesn’t demand sobriety as a condition of use, including managed alcohol programmes, therapy, medication-assisted treatment and psychiatric care”. “Ultimately, this is about expanding opportunities for relaxation, socialising and pleasure in ways that don’t eventually kill, injure or harm.” IN OUR PODCAST WE SPOKE TO JAMES WILT ABOUT HIS GUARDIAN ARTICLE, AS WELL AS HIS NEW BOOK: DRINKING UP THE REVOLUTION: HOW TO SMASH BIG ALCOHOL AND RECLAIM WORKING-CLASS JOY https://repeaterbooks.com/product/drinking-up-the-revolution-how-to-smash-big-alcohol-and-reclaim-working-class-joy/. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition: Shift in England’s drinking during COVID-19 could lead to 150,000 more cases of disease by 2035 🎵 Podcast feature 🎵 The global burden of poor analysis Minimum pricing has never been promoted as a panacea Pubs: “lost forever” or consolidated? Health Disparities white paper delayed Boris Johnson “minimises” sexual harassment and blames alcohol Industry arguments dominate Commons debate on alcohol tax reform Alcohol packaging captures the attention of and creates appeal among young people Alcohol Toolkit Study: update We hope you enjoy our roundup of stories below: please feel free to share. Thank you. IAS BLOGS https://www.ias.org.uk/blog/ SHIFT IN ENGLAND’S DRINKING DURING COVID-19 COULD LEAD TO 150,000 MORE CASES OF DISEASE BY 2035 🎵 PODCAST FEATURE 🎵 A new IAS and HealthLumen modelling study suggests changes in alcohol consumption during the COVID-19 pandemic are likely to lead to thousands of additional cases of diseases and premature deaths. The pandemic saw heavier drinkers consuming more alcohol and this trend is continuing. If consumption does not return to 2019 levels or lower, England could see an additional 147,892 cases and 9,914 additional premature deaths from nine alcohol-related diseases, costing the NHS £1.2bn. Three scenarios were modelled between 2022 and 2035 to project how recent changes in drinking may affect health harm from nine alcohol-related diseases: high blood pressure, stroke, liver cirrhosis, and six forms of cancer. The research found: Joint Lead on the study Dr Sadie Boniface said: “Much of the health harm from alcohol is from chronic diseases which take years to develop. Our results shed light on the long-term impacts of recent changes in drinking patterns. “These increases in alcohol harm, lives lost, and costs to the NHS projected in our study are not inevitable. “Deaths from alcohol are at record levels, and this research should act as a ‘wake-up call’ to take alcohol harm seriously as part of recovery planning from the pandemic.” A very similar modelling study by the University of Sheffield was published at the same time and backed up IAS’ findings. The Sheffield study looked at more diseases across a longer period of time, so projected higher alcohol-related deaths and hospital admissions. Dr Boniface was interviewed on the BBC News, explaining the study findings and implications: If you missed our launch webinar, where Dr Boniface and Sheffield’s lead author Colin Angus presented their studies, you can catch up on YouTube here. https://www.youtube.com/watch?v=iQb-Nt9TvC4&t=1917s THE GLOBAL BURDEN OF POOR ANALYSIS In mid-July, a new Global Burden of Disease (GBD) study https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00847-9/fulltext#%20 was published in The Lancet. The GBD study is a long-running observational epidemiological study. Their new publication was widely covered in the media with most either stating that “alcohol is never good for people under 40” or “Young people should not drink alcohol but older people may benefit from small amounts”. The study found that for men aged 15-39, the recommended amount of alcohol before “risking health loss” was just 0.136 of a standard drink a day. For women of the same age, the “theoretical minimum risk exposure level” was 0.273 drinks – about a quarter of a standard drink a day. Among those aged 40-64, safe alcohol consumption levels ranged from about half a standard drink a day to almost two standard drinks. For those aged 65 or older, the risks of “health loss from alcohol consumption” were reached after consuming a little more than three standard drinks a day. The senior author, Dr Emmanuela Gakidou, professor of health metrics sciences at the University of Washington’s School of Medicine, said: “Our message is simple: young people should not drink, but older people may benefit from drinking small amounts.” This is in contrast to their study four year ago, which said that even the occasional drink was harmful to health and suggested governments should advise people to abstain entirely. Colin Angus wrote an IAS blog https://www.ias.org.uk/2022/07/15/should-we-have-lower-drinking-guidelines-for-younger-people/ criticising elements of the study, for instance the study saying “older people may benefit from drinking small amounts” could be seen to suggest non-drinking older people should take up drinking for its supposed protective effects. Another major issue he flagged was that the study tells you “absolutely nothing about the difference in risks between age groups or the absolute risks that people are facing as a consequence of their drinking”. In the media Mr Angus said: “Younger people are, on average, much less likely to become ill or die than their older counterparts. Assessing how we should set drinking guidelines or prioritise interventions to minimise the total harm of alcohol requires an assessment of , not risk. “The GBD’s own figures suggest that there are over 14 times as many alcohol-attributable deaths in the UK among 70-74 year-olds than 20-24 year olds, which rather contradicts the assertion in this new study that we should focus on the drinking of younger age groups.” Statistician Sir David Spiegelhalter also criticised the study on Twitter: MINIMUM PRICING HAS NEVER BEEN PROMOTED AS A PANACEA In the 22nd of July’s BMJ Editorial https://www.bmj.com/content/378/bmj.o1810, IAS’ Dr Sadie Boniface discussed the new WHO report https://www.who.int/europe/publications/i/item/9789289058094 on minimum pricing policies for alcohol, explaining the report structure and stating that minimum pricing “is an effective part of the policy toolbox for reducing harm from alcohol”. Following a number of recent reports that minimum pricing has failed in Scotland, Dr Boniface writes in the Editorial: “Minimum pricing has never been promoted as a panacea, so arguments that it does not singlehandedly eliminate harm from alcohol can be rejected. Proponents do not claim, for example, that minimum pricing is enough to reduce alcohol consumption and harm among people who are dependent on alcohol, for whom the wider healthcare and support needs are obvious. Minimum pricing is one policy in the toolbox, needed alongside others as part of a coherent strategy.” Dr Boniface discusses what a coherent policy landscape would look like, with population level policies implemented, effectively monitored and evaluated, alongside a suitably resourced and accessible healthcare system offering support. She explains that policies have to be independent from industry influence, an influence which remains a major challenge to a coherent approach. PUBS: “LOST FOREVER” OR CONSOLIDATED? According to real estate consultancy Altus Group https://www.bbc.co.uk/news/business-62031833, there were 39,970 pubs in June, down by more than 7,000 since 2012. Altus said after struggling through Covid the industry now faces soaring prices and higher energy costs. Altus said that pubs which had "disappeared" from the communities they once served had either been demolished or converted for other purposes, meaning that they were "lost forever". A 2017 IAS publication https://www.ias.org.uk/wp-content/uploads/2020/06/rp26092017.pdf found publicans often attributed pub closures to failures of their managers who are unable to respond to shifting consumer expectations. It also found supermarkets undercutting pubs in price was major threat to pubs’ commercial viability. As shown below, the gap between on and off-trade consumption has been steadily widening for many years: Another reason for pub closures is consolidation of business into bigger bars. This ONS report in 2018 https://www.ons.gov.uk/businessindustryandtrade/business/activitysizeandlocation/articles/economiesofalesmallpubscloseaschainsfocusonbigbars/2018-11-26 showed that while small pubs were closing, big pub chains were consolidating business, with employee numbers and overall revenue remaining relatively constant The Government said: "We've cut taxes for hundreds of thousands of businesses by increasing the Employment Allowance while slashing fuel duty. We've also introduced a 50% business rates relief for eligible High Street businesses and prevented bill increases by freezing the business rates multiplier, saving businesses £4.6bn over the next five years." HEALTH DISPARITIES WHITE PAPER DELAYED The Health Disparities white paper – due to be published in late July – has been delayed for the summer https://www.itv.com/news/2022-07-18/efforts-to-reduce-smoking-and-alcohol-consumption-paused-until-next-pm-is-chosen and will only go ahead if given the green light by the new Prime Minister. The white paper is set to include further legislation to increase alternatives to tobacco products and increase alcohol-free products in pubs. An ITV article said: “In recent weeks charities and other health groups have been pushing for the paper to introduce preventative measures and measures that have a population wide focus. Sources said there was a risk that a future pm could drop this agenda - although pointed out that the policies had been framed as "non-nanny state" - perhaps to try to make sure it had Cabinet support.” The white paper is said to include https://www.thetimes.co.uk/article/low-alcohol-beer-set-to-have-more-strength-phjg5xj8d a change to the classification of no and low alcohol beers. Currently no-alcohol has to be 0.5% or lower and low-alcohol 1.2% or lower. This could rise to 1% and 3% respectively. The change is said to be designed to help people cut down alcohol consumption “by helping brewers make low-strength options more appealing”. Professor Sir Ian Gilmore, chair of the AHA, suggested that more evidence was needed on low-alcohol products but said “if it could be done in a way without brand promotion, we would be supportive”. However, Gilmore said the plan was “tinkering round the edges” and that the government had “consistently put its head in the sand on evidence-based policies that have been shown worldwide to reduce harm”, mainly by increasing prices and reducing availability. BORIS JOHNSON “MINIMISES” SEXUAL HARASSMENT AND BLAMES ALCOHOL While being question by the Liaison Committee about his handling of the conduct of former deputy chief whip Chris Pincher, Boris Johnson said there’s a problem with alcohol in Westminster and that “some people simply can’t take their drink”. Conservative committee member Caroline Nokes MP asked him “have you just sat there and told us that alcohol is an excuse?”, to which Boris disagreed. In the resignation letter of parliamentary private secretary Mark Fletcher, he wrote about the Pincher assault: “You suggested that the events of that night were the fault of the colleagues who were present for allowing him to drink too much. Such a view seems to me an attempt to absolve Mr Pincher of his actions and, in so doing, to be an apologist for someone who has committed sexual assault.” Ian Hamilton, of the University of York, wrote in the Independent https://www.independent.co.uk/voices/chris-pincher-alcohol-behaviour-allegations-b2120231.html that alcohol should not be used as an excuse for predatory sexual behaviour as this displaces responsibility from the perpetrator. He wrote: “While the victim is left with the impression that it was the drug rather than the person responsible, the perpetrator tries to evade taking responsibility for what they did. This hardly gives anyone hope that this predatory behaviour will change. Even if predators become abstinent from alcohol, this won’t magically displace their thought processes and perception about what is permissible and what isn’t, in relation to others.” INDUSTRY ARGUMENTS DOMINATE COMMONS DEBATE ON ALCOHOL TAX REFORM On 7 July the Commons debated https://hansard.parliament.uk/Commons/2022-07-07/debates/9AE507E8-6359-40E9-96DD-C57F441FB9FF/AlcoholTaxation?highlight=alcohol#contribution-15D8D163-DB3D-46A6-9108-98C35D836C5F the proposed reform to alcohol duty, with discussion of its impact on the alcohol industry – particularly the wine industry – dominating proceedings. Welsh Conservative Alun Cairns opened the debate and asked for “minor adjustments” to the strength bands and Small Brewers’ Relief. Various other MPs spoke of the new system being too complicated, with too many tax bands, and how wine producers will find it difficult as wine strength is dependent on the weather. Liberal Democrat MP Daisy Cooper said: “Overall, the alcohol duty reforms proposed by the Government just tinker around the edges in dealing with the pressures facing hospitality”, seemingly not recognising the importance of the public health element of the reform. Shadow Exchequer Secretary, Abena Oppong-Asare MP, said Labour agrees the system should be simplified and be more consistent, and be balanced across public health and supporting business. She said the wine bands should be looked at, as the new system has too much red tape, as should changes to beer duty which currently would help bigger brewers more than small brewers. Oppong-Asare went on to point out the cider exceptionalism, with it having a lower rate than beer in the proposals, and asked the Treasury to explain why this is when strong cheap cider causes so much harm. Financial Secretary to the Treasury, Lucy Frazer MP responded to the majority of the concerns and said they will be looked into. She did highlight that public health was a major reason for the reform. ALCOHOL PACKAGING CAPTURES THE ATTENTION OF AND CREATES APPEAL AMONG YOUNG PEOPLE A new Stirling study https://www.jsad.com/doi/10.15288/jsad.2022.83.565 has highlighted the impact alcohol packaging has on capturing the attention of and creating appeal among young people. 50 current drinkers aged 18-35 participated in 8 focus groups, in which they were asked about a range of alcoholic products. Daniel Jones, the lead author, said: “Five main themes emerged from our data: the ubiquity of alcohol packaging; its appeal and ability to catch attention; its association with particular occasions and activities; its ability to inform perceptions; and its engagement of both visual and non-visual senses – taste, touch, sound and smell.” Notably, some participants reported purchasing alcohol products solely on pack appeal, with one saying: “I don’t actually like beer, but I bought it specifically because I liked the packaging”. Drinkers preferred exclusive-looking “limited edition” packaging over large price marks portraying the drink as value for money, as they felt value drinks were inferior. Most retained expensive or “cool” empty bottles for display or collection. Matt Lambert of the Portman Group said https://www.dailymail.co.uk/health/article-11031093/Now-experts-want-ALCOHOL-sold-plain-packaging.html: “This study demonstrates that the packaging of a product is designed to appeal to different audiences, something that would ring true across all forms of marketing and is not in itself a surprise.” He added that the group's code of practice ensures alcohol is not marketed inappropriately and highlighted how adherence to the code had contributed to “over a decade of decline in underage drinking in Scotland”. ALCOHOL TOOLKIT STUDY: UPDATE The monthly data collected is from English households and began in March 2014. Each month involves a new representative sample of approximately 1,700 adults aged 16 and over. See more data on the project website here. https://www.alcoholinengland.info/graphs/monthly-tracking-kpi PREVALENCE OF INCREASING AND HIGHER RISK DRINKING (AUDIT-C) CURRENTLY TRYING TO RESTRICT CONSUMPTION ALL PAST-YEAR ATTEMPTS TO CUT DOWN OR STOP The UK Alcohol Alert (incorporating Alliance News) is designed and produced by The Institute of Alcohol Studies. Please click the image below to visit our website and find out more about us and what we do, or the ‘Contact us’ button. Thank you. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition: International experts call for ban on all alcohol promotion 🎵 Podcast feature 🎵 ‘No clear evidence’ MUP reduces harmful drinking Vast difference in alcohol-related deaths remains between richest and poorest in Scotland Contents Unknown: How alcohol labelling still fails consumers ‘No place for cheap alcohol: The potential value of minimum pricing for protecting lives’ Sobriety tags rolled-out further despite no evidence of efficacy Irish Government makes moves to improve product labelling Brexit Freedoms Bill could deliver pint-sized wine bottles No and low alcohol sales double in the UK Alcohol Toolkit Study: update We hope you enjoy our roundup of stories below: please feel free to share. Thank you. IAS BLOGS https://www.ias.org.uk/blog/ INTERNATIONAL EXPERTS CALL FOR BAN ON ALL ALCOHOL PROMOTION 🎵 PODCAST FEATURE 🎵 Realising Our Rights https://www.alcohol-focus-scotland.org.uk/media/440171/realising-our-rights-how-to-protect-people-from-alcohol-marketing.pdf?utm_source=Report&utm_medium=PDF&utm_campaign=Alcohol+Marketing, a new report launched on 28 June by Alcohol Focus Scotland (AFS) and a group of subject experts, calls on governments across the world to introduce comprehensive restrictions on alcohol marketing in order to improve health. The publication explains how increasingly sophisticated marketing means that people are being constantly bombarded with positive messages about how alcohol enhances their lives. The alcohol marketing experts who helped develop the report point out that this seeks to build long-term relationships between people and alcohol brands, which reinforce alcohol as a social norm and ultimately contribute to high levels of consumption and harm across the world. They particularly draw attention to at-risk population groups, with children and young people, and people at risk of an alcohol problem, more affected than others. A number of additional pieces of research were commissioned to help develop the report, including research examining the impact of alcohol marketing on people with an alcohol problem. The complementary research found that this demographic has an increased susceptibility to alcohol marketing, which fosters positive alcohol-related emotions and increases their likelihood of drinking. The group’s recommendations include: Additional research for the report included analysing case studies from seven countries with marketing restrictions https://www.alcohol-focus-scotland.org.uk/media/440166/alcohol-marketing-restrictions-learning-from-international-implementation.pdf, to understand the processes, successes and challenges to introducing these restrictions. These case studies can be used by countries looking to introduce similar restrictions, to better understand issues around: Utilising a window of opportunity Opposition from the alcohol industry How to frame regulations Use of evidence and arguments The AFS report includes a human rights-based approach to marketing restrictions, highlighting that states have a legal obligation to protect citizens’ rights – such as the right to health – and that commodities that infringe on these rights need further restriction. AFS’ Chief Executive, Alison Douglas, said: “The current self-regulatory approach to alcohol marketing is failing to protect people and has led to our communities being wallpapered with promotions for a product that harms our health. “People don’t just have a to be protected from alcohol marketing they have a to be protected. A number of other countries have already imposed bans on alcohol marketing, if we want to create a more positive culture where everyone can realise their right to health, the UK and Scottish governments must act to restrict alcohol marketing.” The Scottish Government is consulting this year on marketing restrictions, and the Minister for Public Health, Maree Todd said: “I welcome this report and will study carefully its detailed findings and recommendations. I am determined to tackle the harmful impacts that alcohol marketing can have on children and young people, as well as the triggering effect it can have on heavy drinkers and those in recovery.” Tom Bennett, one of the report experts who is in long-term, abstinent recovery from an alcohol problem, said: “Alcohol marketing can be massively triggering; it’s designed to be. Seeing an image of a cold beer on a warm sunny day or a midwinter glass of whisky in front of an open fire can be highly appealing. Yet the message these images convey, that alcohol is life enhancing, is at odds with the health risks.” ‘NO CLEAR EVIDENCE’ MUP REDUCES HARMFUL DRINKING Public Health Scotland and the University of Sheffield released the final report on the impact of minimum unit pricing https://publichealthscotland.scot/news/2022/june/final-report-published-on-the-impact-of-mup-on-people-drinking-at-harmful-levels-including-those-dependent-on-alcohol/ in Scotland, which suggests that among those drinking at harmful levels or those with alcohol dependence, there is “no clear evidence of a change in consumption or severity of dependence”. It also found that some economically vulnerable groups saw increased financial strain as they ended up spending more on alcohol. Some of those surveyed reduced spending on other things such as food and utilities. PUBLIC HEALTH SCOTLAND’S THEORY OF CHANGE FOR MUP (REPRODUCED FROM BEESTON ET AL, 2019) However, there was little evidence of other negative consequences, such as increased crime or a shift to illicit substances. As this was an argument frequently used against the introduction of MUP, it is an important consideration. Further, the proportion of people who had drunk at hazardous levels in the last week fell significantly by 3.5% in the market research data. Other analyses of Scotland’s MUP have also found reductions in consumption among some population groups. Professor John Holmes, the lead researcher on the project, highlighted in a recent IAS blog https://www.ias.org.uk/2022/06/21/minimum-unit-pricing-and-harmful-drinking-mixed-findings-should-not-override-the-bigger-picture/ that MUP isn’t designed to reduce drinking for those who are dependent: “Alcohol dependence is a more complex problem than harmful drinking and is best-tackled by early identification of alcohol problems and the provision of an accessible and effective treatment system. “MUP may therefore only contribute to a reduction in alcohol dependence by preventing future cases rather than addressing current ones. “Overall, our report offers a nuanced and mixed picture of the impact of MUP on a key population of concern, with both positive and negative findings for those on both sides of the policy debate.” During a meeting of the health committee in Holyrood, Dr Sandesh Gulhane (Conservative MSP for Glasgow) claimed https://www.thenational.scot/news/20225060.public-health-expert-rubbishes-tory-msps-minimum-alcohol-pricing-claim/ that MUP was failing, and that the most vulnerable were cutting back on food to afford the high prices. Professor Petra Meier responded that pricing policies alone would not be enough to alter the consumption for some very heavy drinkers, and investment in health services is also necessary: “addiction services have had major cutbacks during Covid, they have been virtually inaccessible unless you were able to join online groups and make do with things like alcoholics anonymous online and so on.” VAST DIFFERENCE IN ALCOHOL-RELATED DEATHS REMAINS BETWEEN RICHEST AND POOREST IN SCOTLAND In related news, Public Health Scotland (PHS) also released its MESAS report 2022 https://publichealthscotland.scot/publications/mesas-monitoring-report-2022 (Monitoring and Evaluating Scotland's Alcohol Strategy) on 21 June , which shows huge inequality between the poorest and most affluent adults who consume alcohol, in terms of hospital stays and deaths. Rates of alcohol-specific deaths were five times higher in the poorest communities and hospital stays were nearly eight times higher. Vicki Ponce Hardy of PHS said the report showed that significant inequalities were resulting in "preventable" deaths: “The most recent survey data shows that almost a quarter (24%) of adults in Scotland still drink more than the recommended, low risk, weekly, drinking guideline. Among those exceeding the guideline, it's those in the lowest income group who are likely to consume the most." CONTENTS UNKNOWN: HOW ALCOHOL LABELLING STILL FAILS CONSUMERS A new study https://ahauk.org/wp-content/uploads/2022/06/Labelling_Report_2022_.pdf by the Alcohol Health Alliance (AHA) looked at alcohol product labelling information on 369 products and found that: The AHA recommends that the UK Government sets up an independent body to monitor and enforce mandatory labelling, based on the WHO’s best practice for labelling. Professor Sir Ian Gilmore, AHA’s chair, said: “Those who profit from the sale of alcohol cannot be trusted to willingly provide product information. Legislation on alcohol labelling must ensure that consumers have the full picture of the contents and risk to health of the products they buy through Government making clear labelling on all alcohol products a legal requirement. “Given the choice, most alcohol producers are leaving this vital information off the labels, keeping consumers in the dark about what’s in the products they are drinking.” PRODUCT DISCREPANCIES WERE ALSO FOUND Matt Lambert, the chief executive of the industry body the Portman Group, responded: “This report doesn’t correspond to the findings of Portman Group’s much larger and more comprehensive recent survey where we looked at 400 products including the biggest brands by market share – the ones which accurately represents what most customers are buying. That research found near universal coverage of industry best practice showing pregnancy warnings, alcohol unit information, signposts to responsibility messages, and four in five products carrying the Chief Medical Officer’s low risk guidelines. “Industry self-regulation has been responsible for voluntarily delivering greater information and awareness for consumers and the AHA’s own report shows that significant progress has been made. The sector is firmly on track to provide more information to consumers without recourse to valuable Parliamentary time, public funding or mandatory measures.” The UK Government is set to consult on alcohol product labels “in due course”. ‘NO PLACE FOR CHEAP ALCOHOL: THE POTENTIAL VALUE OF MINIMUM PRICING FOR PROTECTING LIVES’ The World Health Organization has published a comprehensive review of minimum pricing policies https://www.who.int/europe/publications/i/item/9789289058094, in order for states and policymakers to understand the best available evidence and implementation practicalities on these policies. The report looks at evidence from simulation modelling studies and real-world studies in Scotland and Canada, which show encouraging results regarding reducing overall alcohol consumption. It goes on to look at objections and concerns around minimum pricing policies, such as any adverse economic impact and increases in illicit alcohol, and finds little to support these. As Scotland struggled to introduce minimum unit pricing due to legal battles with the whiskey industry, the report discusses requirements for the policies to be consistent with international trade law. INTERNATIONAL COMPARISONS OF MINIMUM PRICING RATE As Dr Aveek Bhattacharya, one of the report’s lead authors, explained in an IAS blog https://www.ias.org.uk/2022/06/29/everything-you-wanted-to-know-about-minimum-pricing-in-one-place/ this week: “Here in one place, WHO Europe has collected a fact base on how and how well the measure works in different countries. “It is, to our knowledge, a unique resource, and we hope it will be useful to policymakers as other governments consider taking the leap in future.” SOBRIETY TAGS ROLLED-OUT FURTHER DESPITE NO EVIDENCE OF EFFICACY From the 15 June, the Government rolled-out so-called ‘sobriety tags’ further. The tags monitor alcohol through sweat and are being used for prison leavers if their probation officer thinks they could reoffend when drinking. Alcohol is believed to play a part in 39% of violent crime in the UK and roughly 20% of offenders supervised by the Probation Service are identified as having drinking issues. Justice Secretary Dominic Raab said: “We’ve seen that alcohol tags work - with tagged offenders complying 97% of the time. That’s why we’re going to double the number wearing them from 900 to 1,900 over the next two years, focusing on those leaving prison on license.” This focus on compliance while wearing the device says little about whether the scheme works in the long-term in reducing reoffending. As Dr Carly Lightowlers wrote in an IAS blog last year https://www.ias.org.uk/2022/01/11/sentencing-people-to-sobriety-and-coerced-alcohol-abstinence/: “A focus on compliance – in terms of alcohol-free days – is somewhat of a smokescreen as what is needed is evidence of whether drinking and related offending are reduced in the long term after tag removal, which is yet to be provided.” Additionally, a report https://www.nao.org.uk/report/electronic-monitoring-a-progress-update/?utm_campaign=electronic-monitoring-a-progress-update&utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term= from the National Audit Office released on 8 June said a failed plan to transform the electronic tagging system has wasted £98 million. The report says that the Government does not know if tagging offenders is helping to cut reoffending because of failings in the system, and that efforts to change the system were abandoned in March after 11 years and £153 million. IRISH GOVERNMENT MAKES MOVES TO IMPROVE PRODUCT LABELLING Last week, the Irish Examiner reported https://www.irishexaminer.com/news/arid-40901312.html that the Irish Government has made an application to the European Commission to enact regulations that would require health warnings on all alcohol products. These would include warnings regarding liver disease, fatal cancers, and consuming alcohol while pregnant. The regulations also provide for those selling alcohol in licensed premises to be required to display a notice containing the same health warnings, a link to the public health website and an indication that the alcohol and calorie content of products is available on request. The measures are contained in the Public Health Alcohol Bill, which has introduced a range of interventions including minimum unit pricing and restrictions on advertising at sporting events. BREXIT FREEDOMS BILL COULD DELIVER PINT-SIZED WINE BOTTLES In a Telegraph article https://www.telegraph.co.uk/politics/2022/06/01/simple-snip-could-put-fizz-british-wine-revolution/ on the first day of June, Brexit Opportunities Minister, Jacob Rees-Mogg, was said to be “spearheading the drive to ditch unnecessary regulations” around the sale of alcohol. One of the mentioned regulations was that sparkling wine “can only be sold in traditional champagne-style glass bottles, complete with mushroom cork and foil”. The article states that regulations about bottle sizes could be scrapped, meaning wine producers could offer pint-sized bottles for the first time in half a century. Another rule that says drinks cannot be called wine if they are under 8% could be got rid of, meaning no and low-alcohol wines can be referred to as wine, instead of synonyms such as “wine-based drink”. The article states that: “The plans, set to be outlined in the upcoming Brexit Freedoms Bill, could be enacted swiftly because legislation giving ministers the power to make the changes has already passed Parliament.” NO AND LOW ALCOHOL SALES DOUBLE IN THE UK According to alcohol market research group IWSR https://www.ft.com/content/e7ff0844-06f3-4b6a-89d8-ea2f2a329cff, sales of no and low alcohol products in the UK have doubled from 2016 to 2021, from $240m to $454m. Alcohol-free sales tripled from $52m to $184m. Emily Neill, head of research at IWSR, said promoting low-alcohol drinks was partly a commercial decision by companies: “What you’ve seen in markets such as the UK and US is consumers becoming much more conscious of their health…there’s a higher proportion of younger consumers who don’t drink at all or would like to moderate their consumption.” AB InBev said six years ago that it would aim for low-alcohol and no-alcohol beers to make up a fifth of sales by 2025, a target it admits it is unlikely to meet, with about 6% of sales currently from the products. Despite this, sales of no and low alcohol products are still very low in the UK. A study summarised in an IAS blog last year https://www.ias.org.uk/2021/12/08/who-drinks-zero-and-low-alcohol-beer-in-great-britain/ showed that of UK households that bought alcohol, only “0.92% also bought zero alcohol beer between 2015 and 2020” and only “2.17% bought low alcohol beer”. ALCOHOL TOOLKIT STUDY: UPDATE The monthly data collected is from English households and began in March 2014. Each month involves a new representative sample of approximately 1,700 adults aged 16 and over. See more data on the project website here. https://www.alcoholinengland.info/graphs/monthly-tracking-kpi PREVALENCE OF INCREASING AND HIGHER RISK DRINKING (AUDIT) CURRENTLY TRYING TO RESTRICT CONSUMPTION ALL PAST-YEAR ATTEMPTS TO CUT DOWN OR STOP The UK Alcohol Alert (incorporating Alliance News) is designed and produced by The Institute of Alcohol Studies. Please click the image below to visit our website and find out more about us and what we do, or the ‘Contact us’ button. Thank you. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition: Alcohol packaging as a health communications tool 🎵 Podcast feature 🎵 WHO marketing report exposes loophole; Assembly agrees to action plan; and industry donations to the WHO Foundation Is it enough to reduce youth exposure to alcohol ads? Should people who are overweight have lower drinking guidelines? The pollution of health discourse and need for effective counter-framing Europe ignoring alcohol harm as impediment to sustainability Alcohol Toolkit Study: update We hope you enjoy our roundup of stories below: please feel free to share. Thank you. IAS BLOGS https://www.ias.org.uk/blog/ IAS Annual Report 2021/22 Our Annual Report 2021/22 is available on our website here https://www.ias.org.uk/wp-content/uploads/2022/05/IAS-Annual-Report-2021-22.pdf, detailing the work our team has done over the past year. Thank you to everyone who has supported IAS this year! EVENTS ALCOHOL HEALTH ALLIANCE: The next AHA Seminar Session will be held on 29th June 2022 at 2PM. The speakers Dr Laura Goodwin, Jo-Anne Puddephatt and Jaz Rai OBE will be discussing alcohol harm and ethnicity, and the event will be chaired by Dr Andrea Mohan. You can sign up to the seminar on Eventbrite https://www.eventbrite.co.uk/e/aha-seminar-sessions-alcohol-harm-and-ethnicity-tickets-344166099067. WHO LESS ALCOHOL UNIT: Join the WHO for the upcoming webinar ‘Zero and low-alcohol beverages: real improvement or apparent solution?’ on 23 June 2022 at 13:30 to 15:00 CET (Central European Time). This webinar aims to raise awareness about Zero and low-alcohol beverages (NoLos) by untapping their potential and hidden pitfalls, scoping existing policy and regulatory gaps and identifying potential harm and public health measures to address a future increase in NoLos consumption. Register here https://who.zoom.us/webinar/register/WN_W-GF5GtSTWy-ai8YzOTGoA ALCOHOL PACKAGING AS A HEALTH COMMUNICATIONS TOOL 🎵 PODCAST FEATURE 🎵 A study in April https://onlinelibrary.wiley.com/doi/10.1111/dar.13469 surveyed 1,360 people aged 18-35 to understand exposure and engagement with messaging on alcohol packs, as well as support for product and health information. Participants of the study were asked questions about a vodka bottle that either had no warnings on it, small text warnings, or large text or pictorial warnings. Two fifths (40%) rarely or never saw health-related information on packs, with almost 75% rarely or never reading or looking closely into this. However, there was strong support for displaying information such as units and ingredients. Products with health warnings were more likely to be seen as unappealing and socially unacceptable, and to positively impact alcohol-related cognitions and behaviours. For instance, pictorial warnings were 10 times as likely to positively influence cognitions and behaviours. For this month’s podcast we spoke to lead author Daniel Jones, of the University of Stirling’s Institute of Social Marketing and Health, who explained that more research is needed for us to understand how effective product warnings could be in reducing harm: “The warnings on products aren’t designed to be effective or engaging. There’s definite potential for better warnings to work and consumers are entitled to know what is in the products they are consuming. Real life studies in the UK are required for us to understand the positive impact such warnings could have.” WHO MARKETING REPORT EXPOSES LOOPHOLE; ASSEMBLY AGREES TO ACTION PLAN; AND INDUSTRY DONATIONS TO THE WHO FOUNDATION A comprehensive new report https://www.who.int/publications/i/item/9789240046504 from the World Health Organization released this month highlighted the increasing use of sophisticated cross-border online marketing techniques for alcohol and the need for more effective regulation. The publication – the first of its kind from WHO to look at the full extent of marketing across national borders – stated that such marketing happens “regardless of the social, economic or cultural environment in receiving countries”. It also showed that young people and heavy drinkers were often targeted by marketing. Director General Tedros Ghebreyesus said: “Controls on the marketing of alcohol are much weaker than for other psychoactive products. Better, well enforced and more consistent regulation of alcohol marketing would both save and improve young lives across the world.” The report highlighted the issue of online advertising and difficulties regulating it, as well as sponsorship of sporting events, and targeting of young people and women. It concluded that national governments need to integrate comprehensive restrictions or bans of alcohol marketing in public health strategies. It highlighted key features and options for the regulation of cross-border marketing of alcohol and stressed the need for strong collaboration between states in this area. MEMBER STATES AGREE TO ALCOHOL ACTION PLAN In related news https://www.who.int/news/item/27-05-2022-seventy-fifth-world-health-assembly---daily-update--27-may-2022, during the World Health Assembly last week, delegates agreed to the 2022-2030 alcohol action plan https://apps.who.int/gb/ebwha/pdf_files/EB150/B150_7Add1-en.pdf to help implement the Global strategy to reduce harmful alcohol use. The strategy has not been very effective, so the action plan proposes operational objectives and principles, key action areas for Member States and relevant partners, and sets global targets, indicators, and milestones for monitoring progress. WHO FOUNDATION SHOULD NOT ACCEPT ALCOHOL INDUSTRY DONATIONS Perhaps suggesting a lack of policy coherence within the WHO, a BMJ Commentary piece https://gh.bmj.com/content/7/5/e008707?rss=1 published the week before the Assembly highlighted that the WHO Foundation – which was set up to fundraise for the WHO – does not reject alcohol industry donations and funding. Initially alcohol industry gifts and funding were red listed along with arms and tobacco, but were moved into the orange category (judged on a case-by-case basis), and then seemingly removed entirely https://who.foundation/cms/wp-content/uploads/2020/11/Gift-Acceptance-Policy-English-and-French-January-2022.pdf in January 2022. The authors of the Commentary say that this exposes WHO to potential influence by the industry’s conflicting interests. They write that the Gift Policy lacks transparency, preventing scrutiny, and that such funding should be explicitly rejected. They conclude that: “As improvements to the sustainability of WHO’s current financing model remain uncertain, safeguards against corporate influence must be strengthened. Clarification of WHOF’s policy not to accept donations from the alcohol industry is an important first step.” IS IT ENOUGH TO REDUCE YOUTH EXPOSURE TO ALCOHOL ADS? The Advertising Standards Authority published a report https://www.asa.org.uk/news/asa-report-ongoing-decline-in-children-s-exposure-to-age-restricted-tv-ads.html stating that children’s exposure to alcohol and gambling adverts on TV has decreased significantly over the past ten years: The numbers are also segmented by country, with the average number of alcohol ads seen by children in England, Scotland, Wales, and Northern Ireland each week being 0.8, 0.9, 1, and 1 respectively. However, a research publication https://academic.oup.com/jpubhealth/advance-article/doi/10.1093/pubmed/fdac046/6580637?login=false#.YnNsUlNZj50.twitter released this month shows that reality TV “bombards” young people with images of alcohol use, drawing attention to the additional considerations regarding alcohol on TV. Dr Alex Barker’s study looked at all reality TV shows that aired over the year from August 2019 and recorded any alcohol content either shown or implied. He found actual alcohol use was seen in 966 intervals across 212 episodes, with wine and champagne the most common type of alcohol consumed on screen. Using viewing figures, they estimated that alcohol content was seen 3.5 billion times by the UK population, including 197.3 million times by children aged under 16. Professor Sir Ian Gilmore responded to the study, saying that: “As alcohol is an age-restricted, health harming product, children and young people, in particular, should be protected from exposure to alcohol marketing on the television shows that they watch…the Government must introduce comprehensive restrictions to ensure that young people are protected from alcohol marketing in all its forms in TV programming.” Read our blog by Dr Barker on the study. https://www.ias.org.uk/2022/05/05/lets-get-mortal-alcohol-content-in-reality-tv-programmes-over-a-1-year-period-and-youth-exposure/ SHOULD PEOPLE WHO ARE OVERWEIGHT HAVE LOWER DRINKING GUIDELINES? At the European Congress on Obesity a study presented https://easo.org/media-coverage-from-friday-6-may/ suggested that excess weight increases the chances of developing alcohol-related cancers. The authors used UK Biobank data to show that despite drinking within the 14-unit guidelines, those who were overweight or living with obesity were three times more likely to develop such cancers. Study author Dr Elif Inan-Eroglu of the University of Sydney said: “Alcohol drinking guidelines should also consider the obesity levels of people. People with obesity, especially those with excess body fat, need to be more aware of the risks around alcohol consumption.” Dr Alison Giles drew attention to the call for improving information on alcohol packs: "What is crucial is that people who drink alcohol understand these risks, and better product labelling and public health campaigns can raise awareness of this. It's simply a case of people having the right to know the health risks of alcohol in order to make informed decisions about what they consume." Industry body the Portman Group’s Matt Lambert said: "We believe in having clear information on pack that aids rather than alienates consumers. It is likely that having varied guidance for people would be confusing, counterproductive and also potentially patronising.” THE POLLUTION OF HEALTH DISCOURSE AND NEED FOR EFFECTIVE COUNTER-FRAMING Professor Nason Maani and colleagues from the London School of Hygiene and Tropical Medicine discussed the framing of health in public discourse https://www.bmj.com/content/377/bmj.o1128 in a BMJ Opinion piece, and how large commercial actors actively shape how health issues are framed to further their economic and brand interests. Prof Maani explains that harmful product industries, from tobacco and sugar sweetened beverages to alcohol and fossil fuels, frame consumption as a matter of personal responsibility and freedom of choice, and focus on “downstream” treatment rather than “upstream” prevention efforts: “These framings reduce faith in national and international regulatory agencies, undermine the public’s trust in science and evidence, and promote industries’ preferred solutions such as self-regulatory corporate social responsibility or “better regulation” as alternatives to effective public policy.” He says to combat this we need: EUROPE IGNORING ALCOHOL HARM AS IMPEDIMENT TO SUSTAINABILITY The global alcohol prevention NGO Movendi International published an insightful paper https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0267010#abstract0 at the beginning of May which looked at alcohol policy commitments by 32 European countries in relation to the sustainable development agenda. Countries, including the UK, submitted voluntary national reviews to the United Nations’ Sustainable Development forum, however 28% of these did not mention alcohol at all despite it being an impediment to 14 of the 17 Sustainable Development Goals. Only 25% mentioned one or more of the WHO’s alcohol policy “best buys” https://apps.who.int/iris/bitstream/handle/10665/259232/WHO-NMH-NVI-17.9-eng.pdf among actions they are taking to reduce alcohol harm. The study states its findings “show that these effects are not considered in the design of measures to achieve these goals”. ALCOHOL TOOLKIT STUDY: UPDATE The monthly data collected is from English households and began in March 2014. Each month involves a new representative sample of approximately 1,700 adults aged 16 and over. See more data on the project website here. https://www.alcoholinengland.info/graphs/monthly-tracking-kpi PREVALENCE OF INCREASING AND HIGHER RISK DRINKING (AUDIT) CURRENTLY TRYING TO RESTRICT CONSUMPTION ALL PAST-YEAR ATTEMPTS TO CUT DOWN OR STOP The UK Alcohol Alert (incorporating Alliance News) is designed and produced by The Institute of Alcohol Studies. Please click the image below to visit our website and find out more about us and what we do, or the ‘Contact us’ button. Thank you. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast&utm_campaign=CTA_1
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition: Will the Health Disparities White Paper help where previous strategies have failed? 🎵 Podcast feature 🎵 Ban on drinking during football matches may be overturned after nearly 40 years ‘Sobriety tags’ to be rolled-out further, following scheme’s “success” Councils to receive £85.7 million for drug and alcohol services Parents choose a “reluctantly accepting” approach to children drinking Protecting public health in trade and investment agreements Mandatory calorie labelling on menus comes in and cracking down on gambling ads We hope you enjoy our roundup of stories below: please feel free to share. Thank you. IAS BLOGS https://www.ias.org.uk/blog/ WILL THE HEALTH DISPARITIES WHITE PAPER HELP WHERE PREVIOUS STRATEGIES HAVE FAILED? 🎵 PODCAST FEATURE 🎵 Following the February release of the Levelling Up White Paper https://www.gov.uk/government/publications/levelling-up-the-united-kingdom*, the Government is set to publish a Health Disparities White Paper this Spring, which should set out how the gap in health inequalities will be reduced and how the Levelling Up plan of delivering 5 additional years of healthy life by 2035 will be achieved. In our podcast we spoke to Alice Wiseman, Director of Public Health at Gateshead Council, about what could be expected from the White Paper, particularly in terms of alcohol. She said, “It’s really important that it’s a cross-government approach, if we don’t combine action across all wider determinants of health we won’t achieve the aspirations set out in the Levelling Up White Paper.” The Health Foundation think tank has highlighted ‘Five tests for tackling health disparities’ https://www.health.org.uk/news-and-comment/blogs/five-tests-for-tackling-health-disparities within the levelling up agenda, including that there needs to be significant investment to support the proposals – which the Levelling Up White Paper did not include – and how a cross-government approach is crucial to success. The Alcohol Health Alliance and IAS will be responding to the Health Disparities White Paper once it is published. BAN ON DRINKING DURING FOOTBALL MATCHES MAY BE OVERTURNED AFTER NEARLY 40 YEARS In November 2021, the Fan Led Review of Football Governance https://www.gov.uk/government/publications/fan-led-review-of-football-governance-securing-the-games-future/fan-led-review-of-football-governance-securing-the-games-future#chap9 was published, which set out recommendations for how to reduce issues within the game, particularly financial issues. On 25 April 2022 the Government announced https://www.gov.uk/government/publications/government-response-to-the-fan-led-review-of-football-governance/government-response-to-the-fan-led-review-of-football-governance#:~:text=The%20government%20launched%20the%20Fan,published%20on%2024%20November%202021. that it accepts or supports all ten of the strategic recommendations. Within one of the recommendations is the suggestion to assess whether the current alcohol rules – established 37 years ago – are fit for purpose. The current rules mean spectators cannot drink alcohol in sight of the pitch in England’s top five leagues. The Review refers to the “perverse outcome” of being promoted from the sixth to the fifth league and it being unaffordable to the club due to not being able to sell as much alcohol. The Government says it will consider the case for pilot schemes of the sale of alcohol in sight of the pitch, but that this “must be balanced against wider fan safety considerations”. They cited the “appalling conduct of some fans at the EURO 2020 final between England and Italy at Wembley Stadium” partly being driven by alcohol. Chief Constable Mark Roberts of Cheshire Police, previously told Sportsmail https://www.dailymail.co.uk/sport/sportsnews/article-10243043/Britains-football-cop-says-MADNESS-let-fans-drink-alcohol-stands.html that it was “madness” to lift the alcohol ban in stadiums during matches, highlighting a surge in arrests at football matches this season and the violence at Euro 2020. There is very little evidence as to how a change in alcohol sales legislation at football stadiums would affect rates of violence. The University of Stirling is currently working on a number of studies on ‘Understanding the role of alcohol consumption in football cultures https://gtr.ukri.org/projects?ref=ES%2FR008485%2F1‘. The first of these was published in December 2021 https://protect-eu.mimecast.com/s/qkoBCjvpPCR25FWhlLE?domain=journals.sagepub.com and concludes that “alcohol regulations in some nations and sports – where restrictions are based on historical disorder – may no longer be appropriate”. Focus on alcohol-related violence in football has predominantly been on violence in and around stadiums, however there should also be consideration of changes to alcohol rules potentially affecting domestic violence when spectators return home. ‘SOBRIETY TAGS’ TO BE ROLLED-OUT FURTHER, FOLLOWING SCHEME’S “SUCCESS” The Ministry of Justice has judged the rolling out of alcohol-monitoring tags “a success” and will therefore widen the roll-out https://www.gov.uk/government/news/alcohol-tags-helping-thousands-of-offenders-stay-sober to other people leaving prisons. More than 3,100 people have been fitted with such tags and it is estimated that by 2025 around 12,000 people will have had a tag. This apparent success is based on compliance to wearing the tag, with the Government stating that over 97% of those on so-called ‘sobriety tags’ have not drunk while tagged. In January, Dr Carly Lightowlers wrote a blog for IAS on the topic https://www.ias.org.uk/2022/01/11/sentencing-people-to-sobriety-and-coerced-alcohol-abstinence/, and highlighted that: “A focus on compliance – in terms of alcohol-free days – is somewhat of a smokescreen as what is is evidence of whether drinking and related offending are reduced in the long term after tag removal, which is yet to be provided.” Minister for Policing, Kit Malthouse, said, “It is not only protecting the public from the scourge of alcohol-fuelled crime – it also gives probation officers the chance to work with offenders to help them turn their lives around.” COUNCILS TO RECEIVE £85.7 MILLION FOR DRUG AND ALCOHOL SERVICES As part of the promise to implement the vast majority of Dame Carol Black’s drug review recommendations https://www.gov.uk/government/collections/independent-review-of-drugs-by-professor-dame-carol-black within its Drug Strategy, the Government has announced https://www.gov.uk/government/publications/extra-funding-for-drug-and-alcohol-treatment-2022-to-2023/additional-drug-and-alcohol-treatment-funding-allocations-2022-to-2023 the allocation of £85.7 million to local councils in additional grants to improve drug and alcohol treatment services. The release lists how much each local authority will be given for ‘Drug strategy allocation’ and ‘Inpatient detoxification allocation’. Local councils and their partners have been asked to provide plans to improve these systems, which will be agreed with the Office for Health Improvement and Disparities (OHID). The Local Government Association welcomed the additional funding https://www.local.gov.uk/about/news/lga-responds-drug-strategy-funding-allocations with Councillor Louise Gittins, Vice Chair of the LGA’s Community Wellbeing Board saying: “People with drug and alcohol problems should be able to get the right support and treatment when they need it. Councils want to see vulnerable people being given another chance to find work, rebuild relationships and find safe and secure accommodation and will work with partners to improve the life chances of those impacted by drug addiction.” It is not clear how far the Drug Strategy will go to support those needing alcohol treatment services, with references to drug treatment and support being the prevailing rhetoric. Conservative Minister Maggie Throup responded to a call for an Alcohol Strategy https://questions-statements.parliament.uk/written-questions/detail/2021-12-10/90865 by saying that “the implementation of many aspects of the drug strategy will also benefit people seeking treatment for alcohol dependency”. MPs such as Labour’s Dan Carden continue to call for a specific Alcohol Strategy: PARENTS CHOOSE A “RELUCTANTLY ACCEPTING” APPROACH TO CHILDREN DRINKING A University of Bristol study https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-12992-6 explored parental views and attitudes towards alcohol use during adolescence among their children and other young people. In general, parents felt that it was inevitable that adolescents would drink alcohol, although they were aware of the risks and were mostly disapproving. Many parents therefore chose a “reluctantly accepting” approach. The researchers write that “This approach was determined by weighing disapproval of drinking against consistency with wider culture and parental behaviour, support for autonomy of the child, and avoidance of social sanctions.” A key theme was that parents wanted to protect their relationship with their children, maintain an open, honest and communicative relationship, and ultimately limit risk and minimise harm. The researchers write that: “Various boundaries and strategies were employed to this end, including care around role modelling, gradual introductions to alcohol, boundaried provision, clear risk reduction messaging and parental monitoring.” PROTECTING PUBLIC HEALTH IN TRADE AND INVESTMENT AGREEMENTS Following a recent publication https://www.sciencedirect.com/science/article/pii/S2214109X21005702 that showed alcohol industry arguments were infiltrating World Trade Organization discussions (see our blog here https://www.ias.org.uk/2022/02/08/under-the-influence-is-the-alcohol-industry-using-the-world-trade-organization-to-lobby-against-alcohol-policies/), a number of academics have released a WHO Bulletin https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958824/ on non-communicable disease prevention policy and trade and investment agreements. The analysis identified opportunities for protecting and promoting public health in trade and investment agreements, including: The researchers write that this analysis provides support for greater engagement between the health and trade policy sectors, and that a high level of health protection in trade and investment agreements requires cooperation between disciplines, and engagement with experts in law, economics and public health policy. MANDATORY CALORIE LABELLING ON MENUS COMES IN AND GAMBLING ADS FACE A CRACK DOWN As part of the obesity strategy, from 6 April new rules https://www.gov.uk/government/news/new-calorie-labelling-rules-come-into-force-to-improve-nations-health came into force requiring calorie information to be displayed on menus and food labels for businesses employing over 250 people. The two exceptions are for food that is only on a menu for 30 days of the year or less and alcoholic drinks above 1.2% ABV. Regarding alcohol labelling, Ministers are still stating https://questions-statements.parliament.uk/written-questions/detail/2022-03-29/149354 that the consultation on mandatory labelling will “be launched in due course”. In marketing news, the Committee for Advertising Practice (CAP) has announced https://www.asa.org.uk/resource/gambling-consultation-guidance-annex-2022.html that gambling and lottery advertising will no longer be allowed to use content “likely to be of strong appeal to children or young persons”. This will include “all sportspeople well-known to under-18s” – including topflight footballers and those with large social media followings – as well as people from reality TV shows popular with young people, and any references to video game content. The UK Alcohol Alert (incorporating Alliance News) is designed and produced by The Institute of Alcohol Studies. 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Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition: Marketing and Consumption of No and Low Alcohol Drinks – event recording New way of calculating alcohol attributable deaths and hospital admissions 🎵 Podcast feature 🎵 Ireland introduces minimum unit pricing World Heart Federation strongly rebukes ‘myth’ of alcohol prolonging life Many schools use materials on alcohol harm from industry-funded sources Heaviest drinkers bought 17 times the amount of alcohol as lowest drinkers in lockdowns ‘Misleading claims’ by industry in WHO consultation submissions Children exposed to 554 brands every day, including from harmful commodities Artificial Intelligence tech trialled to estimate age of customers What language should we use and what language contributes to stigma? We hope you enjoy our roundup of stories below: please feel free to share. Thank you. IAS Blogs To read blogs click here https://www.ias.org.uk/blog/. IAS Sustainability Series Seminar 4: Alcohol & Human Rights The last seminar in our four-part series will consider human rights and alcohol, including: Workers’ rights for alcohol industry employees in the developing world Industry practices in Africa Female promotional workers’ rights and their risk of sexual harassment and assault Gender and health inequality How human rights litigation can be used as a last resort control policy Register for the event here. https://www.eventbrite.co.uk/e/240939836537 You can watch the third seminar https://www.youtube.com/watch?v=q_5eFDUEovc&t=1021s on YouTube where we discussed the alcohol industry’s sustainability commitments in the context of Corporate Social Responsibility activity. Marketing and Consumption of No and Low Alcohol Drinks – event recording On 27 January we held the launch of the findings of a new IAS-funded report by Dr Emily Nicholls of the University of York. Dr Nicholls looked at whether there is potential for NoLos to support moderate drinking, whilst highlighting problematic marketing issues that reinforce harmful drinking and gender norms. The report will be launched end of February. Catch up here: New way of calculating alcohol attributable deaths and hospital admissions 🎵 Podcast feature 🎵 At the beginning of October, Public Health England (PHE) became the Office for Health Improvement and Disparities (OHID). One of their first jobs was to publish new estimates for alcohol attributable deaths and hospital admissions, due to an updated methodology and way of calculating these figures. For alcohol-related conditions – conditions that are sometimes caused by alcohol but sometimes not – academics use what is called ‘alcohol attributable fractions’ (AAFs) to calculate the proportion of these cases caused by alcohol. As opposed to alcohol-specific conditions that are a direct consequence of alcohol use, which are far easier to work out. AAFs are calculated by looking at the relative risk of certain diseases among those who drink compared to those who don’t drink, and the prevalence of alcohol consumption across the population. AAF estimates were calculated in 2013 using the data PHE had at the time. Since then, drinking across the population has fallen on average and the relative risk has changed for 29 conditions. Therefore PHE/OHID recalculated using more up-to-date population figures. The new calculation shows a 23% reduction in deaths and admissions, however as OHID says, this “doesn’t mean that the health risk due to alcohol is lower than it was before”. It means that people are drinking less across the population, but not that the risk of drinking has changed. Also worth noting is that the shocking 20% rise in alcohol-specific deaths last year remains unchanged. Furthermore, this reduction in consumption seems to be happening among moderate drinkers, whereas heavier drinkers seem to be consuming more. Given heavier drinkers are more at risk of developing health conditions, this reduction across the adult population could be seen as a red herring. Using the new method https://www.rsph.org.uk/about-us/news/guest-blog-alcohol-attributable-deaths-and-hospital-admissions-in-england-when-the-information-changes.html there are still almost 1 million alcohol-related hospital admissions in England each year. Every few years the AAFs will need updating to reflect changes in consumption across the country. Ireland introduces minimum unit pricing The Republic of Ireland has commenced with its minimum unit pricing (MUP) policy, which sees the lowest price that can be charged for a gram of alcohol set at 10c, meaning a ‘standard drink’ — one that contains 10 grams of alcohol — will cost a minimum of €1. Here are some examples of the minimum products will now cost: Table credit: Compton Solicitors http://comptonsolicitors.ie/minimum-unit-pricing-alcohol-set-commence-january-2022 Ireland’s Minister for Health Stephen Donnelly said that “Addressing the availability of cheap strong alcohol products will reduce the disease and death caused by the harmful use of alcohol and will ensure that cheap strong alcohol is not available to children and young people at pocket money prices.” As Alcohol Action Ireland explain on their website https://alcoholireland.ie/campaigns/minimum-pricing/: “MUP can save lives precisely because it targets only the strongest and cheapest drinks, which are the alcohol products favoured by two groups most vulnerable to alcohol-related harm – the very heaviest drinkers among us, who generally seek to get as much alcohol as they can for as little money as possible, and our young people, who generally have the least disposable income but the highest prevalence of binge drinking. “MUP will have no impact on the price of a pint, or any alcohol sold in pubs, clubs or restaurants and will have little or no impact on those who drink in a low-risk manner.” Alcohol producers and retailers are divided as to whether the measure is good news for them. The chief executive of the Convenience Stores and Newsagents Association said, “I represent retailers that are hard pushed at the moment, particularly as it’s so difficult to get staff and maintain them. They’ve been through a war and it’s given them a kick in the teeth by allowing this product to effectively be exported”. Some retailers have expressed concern https://www.irishexaminer.com/news/arid-40777494.html that people living close to the border will drive to Northern Ireland to buy alcohol, where MUP is yet to be implemented. Many agree https://www.belfasttelegraph.co.uk/news/northern-ireland/all-island-approach-needed-for-minimum-unit-pricing-to-address-alcoholism-says-ni-addiction-expert-41207119.html that the policy should be an all-island policy, to avoid such issues. Eunan McKinney of Alcohol Action Ireland said: “There is no question that introducing MUP to Northern Ireland, at the appropriate rate, would help reduce the dreadful impact of alcohol harm across the community. A renewal of a political commitment to the policy is now needed from all parties as Northern Ireland heads into the next electoral cycle.” However, other retailers are less worried https://www.thetimes.co.uk/article/minimum-unit-pricing-drinks-trade-ireland-bjzcwtnx6 about any major financial impact, partly due to research from Scotland suggesting a “modest impact” on the drinks industry. For small producers and craft breweries that already sell products for a higher price, some argue it makes them more competitive with supermarkets and large multinational producers. Professor Michel Destrade of NUI Galway was critical of the policy as he argues it will make alcohol retailers and illegal drug criminals richer: “Is it wise or correct for the Government to base an economic policy on the assumptions that price is enough to deter heavy drinkers and that heavy drinkers only seek cheap alcohol?”. Destrade argues that is likely that “heavy drinkers will switch to different beverage categories, cut down on other outgoings, travel more to Northern Ireland or France, support contraband, and switch to or increase their consumption of legal and illegal intoxicants”. World Heart Federation strongly rebukes ‘myth’ of alcohol prolonging life On Thursday 20 January the World Heart Federation (WHF) published a policy briefing https://world-heart-federation.org/wp-content/uploads/WHF-Policy-Brief-Alcohol.pdf that was widely covered in the media, which stated that: “Risks due to alcohol consumption increase for all the major cardiovascular diseases, including hypertensive heart disease, cardiomyopathy, atrial fibrillation and flutter, and stroke. The widespread message for over 30 years from some researchers, the alcohol industry, and the media has been to promote the myth that alcohol prolongs life, chiefly by reducing the risk of CVD.” They recommend that advocacy societies and organisations “must play a central role in advocating for stricter alcohol control measures… To begin with, all such actors should uniformly indicate that no level of alcohol is safe, given the current evidence”. Further, they argue that cardiology societies can play a role in a range of activity including advocating for WHO’s SAFER guidelines, calling for stricter regulation of alcohol, and for specific measures such as MUP. Despite the WHF highlighting that the media and alcohol industry is somewhat to blame for this misinformation, a few papers sought comment from the trade body the Portman Group, who responded with: “It is important not to exaggerate the risk of moderate drinking and unduly alarm responsible consumers who are more than able to make informed decisions and enjoy alcohol sensibly”. On Twitter the Portman Group linked to another industry website which says, “the majority of large studies have found that risk [of CVD] is lower for individuals who are light or moderate drinkers than for those who do not drink at all”. In response to this IAS released the following statement: "The health risks of alcohol are in the news again today following the World Heart Federation (WHF) stating that “Risks due to alcohol consumption…. chiefly by reducing the risk of CVD [see above].” “The evidence on the relationship between alcohol and cardiovascular diseases continues to accumulate, with reliable information available from Alcohol Change UK, Alcohol Focus Scotland, Alcohol Action Ireland, SHAAP and the WHF. “Various media articles today sought comment from the alcohol industry on the WHF policy briefing, leading to industry organisations commenting on health matters. Research has shown alcohol industry and corporate social responsibility body funded materials may not be a reliable source of health information for the public. Health information on the risks of alcohol should be provided by independent bodies, free from conflicts of interest, just as the tobacco industry is not involved in educating about the risk of smoking." Many schools use materials on alcohol harm from industry-funded sources Research https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0259560#references from the London School of Hygiene and Tropical Medicine was publish on 12 January which found that many schools use materials to educate children about alcohol harm that come from alcohol industry-funded sources. The Guardian covered the story https://www.theguardian.com/society/2022/jan/20/uk-pupils-taught-about-alcohol-with-misleading-industry-funded-resources and said analysis by the researchers, including Dr May van Schalkwyk and Professor Mark Petticrew, found that the materials are potentially harmful because they downplay the harms drink can cause and seek to “blame-shift” responsibility for problems from manufacturers on to young people. They said: “Alcohol industry-sponsored youth education programmes serve industry interests and promote moderate consumption while purportedly educating children about harms and influences of alcohol use.” The materials they analysed are from Drinkaware, Smashed and Talk About Alcohol (a project by the Alcohol Education Trust) – all of which receive industry funding. Drinkaware swiftly removed the materials from their website and said: “The materials included in this research are out of date and don’t reflect our current guidance. They should have been removed from our website and they now have been. We’re sorry this didn’t happen sooner.” Helena Conibear, the Alcohol Education Trust’s chief executive, accused the authors of “gross misrepresentation” and including “assertion”, “polemic” and selective quotation in their findings. The publication found that the programmes promoted a familiarisation and normalisation of alcohol as a ‘normal’ adult consumer product, “which children must learn about and master how to use responsibly when older”. The materials “employ selective presentation of harms, including misinformation about cancer”. Some misleadingly imply that only heavy or excessive drinking raises the risk of the disease. Heaviest drinkers bought 17 times the amount of alcohol as lowest drinkers in lockdowns A Newcastle University study https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0261609 was published on 19 January which analysed household purchasing data to understand the change in alcohol purchasing habits in Britain during the Covid lockdowns. In a recent article https://theconversation.com/heavy-drinkers-increased-their-alcohol-consumption-the-most-during-lockdown-new-research-175174 the researchers stated that upon first review of the data there appeared to be a paradox; that despite the huge rise in alcohol harm and death in 2020, the amount of alcohol purchased remained relatively stable. Their study looked at purchase data of 79,000 British households and found that the top fifth of households who previously bought the most alcohol increased their purchasing more than 17 times that of the lowest fifth that bought the least alcohol. This contributes to evidence that suggests the 19% rise in alcohol-specific deaths https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/alcoholrelateddeathsintheunitedkingdom/registeredin2020#:~:text=In%202020%2C%20there%20were%208%2C974,time%20series%20began%20in%202001. in 2020 was due to heavier drinkers consuming more. As heavy drinkers are more at risk of alcohol harm, this increase in purchasing and consumption could have led to many being tipped over the edge into further harm and death. The study also found that those living in the most disadvantaged households increased their purchases of alcohol more than those from the least disadvantaged households. Further, households with older residents and households in the north of England increased their purchases more than other groups. Professor Sir Ian Gilmore of the Alcohol Health Alliance said: “The pandemic highlights the urgent need for the Government to take action to protect the most vulnerable drinkers and disadvantaged communities from alcohol harm. This study suggests that minimum unit pricing can make a difference to purchases.” The researchers concluded that: “Alcohol policy to reduce high consumption of alcohol, and the availability of help and treatment to reduce alcohol consumption become more important during extraordinary times, such as COVID lockdowns.” The study came out at the same time that The Royal College of Psychiatrists highlighted https://www.theguardian.com/society/2022/jan/17/millions-in-uk-drinking-harmful-levels-of-alcohol-at-home-experts-warn a big increase in the number of people drinking at ‘increasing or high risk’ levels. In the three months to the end of October 2021, 8 million people reported drinking at these levels, compared to 6 million up to February 2020, and 5 million up to October 2019. Professor Julia Sinclair, the chair of the addictions faculty at the Royal College of Psychiatrists said: “What we’re going to see is that some people who were perhaps drinking at a higher risk but weren’t physically dependent will have pushed themselves into being physically dependent, and they’re not the group who can suddenly wind back from this.” The NHS also released alcohol statistics at the end of the month https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-alcohol/2021, which show there were 976,429 hospital admissions in 2019/20 linked to alcohol – a 16% rise from the previous data collected in 2016/17 – which makes up 5.7% of all hospital admissions in England. They also highlighted the rising affordability of alcohol, which leads to increased alcohol harm, to which Dr Alison Giles was quoted by the Telegraph: “The statistics highlight the false economy of the Government’s repeated cuts and freezes to alcohol duty in recent years, which will cumulatively cost the Treasury over £16.2 billion from 2013-2027, and further increase hospital admissions and death. This increasing affordability needs to be tackled, such as with a duty ‘escalator’ where alcohol duty rises with inflation each year, a policy that could form part of an alcohol strategy.” ‘Misleading claims’ by industry in WHO consultation submissions The Centre for Alcohol Policy Research in Australia, supported by the Foundation for Alcohol Research and Education (FARE), has released a new report https://fare.org.au/wp-content/uploads/Report-Alcohol-industry-submissions-to-the-WHO-2020-Consultation-on-the-development-of-an-Alcohol-Action-Plan-A-content-and-thematic-analysis.pdf that shows alcohol companies and their lobby groups made 60 submissions to the World Health Organization’s consultation on its alcohol action plan, with many containing misleading claims and misrepresented scientific evidence”. One of the main industry demands is to abandon what they label a “problematic” 2030 target of reducing consumption by 20% and instead to focus on reducing “harmful” consumption – a call that researchers and alcohol control advocates deem to be less effective due to its vagueness. 90% of the industry submissions called for greater alcohol company involvement in harm reduction and policy making and over 50% cast doubt on WHO’s evidence-based policies. Only 36% referenced any specific evidence to support their arguments, with most promoting weak evidence or misinterpreting it. FARE’s Chief Cxecutive Caterina Giorgi said https://www.smh.com.au/politics/federal/australian-booze-lobby-urges-who-to-abandon-plan-to-slash-consumption-20220120-p59psk.html alcohol companies had been lobbying for decades to “minimise health concerns and delay effective measures” to reduce alcohol’s health impacts and they should have “no role in the development of health policy”. ABA president Andrew Wilsmore said the industry has a legitimate role to play in policies that affect them, “to ensure that those policies are effective, efficient and grounded in reality”. Wilsmore said “We focus on supporting effective programs that focus on education, awareness and changing behaviours relating to alcohol consumption”. Such measures have been repeatedly denounced by public health experts as ineffective, especially compared to evidence-based policies advocated for by the WHO. In 2017 Professor Mark Petticrew wrote that https://jech.bmj.com/content/71/11/1078 “the argument against the implementation of effective population-level measures appears to be constructed from at least five frequently recurring elements” including “claims that information, education and personal responsibility are the appropriate and/or most effective solutions”. Artificial Intelligence tech trialled to estimate age of customers Five major supermarkets will be trialling https://inews.co.uk/news/technology/co-op-tesco-asda-aldi-morrisons-supermarkets-trial-facial-age-estimation-tech-buying-alcohol-1406501 facial age estimation technology between January and May this year, via self-service terminals. The technology – Yoti – will take photos of consenting customers who have alcohol in their basket and will estimate their age. The tech claims to have an average accuracy of within 2.2 years for all ages, and within 1.5 years for people aged 16-20 years old. The machine will delete the photos after estimation. During the trial customers will still be required to present ID if asked. The trial is part of the Government’s ‘regulatory sandbox’ https://www.gov.uk/government/publications/age-verification-technology-in-alcohol-sales-regulatory-sandbox/call-for-proposals, which looks to test ways to “improve the experience of consumers and retailers when purchasing age restricted products”. At the end of 2021 IAS published a report developed by Jessica Muirhead of Wrexham Glyndŵr University on ‘Preventing underage alcohol purchasing online using payment card details’ https://www.ias.org.uk/wp-content/uploads/2021/12/IAS-Preventing-underage-alcohol-purchasing-online-using-payment-card-details.pdf, which the Government is looking at as an option. Children exposed to 554 brands every day, including from harmful commodities A New Zealand study https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(21)00290-4/fulltext that placed wearable cameras on 90 children aged 11-13 found that they were exposed to a mean average of 554 brands per 10 hour day, almost a brand every minute. The brands were seen predominantly as product labels (36% of exposures) and product packaging (22%), and mostly in school (43%) and at home (30%). Food and beverages were the dominant product category with 20% of exposures and the most pervasive marketing brands typically sold a range of products across more than one product category. For instance children were exposed to Nike on average 20 times per day. Children were exposed to more than twice as many harmful commodities as core food and social marketing messages (76 compared to 32 per 10hr day). Harmful commodities included junk food, alcohol and gambling. The researchers concluded that: “Given the key role marketing plays in establishing and supporting consumption norms, and perpetuating the normalisation of overconsumption which contributes to environmental degradation, these findings suggest an urgent need to reduce marketing to promote planetary health.” What language should we use and what language contributes to stigma? Dr Kristen Fuller writes https://www.psychologytoday.com/us/blog/happiness-is-state-mind/202201/stigmatizing-language-in-mental-health-and-addiction that our brain responds to words with a process we call “associative activation”, where after hearing a word we form an idea followed by an emotion which then produces an action or reaction. She says that as a result, words have “an immediate, visceral adverse reaction. When we hear words like “crazy,” “addict,” or “alcoholic,” we immediately label the individual as bad, simply because of the stigmatising language that our brain processes into a visceral negative emotion”. Dr Fuller writes that reframing terms to be more “person-centred” means we don’t define people by their illness e.g. instead of calling someone “mentally ill” say “a person living with a mental health condition”, or “a person living with an alcohol use disorder” instead of “an alcoholic”. Alcohol Change UK (ACUK) has an excellent briefing https://alcoholchange.org.uk/policy/policy-insights/how-do-we-talk-about-alcohol on its website which discusses how we should talk about alcohol. ACUK is currently working with https://alcoholchange.org.uk/blog/2021/creating-a-more-compassionate-national-conversation-about-alcohol-harm the University of Stirling on a project that will look at how we frame alcohol harm. The UK Alcohol Alert (incorporating Alliance News) is designed and produced by The Institute of Alcohol Studies. Please click the image below to visit our website and find out more about us and what we do, or the ‘Contact us’ button. Thank you. Subscribe at instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition: ‘No Escape: How Alcohol Advertising Preys on Children and Vulnerable People’ ‘Sobriety ankle tags’ rolled out after successful pilot Cross party group of MPs demands better approach to reduce alcohol harm Disagreement over alcohol duty reform Scottish LibDems and 28 NGOs call for minimum unit price to increase Diageo’s Christmas ‘responsibility’ campaign normalises excessive drinking No major economy covers the cost of harm from alcohol, tobacco and sugar Alcohol-fuelled incidents at Wales rugby matches spark criticism We hope you enjoy our roundup of stories below: please feel free to share. Thank you. Event: New IAS report on restricting underage alcohol purchases Join us on Wednesday 8 December for the launch of our new report on ‘Preventing underage alcohol purchasing online using payment card details’. Register here https://www.eventbrite.co.uk/e/187665621927. With a growth in online purchasing, particularly since the pandemic, online age verification for buying alcohol is increasingly important. Currently most systems are poor, such as relying on honesty policies or uploading documents. In a new IAS-commissioned report, Jessica Muirhead looks at how 'Merchant Category Codes' could be used for online alcohol purchases. Every time a payment is made on a bank card, a code is sent with payment details to identify the type of transaction. This is already used to prevent under-18s from gambling and would better protect retailers from illegally selling alcohol to under-18s. This month’s IAS blogs Link to blogs https://www.ias.org.uk/blog/ Alcohol Toolkit Study: quarterly update UCL’s quarterly alcohol data suggest that the number of increasing and higher risk drinkers has steadily increased since May 2021. Prevalence of increasing and higher risk drinking (AUDIT) Increasing and higher risk drinking defined as those scoring >7 AUDIT. A-C1: Professional to clerical occupation C2-E: Manual occupation Currently trying to restrict consumption A-C1: Professional to clerical occupation C2-E: Manual occupation; Question: Are you currently trying to restrict your alcohol consumption e.g. by drinking less, choosing lower strength alcohol or using smaller glasses? Are you currently trying to restrict your alcohol consumption e.g. by drinking less, choosing lower strength alcohol or using smaller glasses? All past-year attempts to cut down or stop Question: How many attempts to restrict your alcohol consumption have you made in the last 12 months (e.g. by drinking less, choosing lower strength alcohol or using smaller glasses)? Please include all attempts you have made in the last 12 months, whether or not they were successful, AND any attempt that you are currently making. ‘No Escape: How Alcohol Advertising Preys on Children and Vulnerable People’ On 30 November the Alcohol Health Alliance launched a new report https://ahauk.org/wp-content/uploads/2021/11/MarketingReport-FINAL.pdf that looks at alcohol marketing in the UK and calls for the Government to introduce restrictions to such marketing in order to protect children and vulnerable people. Discussing the prevalence and ubiquity of alcohol marketing, the report shows that advertising is across an enormous range of sectors, using a range of mediums: at sporting events, festivals, TV entertainment, theatres, across outdoor media. They rebut the industry assertion that marketing is simply about brand switching and doesn’t increase and encourage consumption. The AHA argues that: “The alcohol industry logically requires the continual recruitment of new generations of drinkers. Indeed, many brands see marketing as a key way to recruit new consumers and some specifically target the youngest demographics of legal drinkers.” The report focuses on the danger of marketing to children and those in recovery. The AHA writes that it normalises alcohol and “creates a culture where alcohol is seen as an essential part of everyday life”. Respondents to the report’s survey said this led to pressure on them to drink in order to fit into that perceived culture. As the report states, studies have shown that children who are exposed to alcohol advertising are more likely to start drinking earlier in life, and subsequently will consume more. They are also more likely to develop alcohol dependency later in life. The AHA report asserts that the UK’s self- and co-regulatory approach to alcohol marketing fails to protect children from exposure to large amounts of marketing, with studies showing that children are aware of alcohol adverts and that they appeal to them too. Although there is less data on the effect of adverts to people in recovery, survey respondents discussed how marketing and imagery of alcoholic products is highly triggering and likely to increase relapse. They argued it should be treated like tobacco due to the harm it causes. The Office for Health Improvement and Disparities agrees that the current system is flawed, stating: “A consistent body of research demonstrates considerable violations of content guidelines within self-regulated alcohol marketing codes, suggesting that the self-regulatory systems that govern alcohol marketing practices are not meeting their intended goal of protecting vulnerable populations.” What is the AHA calling for? In order to catch-up with many other countries across the world who have implemented alcohol marketing restrictions – such as Ireland, Finland, France, and Russia – the AHA report was clear on its policy recommendations: ‘Sobriety ankle tags’ rolled out after successful pilot Following a seemingly successful pilot for community sentences, ‘sobriety ankle tags’ have been rolled-out https://www.gov.uk/government/news/offenders-to-be-banned-from-drinking-to-cut-alcohol-fuelled-crime for ‘serious and prolific offenders’. Those who are known to reoffend after drinking alcohol will face a potential ban from drinking or limitation to the amount they can consume. The tags can detect alcohol in the wearer’s sweat and alert probation services if detected. An estimated 12,000 people will wear the tags over the next three years and judges can either include a condition that requires up to a year of abstinence, or have the person’s alcohol monitored with a defined level allowed. Previously the Government has said https://www.independent.co.uk/news/uk/home-news/alcohol-crime-sobriety-tag-moj-b1824449.html?r=86442 the tags would not be used on adults who are alcohol-dependent or suffering from certain medical conditions, and that they would not be intended as a treatment for alcoholism. The formal name for the requirement is ‘Alcohol Abstinence Monitoring Requirement (AAMR)’, and will be rolled-out in Wales first, with England following suit in summer 2022. Those who are banned from drinking and contravene the order could be: Fined Have their order extended Imprisoned The Ministry of Justice says that the tags will help reduce the level of alcohol-related crime, with alcohol playing a part in 39% of all violent crime in the UK. They also state that such crime costs the UK economy around £21.5 billion every year. Discussing the pilot projects that saw such tags fitted to people with community sentences, Justice Secretary Dominic Raab said: “This innovative technology has been successful in policing community sentences with offenders complying over 97 percent of the time. Offenders now have a clear choice. If they don’t work with probation staff to curb their drinking and change their ways, they face being sent back to jail.” What are the legal complications? Dr Arianna Andreangeli, of Edinburgh Law School, has previously raised concerns https://www.shaap.org.uk/blog/318-sobriety-tagging-arianna-andreangelli.html about the potential legal issues surrounding the policy, stating “there is no doubt that it constitutes an intensive interference with the individual’s right to private life, as enshrined in the European Convention on Human Rights”. She questioned whether there are sufficiently strong safeguards to accompany the policy in protecting these rights. A 2012 paper https://www.researchgate.net/publication/224770438_Reducing_the_harmful_effects_of_alcohol_misuse_The_ethics_of_sobriety_testing_in_criminal_justice however, argued that “the law clearly permits the imposition of sobriety conditions, and there are no convincing grounds for objections based on human rights law”. The authors went further, stating that “in fact, given the prospective benefits to both offenders and the public, it would be extremely unethical not to implement the scheme”. What are the health concerns? When the pilot projects were launched, a number of NGOs highlighted that that the tags needed to be implemented within a holistic system of support and prevention. Nuno Albuquerque, an Addictions Counsellor at the UK Addiction Treatment Group has previously said https://www.independent.co.uk/news/uk/home-news/alcohol-crime-sobriety-tag-moj-b1824449.html: “What they're doing in effect is just slapping a sticking plaster over the top of a person's open wound. Tagging them simply stigmatises them for drinking alcohol and doesn't address the root cause of the problem.” “Collaborative support between probation teams and treatment providers needs to be in place so that when the tag comes off, the person won't want to drink, rather than being forced not to drink.” Dr Richard Piper, Chief Executive of Alcohol Change UK, echoed https://www.google.com/search?q=richard+piper+sobriety+tags&rlz=1C5CHFA_enGB958GB958&ei=1UmeYb6UMZGUkwWKjrLYAQ&ved=0ahUKEwj-0orRmLH0AhURyqQKHQqHDBsQ4dUDCA4&uact=5&oq=richard+piper+sobriety+tags&gs_lcp=Cgdnd3Mtd2l6EANKBAhBGAFQ-gVYjw5gtBBoAnAAeACAAXOIAesFkgEDNS4zmAEAoAEBwAEB&sclient=gws-wiz Nuno’s concern about the risk of stigma, saying that there is risk of reinforcing the stigma that people living with alcohol problems face, reducing the likelihood of them seeking support. He said: “We must address problem drinking as a whole, including preventing it before it starts. We need a properly funded alcohol treatment system that is well-integrated with other forms of health and social care. We need to encourage those whose drinking is increasing to seek help before it becomes a serious issue, and make it easy for them to do so.” This touches on an important aspect of the policy: that it is reactionary and may do little to reduce the number of people initially engaging in alcohol-fuelled crime. The Ministry of Justice is focusing on the 97% compliance rate as they have no data on whether the tags actually reduce crime, especially when the tags come off. Further, as Dr Piper points out, there is little evidence to suggest the scheme will reduce drinking in the long-term, after the tags have been removed. Cross party group of MPs demands better approach to reduce alcohol harm On 25 November the Commons debated https://hansard.parliament.uk/Commons/2021-11-25/debates/BCD8D8C1-3FD0-49F9-8473-E0DCEDB5E332/AlcoholHarm?highlight=alcohol#contribution-DD4636C2-657A-4B09-A3DC-C932CF2502D7 alcohol harm, with a group of cross-party MPs calling on the Government to improve their response to a growing crisis. The debate, jointly secured by Labour MP Dan Carden and Conservative MP Derek Thomas, highlighted the harm alcohol causes to individuals, society and the economy. There was consensus among the parliamentarians present that the Government is not doing enough and needs to launch an alcohol strategy to tackle the rise in deaths and liver disease. Thomas said the strategy needs to be part of the Covid recovery plan and that minimum unit pricing needs to be introduced “without delay”, as it’s already been shown to work in Scotland. Thomas said: “Far from being an issue for individual responsibility, as it is often framed by the industry, there is a compelling case for Government intervention to end the cultural celebration and normalisation of alcohol in public, while vulnerable individuals suffer harm and stigma behind closed doors. Never before has action on alcohol been so urgently needed as it is now. We must do more; we must do better.” Labour MP Liam Byrne spoke of his personal experiences as a child, with a father who struggled with alcohol problems: “Trying to make yourself invisible to disappear from the shame of some terrible public incident; the chronic insecurity; the bouts of violence; the hospital visits; and the trouble with ambulances. There is the pervasive sense of guilt. Am I doing enough? Is my father okay? Is he eating? Is he starving? Or is he on a floor somewhere?”. Shadow Public Health Minister, Alex Norris, highlighted the cuts to treatment services and that Labour wants labelling on products to be improved as “It is about informed choice; we know that that is what customers want too”. Maggie Throup, Parliamentary Under-Secretary of State for Health and Social Care, said the Government have agreed to carry forward the recommendations of part two of Dame Carol Black’s independent review of drugs and will publish a drug strategy later this year which “will also benefit people seeking treatment for alcohol dependency”. Disagreement over alcohol duty reform Following the Government’s October Budget announcement that included proposed reforms to our outdated alcohol duty system, the House of Commons and Lords have discussed the potential impact of the changes. Industry figures too, have reflected on how the reforms will play out. Conservative peer Lord Kamall, Parliamentary Under-Secretary of Health, responded https://hansard.parliament.uk/Lords/2021-11-02/debates/90F52C50-F829-4487-9D43-8A379D9CC4A6/AlcoholDuties?highlight=alcohol#contribution-25F34606-A754-4721-8E29-8CB0626A73E5 to criticism from Labour’s Baroness Hayter, who said freezing duties will be bad for public health, by stating that public health advocates have been calling for this reform for years. Lord Kamall argued that the change will encourage alcohol producers to develop and push lower strength products, and the public to consume these cheaper, lower strength products, which will reduce harm. Baroness Finlay questioned what the Government’s contingency is if the reform doesn’t reduce harm. Kamall responded that a programme is underway to address alcohol harm, including setting up alcohol care teams in hospitals and supporting children of dependent parents. In the Commons many agreed with the duty reform, with Conservative Dehenna Davison focusing on ciders /My%20inner%20low-%20tax%20Tory%20let%20out%20a%20massive%20cheer%20when%20I%20learned%20that%20fruit%20ciders%20were%20going%20to%20see%20a%20reduction%20in%20duty%20as%20well, with: “My inner low-tax Tory let out a massive cheer when I learned that fruit ciders were going to see a reduction in duty as well”. The SNP’s Carol Monaghan asked Davison whether she recognises “that fruit ciders have been linked to alcoholism in children, and that it is not necessarily a good thing to cut the tax on them?”, to which Davison responded that cutting tax is generally a good thing, but has to be alongside a proper public health strategy. Other Scottish MPs pointed out wider issues with the reform, with the SNP’s Peter Grant saying that successive British Governments have failed “to put the wellbeing of the people front and centre of their taxation and spending plans”, highlighting the wealth various Scottish distilleries bring to Westminster coffers but not to the local Scottish populations, many of whom live “on or below the breadline”. Alcohol industry figures have also pointed out perceived flaws to the reforms, with the Wine & Spirit Trade Association’s Chief Executive, Miles Beale, stating https://www.thedrinksbusiness.com/2021/11/the-jurys-out-on-just-how-fair-sunaks-duty-reforms-will-prove-to-be/: “We are mystified by a proposal that embeds unfairness between products meaning that beer will be taxed between 8p and 19p per unit, wine increases to 26p per unit and spirits remain at 29p per unit.” There is undoubtedly a level of unfairness between how much alcohol will be taxed between the ABV strength 3.5-8.4%, with cider paying under half that of beer, wine and spirits. No clear rationale was provided for why beer is charged double that of cider between these strengths. The Grocer file:////Users/jemroberts/Dropbox%20(IAS)/IAS%20Team%20Folder/IAS%20What%20We%20Do/Alcohol%20Alert/2021/11-2021/•%2509The%20Grocer%20argues%20that%20much%20of%20the%20duty%20reform%20makes%20sense,%20with%20the also argued that although much of the duty reform makes sense, the “glaring exception” was that of reducing draught duty only for containers 40 litres and above. They said this will punish small British brewers who tend to use 20-30 litre containers. The Guardian https://www.theguardian.com/food/2021/oct/29/craft-beer-brewers-say-rise-in-alcohol-duty-threatens-their-business agreed with this, saying small producers argue the plans “would stifle innovation and favour large corporations” - as it’s the big brands that cause harm, not small independent producers, even those making high-strength drinks. In response https://questions-statements.parliament.uk/written-questions/detail/2021-11-08/71324 to a Parliamentary Question, Exchequer Secretary Helen Whately said that “We will discuss the size of containers that will qualify for the relief with brewers as part of our consultation process.” Conservative MP Mike Wood was reported https://www.expressandstar.com/news/politics/2021/11/08/ministers-urged-to-ramp-up-support-for-pubs-after-budget-boost/ as being “confident” that this limit will be reduced to 20 litres. Scottish LibDems and 28 NGOs call for minimum unit price to increase In mid-November the leader of the Scottish Liberal Democrats, Alex Cole-Hamilton, called for https://www.heraldscotland.com/politics/19716433.libdems-want-alcohol-minimum-unit-price-increased/ minimum unit pricing (MUP) to be increased from 50-65p in Scotland. Mr Cole-Hamilton said: "Alcohol misuse can wreck lives. Even today we are seeing an average of 20 people per week die due to alcohol misuse. Experts have suggested that raising the minimum unit price to 65p in line with the original ambition of the policy would cut alcohol misuse and reduce the pressure on our health and justice systems.” He added that once it is increased it should be linked to inflation and thus increased each year, in order to avoid a diminishing effect over the years. SNP Public Health Minister, Maree Todd, confirmed that the Scottish Government has "begun to gather information in order to review the minimum unit pricing of alcohol". This call was followed on the 19 November by a group of 28 health charities and medical experts, who urged the Scottish Government to increase MUP to 65p to help reduce harm. Alcohol-related deaths in Scotland The group included Alcohol Focus Scotland, with their Chief Executive Alison Douglas saying: “We need to off-set both the effects of inflation and of the pandemic, and adjust the minimum unit price to a level that will save more lives and prevent a new generation from developing an unhealthy relationship with alcohol.” Dr Alastair MacGilchrist, chairman of Scottish Health Action on Alcohol Problems, said that there is a “sweet spot” when setting MUP: “If you set it too low it's not going to be effective, but if you set it too high it's going to have an unfair impact on moderate drinkers. We think that raising to at least 65p would be the correct level just now and would certainly save lives.” A day before, on 18 November, Nicola Sturgeon responded to a question on raising MUP during First Minister’s Questions, saying that the evaluation was ongoing, and any changes needed to have a “robust evidence base”. "Prior to the pandemic, we were seeing early encouraging signs of a reduction in alcohol sales and a reduction in alcohol specific deaths. The pandemic and the changed legal landscape post-Brexit are two significant events that are impacting on this work and must be factored into the analysis." Diageo’s Christmas ‘responsibility’ campaign normalises excessive drinking The alcohol giant is in full festive swing, recently launching both a bold marketing plan https://www.marketingweek.com/diageo-grow-market-share/ and a corporate social responsibility (CSR) campaign https://www.thedrinksreport.com/news/2021/18693-diageo-launches-responsible-drinking-campaign.html called ‘Know When to Stop’. Within its marketing plan, Diageo is looking to grow its market share by a huge 50% by 2030, using the following tactics: Ironically perhaps, another target for 2030 is to reach 1 billion people worldwide with dedicated ‘responsibility’ messaging. Their Christmas campaign ‘Know When to Stop’ involves a number of animations https://www.youtube.com/watch?v=2TsfPNLF3Nw depicting “overindulging in common holiday pleasures, such as eating sweet treats, binge-watching television and films, and over-decorating your home”. Each animation ends with the line “There’s a happy limit to everything. Drink Responsibly”. It could be argued that this comparison of excessive alcohol consumption and other ‘over-indulgences’ such as decorating one’s home aims to normalise drinking. In a 2019 BMJ blog, Professor Mark Petticrew and Dr May Schalkwyk argued that: “Christmas is a favourable time for the alcohol industry owing to a rise in marketing and sales, and an increase in events during which alcohol is served and consumed. However, this period also poses a threat to the alcohol industry as the adverse social and short-term health impacts potentially become more visible, and this visibility risks elevating public and media awareness of alcohol harms. To deal with these public relations risks, the alcohol industry is well versed in employing corporate social responsibility initiatives”. They pointed out that: “These attempts by the alcohol industry at promoting safety during this time of increased risk from alcohol harms, may actually be something different: mixed messages that normalise or even promote drinking heavily while attempting to minimise the visibility of short term overt harms, thereby ensuring that the industry gets its gift this Christmas—increased profits partnered with an unharmed corporate image.” No major economy covers the cost of harm from alcohol, tobacco and sugar The Centre for Global Development, a US international development think tank, published a paper https://www.cgdev.org/publication/meeting-global-health-challenge-reduce-death-and-disability-alcohol-tobacco-and-sugar on 17 November that looked at taxes on alcohol, tobacco, and sugar, across 25 major economies, and whether they cover the cost of the harm they cause. The authors write that carbon taxing has garnered a lot of interest recently, whereas corrective taxes on the mentioned three products are “comparatively overlooked”. They state that these taxes “fall far short of the huge negative externalities and self-imposed costs from alcohol, sugar and tobacco”. Across the 25 countries, which account for three-quarters of global GDP, 60 million productive life years are lost every year due to the harm these three products cause, with an economic cost of $2.1 trillion each year, about 2% of GDP in advanced economies. The following graph highlights how none of these countries get back the money lost in harm, with Bangladesh the closest to recouping the money, and Russia and Ukraine furthest away. When looking at alcohol individually, Turkey is the only country that raises enough tax to cover finances lost due to alcohol harm. The authors argue that such taxes “should be a routine part of the advice provided by international financial institutions to emerging markets and advanced economies with high rates of consumption” and that the IMF and World Bank are paying “growing but still limited attention to these kinds of taxes in operations in fiscal policy”. IAS will shortly publish a blog by the authors on the subject. Alcohol-fuelled incidents at Wales rugby matches spark criticism BBC Wales published a story https://www.bbc.co.uk/news/uk-wales-59377882 on 23 November highlighting a number of alcohol-related incidents at rugby matches in Wales during the Autumn internationals. These incidents included a child being vomited on, a boy being given £20 after having a beer spilled on him, and pitch invaders in two matches, one of which potentially prevented Wales from scoring a try. The article quotes a liver specialist, Dr Dai Samuel, who said, “the halo of rugby has well and truly slipped this autumn”. It goes on to quote IAS’ Dr Sadie Boniface, who said: "The normalisation of heavy drinking in relation to sport is at odds with the health benefits of participating in sport. Alcohol marketing also means alcohol is virtually unavoidable in sport. For example, in the 2020 Six Nations, there were alcohol references several times a minute https://www.ias.org.uk/wp-content/uploads/2021/09/Alcohol-marketing-during-the-2020-six-nations-FINAL.pdf. There is a link between alcohol sponsorship in sports and alcohol consumption, including among children and young people.” Dr Boniface argued that IAS would like to see similar legislation in the UK to Ireland, which has banned alcohol advertising during sporting events. Interestingly, the framing of the new law by some https://www.thedrinksbusiness.com/2021/11/loi-evin-equivalent-introduced-in-ireland/ seems to already be comparing it to the French Loi Évin rules, which are often circumvented by using ‘alibi marketing’: using marketing that is synonymous with a brand without directly mentioning it. The Welsh Rugby Union said: "It is policy for our staff to intervene if people are visibly intoxicated - this happens in three main areas: The turnstiles where people can be denied entry, at the point of sale if they try and buy alcohol, and in the stadium bowl." The story also quoted a previous IAS blog by Habib Kadiri, who asked "why we haven't extended the alcohol ban to all sporting grounds? Perhaps it is because no other sports have attained football's notoriety. But why risk it?". In a recent Parliamentary Question https://questions-statements.parliament.uk/written-questions/detail/2021-10-18/hl3153, Baroness Hayter asked what plans the Government has “to protect children and vulnerable populations from exposure to alcohol marketing”, following the IAS, SHAAP and AAI Six Nations marketing report https://www.ias.org.uk/wp-content/uploads/2021/09/Alcohol-marketing-during-the-2020-six-nations-FINAL.pdf. In response, Lord Parkinson said that the “UK advertising industry has some of the strictest alcohol regulations in the world [and that] if new evidence emerges that clearly highlights major problems with the existing Codes, then the Advertising Standards Authority has a duty to revisit the Codes and take appropriate action.” The UK Alcohol Alert (incorporating Alliance News) is designed and produced by The Institute of Alcohol Studies. Please click the image below to visit our website and find out more about us and what we do, or the ‘Contact us’ button. 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Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition: Upcoming events This month’s IAS blogs Big change for alcohol duty but will public health win or lose?🎵 Podcast feature 🎵 Alcohol industry funded websites spread misinformation on cardiovascular risk How has minimum unit pricing in Scotland affected alcohol-related crime? The Lords discuss gambling evidence review and links to alcohol harm Ireland must commence with alcohol labelling or risk further harm Government rejects call for alcohol to be considered a “less healthy product” and for better labelling of products Which studies came out? We hope you enjoy our roundup of stories below: please feel free to share. Thank you. Upcoming events Join us on Wednesday 03 November, 14:00-15:30, to discuss alcohol’s impact on the environment, seminar 2 of our four-part sustainability series. IAS Chief Executive, Dr Katherine Severi, will introduce the seminar and give an overview of the topic, including how the production and distribution of alcohol can affect greenhouse gas emissions, water use and waste, and how climate change may affect alcohol production in future. Joining us is Dr Modi Mwatsama of the Wellcome Trust, who will go into more detail about how food and drink affects our environment, what individuals can do to reduce their impact, and how we need a food revolution to improve our practices. Tom Cumberlege of the Carbon Trust will round off the event by discussing the work they do in helping businesses to reduce their environmental impact, including a number of case studies of working with the alcohol industry. Please register for the event here https://www.eventbrite.co.uk/e/191094066497 and come prepared with lots of questions for our panel! This month’s IAS blogs Big change for alcohol duty but will public health win or lose? On 27 October the Chancellor Rishi Sunak unveiled the Government’s Autumn 2021 budget, which saw a big change to alcohol duties: from 2023 alcohol will be taxed based on its strength, so the stronger the alcohol the higher the tax. However, as many have said, the devil is in the detail. So what is the detail? Our current alcohol duty system is full of inconsistencies whereby different drinks are taxed at different rates according to both strength and volume. An overview of the current system is presented in chart 4A, which is taken from the Government’s Alcohol Duty Review consultation document https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1028702/20211026_Alcohol_Duty_Review_Consultation_and_CFE_response.pdf. The new system proposed by the Chancellor will simplify the alcohol duty structures by reducing the number of strength ‘bands’, or Alcohol by Volume (ABV) ranges to apply duty rates to. These bands will be applied more consistently across alcohol product categories and are presented in chart 4B. The alcohol content bands that duties will now be applied to are: 1.2-3.4% ABV, 3.5-8.4% ABV, 8.5-22% ABV, and above 22% ABV. For the bands 8.5-22% ABV and above 22% ABV, all products across all categories will pay the same rate of duty. The duty applied to a bottle of rose wine, for instance, will come down by 23p per bottle while strong beer will attract more duty. Here’s an example from The Guardian of how some drinks will change in price. Draught beer duties will be reduced by 5% for containers over 40 litres, in an attempt to support the hospitality industry. The Campaign for Real Ale (CAMRA) said: “The introduction of a draught duty rate is a game-changer for cask beer drinkers, cider and perry drinkers and the great British local. This is something CAMRA has campaigned on for many years and we are delighted the Government has listened”. However the Society for Independent Brewers (SIBA) said it had called for the draught beer duty relief to apply to containers above 20 litres – so that it would benefit craft keg and cask. As the policy only applies to 40 litre containers, bigger companies will benefit more. One of the less rational aspects of the changes is the continuation of lower duty rates for cider. Under the new proposals, cider will attract less duty than other products of the same strength, until it reaches the higher band of >8.5%. As table 4B below shows, cider duties will be less than half of beer duties for the same strength products. The Government reasoning for this is that they are “mindful of the significant impact this would likely have on the cider industry. Apple and pear cider clearances have been in decline for the last decade, with volumes decreasing 28% since between 2009 and 2019”. In response to this, health economist Colin Angus, of the University of Sheffield, said: “All this does is encourages heavier drinkers to drink cider. Because it's much cheaper. And they do. The Treasury acknowledges the issue, but protests they can't fix the huge disparity, because it would involve there then not being a huge disparity... This is by far the biggest failing of the UK duty system and until somebody fixes it and taxes cider on a par with beer, heavy drinkers are going to continue to do themselves a huge amount of harm drinking incredibly cheap white cider.” Another announcement at the Budget that sparked concern amongst public health bodies was the freezing of alcohol duties once more this year. As the Treasury’s own figures show below, this will cost the UK Government over £0.5billion every year, as well as increasing harm, which the increase in affordability inevitably leads to. In response to the changes, IAS Chief Executive Dr Katherine Severi said: “We welcome the principles outlined in the Chancellor’s alcohol duties review to protect public health and simplify the system by tackling high-strength low-cost alcohol. It is common sense that stronger drinks should cost more, as they do more damage to the health of individuals, to families, and to wider society. Alcohol harms have been felt more acutely during the pandemic, with alcohol-related deaths increasing 20% in 2020. Unfortunately, today’s freeze on all duties over the next year will do nothing to alleviate these harms in the short-term, which represents a missed opportunity to achieve the public health goals set out by the Chancellor today. This means the new duty structures will need to work harder to improve public health and tackle inequalities across the UK. We will continue to work with government to push for changes to alcohol duty that result in meaningful health gains and reduce the cost of alcohol to society.” Professor Sir Ian Gilmore, of the Alcohol Health Alliance, said: “The decision to once again freeze alcohol duty is totally misguided. We are already at crisis point when it comes to alcohol harm. Deaths caused by alcohol reached record highs in 2020 and making alcohol even cheaper will only deepen the health inequalities that this government had promised to address.” In terms of next steps, the Government has launched a consultation https://www.gov.uk/government/consultations/the-new-alcohol-duty-system-consultation on the duty changes, the deadline for which is 30 January 2022. Alcohol industry funded websites spread misinformation on cardiovascular risk Research https://academic.oup.com/eurpub/advance-article-abstract/doi/10.1093/eurpub/ckab135/6363930?redirectedFrom=fulltext by the London School of Hygiene & Tropical Medicine has found that alcohol industry (AI) and AI-funded groups misrepresent the evidence on cardiovascular (CV) effects of moderate alcohol consumption. The study looked at the accuracy and completeness of CV health information that the alcohol industry and funded groups disseminated, compared to 18 websites of non-AI-funded sources. The results of the study found: 12 of 18 AI/AI-funded websites refer to CV impacts of drinking, with 9 of those (75%) stating drinking is associated with a reduced risk of at least one CV condition Ischaemic heart disease was the most frequently mentioned condition All non-industry groups surveyed referred to CV impacts from alcohol, with alcohol “almost exclusively cited as a risk factor (as opposed to a protective factor) in the development of such conditions The J-shaped curve theorises that low to moderate alcohol consumption represents optimum exposure to alcohol, with increased risk for non-drinkers and heavy drinkers – see graph below. However, this interpretation has been subject to much criticisim, for instance: moderate drinkers may be better off and have a healthier life in general, abstainers may do so due to various health issues, there are issues with self-reporting, and the curve does not include health externalities such as road deaths or death from partner violence due to alcohol consumption. The study found that 55% (10 of the 18) of the AI/AI-funded websites mentioned the J-shaped curve, with 5 of those caveating that the association is specific to age groups or using qualifying descriptors such as ‘may have a protective effect’. In contrast 33% (6 of the 18) of the non-industry groups mentioned the curve, and all who did so discussed associated qualifiers. The AI/AI-funded websites were much more likely to imply that there is a balance between the positive and negative effects of alcohol on CV risk. Further, the analysis showed that these websites used distraction by focusing on alternative risk factors other than alcohol, such as family history, environment, weight, and poor nutrition – a practice far less common by the non-industry funded groups. The researchers state that AI/AI-funded groups were more likely to emphasise the set of causes for CVD by discussing potential confounders of the alcohol-CVD relationship. They argue that this is “a common strategy among unhealthy commodity industries, including the tobacco industry, and risks obscuring that alcohol is an independent risk factor”. They go on to argue that the alcohol industry understands the negative impacts of alcohol on health, but that they frame it as “heart healthy”, and the information they provide does not reflect the best available evidence. An important point highlighted by the study was that Government-funded sources of information, such as the NHS, “should aim for greater rigour and transparency by using and citing the most up-to-date evidence”. And that NGOs linking to industry-funded websites, such as to Drinkaware, “implies endorsement that is ill-advised given the high risk of bias in health information provided”. How has minimum unit pricing in Scotland affected alcohol-related crime? As part of its ongoing analysis of the effectiveness of minimum unit pricing (MUP), Public Health Scotland released a report https://www.publichealthscotland.scot/publications/evaluation-of-the-impact-of-alcohol-minimum-unit-pricing-mup-on-crime-and-disorder-public-safety-and-public-nuisance/ on 12 October that suggests MUP has had “minimal impact” on alcohol-related crime in the country. Researchers at Manchester Metropolitan University looked at Police Scotland data from January 2015 to January 2020 to understand the effect MUP had on alcohol-related crime, disorder and public nuisance. Dr Karl Ferguson, Public Health Intelligence Adviser at Public Health Scotland, said: “Understanding the impact of MUP on social harms including crime and public safety is an important aspect of the overall evaluation. The findings of this research are in line with previous Public Health Scotland studies which reported limited evidence of increased theft or illicit substance use as a result of MUP. These studies included research into how MUP affected small retailers, people drinking at harmful levels, and children and young people.” Dr Carly Lightowlers of Liverpool University and Lucy Bryant of IAS looked at the report’s limitations and will publish an IAS blog https://www.ias.org.uk/blog/ comprehensively explaining these. The limitations they highlight are: Further studies will offer additional insights regarding MUP and crime, such as ambulance callouts, hospital admissions and deaths, and MUP and illicit substance use The Lords discuss gambling evidence review and links to alcohol harm Following September’s review https://www.gov.uk/government/publications/gambling-related-harms-evidence-review by Public Health England (PHE) that showed the shocking harm of gambling in England, the Lords debated the issue https://hansard.parliament.uk/Lords/2021-10-14/debates/1F10B781-B45A-43BC-8A44-3E5C8F859384/Gambling-RelatedHarms?highlight=alcohol#contribution-3BD18F53-227E-4B78-B58C-DC0AA43D56EA. The Lord Bishop of St Albans introduced the debate and said that the gambling industry must pay more to reduce the harm it causes. He highlighted the pressure the industry puts on people to continue to gamble, pushing people toward huge debts and sadly some towards suicide. He argued that the Government must approach it from a public health perspective to prevent further harm. Lord Foster of Bath agreed with the Lord Bishop and added there is a wide range of gambling-related harms, including alcohol dependency. He argued that gambling harm should be tackled in a similar way to drug and alcohol harm – by giving it a higher profile, better resourcing, and a public health approach. Baroness Bennett of Manor Castle raised the issue of gambling and alcohol advertising, saying that we are “trailing on the global scale of controls on this out-of-control industry”. She highlighted how Sweden is “proposing restrictions on gambling parallel to its tight restrictions on alcohol advertising” and that Portugal “has just brought in a ban on advertising on TV and radio between 7 am and 10.30 pm”. Baroness Bennett went on to say: “It is interesting that so many nations are tying together alcohol and gambling advertising, because this review demonstrates that alcohol consumption is strongly associated with gambling. The noble Lord, Lord Robathan, talked about leaving it to individual responsibility, but that is obviously a problem when you combine gambling opportunities with alcohol.” Ireland must commence with alcohol labelling or risk further harm In a letter https://link.springer.com/article/10.1007/s11845-021-02719-8 to the Irish Journal of Medical Science, Dr Nathan Critchlow et al, argued that Section 12 of Ireland’s Public Health (Alcohol) Act 2018 should commence as soon as possible. Section 12 stipulates a number of mandatory packaging requirements for alcohol: Critchlow stated that as there is no scheduled commencement date for Section 12 it prolongs the reliance on the self-regulatory presentation of this health information to the public. He also argued that the initial COVID-19 lockdowns, due to increasing home drinking, would have provided maximum exposure to such health warnings, but that sadly this has been missed. Highlighting the reason why Section 12 needs implementing as soon as possible, Critchlow wrote that it is supported by the public, there is proof that it works in reducing harm, and that tobacco warning labels already provide a template on how best to design such labels. Discussing the tobacco industry and their use of litigation to attempt to prevent or slow public health changes, Critchlow warned that the alcohol industry is likely to use litigation too. However he said that the tobacco industry is “seldom successful”, inferring that the same may be true for alcohol industry attempts. Critchlow et al rounded off their letter by stating that: “Strong political leadership was key to the passage of the Act and will likely be needed to advance Sect. 12 if this policy is to fulfil its intended purpose.” Government rejects call for alcohol to be considered a “less healthy product” and for better labelling of products A less healthy product The Commons debated https://hansard.parliament.uk/Commons/2021-10-26/debates/44990449-eb41-4db1-9057-b3a4fe7dbffc/HealthAndCareBill(SeventeenthSitting)?highlight=alcohol#contribution-531DF03A-5FBD-4BA6-80FF-466BD83B8627 the Health and Care Bill on 26 October, including amendments to include alcohol as a “less healthy” product and therefore liable to the watershed ban on unhealthy product ads and online ad ban of such products. Labour MP Alex Norris argued that: “One of the few parts of the obesity strategy where we have departed from the Government’s view is the curious decision to remove alcohol, particularly with regard to calories and labels. We all know that alcohol is a less healthy product—I may well be the billboard for that, certainly when it comes to weight—so why has it been left out? Our amendments are more probing than an attempt to actually change the Bill, because I hope that alcohol has already been covered. However, in the obesity strategy in general, it seems to have disappeared, which seems very odd. I hope that the Minister can explain his thinking on that.” In response to Mr Norris’ argument, Conservative Minister for Health, Edward Argar, argued that the Government is committed to ensuring children are protected from alcohol marketing via rules in advertising codes. After listing out some of those codes – for instance that no more than 25% of audience can be children and ads must not strongly appeal to children – Argar said: “We do not believe it is necessary to consider alcohol a less healthy product in this context, or to apply the new restrictions to it”, going on to say that less healthy food and drink are unique and different to alcohol as they are not age-restricted when purchasing. Argar said that as the consultations on advertising restrictions didn’t include alcohol, we can’t be sure of the impact of the amendments on the advertising industry, regulator, alcohol industry or “wider public opinion”. He concluded that: “Material in the broadcast code and non-broadcast code relating to the advertising and marketing of alcohol products is already robust. That recognises the social imperative to ensure that alcohol advertising is responsible and, in particular, that children and young people are suitably protected. If new evidence emerges that clearly highlights major problems with the existing codes, the Advertising Standards Authority has a duty to revisit them and take appropriate action. For those reasons, I encourage the hon. Member for Nottingham North not to press the amendments to a vote.” As a recent report https://www.ias.org.uk/wp-content/uploads/2021/09/Alcohol-marketing-during-the-2020-six-nations-FINAL.pdf co-funded by IAS, AAI and SHAAP highlighted, the current self-regulatory alcohol advertising policy is anything but robust when it comes to preventing children from exposure to alcohol ads, particularly during sporting events. It showed ‘responsible drinking’ messages were only visible in 0.4% of the alcohol references during the 2020 Six Nations England vs. Scotland match. If 25% of the 120 million Six Nations audience were children, it would be acceptable, under the self-regulatory rules, for 30 million children to see this advertising. Better labelling On 28 October the Commons debated https://hansard.parliament.uk/Commons/2021-10-28/debates/40b78f44-b96a-4ac6-a9f6-07ee17390639/HealthAndCareBill(TwentiethSitting)?highlight=alcohol#contribution-6DEEB20E-CFBF-4BC4-B10D-23A84F3CB9A7 an alcohol product labelling clause, that would ensure alcoholic drinks display: Labour MP Alex Norris argued that people have the right to know what they’re consuming and the risks, highlighting research that shows 80% of people don’t know the calories in a large glass of wine. He went on to say that not enough people know of the dangers of drinking while pregnant, particularly around the issue of FASD and the profound impact that it has on a child’s development. Norris also highlighted a recent YouGov report that shows the public are in favour of more information on alcoholic products. Norris asked the Secretary of State to introduce secondary legislation to include this information, which he said is a “modest ask, but it promotes informed choice”. In response Conservative Edward Argar agreed that people have the right to accurate information but that the clause is unnecessary as the Government is about to launch a consultation on labelling and all stakeholders must be involved. He said if the decision is taken to mandate labelling requirements, the Government will do so through a new power in the Food Safety Act 1990. Norris said he respected the process although highlighted that the consultation shouldn’t be confused with action, and that there is a growing sense of impatience Additional studies published this month The UK Alcohol Alert (incorporating Alliance News) is designed and produced by The Institute of Alcohol Studies. Please click the image below to visit our website and find out more about us and what we do, or the ‘Contact us’ button. Thank you. Get on the email list at instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition: Study finds alcohol ads appeared every 12 seconds in England vs. Scotland 2020 Six Nations match and responsible drinking messages were barely visible 🎵 Podcast feature 🎵 The Scottish Government launches its 2021-2022 Programme for Government Serious injuries from drink-driving road traffic accidents are at their highest point since 2008 YouGov survey shows public support for restricting alcohol advertising Study shows doubling alcohol taxes could save 4,850 Europeans from cancer deaths each year Alcohol Change UK publishes a report on how to use legal powers to safeguard vulnerable dependent drinkers Nicola Sturgeon calls for perseverance and determination against industry opposition to pricing policies Public Health England publishes review on gambling-related harms Lords debated the Police, Crime, Sentencing and Courts Bill We hope you enjoy our roundup of stories below: please feel free to share. Thank you. Upcoming events The Global Alcohol Policy Alliance is running a 3-day virtual event in place of their annual conference, from 12-14 October 2021. Each day there will be a session with a key-note speaker, followed by a session with comments from a panel of regional representatives and Q&As. The event will cover: See more information and register for the event here http://gapa.samrc.ac.za/. This month’s IAS blogs Alcohol Toolkit Study: quarterly update The Alcohol Toolkit Study is run by University College London and tracks the latest trends in alcohol consumption in England on a quarterly basis. We will include the recent data in our Alert each quarter when it is released. For more information and data graphs please visit their website here http://www.alcoholinengland.info/. Prevalence of increasing and higher risk drinking (AUDIT) Increasing and higher risk drinking defined as those scoring >7 AUDIT. A-C1: Professional to clerical occupation C2-E: Manual occupation Currently trying to restrict consumption A-C1: Professional to clerical occupation C2-E: Manual occupation; Question: Are you currently trying to restrict your alcohol consumption e.g. by drinking less, choosing lower strength alcohol or using smaller glasses? Are you currently trying to restrict your alcohol consumption e.g. by drinking less, choosing lower strength alcohol or using smaller glasses? Triggers for past-year attempts to cut down Question: Which of the following, if any, do you think contributed to you making the most recent attempt to restrict your alcohol consumption? Study finds alcohol ads appeared every 12 seconds in England vs. Scotland 2020 Six Nations match A new study https://www.ias.org.uk/wp-content/uploads/2021/09/Alcohol-marketing-during-the-2020-six-nations-FINAL.pdf highlights the prevalence of alcohol advertising in the Guinness Six Nations Rugby Championship and subsequent risk to children, with adverts appearing hundreds of times throughout matches. Researchers at the University of Stirling found 961 references in the Scotland vs. England match and 754 in the Ireland vs. Wales match: every 12 and 15 seconds respectively. On Thursday 30th September we held a webinar to launch the findings of the study and to discuss policy implications across different countries of the UK. The research was sponsored by IAS, Scottish Health Action on Alcohol Problems (SHAAP) and Alcohol Action Ireland (AAI). During the presentation study author Dr Richard Purves showed that ‘responsible drinking’ messages were only visible in 0.4% of the alcohol references during the England vs. Scotland match. Despite this, the Portman Group – the alcohol industry’s social responsibility body – responded that “socially responsible sponsorship is needed more than ever before”, going on to say that banning alcohol ads in sport would have no “tangible effect on public health”. Previous research has shown that children exposed to alcohol advertising are more likely to start drinking at a younger age, and drink more heavily in later life. This new study adds to a wealth of information showing the failings of alcohol marketing regulations, particularly in sport. As part of Portman’s regulatory code, “drinks companies must use their reasonable endeavours…to ensure that at least 75% [of the audience] are aged over 18”. Dr Katherine Severi, Chief Executive of the Institute of Alcohol Studies argues that: “This is slightly meaningless posturing when the Six Nations has an audience of 125 million. Under these rules it is permitted for over 30 million children to see and be influenced by alcohol ads.” In the presentation Dr Purves and co-author Dr Nathan Critchlow discussed Ireland’s impending alcohol marketing restrictions, which are set to come in in November 2021, asking “how Ireland’s impending restrictions may influence alcohol marketing practice in future iterations of the tournament?”. They spoke about how the alcohol industry has worked to circumvent marketing restrictions in France with so-called ‘alibi marketing’: using features that are linked to the brand without explicitly referring to it – a practice that has been used by tobacco companies in sport too. In France, the Six Nations’ lead sponsor, Guinness, uses the term ‘Greatness’ instead – with the same branding. The study found that this occurs in France matches despite alibi marketing appearing to be against the French regulations, which prohibit “advertising [that] by its design, use of a name, trademark, advertising emblem or other distinctive sign, recalls an alcoholic beverage”. Dr Purves and Dr Critchlow’s study highlights the continued presence of alcohol marketing in France and its implications for Ireland’s restrictions: “The continued presence of alibi marketing in France does have implications for the regulators and policymakers overseeing the new restrictions in Ireland, namely whether alibi marketing will also be restricted under the wording of their legislation and what arrangements are in place to monitor and enforce the restrictions.” Dr Sheila Gilheany, Chief Executive of AAI said: “This is a great opportunity for Ireland to implement a public health policy that will reduce alcohol advertising exposure to children. As this report highlights, the Irish Government and public health officials need to be wary of the current loopholes we see in the French approach, and ensure our regulations protect against this.” Please see below or on our YouTube channel for the full webinar: Scottish Government launches its 2021-2022 Programme for Government The Scottish Government released its Programme for Government https://www.gov.scot/programme-for-government/ on 7 September, which lays out its plan for the next year, with this year’s focus on a ‘Fairer, Greener Scotland’. In Chapter 1 https://www.gov.scot/publications/fairer-greener-scotland-programme-government-2021-22/pages/4/ of the programme, entitled ‘A Caring Society’, the government unveils its new vision for health and social care, including: Plans to take forward its NHS Recovery Plan to increase capacity and address backlogs in treatment Establishing the new National Care Service Providing the first £50million of a planned £250million investment to tackle drug deaths The National Care Service will be tasked with handling alcohol and drug services and the programme says Scotland will “continue to lead the way with bold population-wide approaches to reduce the significant disproportionate harms of tobacco, alcohol and unhealthy diets, and to inspire healthy behaviours and lifestyles”. This will include driving forward with their Alcohol Framework 2018 https://www.gov.scot/publications/alcohol-framework-2018-preventing-harm-next-steps-changing-relationship-alcohol/pages/2/, which contains a number of actions to reduce alcohol harm and “embeds the World Health Organization's focus on tackling the affordability, availability and attractiveness of alcohol”. Specific actions include monitoring the effect of minimum unit pricing, improving alcohol labelling information, consulting on advertising restrictions in 2022, and raising awareness of the links between alcohol and cancer. Serious injuries from drink-driving road traffic accidents at highest point since 2008 The Department for Transport released data on drink-driving accidents and casualties in 2019, which show continued stagnation of fatalities and a rise in serious injuries. 2009-2010 saw a significant drop in the number of people killed in drink-driving accidents. However since then, the numbers have plateaued around 230 deaths, as the following graph shows. 230 deaths equates to 13% of the total road traffic deaths in 2019. Department for Transport: Fatalities in reported drink-drive accidents: GB, 2009 to 2019 Serious injuries on the other hand, rose significantly from 1,370 to 1,580 – a 15% rise. Serious injuries https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/743853/reported-road-casualties-gb-notes-definitions.pdf include fractures, internal injuries, crushings, severe cuts, or injuries that cause death 30 or more days after the accident. In terms of sex, males were much more likely to be involved in drink-driving accidents, including being more likely to be a casualty in such accidents. Media coverage of the report quoted RAC’s head of policy Nicholas Lyes (RAC is a British automotive services company), who said: “While there will be much interest in the 2020 casualty figures when they come out to understand the impact of the Covid lockdowns on drink-driving, these figures still represent a rather chilling reminder that in the region of 250 people are killed by drink-drivers on Great Britain’s roads every year, a figure that’s barely fallen since 2010”. A report https://www.pacts.org.uk/news-and-publications/pacts-report-drink-driving-taking-stock-moving-forward/ at the beginning of 2021 by the Parliamentary Advisory Council for Transport Safety (PACTS) made a number of clear recommendations to combat drink-driving casualties, including: The 2020 provisional road casualty statistics were released in June this year and show a significant decrease in deaths and other casualties, likely due to travel restrictions in place during coronavirus lockdowns. In February 2022 the drink-driving casualty statistics will be released for 2020. What does the public think about restricting alcohol advertising? A policy that alcohol harm groups and the World Health Organization frequently table is restricting alcohol marketing, with focus primarily being on the danger to children being exposed to so much of this marketing. Less is spoken about the public perception of alcohol marketing and whether they support restrictions. Research by YouGov https://ahauk.org/news/brits-back-new-controls-to-protect-children-from-alcohol-advertising/#_ftn1, conducted on behalf of the campaign group Action on Smoking and Health, asked the British public whether they would support measures to limit the exposure of children and young people to alcohol advertising. The poll of over 12,000 people found that: With the UK Government banning the online and pre-9pm TV advertising of high fat, sugar and salt foods from 2023, health groups argue that alcohol should be included within these controls. Professor Sir Ian Gilmore, Chair of the Alcohol Health Alliance, said: “We are constantly bombarded with alcohol advertising both online and in the real world – and so are our children. Studies show that the more young people are exposed to alcohol marketing, the more likely they are to start drinking at an earlier age. “The Government has taken a great step forward for public health by stopping junk food advertising online and introducing other limits to its promotion. If alcohol is not included in those plans, we risk alcohol advertising filling the void that is left behind. The public want to see more done to limit young people’s exposure to alcohol advertising.” Doubling alcohol taxes could save 4,850 Europeans from cancer deaths each year A modelling study in the Lancet https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(21)00210-6/fulltext#%20 looked at how many cancer cases and deaths would be avoided by increasing alcohol excise duties for beer, wine, and spirits in the World Health Organization’s European Region in 2020. The study modelled increases of 20%, 50%, and 100% and assumed that these increases would be passed down to the customer and not absorbed by the producer. In 2019 there were an estimated 180,887 cancer cases and 85,130 cancer deaths caused by alcohol. The highest number of new cancer cases and deaths that could have been avoided were for breast and colorectal cancers. The study authors argue that “Breast cancer takes on a particularly important role, as the risk is sharply increased even with small daily amounts of pure alcohol. About half of alcohol-attributable breast cancer cases in the EU are caused by light to moderate alcohol consumption.” Proportion of new alcohol-attributable cancer cases that would have been avoided by cancer site and tax increase “While a 100% increase in excise duty may appear to be unrealistically high, a doubling of current excise duties in most countries would still keep tax rates, particularly for beer and wine, below those in Finland, which was selected as good practice example in the sensitivity analysis. We believe that our findings are important in informing the public as well as policy makers about the cancer risk posed by alcohol, empowering them to make informed decisions about their individual consumption and alcohol policies, respectively.” How to use legal powers to safeguard vulnerable dependent drinkers Alcohol Change UK has developed a detailed guide https://alcoholchange.org.uk/publication/how-to-use-legal-powers-to-safeguard-highly-vulnerable-dependent-drinkers for practitioners on how to use legal powers to improve the wellbeing and safety of adults who are highly vulnerable, chronic, dependent drinkers. The legal powers the report focuses on are below, with examples of actions that can be taken under these powers: It also discusses other relevant powers, such as the 2014 Anti-social Behaviour Act and the 1998 Human Rights Act Alongside the central focus on legislation, it emphasises the importance of having systems and processes in place that enable the powers to be used most effectively. It also addresses the myths and misconceptions that hinder work with this group, and challenges the idea that this client group are choosing to live chaotic lives. For instance it challenges the statement “If someone says they don’t have a problem and doesn’t want help, there is nothing we can do”, by stating that if someone is being exploited, neglected, or self-neglected then consent is not required to raise an adult safeguarding concern. At that point the local authority needs to determine what action is required. Alcohol Change UK runs a half-day training course on how to use these legal powers, which is available at a cost. Find out more. https://alcoholchange.org.uk/help-and-support/get-help-now/for-practitioners/safeguarding-vulnerable-dependent-drinkers-half-day Nicola Sturgeon calls for perseverance and determination against industry opposition to pricing policies Scotland’s First Minister Nicola Sturgeon spoke at the World Health Organization’s 71st Regional Committee for Europe on 16 September and was asked what messages she could give to others regarding Scotland’s battle to implement minimum unit pricing (MUP). After introducing the rationale for bringing in MUP – due to the severe health challenge Scotland faced and still faces regarding alcohol harm – the First Minister said that MUP was introduced as other pricing policies, such as excise taxes, could only be decided by the Westminster Government. Ms Sturgeon stated that after many years of legal battles with the alcohol industry, the Scottish Government “eventually prevailed” and the country very quickly saw the positive impact with a reduction in alcohol deaths. In terms of messages to other countries, Ms Sturgeon said that firstly you have to: “Recognise clearly and explicitly that an alcohol strategy won’t be as effective without a pricing policy. Secondly governments need to be prepared to be determined and persevere, as the alcohol industry will resist any innovative measures like this. And thirdly to make sure you build a strong evidence base in order to persevere”. She concluded by saying that she’s more convinced than ever that MUP is a really effective tool in reducing alcohol harm and that countries need to learn from each other’s experiences and lessons learnt, and “turn aspirations into action”. Ms Sturgeon’s 8-minute section can be found from 19:50 below: Public Health England (PHE) publishes review on gambling-related harms On 30 September PHE published a review https://www.gov.uk/government/publications/gambling-related-harms-evidence-review/gambling-related-harms-evidence-review-summary that looked at the prevalence of gambling and gambling harm, determinants of harm, and the social and economic burden of gambling. The key findings of the review were: Rosanna O’Connor, Director of Alcohol, Drugs, Tobacco and Justice at PHE, said: “The evidence is clear – harmful gambling is a public health issue and needs addressing on many fronts, with an emphasis on preventing these harms from occurring as well as with help readily accessible for those directly and indirectly affected by the wide ranging and long-lasting negative impacts of gambling.” Lords debate the Police, Crime, Sentencing and Courts Bill The House of Lords discussed drink driving in their debate on the new Police and Crime Bill on 14 September. Baroness Williams of Trafford (Minister of State, Home Office) https://hansard.parliament.uk/Lords/2021-09-14/debates/4D726E25-3924-4BB5-B399-4C839D773815/PoliceCrimeSentencingAndCourtsBill?highlight=alcohol#contribution-57F2025F-6FEC-48F9-9C90-1AE9A594001F introduced the debate and said: “The sentencing measures in the Bill will target the most serious violent and sexual offenders and those who pose the greatest threat to the public. That includes those who commit the premeditated murder of a child, those who kill through dangerous driving or careless driving under the influence of alcohol and drugs, and those who become more dangerous while in prison.” Labour peer Lord Brooke of Alverthorpe argued that we should reduce the drink drive limit in England and Wales to 50mg as we have plateaued in reducing deaths since 2010. He said he’ll be bringing an amendment on reducing the limit, “backed by appropriate enforcement and provision of alternative transport choices”. This comes after a recent study that showed Scotland’s reduction of its drink drive limit has not reduced road traffic incidents. The authors of the study, who wrote an IAS blog on the subject https://www.ias.org.uk/2021/08/25/none-for-the-road-why-lowering-drink-drive-limits-didnt-lower-road-traffic-collisions/, said that part of the reason for the lack of impact was that there was no increase in alternative means of transport and there was low enforcement. Therefore if other home nations are to consider reducing their limits, there are additional policies that may need to be implemented. Additional studies published this month The UK Alcohol Alert (incorporating Alliance News) is designed and produced by The Institute of Alcohol Studies. Please click the image below to visit our website and find out more about us and what we do, or the ‘Contact us’ button. Thank you. Get on the email list at instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition: Upcoming events This month’s IAS blogs Scotland sees the highest number of alcohol deaths since 2008 🎵 Podcast feature 🎵 England and Wales saw a record number of 11,000 deaths from alcohol and drugs in 2020, with many suggesting that policies and treatment services aren’t doing enough to help. The Local Government Association has called for public health issues to be a “legal requirement” when councils grant licences for pubs, clubs, bars and restaurants. A new advert by French alcohol giant Pernod Ricard highlights the industry’s tactics when developing corporate social responsibility (CSR) strategies Issues in Australia highlight the need for regulatory change in response to emerging technologies A new study looks at UK ministerial meetings with the alcohol industry and links with political donations 🎵 Podcast feature 🎵 Which studies came out? Upcoming events On 30 September, 14:00-15:00 BST, we are hosting a webinar to launch the new publication ‘Alcohol marketing during the 2020 Six Nations Championship’, which looks at: To register for the event click here. https://www.eventbrite.co.uk/e/166774058699 This month’s IAS blogs Read the blogs here https://www.ias.org.uk/blog/. Scotland sees highest alcohol deaths since 2008 🎵 Podcast feature 🎵 New data show https://www.nrscotland.gov.uk/news/2021/alcohol-specific-deaths-in-scotland-increase that between 2019 and 2020 there was a 17% increase in alcohol-specific deaths in Scotland, up from 1,020 to 1,190. This represents the highest number of deaths since 2008 and reverses the downward trend of alcohol-specific deaths that Scotland had been seeing. Those living in the most deprived areas of the country were 4.1 times more likely to die and men were more than twice as likely to die. The following chart shows the marked increase in male deaths, compared to the relatively unchanged number of women dying. Most of the deaths were of people in their 50s and 60s, representing 60% of the 2020 total. 2019 saw a drop in alcohol-specific deaths, which is widely attributed to the introduction of minimum unit pricing (MUP) in May 2018. Elinor Jayne, Director of Scottish Health Action on Alcohol Problems (SHAAP), rightly drew attention https://www.scotsman.com/news/opinion/columnists/alcohol-deaths-in-scotland-heres-what-should-be-done-to-stem-this-tide-of-grief-and-suffering-elinor-jayne-3349677 to the fact that these deaths mean that “colleagues, friends, family, [and] partners now have the burden of their grief to struggle with”. Both Ms Jayne and Alison Douglas, Chief Executive of Alcohol Focus Scotland, reiterate https://www.theguardian.com/society/2021/aug/17/deaths-caused-by-alcohol-at-highest-level-since-2008-in-scotland the policy demands that public health campaigners and researchers have previously called for: Raise MUP from 50p to 65p as inflation has reduced its effect Reform alcohol duty so that it rises with inflation and is based on the strength of a product Ban alcohol marketing as it increases alcohol harm to children Label alcohol to inform people of its risks e.g., cancer risk Improve access to and provision of treatment services Jayne also called for alcohol availability to be reconsidered: “Let’s look at models in countries such as Sweden and Canada where alcohol is sold in designated alcohol stores rather than in supermarkets and convenience stores.” Those in opposition to the Scottish National Party (SNP) were quick to berate the government for the rise in deaths. Annie Wells, Scottish Conservative health spokeswoman, said: “Scotland has a real problem with treating addiction that has grown far worse since the SNP came to power. The Scottish Conservatives are developing plans for a Right to Recovery Bill alongside frontline experts, so that more people can immediately access the drug or alcohol addiction treatment they need. We urge the SNP Government to take the decisive action that is necessary and back our bill.” Gillian Mackay, Scottish Greens health spokeswoman, had a slightly different focus: "We need to recognise the role that poverty and mental health play in this, providing earlier treatment and support where it is needed. There also still needs to be action on the marketing and promotion of alcohol and a reassessment of the minimum unit price." Record alcohol and drug deaths in the UK England and Wales saw a record number of 11,000 deaths from alcohol and drugs in 2020. With Scotland’s recent alcohol data adding to that, many are suggesting that policies and treatment services aren’t doing enough to help. Reported https://www.independent.co.uk/news/uk/politics/drug-alcohol-deaths-record-high-treatment-cuts-b1902328.html by The Independent, data from the House of Commons Library show that only 10 of over 300 English councils have been able to increase spending on alcohol and drug services. Other councils, including South Tyneside and Wiltshire, have had cuts of over 40% to services. Labour’s shadow health secretary, Jonathan Ashworth, said: “Years of Tory cuts to vital public health services have seen sickness increase and health inequalities widen. We need a new settlement for public health services, a clear target to reduce inequalities and action to minimise harm and help prevent so many dying from addiction.” These figures come at the same time it was reported https://www.dailymail.co.uk/health/article-9884297/Covid-19-UK-Nearly-one-million-people-England-addicted-alcohol-pandemic.html#comments that since the pandemic the number of people in England drinking over 50 units a week increased from 1.5 million to almost 2.5 million. Dr Tony Rao said: “The impact of the Covid pandemic on alcohol use has been devastating and is a stark warning for the Government.” The largest increase was in over-65s, with a rise from 190,000 (or 3.4%) of this group drinking over 50 units pre-pandemic, to 453,000 (8.1%) subsequently. This represents a 139% increase. MPs Dan Carden and Christian Wakeford, who sit on opposite sides of the House of Commons, have been working together to raise awareness of alcohol harm in the UK. They spoke to https://www.itv.com/news/granada/2021-08-03/it-destroyed-my-family-how-tragedy-united-rival-mps-to-tackle-alcohol-harm ITV News about the shocking alcohol death data that has emerged recently. Christian said: "I think my burning question is - if these are the ones we know about, how many more? How many are crying out for help and not being able to get it? And that to me is something we fundamentally need to change." Both MPs sit on the All Party Parliamentary Group on Alcohol Harm, which as well as recommending that the Government tackles the availability of cheap alcohol and improves labelling, also calls for better support and treatment. One of the major issues the Government consistently faces is pressure from the alcohol industry when trying to improve public health policies, often backing down due to the argument that the economy will be negatively affected by such policies. However this argument has frequently been shown https://www.oecd.org/health/preventing-harmful-alcohol-use-6e4b4ffb-en.htm to be a false economy due to the net-negative financial impact that alcohol has on society. Local authorities call for alcohol-related injuries to be considered when granting licences The Local Government Association (LGA) – the body that represents local councils – has called for http://www.local.gov.uk/about/news/lga-licensing-powers-need-cover-public-health public health issues to be a “legal requirement” when councils grant licences for pubs, clubs, bars and restaurants. In a press release the LGA said it is “vital to protect communities from harm, reduce NHS costs and save lives”. Alcohol-related harm is estimated to cost the NHS in England, Scotland and Wales almost £4billion a year. Annual estimated costs of alcohol harm to the NHS, 2006-07 The measure would update the Licensing Act to include a public health objective and allow for action against premises that fail to protect the health of the community. As it stands, councils can only consider four issues: the prevention of crime and disorder; public safety; prevention of public nuisance; and protection of children from harm. The change would allow them to consider whether granting a licence would exacerbate existing public health issues, such as alcohol-related hospital admissions. Councillor Nesil Caliskan, Chair of the LGA’s Safer and Stronger Communities Board, said: “The last year has shown us the importance of businesses taking measures to protect public health, yet currently councils are specifically discouraged from using the Licensing Act to consider public health issues. Councils do not want powers to refuse every application. But being able to consider the public health impact of new licensed premises would allow them to take a more balanced view in line with their other priorities such as creating vibrant and safe town centres and protecting people from harm.” The Federation of Small Businesses (FSB) national chair, Mike Cherry, said: “This suggested licensing change would hit small businesses disproportionately. Perhaps a period of allowing small business hospitality to recover after an exceptionally difficult 18 months is in order.” The Government has said it will respond in due course, and that “Directors of public health are responsible authorities which means that they must be given notice of all licence applications and can make representations about any that raise concerns relevant to the four licensing objectives.” New advert exemplifies Big Alcohol’s ‘dark nudges’ A new advert https://www.youtube.com/watch?v=hVk8DHc4O1w by French alcohol giant Pernod Ricard highlights the industry’s tactics when developing corporate social responsibility (CSR) strategies. The digital campaign https://test-responsible-party.pantheonsite.io/drink-more was developed by the company’s CSR wing – the ‘Responsible Party’ – whose aim is to promote “responsible alcohol consumption and combat binge drinking among young adults in Europe and beyond”. The advert itself shows dramatised clips of inebriated people falling over and passing out, with the line ‘Drink More’ repeatedly flashing up, before it eventually says: ‘Drink More…Water’. Nudges steer people toward certain options, and ‘dark nudges’ encourage the consumption of harmful products, such as alcohol or gambling. In the 2020 publication https://onlinelibrary.wiley.com/doi/full/10.1111/1468-0009.12475 ‘Dark Nudges and Sludge in Big Alcohol’, the authors looked into the alcohol industry’s CSR activities and found it is rife with ‘dark nudges’. This new Pernod Ricard advert and CSR activity can be seen as a clear example of a dark nudge and what the authors describe as “priming drinkers by offering verbal and pictorial cues to drink, while simultaneously appearing to warn about alcohol harms”. The study also highlighted that CSR activity often misrepresents alcohol harm by highlighting apparent social benefits whilst making information on alcohol harm difficult to access. On the ‘Responsible Party’s’ ‘Drink More’ website, there is no explicit statement encouraging people to consume less alcohol as a way of reducing harm. Instead it says its aim is to combat binge drinking and mentions moderation towards the end of the page. The study authors conclude that: “reducing, removing, and mitigating the impact of dark nudges should be an important priority for public health policy”. And that “public health policymakers and practitioners also need to consider whether there is a role for sanctions for making misleading and false health claims on alcohol and other harmful commodity industry websites”. Regulations and youth drinking in Australia Over the past month there have been a number of stories from Australia that highlight the need for regulatory change in response to emerging technologies that enable unhealthy commodity producers to market their products to children and young people The Cancer Council Western Australia drew attention to https://www.croakey.org/alcohol-marketing-and-digital-platforms-stronger-regulation-is-required/ the “world of opportunities” for alcohol companies to market their products, especially on social media platforms that are not open to public scrutiny. The group’s recent research https://www.phrp.com.au/issues/alcohol-brands-use-of-age-restriction-controls-on-social-media/ found that 28% of alcohol brand accounts on Instagram had no age-restriction controls. The authors write that of the three top wine and spirits companies, only one of each had controls across all their accounts. This highlights the more hidden ways that alcohol continues to be promoted to children and shows the need for stricter marketing restrictions across social media. In addition to this, a story https://www.croakey.org/public-awareness-and-attitudes-towards-political-donations-from-the-alcohol-industry/ earlier in the month looked at the State of Victoria’s failure of regulations on alcohol deliveries, with alcohol harm groups saying that the current system makes it far too easy for children to buy alcohol online. A survey by Alcohol Change Victoria of over 1,000 people found that over a quarter of 18-24-year-olds who used delivery services were not asked for ID or didn’t personally receive the order. Not only is it often too easy for young people to buy alcohol without necessary checks, a study published this month shows that a quarter of Australians aged 16 and 17 are allowed to drink at home. Dr Brendan Quinn, lead researcher of the Australian Institute of Family Studies report, said: “In some cases, parents may be allowing their teenagers to drink at home in the belief that supervised alcohol consumption could facilitate a more responsible relationship with alcohol and reduce potential harm. However research suggests early alcohol use could lead to harmful drinking practices, both now and later in life.” Whilst regulations are a few steps behind technology, the alcohol industry continues to develop products that seem to target young people. Mid-month, an alcoholic stout drink was banned https://www.thisismoney.co.uk/news/article-9882511/Brewing-company-BANNED-advertising-beer-child-mistook-Milo.html from being advertised after a child accidentally drank it, mistaking it for chocolate milk. The stout brand was also ordered to change its branding, due to being so similar to the chocolate milk brand. Another recent example of alcohol brands appearing to target younger drinks is the news https://adage.com/article/marketing-news-strategy/mtn-dew-alcohol-hit-stores-next-year/2356551%5d that the energy drink Mountain Dew is releasing an alcoholic version. From the packaging it is difficult to tell that it is alcoholic. Which studies came out? The UK Alcohol Alert (incorporating Alliance News) is designed and produced by The Institute of Alcohol Studies. Please click the image below to visit our website and find out more about us and what we do, or the ‘Contact us’ button. Thank you. Get on the email list at instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast
Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition: Public Health England releases a report that shows the shocking death statistics from alcohol in 2020, particularly due to alcoholic liver disease A Lancet study shows the huge number of cancer cases caused by alcohol across the world 🎵 Podcast feature 🎵 An aspirational alcohol and cancer risk campaign launched in Australia 🎵 Podcast feature 🎵 A study suggests early football matches lead to more drinking and subsequently more domestic violence The South African alcohol industry continues to battle the bans New handbook released refuting the 7 main industry arguments We hope you enjoy our roundup of stories below: please feel free to share. Thank you. Subscribe to our podcast Our podcast is now available on all major platforms including Apple https://podcasts.apple.com/us/podcast/alcohol-alert-podcast/id1205933824, Spotify https://open.spotify.com/show/6hEbUIaIv8OJ2aQvTxcrQL, and Stitcher https://www.stitcher.com/show/alcohol-alert-podcast. Subscribe now and don’t miss any future releases. The ‘Listen to podcast app’ link above should take you to your preferred platform. Consumption, hospital admissions and mortality: Public Health England report on alcohol during the pandemic Public Health England (PHE) released a report https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1002627/Alcohol_and_COVID_report.pdf entitled ‘Monitoring alcohol consumption and harm during the COVID-19 pandemic’ on 15 July, which highlights the increase in alcohol harm during 2020. What it says about alcohol consumption With a shift from on-trade alcohol sales to home drinking, off-trade sales increased by 25% from 2019. The largest increase was beer sales, at a 31% increase, however all types of alcohol sales rose: Volume sales increase by alcohol type: With the heaviest 20% of drinkers accounting for 42% of the increase in purchasing, the report states that “This may present a risk that alcohol harm persists or worsens among people already at risk of experiencing harm”. PHE suggests that drinking patterns were polarised, with most people drinking the same as before the pandemic, and similar proportions of people drinking less and more. How did this affect hospital admissions? Admissions due to alcohol highlight the complexities around access to healthcare during the pandemic. Although unplanned admissions decreased by 3.2%, that does not suggest a reduction in harm. Instead, it is likely due to the ‘lockdown effect’ of people wanting to ease pressure on the NHS and also being fearful of catching COVID in hospital. Whereas admissions due to alcohol-related mental and behavioural disorders fell, unplanned admissions for alcoholic liver disease increased by 13.5%. The impact on mortality This increase in alcoholic liver disease admissions led to a dramatic 20% increase in alcohol-specific deaths, with 33% of deaths being among the most deprived societal group. Despite hospital admissions for mental and behavioural disorders seeing a drop, there was a 10.8% increase in deaths from these disorders caused by alcohol. Alcohol poisoning deaths also saw an increase – of 15.4%. Dr Katherine Severi, Chief Executive, Institute of Alcohol Studies, said: “The evidence to support policy action is clear: tackling ultra-cheap alcohol through minimum unit pricing (MUP) and alcohol duty reforms will save lives and reduce costs for the NHS. Scotland has already witnessed a reduction in alcohol-specific deaths following the introduction of MUP in 2018, and with Wales adopting this measure it makes no sense for England to be left behind.” “We also need to see better information provided to consumers about the health risks linked to alcohol, including the risk of breast and bowel cancer. The Chief Medical Officers’ low risk drinking guidelines must be present on all alcohol labels and adverts, to ensure the public are fully-equipped to make informed decisions about their drinking.” The authors of the report concluded that: “Tackling alcohol consumption and harm must be an essential part of the UK government’s COVID-19 recovery plan, given that tackling geographic health disparities are part of the government’s Build Back Better plans.” 741,300 cancer cases a year worldwide attributable to alcohol 🎵 Podcast feature 🎵 Researchers at the International Agency for Research on Cancer (IARC) (part of the World Health Organization), have found that https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00279-5/fulltext over 740,000 cancer cases each year, or – 4.1% – are directly caused by alcohol consumption. In the UK this means 17,000 cases each year. Alcohol causes cancer in a number of ways, including altering DNA, damaging carcinogen metabolites, and altering hormone regulators. The study found that men accounted for 568,700 of the cases, or 77%. Most of the difference can be explain by different levels of consumption, with men globally consuming over double the amount of alcohol that women consume – 1.7 daily drinks compared to 0.73 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext#seccestitle150. Of course, this varies across world regions, as do the levels of consumption. Comparison of men and women’s alcohol consumption and attributable cancer cases However, the report highlights that with an increase in women involved in employment across the world, and therefore increased resources, women are consuming more alcohol. If this continues, we could see a shift in the proportion of cancer cases. This is particularly poignant when you consider the alcohol industry’s targeting of women https://www.ias.org.uk/wp-content/uploads/2020/06/rp39102019.pdf as a market for growth, especially in emerging markets such as India. Professor Jeff Collin discussed this at our sustainability seminar, which can you watch from here https://youtu.be/vErKX4o0cOg?t=1991. We spoke to lead author Harriet Rumgay on our podcast, who said: “Alcohol industry lobbying parallels the tactics of the tobacco industry. It took so long for any kind of sanctions against the tobacco industry after we knew for decades about its links to harm. We need to make policymakers aware of how important it is for our environments to support healthy choices, and to not have such pressures from the industry.” An important point that the report makes is that these cancer cases are not simply among those who drink heavy or risky amounts (>60g and 20-60g of ethanol a day respectively). Moderate drinking accounts for 14% of the cancer cases, showing that when it comes to cancer risk, there is no safe level of consumption. The authors draw attention to WHO’s ‘best buys’ for tackling non-communicable diseases, including policies to increase taxation, limit availability, and reduce marketing of alcohol brands. Rumgay said that a top-down approach is required by governments to increase awareness regarding cancer risks and to reduce harm. Dr Sadie Boniface, Head of Research at the Institute of Alcohol Studies, said: “The results are in line with other studies, and scientists already knew that alcohol causes seven types of cancer. However there is low public awareness of this risk, particularly for breast cancer. The forthcoming consultation on alcohol labelling will be a real opportunity to introduce independent health information on alcohol products, so consumers can make fully informed decisions about their drinking.” A top-down approach in Australia raises awareness of cancer risk: ‘Alcohol & Cancer Go Together’ 🎵 Podcast feature 🎵 A health campaign that aims to educate the public about the risk of alcohol attributable cancer is expanding across Australia, with the Foundation for Alcohol Research and Education (FARE) leading the campaign. The stated focus is to “reduce alcohol use by increasing awareness of alcohol-caused cancer”. In 2010 Western Australia launched an alcohol and cancer risk campaign called ‘Spread’, which received international recognition for its effects on behaviour change. An independent study https://bmjopen.bmj.com/content/7/4/e014193 of 83 English-language alcohol harm reduction ads found that ‘Spread’ was the most motivational at reducing alcohol consumption. Following the success of Western Australia’s campaign, Victoria state launched its own version, and now Australian Capital Territory is following suit with the campaign ‘Alcohol & Cancer Go Together’. FARE is building upon the previous successful campaigns and incorporating the new alcohol guidelines, which suggest consuming no more than 10 standard drinks a week and no more than four standard drinks in one day. The campaign will launch for an initial 10-week period across TV, social media, Spotify, YouTube, and outdoor media, to: We spoke to FARE’s Chief Executive, Caterina Giorgi, who highlighted that the dominant messaging in Australia comes from the alcohol industry and has been particularly focused on drinking to cope with COVID. She argues that: “These awareness campaigns that point to the risk and reasons why reducing drinking is so important, are vital to counter that excessive [alcohol] marketing that goes on.” Earlier football matches lead to increased alcohol consumption and domestic violence incidents A team at London School of Economics’ Centre for Economic Performance analysed police data to better understand how football matches affect domestic violence, and whether a change in violence is due to heightened emotional states or increased alcohol consumption. They found https://cep.lse.ac.uk/pubs/download/dp1781.pdf that earlier football matches allow more drinking time and subsequently increase domestic violence. As the Guardian points out https://www.theguardian.com/society/2021/jul/04/early-kick-offs-linked-to-more-alcohol-abuse-and-violence-in-the-home, “the findings raise questions about previous police requests to have some contentious games played earlier in the day”. The data consisted of police calls and crime over an eight-year period in the Greater Manchester area and was compared to data on Manchester United and Manchester City football matches. This totalled almost 800 games. The LSE team found that during the two-hour duration of the game, domestic violence incidents decreased by 5%, which they said suggests a “substituting effect of football and domestic violence”. However following the game, incidents increased by 2.8% each hour and peaked 10-12 hours later. As there was no change in domestic violence relating to the outcome of the game (win or loss), and no change caused by sober perpetrators, the team concluded that the increase in violence is due to the increase in alcohol consumption. There was no increase in violence when games kicked-off at 7pm, so the researchers say: “Scheduling games later in the evening and implementing policies that reduce drinking can prevent a majority of the football related abuse from occurring.” This study highlights the multitude of factors that need to be considered when implementing policies aimed at reducing violence. As study author Tom Kirchmaier said: “what we actually substitute is a kind of visible crime for invisible crime. You have less crime around the stadium and so on, but you have issues more than eight hours later at home”. There will undoubtedly be studies that look at the Euro 2020 Championship, alcohol consumption, and domestic violence. With the COVID-19 pandemic meaning matches were predominantly watched from home, it will be interesting to see how domestic violence incidents were affected. Alcohol industry in South Africa: an ongoing battle At the end of June, South Africa implemented its fourth alcohol ban – which was then extended in mid-July – as the country continues to struggle to tackle coronavirus infections. A few days later, the South African Medical Research Council released a study /University%20of%20Cape%20Town%20and%20Medical%20Research%20Council%20study that found that full restrictions of alcohol reduced unnatural deaths by 26%, around 42 deaths a day. Where there was no full restriction, unnatural deaths were not significantly reduced. The study did state that: “while complete restrictions on sale of alcohol might avert unnatural deaths, long-term implementation of this policy would require significant trade-offs in terms of economic activity, as well as lives and livelihoods”. Professor Charles Parry, co-author of the study, said the study adds to the body of evidence that shows policymakers should be adopting evidence-based strategies known to reduce alcohol harm: “These include stricter advertising and promotions restrictions, minimum unit pricing, increased excise taxes, raising the minimum drinking age, and restrictions on container sizes among others.” The alcohol industry was quick to hit back against the government ban, employing a number of known tactics aimed at undermining the scientific rationale and muddying the argument. These claims have been widely publicised, and touch on a point made by Aadilelah Maker Deidericks (Southern African Alcohol Policy Alliance, SAAPA) during the IAS sustainability seminar regarding the media exposure the industry gets compared to alcohol policy advocates – watch from here https://youtu.be/vErKX4o0cOg?t=3342. The South African industry tactics and arguments include: The stated aim of the ban is to reduce hospital admissions due to alcohol-related trauma, in order to ease pressure on healthcare services and allow them to focus on tackling the pandemic. The industry argued that the Government did not consult with them when deciding on the ban, and that their research was ignored. The judge who dismissed South African Breweries’ court claim said that in a state of disaster the government has the legislation to ban alcohol and that a lack of full and proper consultation is justified. Arguments relating to looting and illicit sales are far more complex than simply due to the alcohol ban, and points at the disingenuous position the industry takes. For instance, since the imprisonment of ex-President Jacob Zuma, there has been widespread violence and rioting in the country after initial protests at his imprisonment turned into a wave of looting. The looting wasn’t directly due to the alcohol ban. Maurice Smithers of SAAPA in late June argued that https://www.enca.com/news/calls-review-alcohol-sales-restrictions the main issue was of on-trade alcohol (pubs, bars, and restaurants) and not so much off-trade. He argued that people should be allowed to take alcohol home, as it is when people drink out that “the virus spreads, where people get involved in interpersonal violence and end up in hospital with alcohol-related trauma incidents”. ‘The Seven Key Messages of the Alcohol Industry’ A new publication https://viewer.pdf-online.nl/books/liem/#p=1 looks at the strategies and arguments used by the alcohol industry to defend their products and prevent or delay effective harm reduction policies. The book states that “certain projects and strategies look constructive, but are ultimately aimed at preventing or delaying government action”. If you’d like a hard copy of the book, please follow this link https://eucam.info/order-form-the-seven-key-messages-of-the-alcohol-industry-edition-2021/. The UK Alcohol Alert (incorporating Alliance News) is designed and produced by The Institute of Alcohol Studies. Please click the image below to visit our website and find out more about us and what we do, or the ‘Contact us’ button. Thank you. Get on the email list at instalcstud.substack.com https://instalcstud.substack.com?utm_medium=podcast
