ALCOHOL POLICYWHAT’S HAPPENING IN

ENGLAND?

Professor Colin DrummondSt George’s

University of London

Alcohol is a big problem• 90% males, 80% females drink alcohol (16 and over)• 30% males, 19% females drink above “safe” level (ONS,

2002) • 32% males, 15% females “hazardous/harmful drinkers”

AUDIT 8-15 (Drummond et al., 2005) 7M• 7% males, 3% females drink above 50/35 units/wk (ONS,

2003)• 6% males, 2% females “alcohol dependent” 16+ AUDIT

(Drummond et al., 2005) 1M

• Compared to 0.5% “problem drug misusers”

Binge-drinking in last monthAverage number of occasions

2.1 to 2.6 (4)1.6 to 2.1 (2)1.1 to 1.6 (5)0.6 to 1.1 (4)

Source: Anderson et al., forthcoming

Alcohol problems are increasing

• Alcohol misuse in 18-24 yr old men increased by 32% in last 12 years

• In women (all age groups) increase of 70% over same period

• In 65 years + increase of 31% in men and 75% in women

• Increase in alcohol related mortality of 25% in last 10 years (women>men)

• 23% increase in alcohol related road injuries 1993-2001

NATIONAL A&E STUDY, 2003Hourly attendance at A&E for alcohol positive and negative attendees - proportions

0%

20%

40%

60%

80%

100%

Hour

%

ETOH-

ETOH+

Source: ONS 2001

“Rising consumption over the last 25 years have been accompanied by an increase in availability”

• 68% increase in licensed hotels and restaurants

• 100% increase in off licences• 145% increase in on licence applications• Increased capacity of on licenses:

“Super pubs” are now 20 times bigger than typical pubs

Student monthly binge-drinking% bingeing 3+ times / month

24 to 32 (6)18 to 24 (6)13 to 18 (6)8 to 13 (6)

Source: Anderson et al., forthcoming

What is planned?

The Licensing Act 2003

explained:

“Flexible opening hours for premises,

with the potential for up

to 24 hour opening, seven days a week.”

“This will help to minimise public

disorder resulting from fixed closing

times.”Source: DCMS, 2004

DISCLAIMER:DISCLAIMER:NO EFFECTIVE STRATEGIES HAVE BEEN NO EFFECTIVE STRATEGIES HAVE BEEN

USED IN THE MAKING OF THIS DOCUMENTUSED IN THE MAKING OF THIS DOCUMENT

Content of the strategy

• Better education and communication

• Improving health and treatment services

• Combating alcohol-related crime and disorder

• Working with the alcohol industry

STRATEGY IMPACT NAHRSE & LA Taxation & pricing High "more complex than price" Restricting availability High 24 hour availability Limiting density of outlets High “Local planning” Lower BAC driving limits High No change Graduated licensing for young drivers

High No

Minimum drinking age High More enforcement Brief interventions/ treatment Medium "Lack of evidence" -->

Needs assessment; evidence review; MOCA

Safer drinking environment Medium Voluntary codes: change glasses Heavier policing Medium 1902 Act, ASBOs, on the spot

fines Public education campaigns Low Change safe drinking message,

unit labelling School based education Low More education Voluntary advertising restrictions Low Yes please!

National Alcohol Strategy mapped against Babor et al., 2003 Alcohol: No Ordinary Commodity

Some major problems

• No money• No targets• No high impact strategies• Licensing relaxation• Voluntary codes for alcohol industry• Less effective controls on alcohol

consumption• Increased criminalisation

Policy score

Less than 9½

9½ to 10½

10½ to 12½

More than 12½

Source: Anderson et al., forthcoming

CONCLUSIONS• Sharp increase in alcohol consumption in UK has led to

dramatic increase in alcohol misuse and alcohol related problems

• This has occurred in an alcohol policy vacuum• Government appears more persuaded by the alcohol

industry and their lobbyists than public health experts• Hence alcohol strategy designed to be acceptable to

industry and to have minimal impact on whole population alcohol consumption

• Strategy unlikely to reduce or even stem increase in alcohol misuse and alcohol related harm

• There is a need for close monitoring of indicators of alcohol-related harm