Alcohol Alert Podcast

In our latest podcast Dr Will Haydock, Executive Director of Collective Voice, sheds light on alcohol treatment services in England. Representing an alliance of charities supporting people with alcohol and other drug issues, Haydock emphasises that free treatment is available in every local area – yet awareness remains low. He discusses barriers like stigma and the misperception that support is costly or inaccessible. Haydock calls for a whole-system approach, integrating alcohol treatment into broader health and social care.“There can be almost more shame around having developed a problem with alcohol than with other drugs.” 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

In our latest podcast, Dr Megan Cook of La Trobe University discusses alcohol's overlooked environmental impact. Dr Cook explores how alcohol production exacerbates climate harms, from water scarcity to packaging waste, and highlights the industry's "greenwashing" through corporate social responsibility campaigns. She argues that:"If we reduce alcohol consumption for health reasons, that's going to have climate benefits. And if we reduce consumption for climate reasons, that's going to have health benefits too."We also discussed a recent report from the British Beer & Pub Association (BBPA) and Zero Carbon Forum, which looked at the risk of climate change to the UK's beer production. In a news article publicising the report, it stated that:“Concern was also raised in the report that crops may be prioritised for food rather than brewing, which would risk livelihoods across the supply chain.” 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

On this month's podcast we spoke to Florence Berteletti and Anamaria Suciu, who work for the European Alcohol Policy Alliance, or Eurocare. We spoke about levels of alcohol harm in Europe, the crucial role the EU plays in shaping the alcohol policy landscape, and lessons we can learn from tobacco control about how to counter powerful lobbying by the alcohol industry.“Because even if we are David and Goliath... David wins, but we need a sling. The sling comes from our members, their collaboration and knowledge.” - Florence Berteletti 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

On this month's podcast we spoke to Tabbin Almond, alcohol-freedom coach and author of the recent book: ‘Bottling Up Trouble: How alcohol is harming your business... and what to do about it'. Tabbin shares insights from her work helping people change their relationship with alcohol. We discussed the pro-alcohol workplace culture, its impact on employees and businesses, and the need for structural change. We also delved into her new podcast, The Alcohol Debate.“We are pretty much the only country in the world where alcohol addiction is not a protected disability. Employers encourage drinking, then punish people when it becomes a problem. That needs to change.” 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

In this episode, we dive into the history, structure, and impact of Alcoholics Anonymous (AA). Our guests, Tim, a long-standing member and trustee on the General Service Board, and Dr Kieran Moriarty, founder of Alcohol Care Teams and AA trustee, share their insights into the organisation's role in supporting individuals struggling with alcohol dependence.Tim outlines AA's origins in 1935, its foundational principles, and how it operates as a fellowship rather than a governing body. Kieran discusses the success of AA as outlined in a Cochrane review and NICE Quality Standard on alcohol-use disorders.A key takeaway is the power of community in recovery. As Tim puts it:“AA isn't about rules or restrictions; it's about one alcoholic helping another. That's where the real change happens.”To find information on AA, including meetings, visit: https://www.alcoholics-anonymous.org.uk/ 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

On this month's podcast we spoke to Will Prochaska, Leader of the Coalition to End Gambling Ads and former Chief Executive of the charity Gambling with Lives. We discussed:* What the gambling world looks like.* The harms associated with gambling.* Why New Labour's liberalisation of gambling was "one of the worst things we did as a government" according to Alastair Campbell.* The many similarities in how the alcohol and gambling industries behave.* And the pros and cons of a levy on the gambling industry.On the podcast Mr Prochaska said:“The industry would like to present that only those people who are addicted are harmed. But actually, there are a whole host of lower level harms that aren't given the importance they deserve.”On Wednesday 27 November, after our podcast recording, the government announced that it will introduce a £5 per spin limit to online slots betting for adults 25 and older, and a £2 limit per bet for 18 to 24-year-olds. Gambling minister Baroness Fiona Twycross also said that the government would introduce “the first legally mandated” tax on the betting industry, which will be used to fund research, prevention, and treatment of gambling harm. On Twitter Mr Prochaska said:“Today's announcement of a statutory levy on gambling companies is a hard won step in the right direction, but it must mark the beginning of a full government review of gambling's place in society." 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

On this month's podcast we spoke to Dr Aveek Bhattacharya about the decisions taken on alcohol duty in Labour's first Budget in 14 years. We discussed the positives and negatives of the decisions, whether Labour could and should have been more radical, how duty should be structured to cover the cost of alcohol harm, and whether public health groups should have welcomed the decision. 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

False equivalence and ‘empty rhetoric'

In this month's podcast we spoke to Alfie Slade, Government Affairs Lead at the Obesity Health Alliance (OHA), about a new report called Killer Tactics. The report was developed by the OHA alongside the Alcohol Health Alliance and Action on Smoking and Health, and calls for MPs to reject corporate hospitality from these unhealthy product industries.The report shares the common tactics used by these three industries in order to protect industry profits at the expense of 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

On this month's podcast we spoke to Lisa Erlandsen, the Policy and Advocacy Manager at the Alcohol Health Alliance.We discussed reasons to be cautiously optimistic with the new government regarding public health, what could prevent progress from being made, why the alcohol industry needs to be removed from health policy-making, and what the AHA will be focusing its attention on in the coming months. 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

In our podcast this month we spoke to liver doctor Professor Sir Ian Gilmore, who is also chair of the Alcohol Health Alliance and current president of the BMA, as well as Suzanne Wood, Head of Population Health at the BMA. We discussed the BMA's recent consensus statement calling on the government to reduce the drink driving limit, what else would need to be introduced for the policy to reduce harm, and Sir Ian's words of wisdom to the next BMA president. 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

On this month's podcast we spoke to IAS's Chief Executive, Dr Katherine Severi, about our new research that found that alcohol harm costs society £27.4 billion a year. We discussed the cost to various elements of society, why it is important to understand the cost, why reducing harm and supporting the hospitality industry are not mutually exclusive, and what an incoming government should focus on to reduce alcohol harm and its cost. 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

In this month's podcast we spoke to Dr Katherine Severi about the rise in alcohol deaths, and Dr Nason Maani, about his latest research paper that looked at correspondence between Public Health England (PHE), The Portman Group, and Drinkaware, in the run up to and launching of the Drink Free Days campaign, which ran in 2018-2019. The paper, which was featured in Private Eye, highlights the collegial relationship between senior figures at PHE, The Portman Group, and Drinkaware, and also show how The Portman Group attempted to paint members of PHE's alcohol advisory group as having a conflict of interest. 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

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

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

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

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

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, 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

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

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

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

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

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

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

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

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

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

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. 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

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 productIn 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

How far can we trust the latest Global Burden of Disease study?

Why the alcohol industry can't afford to let us kick our drinking problem

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 analysisMinimum pricing has never been promoted as a panaceaPubs: “lost forever” or consolidated?Health Disparities white paper delayedBoris Johnson “minimises” sexual harassment and blames alcoholIndustry arguments dominate Commons debate on alcohol tax reformAlcohol packaging captures the attention of and creates appeal among young peopleAlcohol Toolkit Study: updateWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.IAS BlogsTo read blogs click here.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.The global burden of poor analysisIn mid-July, a new Global Burden of Disease (GBD) study 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 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 from any cause 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 absolute, not relative 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 panaceaIn the 22nd of July’s BMJ Editorial, IAS’ Dr Sadie Boniface discussed the new WHO report 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, 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 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 the 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 showed that while small pubs were closing, big pub chains were consolidating business, with employee numbers and overall revenue remaining relatively constantThe 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 delayedThe Health Disparities white paper – due to be published in late July – has been delayed for the summer 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 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 alcoholWhile 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 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 reformOn 7 July the Commons debated 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 peopleA new Stirling study 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:“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: updateThe 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.Prevalence of increasing and higher risk drinking (AUDIT-C)Increasing and higher risk drinking defined as those scoring >4 AUDIT-C. A-C1: Professional to clerical occupation C2-E: Manual occupationCurrently trying to restrict consumptionA-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 stopQuestion: 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.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

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 drinkingVast difference in alcohol-related deaths remains between richest and poorest in ScotlandContents 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 efficacyIrish Government makes moves to improve product labellingBrexit Freedoms Bill could deliver pint-sized wine bottlesNo and low alcohol sales double in the UKAlcohol Toolkit Study: updateWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.IAS BlogsTo read blogs click here.International experts call for ban on all alcohol promotion 🎵 Podcast feature 🎵Realising Our Rights, 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, 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 opportunityOpposition from the alcohol industryHow to frame regulationsUse of evidence and argumentsThe 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 need to be protected from alcohol marketing they have a right 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 drinkingPublic Health Scotland and the University of Sheffield released the final report on the impact of minimum unit pricing 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 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 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 ScotlandIn related news, Public Health Scotland (PHS) also released its MESAS 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 consumersA new study 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 foundMatt 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, 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 rateAs Dr Aveek Bhattacharya, one of the report’s lead authors, explained in an IAS blog 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 efficacyFrom 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:“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 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 labellingLast week, the Irish Examiner reported 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 bottlesIn a Telegraph article 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.”Patrice Noyelle, President of Pol Roger Champagne, presents a pint bottle of champagne to the Churchill Museum and Cabinet War Rooms in 2008. CREDIT: Daniel JonesNo and low alcohol sales double in the UKAccording to alcohol market research group IWSR, 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 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: updateThe 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.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 occupationCurrently trying to restrict consumptionA-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 stopQuestion: 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.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

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 FoundationIs 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-framingEurope ignoring alcohol harm as impediment to sustainabilityAlcohol Toolkit Study: updateWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.IAS BlogsTo read blogs click here.IAS Annual Report 2021/22Our Annual Report 2021/22 is available on our website here, detailing the work our team has done over the past year. Thank you to everyone who has supported IAS this year!EventsAlcohol Health Alliance: Alcohol Harm and EthnicityThe 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.WHO Less Alcohol Unit: Zero and low-alcohol beverages: real improvement or apparent solution?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 hereAlcohol packaging as a health communications tool 🎵 Podcast feature 🎵A study in April 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 FoundationA comprehensive new report 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 planIn related news, during the World Health Assembly last week, delegates agreed to the 2022-2030 alcohol action plan 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 donationsPerhaps suggesting a lack of policy coherence within the WHO, a BMJ Commentary piece 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 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 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 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.Should people who are overweight have lower drinking guidelines?At the European Congress on Obesity a study presented 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-framingProfessor Nason Maani and colleagues from the London School of Hygiene and Tropical Medicine discussed the framing of health in public discourse 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 sustainabilityThe global alcohol prevention NGO Movendi International published an insightful paper 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” 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: updateThe 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.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 occupationCurrently trying to restrict consumptionA-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 stopQuestion: 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.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

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 servicesParents choose a “reluctantly accepting” approach to children drinkingProtecting public health in trade and investment agreementsMandatory calorie labelling on menus comes in and cracking down on gambling adsWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.IAS BlogsTo read blogs click here.Will the Health Disparities White Paper help where previous strategies have failed?🎵 Podcast feature 🎵Following the February release of the Levelling Up White Paper*, 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’ 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.* A White Paper is a report that sets out proposals for future legislation.Ban on drinking during football matches may be overturned after nearly 40 yearsIn November 2021, the Fan Led Review of Football Governance was published, which set out recommendations for how to reduce issues within the game, particularly financial issues. On 25 April 2022 the Government announced 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 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‘. The first of these was published in December 2021 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 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, and highlighted that:“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.”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 servicesAs part of the promise to implement the vast majority of Dame Carol Black’s drug review recommendations within its Drug Strategy, the Government has announced 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 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 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 drinkingA University of Bristol study 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 agreementsFollowing a recent publication that showed alcohol industry arguments were infiltrating World Trade Organization discussions (see our blog here), a number of academics have released a WHO Bulletin 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 downAs part of the obesity strategy, from 6 April new rules 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 that the consultation on mandatory labelling will “be launched in due course”.In marketing news, the Committee for Advertising Practice (CAP) has announced 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. 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

Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies.In this edition:IAS BlogsIAS Small Grants Scheme now open for applicationsWHO Europe looks to strengthen implementation of alcohol Action PlanGovernment’s “dismal record” in meeting 2012 Alcohol Strategy initiatives NICE says pregnant women should be asked how much they drinkAudit Scotland says Scottish Government’s drug and alcohol plans must be clearerLords continue to debate alcohol labelling232 million workdays missed in the US due to alcohol use disorderMounting evidence that alcohol increases CVD risk even at low amountsAlcohol Toolkit Study: updateWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.IAS BlogsTo read blogs click here.IAS Small Grants Scheme now open for applicationsWe are inviting applications from researchers – especially early career researchers – to our small grants scheme.This scheme will provide funding for innovative research ideas that can help inform public policy debates on how to tackle alcohol harm. Priority will be given to proposals that align with our organisational objectives, as outlined in our Strategy 2020–2023.Please send to relevant contacts. More details and how to apply are here.WHO Europe looks to strengthen implementation of alcohol Action PlanWHO Europe consulted on the draft of a new Framework, which aims to strengthen implementation of the WHO European Action Plan to Reduce the Harmful Use of Alcohol, 2022 – 2025.The Framework includes recommendations for Member States on how to implement the Plan and Actions of the WHO Regional Office for Europe, on each of the following six focus areas:WHO Europe will now finalise the draft and submit it to the WHO Regional Committee for Europe at its 72nd session in September 2022.Government’s “dismal record” in meeting 2012 Alcohol Strategy initiatives On 23 March 2012 the UK Government launched its Alcohol Strategy, with the then Prime Minister David Cameron highlighting the harm caused by alcohol and stating that “We can't go on like this. We have to tackle the scourge of violence caused by binge drinking. And we have to do it now.”A decade on, public health actors and politicians are drawing attention to the inertia over the last 10 years, with the majority of the planned initiatives being scrapped or barely implemented.Labour MP Dan Carden says that lives lost due to alcohol could have been saved if the Conservatives hadn’t scrapped plans for minimum pricing of alcohol (MUP), one of the key parts of the Strategy’s plan to increase the cost of cheap, high-strength drinks.As well as MUP, making health a local licensing objective and banning multi-buy promotions of alcohol were also planned but scrapped by the Home Office in subsequent years.In a recent IAS blog, Head of Research Dr Sadie Boniface wrote that these failures don't "just reflect badly on the Government. Putting commercial interests ahead of health in alcohol policies – such as through freezing and cutting alcohol duty in recent years – has cost lives and widened inequalities".Both Dan Carden and the Alcohol Health Alliance’s Professor Sir Ian Gilmore highlighted the need for a new Alcohol Strategy, with Mr Carden writing:“With record alcohol-specific deaths, rising economic and social harms, and depleted treatment services, people are rightly asking why it has taken so long for the Government to bring forward a plan to tackle alcohol harm.“We need to remove barriers to effective action, including the undue influence of corporate lobbyists on policy decisions. Government must finally put public health first. Lives depend on it.”In agreement, Prof Sir Ian Gilmore said:“The situation has never looked bleaker. We need a strategy with measures to stop the incessant promotion of alcohol, give consumers information on harms, and to properly fund alcohol treatment.”NICE says pregnant women should be asked how much they drinkEarlier this month, the National Institute for Health and Care Excellence (NICE) published a quality standard that focuses on assessing and diagnosing foetal alcohol spectrum disorder (FASD) in children and young people.Among other statements, the new standard states that women who are pregnant should be advised by healthcare professionals not to drink alcohol throughout pregnancy, and that they should be asked about their alcohol use and this should be recorded.NICE dropped an earlier draft which suggested adding a pregnant woman’s alcohol consumption data to their child’s medical notes, with fears that women that may need help might hide their drinking.FASD prevalence is unknown and there is no reliable evidence on incidence of FASD, according to NICE. Estimates for global prevalence are 7.7 per 1,000 population and for UK prevalence are 32.4 per 1,000 population, over four times the global rate. That equates to 2.18 million people in the UK, more than the population of people living with autism, highlighting the need for improved diagnosis and support.Lia Brigante of the Royal College of Midwives said:"As there is no known safe level of alcohol consumption during pregnancy, the RCM believes it is appropriate and important to advise women that the safest approach is to avoid drinking alcohol during pregnancy and advocates for this.”Others have raised concerns about the guidance, with Claire Murphy of the British Pregnancy Advisory Service stating that:“We remain concerned about the routine questioning of women throughout pregnancy on this issue."Our research shows women find antenatal discussions about alcohol - even when they don't drink at all - can supersede other issues important to them, like their own mental health and wellbeing.”Ian Hamilton of the University of York argued that considering the short amount of time in appointments, midwives and GPs risk missing other connected issues:“For example, higher consumption of alcohol is often related to mental problems like depression and anxiety. It could be more effective to make that the focus of scarce appointment time – rather than going through tick-box-driven conversations about alcohol.”Audit Scotland says Scottish Government’s drug and alcohol plans must be clearerThe independent public body Audit Scotland, which looks to ensure public money is spent “properly, efficiently and effectively”, has said that the Scottish Government must have a clearer spending plan for its “complex” drug and alcohol services.Scotland saw a marked increase in the number of alcohol and drug deaths in 2020 and the Government has announced £250 million over this parliamentary term to tackle drug deaths.Audit Scotland’s report states that there needs to be more information from the Government about where the money was being spent and that this should be available in one place."This includes more clarity on the different funding streams, which organisations are receiving funding, the purpose of funding and how decisions are made on prioritisation and distribution of funding.”Auditor General Stephen Boyle said:"We've recently seen more drive and leadership around drug and alcohol misuse from the Scottish government."But it's still hard to see what impact policy is having on people living in the most deprived areas, where long-standing inequalities remain."A Scottish Government spokesperson said they welcome the report and acknowledge the concerns. Regarding alcohol, they said, "We are working with Public Health Scotland (PHS) to improve alcohol treatment data, including the development of PHS's surveillance system."In other Scottish news, a recent study by the University of Stirling has identified the major obstacles faced by local public health actors in seeking to influence the alcohol premises licensing system. These challenges included:The researchers wrote that having a public health objective for alcohol licensing – a policy measure frequently called for by public health groups – may not “remove the need for effective local advocacy in a multi-centric system” and that successful advocacy may “involve diverse strategies and relationship building over time”.Another Scottish study to come out in March was by Glasgow Caledonian University, which identified barriers people from the LGBTQ+ community face in accessing alcohol services. These included:Professor Carol Emslie, who led the SHAAP-funded study, said:“Our report recommends that all staff working in alcohol services should receive LGBTQ+ diversity training and services should check they are reaching the LGBTQ+ community, and tailoring their services appropriately.”Lords continue to debate alcohol labellingThe Health and Care Bill is in its final stages, having had its third reading in the House of Lords. It will now pass to the Commons for consideration of Lords amendments. One amendment that was withdrawn during debate was tabled by Baroness Finlay of Llandaff, in order to give the opportunity to discuss alcohol labelling requirements.Baroness Finlay stated that voluntary labelling has failed and highlighted public support for improved labelling.Many of the peers present gave their support, including Lord Bethell of Romford, who was Minister of the Department of Health from March 2020 until September 2021. He made clear that he thinks it is a moral obligation to give people more information so that they can make informed choices.Lord Bethell also mentioned his time as Health Minister and the promises he made that the labelling consultation would be issued by the end of 2021. He therefore asked the current Minister to make “the very specific time commitment the amendment seeks”: no later than 1 year from the Act passing.Earl Howe responded that “The consultation will be launched in due course” but that he couldn’t give definitive timings. In response Baroness Finlay withdrew the amendment, saying:“I note the tone with which “in due course” was uttered, which is really disappointing. I hope the Government will take the message back to the Secretary of State to empower him to grasp the nettle, provide leadership in public health and, for the first time, proceed to make sure that people know what they are drinking and what the harms are…we will hold the Government’s feet to the fire over what “in due course” means; I hope it is a very short course.”232 million workdays missed in the US due to alcohol use disorderA study in the United States looked at data from the US National Survey on Drug Use and Health, to examine the association of alcohol use disorder (AUD) and workplace absenteeism each year.It found that increasing severity of alcohol use disorder (AUD) was associated with an increased number of days of work missed due to sickness:In total, workers with alcohol use disorder missed more than 232 million workdays annually. People with AUD represented 9.3% of the full-time workforce yet contributed to 14.1% of total reported workplace absences.The study researchers concluded that:“These results provide economic incentive for increased investment in AUD prevention and treatment, both for employers and policy makers.”In the UK estimates for working days lost each year due to alcohol-related sickness stand at 17 million, at a cost of £1.7billion to employers.This US research came at the same time that a study reported a 26% increase in deaths involving alcohol in the US, between 2019 and 2020. The researchers wrote that:“Deaths involving alcohol reflect hidden tolls of the pandemic. Increased drinking to cope with pandemic-related stressors, shifting alcohol policies, and disrupted treatment access are all possible contributing factors.”Mounting evidence that alcohol increases CVD risk even at low amountsA Massachusetts’ study of UK Biobank data looked at the association between alcohol consumption and cardiovascular disease (CVD) risk. Observational studies have previously suggested lower CVD risk among light to moderate drinkers compared to those abstaining or drinking heavily.This new research initially found the same, however the study found that those light to moderate drinkers had healthier lifestyles than abstainers. For instance they tended to engage in more physical activity, have lower BMI, and smoke less. Adjusting for these lifestyle factors, and using newer Mendelian randomization techniques, the researchers concluded that the relationship between alcohol consumption and CVD risk looks like this:As one of the researchers wrote on Twitter:Dr Aragam went on to say:“These findings imply that alcohol intake should not be recommended to improve CV health and that reducing intake reduces CVD risk in all individuals.”Alcohol Toolkit Study: updateThe 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.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 occupationCurrently trying to restrict consumptionA-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 stopQuestion: 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.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

Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies.In this edition:Sugar content in wine bottles ranges from 0 to 15 teaspoons of sugar 🎵 Podcast feature 🎵House of Lords debates alcohol labelling and advertising 🎵 Podcast feature 🎵European Parliament ‘waters down’ alcohol labelling recommendationsAlcohol-related hospital stays fall in Scotland during pandemicGovernment inaction on leading risk factors driving ill healthAlcohol industry lobbies via the World Trade OrganizationHarmful commodity industry messaging creates doubtUtah’s lower drink drive limit saves livesTFL’s ban on HFSS ads is successful and paves the way for other ad bansMan in recovery launches campaign to move alcohol aisle away from checkoutAlcohol Toolkit Study updateWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.IAS EventsThere’s still time to register for our final sustainability event on Wednesday 2 March at 10:00-11:30 GMT, where we will be discussing ‘Alcohol & Human Rights’ with:Chair: Professor Leslie London, University of Cape TownOlivier van Beemen, Investigative journalist - discussing his book Heineken in AfricaDr Sarah Hill, The University of Sydney School of Public Health - presenting on gender and health inequalityProfessor Amandine Garde, University of Liverpool Law School - looking at how human rights litigation can be used as a control policyRegister hereIAS BlogsTo read blogs click here.Sugar content in wine bottles ranges from 0 to 15 teaspoons of sugarResearch by the Alcohol Health Alliance, Alcohol Focus Scotland and Alcohol Change UK has found that bottles of the UK’s most popular wine contain a huge range of sugar, with the highest being enough to reach your recommended daily limit.The charity sent 30 bottles of wine (red, white, rosé, fruit, and sparkling wine) to an independent laboratory to test the sugar content. 15 of the bottles tested had 0-1 teaspoons of sugar, and were all red or white wines. Conversely the bottles that were generally weaker in alcohol content – predominantly the rosé, fruit, and sparkling wines – had far higher sugar content, with the most sugary having the equivalent of 15 teaspoons of sugar.The Government guidelines recommend no more than 30g of free sugars a day, meaning a drinker can reach that limit with only two medium-sized glasses of wine.None of the bottles had nutritional information on labels and calorie content was only on a fifth of the bottles.Highlighting the “absurd” situation that means non-alcoholic products have to have more labelling information than alcoholic products, Professor Sir Ian Gilmore said:“The Government must publish its planned consultation on alcohol labelling without further delay – which we have been waiting for since 2020. As well as calorie labelling and nutritional information, we need prominent health warnings and the UK Chief Medical Officers’ low-risk weekly drinking guidelines on labels. Studies suggest that this could help reduce alcohol harm by increasing knowledge of the health risks and prompting behaviour change.”In this month’s podcast we spoke to Alison Douglas, Chief Executive of Alcohol Focus Scotland, about the study.House of Lords debates alcohol labelling and advertisingOn a related note, the House of Lords debated the Health and Care Bill this month, with Baroness Finlay of Llandaff announcing a probing amendment* which would require the Government to publish a report on labelling that would consider certain mandatory labelling requirements, such as the CMO guidelines, cancer warnings, and full ingredients and nutritional information.In the same session Baroness Finlay also sought an amendment that would make the Government consult on calling alcohol a ‘less healthy product’ and therefore subject to the same advertising restrictions that HFSS foods will soon be.Although many peers supported Baroness Finlay, Lord Lansley – former Health Secretary 2010-2012 – said it was misplaced to treat alcohol like tobacco, which he felt these amendments would do. He argued that the alcohol marketing codes have made a great difference, including contributing to a reduction in children drinking, and that we should work with the junk food and alcohol industries as they’re not like tobacco where there’s no safe level. He said, “we deal with the food and drink industry because there are safe levels of food and drink consumption”.It is worth noting that when Lansley was Health Secretary he enlisted PepsiCo, Kellogg's, Unilever, Mars and Diageo to help write health policy, by drafting priorities and identifying barriers.Conservative Baroness Penn said in response that a consultation is unnecessary as the advertising restrictions are aimed at reducing exposure to children, and alcohol is already an age restricted product, furthermore “there are other measures in place that address the advertising of alcohol”. Baroness Finlay withdrew the amendments.In this month’s podcast we also spoke to Baroness Finlay regarding labelling of alcoholic products and next steps for Parliament. Finlay told us that:“If the Government doesn’t come forward with a date for the consultation we will have to push it to a vote and we have to defeat the Government and get it through, as the population deserves to know what is in the products they drink.”*A probing amendment means there’s no intention of the amendment being carried, but instead is used as an opportunity to discuss a particular topicEuropean Parliament ‘waters down’ alcohol labelling recommendationsAfter ‘fierce lobbying’ from the alcohol industry, Members of the European Parliament voted to ‘water down’ labelling recommendations. Instead of warning that any drinking can increase the risk of cancer, alcohol warning labels should only caution against excessive consumption and advise moderate drinking.MEP Dolors Montserrat, a former Spanish health minister, said they had stopped “the attempt to criminalise cava, wine and beer. We reject the abusive consumption of alcohol, which is harmful to health, and we defend the moderate consumption of wine and our well-known Mediterranean diet”.The resolution is non-binding but could guide new rules from the European Commission, such as those due in 2023 on labelling of alcoholic drinks and possible tax revisions to discourage consumption.The initial resolution had also called for a ban on sports sponsorship by alcoholic drinks companies, but the revised text instead said that the ban should only apply to events that were mainly attended by minors.Alcohol-related hospital stays fall in Scotland during pandemicBetween April 2020 and March 2021 alcohol-related hospital stays in Scotland fell by 10% on the previous period, with Public Health Scotland saying this is likely due to Covid preventing people from accessing necessary treatment.The rate dropped from 681 per 100,000 to 614. There were 35,124 stays in total, with the majority treated in acute hospitals. Men were 2.3 times more likely than women to be admitted for alcohol-related reasons, and people in deprived areas were 7 times more likely than those in least deprived areas: 968 compared to 144 per 100,000.Public Health Scotland also published an analysis of the latest data on alcohol sales and harms during the pandemic, which shows that while hospital stays fell, rates of alcohol-specific deaths increased – mainly due to increases in deaths in men and those aged 45-64. Alcohol sales were 9% lower in 2020 compared to 2017-2019 average and 16% lower in 2021.Alison Douglas, chief executive of Alcohol Focus Scotland, said:"While it is positive that overall Scots drank less during the last two years, this needs to be seen in the context of the devastating rise in deaths caused by alcohol during the same period."Drinking habits appear to have become polarised; some have cut down, while others - particularly heavier drinkers - have increased their drinking.”Government inaction on leading risk factors driving ill health The Health Foundation published a policy review on 23 February that analysed Government policy on the leading risk factors of preventable ill health: smoking, poor diet, physical inactivity and harmful alcohol use. The report highlights the lack of improvement over the past decade and that future targets will continually be missed if we continue along the same path.The report highlights the alcohol strategy of 2012 and the Government’s almost immediate backtracking “on all such policies” announced within it. The Health Foundation is firm in its criticism of Government inaction, drawing attention to:The report goes on to say that action to tackle harmful alcohol use “has been particularly weak” compared to control of other risk factors, with the Government avoiding effective intervention due to successful alcohol industry lobbying “against the introduction of policies to modify prices and marketing”.“In relation to both alcohol and food policy, governments have tended to avoid more deterrence-based, interventionist approaches. Instead, they have often trusted those responsible for producing harmful products to help improve public health voluntarily – regardless of possible conflicts of interest.”The report concludes that “Some of the biggest immediate gains could be made by implementing price-based policies, taxes and regulations designed to decrease affordability of unhealthy food and drink, and increase access to healthier options.”The following demonstrates the policy inaction, particularly policies under the responsibility of the Home Office.The Health Foundation: Summary of policy initiatives on alcohol 2012-2021Alcohol industry lobbies via the World Trade OrganizationA study by the London School of Economics has found that the alcohol industry has influence over the World Trade Organization (WTO), with WTO members using industry arguments to stall alcohol policy.The researchers analysed a decade of WTO member statements on ten alcohol labelling policies proposed by various countries. Over 55% of the statements featured industry arguments, such as:Reframing the nature and causes of alcohol-related problemsPromoting alternative policies such as information campaignsQuestioning the evidenceAnd emphasising wider economic costs of mandatory labelling policies.WTO members raising or subject to discussions on health warning labelling proposals at the TBT Committee meetings, 2010–19Arrows indicate statements raised by a member (left) to the corresponding member to whom the statement was directed (right). Arrow width corresponds to the number of statements raised.The authors concluded that because many of the arguments were industry arguments but few stated that they were, “Increased transparency about vested interests might be needed to overcome industry influence”.Read our blog by Dr Pepita Barlow on the study.Harmful commodity industry messaging creates doubtA new study looked at the use of “alternative causation” arguments by manufacturers of harmful products, and its impact on public understanding. The industries analysed were the alcohol, tobacco, fossil fuel and sweetened drinks industries.The study found that:“Across all industries, exposure to industry-sponsored messages led to greater reported uncertainty or false certainty about risk, compared to non-industry messages.”This excellent 6 minute video explains the study findings and implications:Utah’s lower drink drive limit saves livesAt the very end of 2018 the US state of Utah became the first, and as yet only, state to reduce its drink driving limit from 80mg of alcohol per 100ml of blood, to 50mg.As a reference, England and Wales have a limit of 80mg, which is the highest limit in Europe. Most other European countries have a limit of 50mg, including Scotland.The US’ Department of Transportation released a study at the end of February that evaluated the new limit and has found it led to a decrease in traffic deaths and more drivers arranging for alternative transport.Fatalities dropped by 19.8% in 2019, the first year it was reduced, compared to a 5.6% drop across the rest of the US. And 22% of people said they’d changed their behaviour when the law came in.Fatalities per 100 Million vehicle miles travelled (VMT)The study also found none of the negative economic impacts predicted occurred and there wasn’t a sharp rise in those arrested over the limit, suggesting people were adapting to the new law instead.TFL’s ban on HFSS ads is successful and paves the way for other ad bansIn February 2019, advertising of high fat, salt and sugar (HFSS) foods was restricted on the London transport network. A study by the London School of Hygiene and Tropical Medicine (LSHTM) evaluated the impact of the ban.The study found that calories purchased were 6.7% lower in the London households evaluated compared to the control households in the North of England. Energy from chocolate and confectionary purchases was 19.4% lower in London.Professor Steven Cummings of LSHTM said the study offers “a potentially effective intervention in other important public health policy areas such as the regulation of alcohol and gambling advertising”.The London Mayor’s office said that companies that previously advertised HFSS products were now advertising healthier options:“This shift has not only transformed the types of food and drink being advertised, but through engagement with the industry, TfL’s commercial media revenue actually increased by £2.3m during the first year of the policy.”Man in recovery launches campaign to move alcohol aisle away from checkoutA petition launched by a man in recovery for alcohol use disorder is asking supermarkets to move alcohol aisles away from checkouts to support those in recovery.Matthew Penn stopped drinking in May 2020 and has said one of the biggest obstacles to recovery was queuing along the alcohol aisle, which he said felt like a “ticking time bomb”.Mr Penn runs an online support group and said:“Every single person I speak to on my page says one of their biggest problems is going into shops. It can be so easily avoided. You’d think if you can cover up cigarettes then surely you could cover up alcohol.”IAS’ Dr Alison Giles said:“Strategically-placed alcohol in supermarkets is designed to increase purchasing and consumption, which subsequently leads to an increase in harm. To support those in recovery and reduce the cost of alcohol harm to society, a simple first step for supermarkets would be to move alcohol away from checkouts.”Dr Jyotsna Vohra, director of policy and public affairs at the Royal Society for Public Health, said the Government should incentivise retailers by considering business rate reductions where they show they are taking health seriously by improving layouts.Alcohol Toolkit Study: updateThe 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.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 occupationCurrently trying to restrict consumptionA-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 stopQuestion: 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.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

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 recordingNew way of calculating alcohol attributable deaths and hospital admissions 🎵 Podcast feature 🎵Ireland introduces minimum unit pricingWorld Heart Federation strongly rebukes ‘myth’ of alcohol prolonging lifeMany schools use materials on alcohol harm from industry-funded sourcesHeaviest drinkers bought 17 times the amount of alcohol as lowest drinkers in lockdowns‘Misleading claims’ by industry in WHO consultation submissionsChildren exposed to 554 brands every day, including from harmful commoditiesArtificial Intelligence tech trialled to estimate age of customersWhat 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 BlogsTo read blogs click here.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 worldIndustry practices in AfricaFemale promotional workers’ rights and their risk of sexual harassment and assaultGender and health inequalityHow human rights litigation can be used as a last resort control policyRegister for the event here.You can watch the third seminar 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 recordingOn 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 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 pricingThe 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 SolicitorsIreland’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:“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 that people living close to the border will drive to Northern Ireland to buy alcohol, where MUP is yet to be implemented. Many agree 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 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 lifeOn Thursday 20 January the World Heart Federation (WHF) published a policy briefing 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 sourcesResearch 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 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 lockdownsA Newcastle University study 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 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 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 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, 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 submissionsThe Centre for Alcohol Policy Research in Australia, supported by the Foundation for Alcohol Research and Education (FARE), has released a new report 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 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 “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 customersFive major supermarkets will be trialling 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’, 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’, which the Government is looking at as an option.Children exposed to 554 brands every day, including from harmful commoditiesA New Zealand study 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 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 on its website which discusses how we should talk about alcohol.ACUK is currently working with 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. 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

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 pilotCross party group of MPs demands better approach to reduce alcohol harmDisagreement over alcohol duty reformScottish LibDems and 28 NGOs call for minimum unit price to increaseDiageo’s Christmas ‘responsibility’ campaign normalises excessive drinkingNo major economy covers the cost of harm from alcohol, tobacco and sugarAlcohol-fuelled incidents at Wales rugby matches spark criticismWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.Event: New IAS report on restricting underage alcohol purchasesJoin us on Wednesday 8 December for the launch of our new report on ‘Preventing underage alcohol purchasing online using payment card details’. Register here.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 blogsLink to blogsAlcohol Toolkit Study: quarterly updateUCL’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 occupationCurrently trying to restrict consumptionA-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 stopQuestion: 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 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 pilotFollowing a seemingly successful pilot for community sentences, ‘sobriety ankle tags’ have been rolled-out 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 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:FinedHave their order extendedImprisonedThe 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 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 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:“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 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 harmOn 25 November the Commons debated 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 reformFollowing 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 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, 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:“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 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 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 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 as being “confident” that this limit will be reduced to 20 litres.Scottish LibDems and 28 NGOs call for minimum unit price to increaseIn mid-November the leader of the Scottish Liberal Democrats, Alex Cole-Hamilton, called for 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 ScotlandThe 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 drinkingThe alcohol giant is in full festive swing, recently launching both a bold marketing plan and a corporate social responsibility (CSR) campaign 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 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 sugarThe Centre for Global Development, a US international development think tank, published a paper 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 criticismBBC Wales published a story 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. 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 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, 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.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. 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

Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies.In this edition:Upcoming eventsThis month’s IAS blogsBig change for alcohol duty but will public health win or lose?🎵 Podcast feature 🎵Alcohol industry funded websites spread misinformation on cardiovascular riskHow has minimum unit pricing in Scotland affected alcohol-related crime?The Lords discuss gambling evidence review and links to alcohol harmIreland must commence with alcohol labelling or risk further harmGovernment rejects call for alcohol to be considered a “less healthy product” and for better labelling of productsWhich studies came out?We hope you enjoy our roundup of stories below: please feel free to share. Thank you.Upcoming eventsJoin 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 and come prepared with lots of questions for our panel!This month’s IAS blogsBig 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. 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 on the duty changes, the deadline for which is 30 January 2022.Alcohol industry funded websites spread misinformation on cardiovascular riskResearch 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 conditionIschaemic heart disease was the most frequently mentioned conditionAll 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 conditionsThe 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 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 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 useThe Lords discuss gambling evidence review and links to alcohol harmFollowing September’s review by Public Health England (PHE) that showed the shocking harm of gambling in England, the Lords debated the issue.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 harmIn a letter 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 productsA less healthy productThe Commons debated 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 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 labellingOn 28 October the Commons debated 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 impatienceAdditional studies published this monthThe 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

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 GovernmentSerious injuries from drink-driving road traffic accidents are at their highest point since 2008YouGov survey shows public support for restricting alcohol advertisingStudy shows doubling alcohol taxes could save 4,850 Europeans from cancer deaths each yearAlcohol Change UK publishes a report on how to use legal powers to safeguard vulnerable dependent drinkersNicola Sturgeon calls for perseverance and determination against industry opposition to pricing policiesPublic Health England publishes review on gambling-related harmsLords debated the Police, Crime, Sentencing and Courts BillWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.Upcoming eventsThe 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.This month’s IAS blogsAlcohol Toolkit Study: quarterly updateThe 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.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 occupationCurrently trying to restrict consumptionA-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 downQuestion: 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 matchA new study 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 GovernmentThe Scottish Government released its 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 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 treatmentEstablishing the new National Care ServiceProviding the first £50million of a planned £250million investment to tackle drug deathsThe 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, 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 2008The 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 2019Serious injuries on the other hand, rose significantly from 1,370 to 1,580 – a 15% rise. Serious injuries 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 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, 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 yearA modelling study in the Lancet 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 drinkersAlcohol Change UK has developed a detailed guide 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 ActAlongside 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.Nicola Sturgeon calls for perseverance and determination against industry opposition to pricing policiesScotland’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 harmsOn 30 September PHE published a review 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 BillThe 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) 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, 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 monthThe 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

Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies.In this edition:Upcoming eventsThis month’s IAS blogsScotland 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) strategiesIssues 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 eventsOn 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.This month’s IAS blogsRead the blogs here. Scotland sees highest alcohol deaths since 2008 🎵 Podcast feature 🎵New data show 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 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 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 productBan 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 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 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 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 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 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, 2006-07The 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 by French alcohol giant Pernod Ricard highlights the industry’s tactics when developing corporate social responsibility (CSR) strategies. The digital campaign 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 ‘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 peopleThe Cancer Council Western Australia drew attention to 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 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 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 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 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. 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

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 diseaseA 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 bansNew handbook released refuting the 7 main industry argumentsWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.Subscribe to our podcastOur podcast is now available on all major platforms including Apple, Spotify, and Stitcher. 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 pandemicPublic Health England (PHE) released a report 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 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. Of course, this varies across world regions, as do the levels of consumption.Comparison of men and women’s alcohol consumption and attributable cancer casesHowever, 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 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. 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 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 that earlier football matches allow more drinking time and subsequently increase domestic violence. As the Guardian points out, “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 battleAt 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 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. 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 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 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. 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

Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies.In this edition:IAS seminar on Alcohol and the United Nations’ Sustainable Development GoalsExtensive OECD publication details the investment case for alcohol control policies 🎵 Podcast feature 🎵New minimum unit pricing studies in Scotland bolster the argument for its implementation 🎵 Podcast feature 🎵Confusion over WHO global alcohol action plan 🎵 Podcast feature 🎵Brain imaging study suggests there is no safe level of alcohol consumption for brain health Study highlights the prevalence of alcohol advertising in the Rugby Six Nations Parliament debates labelling and the Misuse of Drugs ActWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.Alcohol and the United Nations’ Sustainable Development GoalsIAS sustainability series, seminar 1. Seminar speakers: Chair: Kristina Sperkova, Movendi InternationalDudley Tarlton, United Nations Development ProgrammeProfessor Jeff Collin, University of EdinburghAadielah Maker Diedericks, South African Alcohol Policy AllianceThe Institute of Alcohol Studies hosted the first seminar in its four-part series on alcohol and sustainability, 10 June 2021. The seminar focused on the impact of alcohol on the United Nations’ (UN) Sustainable Development Goals (SDGs) and the opportunities for improved alcohol policy arising from the Goals.Goal 3.5 explicitly targets alcohol, with the commitment to ‘Strengthen the prevention of treatment of substance abuse, including…harmful use of alcohol’. Beyond that, alcohol has been identified as an obstacle to achieving 14 of the 17 SDGs, which can be seen as social, environmental, and economic. Social goals such as ending poverty, hunger, achieving gender equality and maintaining peace and justice, are all affected by alcohol harm. Kristina Sperkova, President of Movendi International, highlighted that alcohol pushes people into poverty and keeps many there, and consumes spending that would otherwise be used on education and food. There are many studies that demonstrate the link between alcohol use and violence, particularly between young men and relating to domestic violence. Ms Sperkova detailed the high environmental cost of alcohol production. Land required to grow crops for alcohol reduces biodiversity. Huge amounts of water are used for alcohol production, with 870 litres of water needed to produce one litre of wine. She pointed out that alcohol is often produced in places that have scarce water supplies, to serve the desires of higher income countries that have an abundance of water.The economic burden of alcohol use across the world is enormous, with high-income countries seeing annual losses of between 1.4% and 1.7% of GDP due to alcohol harm. Much of this is due to the loss of productivity. In England in 2015, 167,000 working years were lost due to alcohol. It was suggested that more effective alcohol control policies would not only reduce the harm but would also help finance sustainable development. The investment case Dudley Tarlton, Programme Specialist at the United Nations Development Programme (UNDP), introduced the work UNDP is doing in collaboration with the World Health Organization (WHO), to present the case for improving and implementing effective alcohol policies, with economic rationale being the main driver.WHO’s SAFER initiative details the five most cost-effective interventions to reduce harm. Mr Tarlton stated that these five interventions would give a 5.8% return on investment.  Modelling by UNDP across 12 countries including Russia, Turkey, and Ethiopia, shows that investing in WHO’s recommended prevention measures would generate 19 billion USD over the next 15 years – mainly due to productivity gain – and 865,000 deaths would be averted. UNDP is also looking into investment cases relating to alcohol-attributable deaths from causes such as liver cirrhosis, road injuries, tuberculosis, and HIV. They are drafting toolkits for countries to take up these policies and could be instrumental in getting revenue to help close covid-related fiscal gaps. As lower socioeconomic groups would disproportionately benefit from the health benefits of increased alcohol taxes, Mr Tarlton highlighted that part of Goal 10 on reducing health inequalities would be targeted by such taxes. The obstacle of the alcohol industryProfessor Jeff Collin, Edinburgh University, posited how the alcohol industry has positioned itself as aligned with the SDGs and as engines of development. The International Alliance for Responsible Drinking (IARD) has a toolkit for governments on how to build partnerships with the alcohol industry. Diageo’s ‘Business Avengers’ coalition highlights their role in aiming to achieve the SDGs. Namibian Breweries (NBL) has listed out which SDGs it is helping, including SDG 3: “NBL has a responsibility to minimise harmful alcohol consumption.”Prof Collin explained that the industry is using the commitment of governments and organisations to SDG 17 – ‘Partnerships for the Goals’ – to push their own strategic agenda, particularly during the Covid-19 pandemic. Pre-pandemic, Diageo collaborated with CARE to address barriers to gender inclusion in the alcohol giant’s supply chain. Following the outbreak of the pandemic, Diageo supported CARE’s emergency response, giving clean water supplies, hygiene kits, and food. According to Prof Collin’s work, the alcohol industry is using corporate social investment (CSI) and philanthropy to shape policy and pursue partnerships, to further its strategic interests. This is especially true in its targeting of women in developing countries, who are seen as a key emerging market. Pernod Ricard India launched an initiative around women entrepreneurs, which aptly shows the two faces of alcohol philanthropy, with the company’s CMO Kartik Mohindra stating: “It is quintessential for brands to create products that appeal to them [women]. And if they don’t have more women in senior leadership roles, they are not likely to have the significant insights needed to tap into the highly sensitive minds of their ever-growing numbers of female consumers.”In Southern Africa – as Aadielah Maker Diedericks of the Southern African Alcohol Policy Alliance (SAAPA) discussed – there are particularly striking examples of industry-government partnerships and conflicts of interest, with civil society in the region perceiving Big Alcohol’s involvement in the region as a form of neo-colonisation. Ms Diedericks explained that policy makers are often on the boards of alcohol companies in the region, that governments hold shares in the industry, and the industry’s agenda is often successfully pushed through. Very few Southern African countries are taking on issues of marketing, pricing, and availability, instead focusing on road safety and underage drinking. Both Prof Collin and Ms Diedericks said that SDG 17 has confused countries, with governments thinking the only relationship with the alcohol industry is one of partnership, ignoring potential conflicts of interest. South Africa case studySouth Africa has seen intense lobbying by the industry in recent months, with Ms Diedericks saying that they are using the narrative of job promotion to demonstrate their value. This is despite R246billion being spent on alcohol harm compared to R97billion in revenue. The industry has campaigned extensively around the idea of economic loss associated with alcohol control policies, using dubious research to back up their claims. This comes at a time of high unemployment rate in South Africa and therefore gets a lot of media attention. Ms Diedericks described the relationship between industry and South Africa’s government as “abusive” due to the industry threatening disinvestment in the country if there were controls to alcohol availability. What next? The speakers argued that the SDGs need to be used better as a rallying point for alcohol control measures. SDG 17 in particular should be used to develop policy coherence and that the building of coordinated approaches across other unhealthy commodities, such as junk food, should be considered. There needs to be clear rationale for why enacting alcohol control policies would help achieve the SDGs, and taxation has a lot to offer towards sustainable financing. Please watch the full seminar below, or click here for a 30minute edited version. Join us in September for seminar two in our four-part series. New OECD report models economic effect of alcohol policies  🎵 Podcast feature 🎵The Organisation for Economic Co-operation and Development (OECD) published a book entitled ‘Preventing Harmful Alcohol Use’, 19 May 2021. It analyses the cost of alcohol consumption in 52 countries (OECD, EU and G20 countries), due to reduced life expectancy, increased healthcare costs, decreased productivity, and lower GDP. As with the IAS seminar on alcohol and sustainability, this report provides clear economic rationale for why countries should consider implementing alcohol control policies. The report looks at trends and patterns in alcohol consumption in the 52 countries, as well as looking at the regional differences across Europe. The following statistics and modelling relate to the 52 countries, unless otherwise stated. Health and economic burden of alcoholHealth care costs for alcohol as percentage of total health care expenditureChildren’s education and bullyingPolicies for reducing consumption The report looked at which alcohol control policies countries currently implement and those that they should consider. It mentions the World Health Organization’s Global Strategy and Global Action Plan in reducing the harmful use of alcohol, referring to these as the best practice policy responses. The report states that:“policies to reduce the harmful consumption of alcohol and associated harms cannot be addressed through one policy intervention – rather, a suite of interventions is needed within a comprehensive strategy”. This will “require a multi-sectoral approach, including health, law enforcement and social services sectors”.How would policies affect health and the economy?  Simulation modelling shows varying degrees of impact of alcohol control policies across the countries. Across the 48 countries analysed by OECD it was found that savings in healthcare costs are greater than the costs of running interventions.How has minimum unit pricing affected Scotland and Wales so far? 🎵 Podcast feature 🎵Since Scotland implemented minimum unit pricing for alcohol (MUP) in May 2018 and Wales in March 2020, initial studies have shown a substantial shift in alcohol purchases and consumption. On 28 May 2021, The Lancet published a study, by Professor Peter Anderson and colleagues, that analysed the purchasing habits of over 35,000 British households, in order to assess the impact of MUP in Scotland and Wales. Purchases in northern England were compared with Scottish purchases, and western England purchases with Wales. The measured changes associated with MUP were: price paid per gram of alcohol, grams of alcohol purchased, and amount of money spent on alcohol.The results of the study were:In Scotland the price per gram saw a 7.6% increase and a purchase decrease of 7.7%In Wales the price increased by 8.2% and purchasing decreased by 8.6%The biggest changes were in households that generally bought the most alcohol. Little change was seen in households that bought small amounts of alcohol and those with low incomesFollowing The Lancet report, on 17 June 2021 Public Health Scotland released its report Monitoring and Evaluating Scotland’s Alcohol Strategy. The report looked at alcohol purchasing, affordability and consumption in Scotland in 2020. The report found that:The report also shows a reduction in alcohol-specific deaths in Scotland from 2018-2019, with the rate for men being the lowest since 1996. However, rates are still higher in Scotland than in both England and Wales. Alison Douglas of Alcohol Focus Scotland (AFS) said:“We're really pleased to see that as a nation we are drinking less for the third year running and that alcohol consumption is at a 25-year low - this is a good indication that minimum unit pricing is having the intended effect. But given nearly a quarter of Scots are still regularly drinking over the chief medical officers' low-risk drinking guidelines, we can't afford to take our eye off the ball where preventing alcohol harm is concerned.” AFS has called on the government to raise the level at which MUP is set from 50p to 65p per unit, arguing that inflation has made it less effective since the legislation was passed eight years ago. Following the success Scotland has seen, Baroness Finlay of Llandaff, Chair of the Alcohol Harm Commission, and Dr Katherine Severi, Chief executive of IAS, called on the UK Government to introduce MUP in England. They argued that there is now sufficient evidence of MUP’s effectiveness and that it is now more urgent than ever due to increases in high-risk drinking and alcohol-specific deaths in England. Public Health Scotland released an interim report at the end of June, which suggests that there is little evidence that MUP has led to people substituting cheap alcohol with other substances or illicit alcohol. Confusion over WHO’s global action plan on alcohol 🎵 Podcast feature 🎵In mid-June, the World Health Organization (WHO) published the first draft of its ‘Global alcohol action plan 2022-2030’. The action plan’s aim is to aid in the implementation of WHO’s Global strategy to reduce the harmful use of alcohol, which in turn aims to reduce morbidity and mortality due to harmful alcohol use and the ensuing social consequences. The strategy aims to “promote and support local, regional and global actions”, giving guidance and support on policy options, national circumstances, religious and cultural contexts, public health priorities, as well as resources and capabilities. In response to the draft action plan, media across the UK focused on a statement included that said:“Appropriate attention should be given to prevention of the initiation of drinking among children and adolescents, prevention of drinking among pregnant women and women of childbearing age.”Most news reports lambasted the wording that women of childbearing age should be prevented from drinking. Two prominent commentators quoted in press reports were Christopher Snowdon of the Institute of Economic Affairs, and Matt Lambert of the Portman Group, who said it was “unscientific, patronising and absurd” and “sexist and paternalistic” respectively. Responding to the media furore, Professor Niamh Fitzgerald, University of Stirling, spoke on BBC Radio 4’s Woman’s Hour: “It is striking that the commentators in the reports are from the alcohol industry. It is clearly an attempt to discredit WHO…before a WHO forum next week [week-commencing 21 June], which is looking at empowering governments against industry marketing. This is a first draft and that mention, which is ill-advised, doesn’t appear in the actions, so we shouldn’t worry that WHO is trying to stop women of childbearing age from drinking.”Dr Sadie Boniface, the Institute of Alcohol Studies’ Head of Research, said “It is a shame that this one phrase in the report has hoovered up attention. This is the launch of an ambitious plan to address alcohol harm, and alcohol is the top risk factor globally for mortality among 15–49 year olds.”According to the Sydney Morning Herald, Dag Rekve, Alcohol Policy Advisor at WHO, said:“It was just meant as the period where you are potentially carrying children and this is not generalising to all women in that age. It can be interpreted that we are saying that women of childbearing age should not drink alcohol and is a completely wrong interpretation and we will make sure that it’s not interpreted like that. If the media also can pick up on the incredible harm from alcohol in the world in the same way they picked up on this poorly formulated phrase, then perhaps we could really achieve something.”No safe level of alcohol for brain health A yet to be peer-reviewed study suggests that all levels of drinking are associated with adverse effects on the brain.Researchers at Oxford University, led by Dr Anya Topiwala, used brain imaging data from 25,000 participants of the UK Biobank study and looked at the relationship between this and moderate alcohol consumption. The results found that higher consumption of alcohol was associated with lower grey matter density and that alcohol made a larger contribution than any other modifiable risk factor, including smoking. Negative associations were also found between alcohol and white matter integrity. Particular damage was seen to the anterior corpus callosum, which connects the frontal lobes of the left and right hemispheres of the brain and ensures both sides of the brain can communicate with each other. Dr Topiwala, said “There’s no threshold drinking for harm – any alcohol is worse. Pretty much the whole brain seems to be affected – not just specific areas, as previously thought.”In response to the study, Dr Sadie Boniface, IAS Head of Research, said:“While we can’t yet say for sure whether there is ‘no safe level’ of alcohol regarding brain health at the moment, it has been known for decades that heavy drinking is bad for brain health. We also shouldn’t forget alcohol affects all parts of the body and there are multiple health risks. For example, it is already known there is ‘no safe level’ of alcohol consumption for the seven types of cancer caused by alcohol, as identified by the UK Chief Medical Officers.”The authors highlighted that one of the limitations of the study was the use of the Biobank data: that the sample is healthier, better educated, less deprived, and with less ethnic diversity than the general population. Dr Rebecca Dewey of the University of Nottingham responded to this, saying that “Therefore some caution is needed, but the extremely large sample size makes it pretty compelling”. The study argues that current drinking guidelines could be amended to reflect the evidence about brain health rather than solely about cardiovascular disease and cancer risk. Professor Paul M. Matthews, Head of the Department of Brain Sciences, Imperial College London, supported this suggestion. Alcohol, rugby and adolescent drinking A study by Dr Alex Barker and colleagues that looked at the prevalence of Guinness advertising in the 2019 Rugby Six Nations Championship, found the following across the 15 games:Two weeks after this study was published it was announced that the National Football League (NFL) in the US was to get its first spirits sponsor, with Diageo signing a multiyear deal. Until four years ago advertising of spirits was banned in the NFL, with beer advertising dominating. Why is this important? Dr Barker’s research states that exposure to alcohol advertising is associated with adolescent initiation of drinking and heavier drinking among existing young drinkers. It goes on to explain that the Advertising Standards Authority in the UK does not regulate footage of imagery from sporting events and although this should be covered by Ofcom it is not. Sports sponsorship is self-regulated by the Portman Group, whose code states that it “seeks to ensure that alcohol is promoted in a socially responsible manner and only to those over 18” and that “drinks companies must use their reasonable endeavours to obtain data on the expected participants, audience or spectator profile to ensure that at least the aggregate of 75% are aged over 18”. The study authors point out that even if 75% of the audience are adults, as sporting programmes are very popular with children they are still being exposed to regular alcohol advertising. If the remaining 25% are children, with huge sporting events there will still be millions of children seeing such advertising. The England versus Croatia Euros 2020 game had a UK audience of 11.6 million, which would potentially mean 2.9 million children seeing alcohol advertising during that game alone – a number acceptable under the self-regulatory rules.  The researchers argue that this weak regulatory approach should be reviewed and “Restrictions on, and enforcement of, alcohol advertising during sporting events are needed to protect children and adolescents from this avenue of alcohol advertising.” They go on to say that future studies should look at if this increased exposure leads to increased sales for alcohol brands. The conversation around advertising of unhealthy commodities in sport has picked up in June, due to the actions of footballers at the European Football Championship.Portugal’s Cristiano Ronaldo removed bottles of Coca-Cola from a press conference and held up a bottle of water declaring “Agua. Coca-Cola, ugh”. A few days later Paul Pogba removed a bottle of Heineken from his conference. This led to the launching of a Muslim athletes’ charter, which seeks to "challenge organisations" to make progress in supporting Muslim sportsmen and women. There are 10 points in the charter, such as “non-consumption of alcohol, including during celebrations, the provision of appropriate places to pray, halal food, and being allowed to fast in Ramadan”. UEFA, the governing body of the Euros, then threatened to fine teams if players continued to snub sponsors. England’s manager Gareth Southgate came out in support of sponsors, saying “the impact of their money at all levels helps sport to function, particularly grassroots sport…we are mindful in our country of obesity and health but everything can be done in moderation”.What happened in Parliament? Obesity strategyThe House of Commons debated the implementation of the 2020 Obesity Strategy on 27 May. Minister Jo Churchill (Department of Health and Social Care) brought up the topic of alcohol labelling. She highlighted the number of calories some people in the UK consume via alcohol: “each year around 3.4 million adults consume an additional day’s worth of calories each week from alcohol”. She went on to state that the Government will be publishing a consultation shortly on the introduction of mandatory calorie labelling on pre-packed alcohol and alcohol sold in the on-trade sector. Churchill said that the main aim was to ensure people were fully informed so that they can make educated choices on what they consume. Labour MP Dan Carden’s contribution focused solely on alcohol labelling. He brought attention to the fact that non-alcoholic drinks have to display far more nutritional information than alcoholic drinks. He also pushed the UK government for a national alcohol strategy, as “We had the highest rate of deaths from alcohol on record this year. Alcohol-specific deaths are at an all-time high at a moment when drug and alcohol services are underfunded and mental health services are overstretched.” During the debate, Alex Norris MP (Labour) and Jim Shannon MP (Democratic Unionist Party) agreed that there needs to be a stronger alcohol strategy. Carden also spoke of the importance of bringing together strategies to combat obesity, drugs, gambling and alcohol.Food and drink regulationsThe House of Lords debated the Food and Drink Regulations 2021 on 19 May. Baroness Finlay of Llandaff discussed alcohol labelling, saying that people had the right to information in order to take control of their health and make informed choices. She argued that alcoholic drink labelling should form part of an obesity strategy and a comprehensive alcohol strategy. “If the role of food labelling is to inform, to empower people to protect themselves from harm and to allow regulation to support that duty to protect our citizens from harm, updating the labelling becomes a moral imperative.”Baroness Bennett of Manor Castle of the Green Party agreed with Baroness Finlay that alcohol labelling is currently inadequate.Baroness Bloomfield of Hinton Waldrist (Conservative) responded to Baroness Finlay “The Department of Health is planning to issue a consultation on calorie labelling for alcohol in the near future with a view to making it a requirement from perhaps 2024.”Misuse of Drugs ActThe Commons debated the 1971 Misuse of Drugs Act on 17 June. MPs agreed that the UK’s current drug policy is not working. Labour MP Jeff Smith argued that it should be liberalised to reduce harm, advocating the legalising of cannabis. He stated that alcohol is more harmful than many illegal drugs and yet it is legal. “We mitigate the harm from alcohol use by legalising it, regulating it, making sure that it is not poisonous and making it safe, and we can invest the tax raised from its sale in the NHS and public messaging.”Labour, Conservative and SNP MPs agreed with Smith, with Allan Dorans of the SNP saying that “Advice, support and education should be provided in the same way as they are for other health issues, including alcohol and tobacco.” 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

Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In the May 2021 edition:The Office for National Statistics released a report that shows there was a 20% increase in alcohol-specific deaths from 2019 to 2020 🎵 Podcast feature 🎵A research study has shown that alcohol adverts are appealing to adolescents and that this is likely to increase their susceptibility to drinkA study by University College London shows that young people who use social media more, also consume alcohol more The Government has announced that it will be holding a consultation on mandatory alcohol labellingThe House of Lords debated the Commission on Alcohol Harm’s 2020 reportThe World Health Organisation has published a new report assessing changes to alcohol consumption between 2010 and 2019The Institute of Alcohol Studies looks at the financial and social impact of the Treasuries decision to once again freeze alcohol duties this yearAnd The Republic of Ireland is set to introduce minimum unit pricing on alcohol. We hope you enjoy our roundup of stories below: please feel free to share. Thank you.20% more deaths directly caused by alcohol in 2020In 2020, England and Wales saw the highest number of alcohol-specific deaths since the Office for National Statistics (ONS) began comparing data in 2001. The ONS report, released earlier this month, shows 7,423 deaths were wholly attributable to alcohol last year. This is a 20% increase from 2019 and the highest annual total ever recorded by the ONS. The following graph clearly shows this increase since 2001.Professor Sir Ian Gilmore, Chair of the Alcohol Health Alliance, told us that “These are the first statistics to really stop me in my tracks in 20 or 30 years; it’s startling and shocking. These data are a warning that the Government would ignore at their peril.” Although the report caveats that it will be some time before we understand the reasons behind these numbers, it does link to Public Health England data that show drinking patterns have changed since the beginning of the coronavirus pandemic. Colin Angus, research fellow at the Sheffield Alcohol Research Group, recently published a blog on the IAS website in which he mentions these changing patterns. He states that there has been a shift “away from beer and towards wine and particularly spirits” and that it is likely alcohol sales in supermarkets increased significantly. Although it will be a while before we see the health impacts of these changing patterns, concerns have been raised by health groups about the long-term health impacts of increased heavy drinking during lockdown.An important finding in the ONS report is that men living in the most deprived areas were 4.2 times more likely to die from alcohol-specific issues compared to those living in the least deprived areas. The same trend is seen for women, who are 3 times more likely to die in the most deprived areas. The following graph shows this dichotomy (IMD means Indices of Multiple Deprivation):Dr Sadie Boniface, Head of Research at the Institute of Alcohol Studies, said “We need to better understand the cause of these deaths by looking at the electronic health records of those who have died. We also need to involve people with lived experience, to understand the what the experience has been of getting appointments and accessing treatment services during the Covid-19 pandemic.”  Alcohol adverts are appealing to adolescents and likely increase susceptibility to drinkA study led by IAS’ Head of Research, Dr Sadie Boniface, and collaborating author’s, has found that adolescents aged 11-17 generally find alcohol adverts appealing and subsequently are more likely to drink.The study is very timely, as it follows a recent piece of research that found that 80% of 11-19 year olds recalled seeing at least one alcohol advert in the past month. Other studies have demonstrated a clear link between under-age people seeing alcohol adverts and increasing their drinking. A report of 277,000 adolescents has shown more restrictive marketing policies were associated with a lower chance of lifetime drinking among adolescents. The research by Boniface et al builds upon this previous research and assesses the relationship between reactions to alcohol adverts and susceptibility to alcohol among adolescents. The study used three alcohol adverts that were not in breach of any marketing codes: a Fosters, Smirnoff and Haig Club advert. It was found that 53% of the 2,582 participants had a positive reaction to the Fosters advert, 52% to Smirnoff, and 34% to Haig Club. Susceptibility to drinking alcohol among those who had never drunk before, but had had a positive reaction to the adverts, increased by 50%. And among the 909 who had consumed alcohol before and had a positive reaction, there was a 40% increase in susceptibility of becoming a higher risk drinker.  Other interesting findings were:Fosters was more popular with men and Smirnoff with women Those of White British ethnicity preferred the Fosters advert whereas other ethnic groups preferred Haig Club’sThe authors of the study highlight their concern about the UK’s complaints-led self-regulation of alcohol marketing, as marketing should not particularly appeal to adolescents. They suggest considering tighter restrictions or bans on certain types of media and marketing, such as product placement and alibi marketing. If not bans, then tighter controls on messaging in alcohol adverts could help limit exposure and appeal; an approach comparable to the loi Évin regulations in France. Does using social media lead to young people drinking more? Young people who use social media more, also consume alcohol more frequently.A study by University College London (UCL) between 2011 and 2016 looked at the social media presence of 6,700 young people aged 10-19 and compared the findings with how often they drank alcohol. Alcohol consumption among young people has decreased globally in recent years. There is still poor understanding as to why it has decreased. Factors such as better legal enforcement, lower affordability, and the rise of new technologies, almost certainly play a part (see 2016 IAS report). With this rise in new technologies and the widespread use of social media platforms, the public sphere and social space amongst young people has somewhat changed. Fewer young people are engaging in activities that are intrinsically linked to alcohol consumption, such as going to nightclubs. Few studies have looked at how social media, and the changing use of social media over time, is related to drinking patterns and changing drinking patterns. UCL’s study is the first in the UK to show a strong correlation between heavier social media use and more frequent alcohol consumption, and that this relationship exists across time. The study found that 18% of 10-15 year olds drank ‘at least monthly’ and that this group used social media more, had more friends and were generally older. Similarly, among young people aged 16-19, those who used social media for less than an hour were less likely to be drinking each month. This age group was also more likely to binge drink three or more times a month if spending more time on social media. Binge drinking was categorised as drinking five or more drinks in one sitting.The researchers concluded that the study was consistent with other studies that show greater use of technology is linked to heavier drinking. Having said that, they do not rule out that the relationship could work the other way: that heavier drinking leads to more frequent use of social media. Professor Yvonne Kelly, who co-authored the study, said “The reasons why time spent online could link to drinking behaviours are not clear but could include having negative experiences in online spaces, as well as exposure to advertising.” They also highlighted that social media may be part of a cultural norm of drinking, for instance posting photos of people drinking. Further, those who use social media may be more sociable already and therefore more likely to be in situations where alcohol is consumed more. Government to hold consultation on alcohol calorie labellingAfter details of an upcoming Government consultation on alcohol labelling were leaked to the media, Dan Carden MP held an adjournment debate on the topic. The proposed consultation was condemned by many representatives of the alcohol industry and in some media outlets. Emma McClarkin, Chief Executive of the British Beer & Pub Association described the proposal as “ludicrous” at a time when pubs are trying to recover from the Covid-19 pandemic. Following suit, Adam Kilcoyne, deputy director of the neoliberal lobbying group the Adam Smith Institute, said “Ministers thinking up this madness should stop and drop the policy.”The Government responded to these comments by saying that “no decisions have yet been taken”. As Dan Carden pointed out in his debate, recent polling on the subject has found that the public are in favour of such labelling, with 74% of people wanting ingredients on labels and 62% wanting nutritional information, such as calories. Jo Churchill – The Parliamentary Under-Secretary of State for Health and Social Care – responded to Mr Carden by saying that the Government believes that “people have the right to accurate information and clear advice about alcohol and the health risks that may be associated with it, to enable them to make informed choices about their drinking and what they consume.” To show its support for considering alcohol labelling policy, the Alcohol Health Alliance UK sent a letter to Health Secretary Matt Hancock echoing Mr Carden’s sentiment: that the public is generally unaware of the calorie content in alcohol, that the public support the inclusion of such information, and that more information should also be included – such as the UK Chief Medical Officers’ low risk drinking guidelines. The letter has 93 signatories, including 13 Members of Parliament and 10 members of the House of Lords.  So what next? The consultation will be launched “very shortly” with Jo Churchill stating that it is important that steps are taken in a measured way to create benefit for the most people. Commission on Alcohol Harm report: Lords DebateFollowing the Commission’s September 2020 report ‘It’s Everywhere’ Alcohol’s Public Face and Private Harm, a debate was held in the House of Lords on 22 April 2021 to discuss the findings.The report highlighted the harm that alcohol causes in the UK, including that:80 people die each day in the UK because of alcohol-related causes Almost 40% of violent crime is committed under the influence of alcohol200,000 children live with alcohol-dependent parentsBaroness Finlay of Llandaff, the Commission’s chair, introduced the debate by highlighting the report’s findings and recommendations, including: calling for an alcohol strategy with evidence-based policies, minimum unit pricing (MUP) in England, a review on licensing, and more informative labelling.Many of the present Lords supported the report’s points. Baroness Randerson referenced the success that Scotland has had with MUP and that this should be considered in England too. Lord Brooke of Alverthorpe asked whether emerging technologies could be used to help people better understand product calories – and how alcohol labelling should be included with this. Lord Bishop of Carlisle highlighted the link between domestic violence and alcohol and that the Government must rethink its strategy. Baroness Fox of Buckley was less supportive of the report. She stated that she is concerned with the direction of the report, as she believes it exaggerates health harms and links alcohol and drinking with “reprehensible behaviours such as domestic abuse, family neglect, crime and child suicide”. Fox went on to say that MUP is illiberal and treats everyone as a potential problem drinker.In response to the discussion, Lord Bethell of Romford, Parliamentary Under Secretary of State at the Department of Health and Social Care:Commended the Commission on its excellent reportShared his personal experience: that his mother died from alcoholism when he was very youngStated that:The Government is committed to publishing a UK-wide addiction strategy to consider alcohol, drug and gambling problems People have the right to accurate information on drinks, and that a consultation will be launched this summer to consider alcohol labellingThere is no plan to implement MUP but the Government will monitor evidence from Scotland and WalesWorld Health Organization: new report assesses changes in alcohol consumption 2010-2019 The World Health Organization (WHO) European office has published a report on how countries have implemented their SAFER policy recommendations, showing that Eastern Europe and Central Asia have done better in reducing alcohol consumption compared to Western Europe. The study finds that:34 out of 51 countries saw a decrease in alcohol consumption. 17 saw an increaseOverall there has been a reduction in consumption from 11.2 litres per capita in 2010 to 9.8 litres in 2016Eastern European and central Asian countries saw the most significant reductions due to introducing stricter control policiesEU member states only saw an average reduction of 1.5%, which is not statistically significant enough to be considered a real reduction Dr Carina Ferreira-Borges, who has been leading the research, praised the actions of Member States that have followed WHO’s recommendations and implemented alcohol policies. She highlighted Eastern Europe and central Asia’s decreases in alcohol consumption, saying that “These countries currently lead by example in implementing alcohol policies, but they need to maintain and increase their efforts, and other countries of the Region need to follow their lead.”The graph below shows the change in implementation of the five SAFER areas between 2016 and 2019 in the European Region, with the numbers representing the percentage of countries deemed to have implemented the areas sufficiently. It highlights the lack of progress made in Europe and that only drink-driving measures were successfully implemented. However this was already being done before the report and saw no improvement.  The report represents a milestone in assessing alcohol control policies across the region. Moving forward it will provide a barometer with which to assess how these policies are being implemented and the effectiveness of them. IAS Analysis: What does the March budget mean for alcohol duties?Alcohol duties were once again frozen this year, the eighth year out of the last nine that the Government has done so. In this briefing, IAS assesses the impact that the freeze will continue to have on healthcare and the UK’s finances, and what the Government needs to consider. What this means for healthcare?Hospitalisation, deaths, and crime will increaseFreezing of duties between 2012 and 2019 led to:2,223 additional deaths in England and Scotland£341million in additional cost to the NHSAlmost 66,000 additional hospital admissionsWhat this means financially?Government figures (figure 1 below) show that freezing duties will cost the UK £1.7billion from 2020-2026 This amount of money could cover all diagnostic imaging equipment for 2 years or fund 40,000 nurses for a year£14billion lost since 2010: If the Government had stuck to the ‘alcohol duties escalator’ (that kept duties 2% above inflation each year) there would be an additional £14billion in additional revenue since 2010 What should the Government do? In response to the Government’s call for evidence in a review of what it admits is a “highly inconsistent” tax system, IAS recommendsthat:Stronger drinks should be taxed more than weaker ones, instead of taxing by drink typeOn-trade alcohol sellers (bars and restaurants) should have a lower level of duty to off-trade sellers (supermarkets) Duties should be automatically updated based on new evidence, instead of annually during budgetsFigure 1Ireland to introduce minimum unit pricingThe Republic of Ireland is pushing ahead with plans to implement minimum unit pricing (MUP) on alcohol by January 2022, despite Northern Ireland not committing. Ireland had been delaying implementation in order for Northern Ireland to implement it at the same time. This was to avoid cross-border trips to purchase cheaper alcohol. The Republic’s Frank Feighan, Minister of State at the Department of Health, stated that Northern Ireland is now “not bringing it in before the northern elections in May 2022”. Although he conceded that there could be issues with cross-border trips, he believes that the positives “far outweigh the negatives”, highlighting the effectiveness of the policy in Scotland in reducing deaths – despite bordering England which does not have MUP. With Scotland, Wales and now Ireland bringing in MUP, pressure is mounting for England to do the same. Figure shows the reduction in alcohol purchases following minimum unit pricing starting in Scotland (vertical line).  The UK Alcohol Alert 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.WHO’s SAFER initiativeStrengthen restrictions on alcohol availabilityAdvance and enforce drink driving counter measuresFacilitate access to screening, brief interventions and treatmentEnforce bans or comprehensive restrictions on alcohol advertising, sponsorship, and promotionRaise prices on alcohol through excise taxes and pricing policies 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

Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition:Chancellor announces a blanket freeze on alcohol duties for a second consecutive year in the spring Budget 🎵 Podcast feature 🎵Irish data highlights ways in which the pandemic has slowed progress in tackling alcohol misuseResearch finds association between alcohol-related violence and deprivation, amplified by the availability of alcohol 🎵 Podcast feature 🎵Doctors in Scotland urge ministers to break sponsorship link between alcohol and sportWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.Budget 2021: Duties for alcohol kept on ice🎵 Podcast feature 🎵All alcohol duties were frozen for the second year in a row in the 2021 Budget, marking the eighth year out of the last nine that alcohol duties have failed to keep up with inflation (03 Mar).According to the Office for Budget Responsibility’s costings, the freeze in alcohol duties – a cut, in real terms – are estimated to cost roughly £1·7bn to the year 2025/26.Chancellor of the Exchequer Rishi Sunak's statement came ahead of the government's much anticipated response to the alcohol duty review consultation held late last year.Responding to the announcement, IAS Chief Executive Katherine Severi said:It is disappointing that the Chancellor has chosen to freeze alcohol duty today, which represents a cut in real terms. This will do nothing to help the thousands of families across the country whose lives are blighted by alcohol, an issue which has become even more acute during the pandemic.We need to rethink how alcohol is taxed to ensure public health is always given priority over alcohol industry profits. Raising alcohol duty can generate vital public funds to support the NHS and social care services and the public are largely supportive of this policy.The ongoing alcohol duty review is a once-in-a-generation opportunity to improve a broken system which promotes cheap, strong alcohol that wrecks lives and burdens our NHS and public services. We will continue to work with government to propose a fairer system that produces net gains for society, not just supermarket profits.A good pandemic for HM Treasury?One reason for Rishi Sunak’s decision to freeze all alcohol duties for another year may lie in the increased revenue from heavier drinking during the COVID-19 pandemic. According to the Office for Budget Responsibility (OBR), HM Treasury stand to rake in £800 million more than predicted for the financial year 2020/21. This makes alcohol duties ‘one of the few tax streams that has outperformed our pre-virus forecast’, as ‘higher sales in supermarkets and other shops have more than offset the loss in receipts from the closures of pubs and restaurants for large parts of the year’.In an article for Alcohol Change UK, alcohol policy modeller Colin Angus suggested that ‘persistently freezing duties changes public perception, encouraging the idea that duty freezes for alcohol are the norm, making it politically more difficult for the Chancellor to increase duties in line with inflation in future years’. You can hear Colin Angus describe this issue in more detail on the podcast.Despite a real terms cut in alcohol duties, some sectors of the industry were left dissatisfied by the Budget, with Society of Independent Brewers chief executive James Calder claiming that it ‘does nothing for independent breweries’ and others believing that approach to beer duty ‘could have been bolder’ (Morning Advertiser, 05 Mar).Yet, this has still not stopped the ‘deluge’ of bookings made for when pubs reopen for outdoor service from 21 April (BBC News Business, 05 Mar), indicating that not only does a pent-up demand exist regardless of the Chancellor’s proclamations on duties, but also that businesses in the hospitality sector could have benefitted from fiscal measures more closely linked to their day-to-day costs, such as rents and business rates.The Budget also neglected to mention any policies to deal with the looming public health crisis in alcohol-related morbidity, as was warned about days before (British Medical Journal, 01 Mar):We are already at crisis point, with the most recent Global Drugs Survey revealing that the UK rate of hospital admissions because of alcohol was higher than among users of any other drug cited in the report apart from heroin and with more than 5% of people under 25 in the UK reporting having sought hospital treatment after getting drunk.Subsequently, a host of public health experts, led by the Alcohol Health Alliance, expressed their disappointment at the duty freeze in the Times (09 Mar). But they did reserve hope for the outcome of a government review to be conducted later this year:… providing an opportunity to overhaul an inconsistent system causing alcohol harm. As a result of the present system it is possible to drink the low-risk weekly guideline of 14 units for just £2·68 in England — about the price of a high-street cup of coffee. This is causing immeasurable damage.The government must create a scaled alcohol duty structure that ensures the strongest products are taxed the most to encourage drinkers to move away from purchasing the most dangerous drinks. With 80 people across the UK dying from an alcohol-related cause every day, we need urgent action to tackle this crisis.Ireland – pandemic slows progress on alcohol misuseNew research findings have shown that while there have been declines in some sections of society regarding Irish drinking habits, the onset of COVID-19 has threatened to reverse them in others.A report titled Health Behaviours, Health Outcomes and Contextual Factors between 1998-2018 found that rates of alcohol use among school-aged children ‘significantly decreased since 1998’ (Irish Times, 08 Mar).Led by senior researcher Aoife Gavin in collaboration with the HBSC research team at the Health Promotion Research Centre in NUI Galway, the study comprised of a sample of 15,557 pupils aged 10 to 17 years from 255 primary and post-primary schools across Ireland, and found a 14 percentage point drop in respondents reporting having ever been drunk over the 20-year period (33% in 1998 vs 19% in 2018).However, the pandemic has led to the dominance of home drinking, which has in turn exacerbated the problem of alcohol’s accessibility to underage drinkers. Reports that on-demand alcohol delivery ‘skyrocketed’ during lockdown ‘with no checks’ on serving children caused Teachtaí Dála (TDs) to call on Justice Minister Helen McEntee to introduce restrictions on delivery services (Irish Sun, 14 Mar).Overall alcohol tax receipts data in Ireland showed a 2·4% decline, suggesting a drop in annual consumption of 6% in 2020, meaning that the country’s public finances ‘experienced little impact’ of the pandemic (Irish Times, 11 Mar). And within the alcohol category, there were significant fluctuations among particular beverages: while excise receipts from beer sales fell 17%, and 11% for cider, wine consumption rose 12% in 2020 ‘even though many restaurants where it would frequently be consumed were closed for a considerable portion of the year’, indicating a sharp year-on-year increase in the number of people drinking wine at home. Alcohol Action Ireland (AAI) expressed their disappointment with the figures, with head of communications and advocacy Eunan McKinney remarking that they highlight ‘the extraordinary shift that has taken place among Ireland’s drinking population and the ocean of alcohol that has poured into the nation’s homes.’Feighan: Ireland to implement MUP with or without the northGiven the urgency of the problem identified by AAI, the Irish government is considering implementing minimum unit pricing, under the 2018 Public Health (Alcohol) Act, asynchronously from its neighbour, Northern Ireland. Frank Feighan, the junior minister for public health, explained that the Oireachtas could ‘not wait any longer for Northern Ireland’ to protect problem drinkers, after their health minister, Robin Swann, elected to defer minimum unit pricing until after the next Stormont assembly elections in May 2022 (The Times (paywalled), 15 Mar).Swann told the assembly: ‘I do not think that we have the scope in [the current assembly term], by way of capacity in my department or the time that is necessary to bring it forward in a meaningful way, but I intend to put it to consultation so that the preparatory work is done for whomever comes into this role in the next mandate.’In response to this development, Feighan said: ‘I will be recommending to government that we have to move. I have talked to minister [for health] Donnelly and I understand he has spoken with the Taoiseach, and I have talked to the Tánaiste. I think it will be discussed in the coming weeks as to what the best way forward would be, and that will be a matter for cabinet. Unfortunately, there may be unintended consequences around excise duties… it would have been ideal to move with Northern Ireland but we cannot wait any longer. I would like to have a short consultation with stakeholders like publicans and off-licences, and then to move with the legislation we have.’AAI said it recognised some consultation may be required to refine the logistics and timing of the measures ‘but we trust that the Taoiseach, Tánaiste and the leader of the Green Party will expedite matters over the coming weeks and that operation will commence in early autumn’.Alcohol-related violence and deprivation🎵 Podcast feature 🎵This week, Lucy Bryant and Dr Carly Lightowlers presented their research on alcohol-related violence and deprivation to an audience at the Scottish Health Action on Alcohol Problems (SHAAP) and Scottish Alcohol Research Network (SARN) Alcohol Occasionals sessions. Between them, the researchers shared findings suggesting that those in the lowest socioeconomic groups experience disproportionate rates of alcohol-related violence and that increases in alcohol availability and deprivation, when seen together, increase the rates of such violence to a greater degree than when either of these factors appears alone.You can listen to Dr Lightowlers explain the research in more detail in our podcast, and you can also watch the presentation in full on SHAAP’s website.In other researchAlcohol pricing policies such as duty increases and minimum unit pricing appear to target men’s drinking habits more effectively than women’s, according to a new study published in Addiction (02 Mar).Researchers found that each of the three policies modelled – a 10% duty increase, and minimum unit prices (MUP) of £0·50 and £0·70 per UK unit – would lead to larger estimated reductions in consumption and hospital admission rates among men than women. The authors also showed how this is driven by gender differences in alcohol consumption, purchasing patterns and harm among adult drinkers in England, leading women’s spending to increase more than men’s. At full effect – that is, once consumption changes have worked their way through to health outcomes - a £0·50 MUP is expected to lead to a sevenfold larger reduction in consumption and a three times larger reduction in hospital admissions for men compared to women.The level and frequency of alcohol consumption rose among drinkers in the UK during lockdown, according to University College London researchers published in the Drug and Alcohol Review journal (03 Mar). Surveying a self-selected sample of nearly 3,000 participants between 30 April and 14 June 2020, they found that 30% of participants reported drinking more frequently in lockdown, with 16% reporting drinking more units per drinking occasion and 14% reporting more frequent heavy episodic drinking. They also found that ‘deterioration in psychological wellbeing was consistently associated with increased frequency of drinking’.The first UK COVID-19 lockdown saw a “rapid and sustained” fall in violence outside the home in the Welsh capital city, a new study led by Cardiff University has shown (Journal of the American Medical Association, 05 Mar). A research team from Cardiff University’s Crime and Security Research Institute (CSRI) and the US Centers for Disease Control and Prevention studied data from Cardiff’s sole emergency department (ED) from March to June 2020, comparing it to weekly data from January 2019 onwards, and found almost 60% fewer attendances per week for violent injury outside the home in the first lockdown. Lead author professor Jonathan Shepherd, from the CSRI, said: ‘This sudden fall in violent injury is the largest any of us has ever seen. It’s likely to reflect closure of city centre pubs and clubs in and around which most violence takes place, and widespread compliance with lockdown restrictions.’ Regarding violence in the home, no significant change was found in any category, which professor Shepherd said was ‘reassuring’. The amount of alcohol consumed during a given drinking occasion is strongly associated with the duration of the occasion combined with the beverage type and serving size, according to a study reported in Alcoholism: Clinical & Experimental Research (05 Mar). Researchers from the University of Sheffield, UK, analysed data from over 18,000 adult drinkers in Great Britain who wrote a seven-day retrospective drinking diary and between them recorded the characteristics of over 46,000 drinking occasions, with the aim of identifying which features – and combinations of features – are most predictive of the units of alcohol consumed during drinking occasions in Great Britain.They found that longer occasion duration, drinking spirits as doubles, and drinking wine were the strongest predictors of heavy alcohol consumption, and that the strongest predictors of longer drinking occasions were drinking in both on-trade venues (eg pubs) and off-trade (eg at home), starting earlier in the day, and drinking with friends.A review of the latest evidence and research on liver disease, authored by over 30 leading hepatology consultants and senior figures from the Foundation for Liver Research, British Liver Trust and Public Health England, has found that almost a quarter of patients (24%) admitted to hospital with liver disease die within 60 days (The Lancet, 11 Mar). These patients have not been previously diagnosed and are admitted as an emergency. The report also observes that people with advanced liver disease admitted to hospital as an emergency, are seven to eight times more likely to die than those admitted with a stroke or heart attack.Updated estimates of population level alcohol consumption undertaken in collaboration with the University of Glasgow, have found an estimated net effect of minimum unit pricing (MUP) of -3·5% in off-trade alcohol sales per adult in the year following its implementation in Scotland in 2018 (Public Health Scotland, 16 Mar).Whilst slightly lower than previously reported, both the estimated net effect of MUP and the observed impact of MUP on different drink categories are comparable with the original findings, and the overall estimate for Scotland in 2019 remains at 9·9 litres of pure alcohol per adult, equivalent to 19·1 units of alcohol per adult per week and the lowest level of pure alcohol sold in Scotland since 1994.Sainsbury’s are the most likely of the major supermarkets to push online shoppers in Scotland towards alcohol, according to campaign group Obesity Action Scotland (17 Mar). Their report found that overall, customers are bombarded by around 500 promotions during the average online grocery shop, with around a tenth (11%) of all promotions for alcohol. Sainsbury’s was the worst offender, hosting the most alcohol promotions as a proportion of all food and drink promotions for both healthy (basket 1) and standard (basket 2) shopping trips.Doctors urge ministers to break sponsorship between alcohol and sport in ScotlandDoctors have renewed calls for Scottish ministers to break links between alcohol and sport with a clampdown on lucrative sponsorship deals, after an alcohol producer declared its support for Scotland’s national football team (The Times, paywalled, 28 Mar).Alcohol policy campaigners Scottish Health Action on Alcohol Problems (SHAAP) said children were especially susceptible to advertising and called for robust restrictions to be considered by the next Scottish government after May’s Holyrood elections.Recent events have exposed a sharp divide between sporting associations that embrace the backing of alcohol producers and those who spurn it: earlier in the month (22 Mar) Tennent’s Lager tweeted its continuing support for Scotland’s national football teams. This stands in sharp contrast to Scottish Women’s Football, who struck up a sponsorship agreement with Scottish Health Action on Alcohol Problems (SHAAP) in March 2019.‘It’s time for others to follow their lead and protect their fans and players,’ said SHAAP interim director, Lindsay Paterson. ‘Alcohol companies have large sums available for sponsorship and it is understandable but disappointing that Scotland’s national teams have accepted this sponsorship.’In response, the Scottish FA said that Tennent’s was the ‘original supporter’ of Scottish football and had been an integral part of the game dating back to 1974. ‘Over the years they have made a positive impact at all levels of the sport, and we look forward to building on that together in the years to come,’ they said in a statement.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

Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition:Pubs pray for Easter resurrection – government roadmap out of lockdown urges hospitality to wait a little longer for salvationSeveral studies uncover more evidence of the impact of home drinking during the COVID-19 pandemicThe European Union promises to beat cancer by tackling alcohol labellingDr Elena Dimova presents a review exploring men’s drinking habits in the context of becoming a father 🎵 Podcast feature 🎵Alcohol policy experts and public policy think tank urge the chancellor to raise duty for the good of the nation‘s health ahead of Budget 2021Child calls about parental alcohol misuse soar during pandemic, say NSPCCRoad safety group urge the government to follow other nations’ drink-driving policiesWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.Lockdown: Easter resurrection for pubs?This month saw rumours about pubs reopening post-lockdown reach a crescendo among the British press. The Sun and The Telegraph reported that as part of ministers’ determination ‘to open properly this time’, they planned to phase in the sale of alcohol, first by ‘allowing pubs to serve takeaway alcohol in April’, before a full reopening in May (05 Feb).However, headlines such as ‘Pubs and restaurants could reopen in April – with no alcohol’ drew ire from several sources. According to The Mirror (06 Feb), ‘a senior Government source was dismissive about the idea, telling PA: “We are not going to open pubs that can't sell booze. What would be the point of that?”’Many industry figures echoed this sentiment, such as Emma Clarkin of the British Beer & Pub Association, who wrote: ‘Opening pubs without selling alcohol is not “reopening” pubs at all’ (Morning Advertiser, 08 Feb). The trade body also claimed that the proposal wouldn’t help almost 30,000 of the country’s pubs – 60% – which would remain shut ‘because their beer gardens are too small for social distancing‘ (Mail Online, 16 Feb).A study from Stirling University suggests that the government may have had good cause to treat the prospect of reopening pubs with caution (Journal of Studies on Alcohol and Drugs, 16 Feb). Observing a varied range of venues operating under detailed guidance from government intended to reduce COVID-19 transmission risks over the summer of 2020, researchers found that practices were variable and a number of incidents of greater concern were observed, including close physical interaction between customers and with staff, which frequently involved alcohol intoxication and were rarely effectively stopped by staff.Professor Niamh Fitzgerald, Director of the University of Stirling’s Institute for Social Marketing and Health, who led the research, wrote that ‘despite the efforts of bar operators and guidance from government, potentially significant risks of COVID-19 transmission persisted in at least a substantial minority of observed bars, especially when customers were intoxicated.’This didn’t stop UKHospitality promising to ‘swiftly, safely and sustainably reopen pubs in April’, issuing their own roadmap to recovery ahead of the prime minister Boris Johnson’s announcement on 22 February (Morning Advertiser, 18 Feb).In the end, Johnson’s roadmap out of lockdown opted for a four-step approach, in which hospitality venues would open for outdoor service only from no earlier than 12 April (Step 2: including an end to both curfews and serving ‘substantial meal’ requirements), and indoor service would resume alongside it from no earlier than 17 May (Step 3). The prime minister’s plans mean pubs and other licensed venues will have to wait a little longer for salvation.Research shows impact of pandemic home drinkingSeveral studies published this month show how the COVID-19 pandemic has both led to soaring levels of home drinking and increases in deaths from alcohol.One Public Health Scotland (PHS) study (16 Feb), conducted with Glasgow University, showed that despite the fact that the pandemic and related restrictions were associated with a 6% reduction in the total volume of pure alcohol sold per adult in Scotland and in England and Wales, weekly consumption remained above the UK chief medical officers’ guideline of 14 units per week in the first months of the pandemic. Adults drank an average of 17·5 units in Scotland and 16·7 units in England and Wales. However, increases in per adult off-trade sales (28% in Scotland and 29% in England & Wales), did not fully replace the loss of on-trade sales.A second PHS study (16 Feb), conducted by the University of Sheffield Alcohol Research Group, found that all measures of self-reported weekly off-trade consumption increased during the first three months of the COVID-19 restrictions in both Scotland (+2·4 units per adult) and England (+1·7 units per adult). However, the researchers wrote, ‘these only compensated for some of the losses in on-trade consumption’, as overall self-reported units of alcohol per week fell 0·8 units and 1·5 units respectively. The analysis of population sub-groups also uncovered some worrying signs of drinking behaviours: in Scotland, there was an increase in solitary drinking for single adult households, households with three or more adults, and those in full time education. Overall, PHS concluded that the studies ‘suggest that at a population level people in Scotland were drinking less in the early months of the COVID-19 pandemic than in previous years.’Another study focusing on the UK as a whole found that more than one in six (17%) UK adults increased their alcohol consumption during lockdown, with a higher proportion of drinkers aged between 18 and 34 years of age (Drug and Alcohol Dependence, 01 Feb). Increased alcohol consumption was independently associated with poor overall mental health, increased depressive symptoms and lower mental wellbeing. Pandemic takes its toll on alcohol death ratesThere are early indications of impact of COVID-19 on alcohol deaths in England and Wales during the first two lockdowns. The Office for National Statistics (ONS) released a provisional dataset showing that there were 5,460 deaths related to alcohol-specific causes registered in the first three quarters of 2020 (Jan to Sept), a 16·4% increase compared with the same nine-month period in 2019. At one point, the death rate reached its highest peak since the data time series began in 2001, of 12·8 deaths per 100,000 people (02 Feb).Commenting on the findings, Ben Humberstone, deputy director of Health Analysis and Life Events at the ONS said: ‘Today’s data shows that in the first three quarters of 2020, alcohol-specific deaths in England and Wales reached the highest level since the beginning of our data series, with April to September, during and after the first lockdown, seeing higher rates compared to the same period in previous years.‘The reasons for this are complex and it will take time before the impact the pandemic has had on alcohol-specific deaths is fully understood.’In the long run, Scotland shows most improvement on alcohol deathsLong term trends highlight contrasting fortunes between Scotland and the other UK nations in recent years.The ONS published ‘Alcohol-specific deaths in the UK: registered in 2019’, which found that there were 7,565 deaths (11.8 per 100,000 population) registered in the UK that related to alcohol-specific causes in 2019. This is the second highest number of deaths since the data time series began in 2001.Between the UK nations, Northern Ireland became the constituent country with the highest alcohol-specific death rate in 2019 (18.8 deaths per 100,000), partly because of its worsening rates (2019 saw the mortality rate reach a record high of 18·8 per 100,000 people) and partly because of Scotland drastically lowering its rate over the same period – Scotland is only UK nation to show statistically significant improvement in its alcohol-specific death rates since records began in 2001.Alcohol deaths, an ageing problemTrend data also indicate that the mortality rate crept upwards over the period, exposing the emerging phenomenon of middle-age / older drinkers’ ill health: there were significant increases since 2001 in the rate of alcohol-specific deaths of people aged 55 to 79 years.The report noted that: ‘Given that the definition of alcohol-specific deaths includes mostly chronic conditions, such as alcoholic liver disease, the increased rates in the older age groups may be a consequence of misuse of alcohol that began years, or even decades, earlier’.EU promises to beat cancer by tackling alcohol labellingEU commissioners agreed to propose placing mandatory health warnings on alcoholic beverages by 2023, as part of Europe’s Beating Cancer Plan (POLITICO, 03 Feb).Brussels will also propose labelling alcoholic beverages with ‘mandatory indications’ of their ingredients and nutritional contents by the end of 2022. The measures will be part of a Commission review of its promotional policy for alcoholic beverages.An earlier draft of the plan had: proposed including calorie content information on labels; committed the Commission to ‘stop stimulating consumption of alcohol via the EU promotion programme for agricultural products’ and to review EU legislation relating to the taxation of alcohol and on cross border purchases of alcohol by private individuals; and called for the Commission to ‘closely work with member states to reduce online marketing and advertising’ as a way of reducing young people’s exposure to alcohol promotion. However, these proposals were dropped from the final version.Both industry and public health figures welcomed the plan, albeit for different reasons. Ulrich Adam, the director general of industry group spiritsEUROPE, said they were ‘heartened to see that the Commission plans to encourage self- and co-regulatory initiatives related to marketing, an area in which our sector has long delivered on ambitious standards and targets’.Mariann Skar, secretary general of European Alcohol Policy Alliance, said in a press statement: ‘It is high time that the forgotten link between alcohol and cancer is brought to the attention of the public. As consumers we have the right to know about the effect’s alcohol consumption has on our health. There needs to be better public information, more awareness among health professionals and effective public health measures to highlight this link and to further promote action to reduce avoidable illnesses and deaths.’Alcohol and fatherhood study finds ‘teachable moment’🎵 Podcast feature 🎵New fathers’ voices are almost absent in relation to their experiences of alcohol use and of research on the effectiveness of interventions to support them to reduce alcohol consumption, according to a new report published under the IAS Small Grants Scheme (25 Feb).Dr Elena Dimova, research fellow at Glasgow Caledonian University, conducted a scoping review of the literature on the subject of alcohol and fatherhood. Qualitative studies suggested that men may reduce their drinking to support their pregnant partner. However, men’s alcohol consumption beyond this narrow focus is rarely explored. Another study explored in depth men’s views of problematic drinking during fatherhood and found that men believed that fathers should be a role model for their children. The review also identified two interventions, of which one showed significant reduction in alcohol use among fathers, suggesting that couple-based interventions may be effective in addressing health behaviours. However, it was a smoking intervention which did not address alcohol directly.Men (especially those from lower socio-economic backgrounds) are more likely than women to drink at hazardous/harmful levels and to suffer from alcohol-related harm. This is compounded by a gender inequality in relation to men’s involvement in family planning and antenatal care. However, the transition to fatherhood may present a ‘teachable moment’ when men evaluate their health, modify existing health behaviours and adopt new ones.The findings have implications for researchers and health practitioners, as insufficient understanding of new fathers’ experiences of alcohol use may result in missed opportunities to address hazardous and harmful drinking among men during an important period of transition into fatherhood.Dr Dimova presented her review, ‘Exploring men’s alcohol consumption in the context of becoming a father’ at the regular Alcohol Occasionals seminars.You can hear highlights of the event in the February 2021 Alcohol Alert podcast.In other researchNew findings show that alcohol-related violence affects the poorest in society to the greatest degree, with the most deprived groups experiencing up to 14 times as many incidents of alcohol-related domestic violence every year, compared with the least deprived (PLoS ONE, 18 Feb). Drawing data from the Crime Survey for England and Wales for the years 2013/14 to 2017/18, IAS research and policy officer Lucy Bryant and Dr Carly Lightowlers from the University of Liverpool also found that lower socioeconomic groups experience higher prevalence rates of alcohol-related violence overall, and that the likelihood of experiencing these types of violence is affected by a person’s socioeconomic status even when other risk factors known to be associated with violence are held constant. The researchers conclude: ‘along with action to address environmental and economic drivers of socioeconomic inequality, provision of publicly funded domestic violence services should be improved, and alcohol pricing and availability interventions should be investigated for their potential to disproportionately benefit lower socioeconomic groups.’Midwife advice about the low risk alcohol guidelines for pregnant women beyond the initial booking appointment can ‘lead to improved outcomes for women and infants’, according to research published in BMC Pregnancy and Childbirth.An online survey of UK midwives found that of 842 respondents, nearly three fifths (58%, 484) were aware of the 2016 Alcohol Guidelines, from which 91% (438) cited abstinence as a recommendation. The study also found that the vast majority of midwives would always (90%) or usually (7%) advise women to abstain from alcohol during pregnancy at the booking appointment. Just over a third (38%) did so at subsequent antenatal appointments.Regarding midwives’ opinions about the usefulness of the low risk guidelines, the research team found that the biggest barriers to advising women using those guidelines were: a lack of belief that the guidelines are accurate and represent the best available evidence on alcohol and pregnancy; a belief that the guidelines do not support building a rapport with women; that women do not like being advised about abstinence and a belief that advising women to abstain has no impact on their behaviour.Midwives were most likely to advise women to abstain from alcohol if the desire and intention was there and if they saw it as integral to their job.Lesbian, gay and bisexual (LGB) people are significantly more likely to have mental health conditions and report alcohol and drug misuse than heterosexual people, according to a new study led by University College London researchers in collaboration with the University of East Anglia and City University (UCL, 17 Feb).Published in Psychological Medicine, the research analysed data from the 2007 and 2014 Adult Psychiatric Morbidity Surveys comprising a total of 10,433 people in England aged 16-64, finding no improvement over the period: LGB people remained at higher risk of poorer mental health when compared to heterosexuals.The prevalence of alcohol misuse was highest in lesbian and gay people, at 37%, compared with bisexual people at 31%, and heterosexuals at 24%.Given this continued disparity, the report’s authors call for government action to ensure equity in health and social care services.In Australia, minimum unit pricing (MUP) has seen consumption of high alcohol content such as cheap cask wine slashed in the Northern Territory region. An examination of the policy – which required retailers to charge a floor price of $1.30(AU) per standard drink (10g pure alcohol) from October 2018 – saw a corresponding halving (50·6%) of per capita alcohol consumption in the 12-month period following its implementation compared with the year before (Australian and New Zealand Journal of Public Health, 09 Feb).Alcohol industry actors use ‘confrontational tactics’ to undermine public health messaging such as the UK’s low risk guidelines, according to research published in the Journal of Studies on Alcohol and Drugs (15 Feb). Interviews with civil servants, parliamentarians, and public health and civil society actors revealed a major public relations campaign in which major alcohol producers strongly criticised the guidance of the UK Chief Medical Officers, rejecting the well-established association between alcohol and cancer ‘without recourse to evidence’. Furthermore, the Portman Group, which was prominent in the industry’s response, failed to instruct their members to carry the revised content on product labels. The authors of the study write that their analysis ‘further calls into question the rationale for co-regulatory and partnership-based approaches with the alcohol industry.’Budget 2021: Raise duty for the good of the nation‘s healthPublic health experts and think tanks are calling on the government to raise alcohol duty to help combat the ill health effects of alcohol ahead of this year’s Budget. Scottish Health Action on Alcohol Problems (SHAAP) and the Institute of Alcohol Studies (IAS) both wrote letters to Chancellor of the Exchequer Rishi Sunak in support of Alcohol Health Alliance (AHA) UK’s campaign to increase alcohol duty by 2%.Lindsay Paterson (interim director) and Dr Alastair MacGilchrist (chair) of SHAAP also wrote in favour of a ‘simpler, fairer system which is proportionate, consistent, scaled and regularly uprated’ (15 Feb). Dr Katherine Severi (IAS chief executive) suggested that raising duties would provide the ‘double dividend’ of both reducing the alcohol harms and generating vital public revenues at this crucial time for HM Treasury, when alcohol duty cuts and freezes since 2012 have cost £1·3 billion annually in lost revenue – the equivalent of the salary of 41,000 nurses (10 Feb).In a blog post for the AHA, Colin Shevills, director of Balance the North East Alcohol Office, noted that a further cut in alcohol duties risks increasing the price differential between the off and on trade, ‘thus making things worse for pubs’ at a time when their trade has been decimated by the pandemic (12 Feb).Recognising this differential, think tank the Social Market Foundation produced analysis setting out reforms to alcohol duty that could provide a lifeline to the hospitality industry while reducing harmful drinking (19 Feb).They claim that a ‘pub relief’ on alcohol duty that allowed pubs, bars and other licensed premises to claim back a percentage of the duty costs that they face would ensure that publicans directly benefit instead of brewers, and even if HM Treasury kept alcohol duty revenue-neutral, such a change would boost on-trade beer sales amounts by roughly 95 million additional pints a year. The next Budget will be held on 03 March 2021.Child calls about parental alcohol misuse soar during pandemicThe average number of calls to leading children’s charity NSPCC about parental or adult substance misuse rose two thirds (66%) in the first 10 months of the COVID-19 pandemic (NSPCC, 17 Feb).According to their figures, there was an average of 709 contacts to the NSPCC helpline about parent/adult alcohol/substance misuse a month before the first national lockdown, which increased to 1,178.This news came during COA Week, led by the charity the National Association for Children of Alcoholics (NACOA), who provide year-round support for children affected by parental alcohol problems. Jonathan Ashworth MP and Josh Connelly from NACOA shared their experiences living with alcohol-dependent fathers in national media outlets including Times Radio.GEM: UK drink-driving policies in the slow laneThe UK Government could learn from overseas countries’ examples of how to tackle drink-driving, say road safety and breakdown organisation GEM Motoring Assist, as it follows other groups in calling for a review of inadequate drink drive laws as deaths involving drink drivers reached a 10-year high (Fleet World, 17 Feb).Provisional government statistics for 2019 show that there were an estimated 280 deaths from drink-driving on Great Britain’s roads, 40 more than the previous year and the highest number of deaths since 2009 (Department for Transport, 11 Feb).This follows a report from the Parliamentary Advisory Council for Transport Safety (PACTS) last month that said UK drink-driving policy needed a major review, advancing solutions such as a lower limit and improved breath testing enforcement.GEM chief executive Neil Worth said: ‘Levels of police enforcement have decreased by 63% since 2009, whilst the much-heralded roadside evidential breath testing equipment shows no signs of making it into the police toolkit any time soon. As things stand, England and Wales have Europe’s highest drink drive limits, with absurdly long and complex police procedures required to secure a prosecution.’GEM has instead said that the government should use examples of good practice from other countries – including Estonia, Denmark, Australia, Israel, Belgium, and Finland – as the basis for taking urgent steps to reform the rules around drink-driving.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

Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition:The Westminster administration relies on its experiences of managing last year’s lockdowns to enforce a ban on takeaway alcohol in England Researchers find that an app designed to help people drink less received a celebrity boost 🎵 Podcast feature 🎵Pandemic makes this year’s Dry January the toughest yetIrish shoppers are no longer allowed to buy discounted alcoholNew PACTS report finds that a lower drink drive limit ‘would have a totemic impact’ on UK road safetyMember of Parliament for Bury South, Christian Wakeford is to become the new chair of the All-Party Parliamentary Group on Alcohol HarmRegulator clears racy alcohol television ad of wrongdoingWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.Lockdown 3: Westminster uses 2020 vision to enforce alcohol takeaway ban in EnglandThe new year began with a now-familiar focus towards lockdown-induced restrictions on alcohol sales during the pandemic, with the government banning alcohol takeaways from licensed premises (The Independent, 05 Jan):Alcohol takeaways are to be banned… until mid-February in England as Boris Johnson clamps down on socialising under the new lockdown regime. All restaurants, pubs and other hospitality settings must close their doors to customers… under the new rules announced by the prime minister… venues will no longer be able to serve takeaway or click-and-collect alcohol.The other Home Nations tightened their rules too, with Scotland, Wales and Northern Ireland still permitting alcohol takeaways, but under more stringent conditions and while licensed premises (throughout Northern Ireland, and in tier level 4 in Scotland and Wales) remained closed to normal custom (BBC News Business, 13 Jan).Alcohol industry players claim that the uncertain trading environment faced by the hospitality sector had a significant impact on alcohol sales last year. The Morning Advertiser reported that 37 pubs a month ‘vanished’ in 2020, not because of a shift in operations from wet- to dry-led sales, or the rise of venues such as micropubs replacing traditional outlets, but simply because they had received insufficient support to remain a financially viable concern while shut (11 Jan). Chair of the Campaign for Real Ale (CAMRA) Nik Antona claimed that the new lockdown restrictions ‘could tip hundreds of pubs over the edge into insolvency in the coming months’, and called on the government to allow pubs to act as off-licences during the lockdown by selling pints in ‘sealed containers’ (Evening Standard, 07 Jan).However, there were also suggestions that appeals for support should instead focus on compensating venue owners for enforced closures of their premises.According to The Independent, the Wine and Spirit Trade Association (WSTA) annual market report estimated 5%, 10%, and 15% declines in beer, wine and gin sales respectively in the year to October 2020, despite retailers enjoying ‘a boom in alcohol sales during the pandemic’ (07 Jan).Based on these industry data, the WSTA chief executive claimed ‘it’s a myth that people are drinking more during lockdown’, a statement which runs contrary to evidence from Public Health England and several independent research groups which have reported increased rates of heavy drinking during the pandemic. Two studies published this month reported that a significant minority of people’s alcohol intake had increased. The first examined vulnerable populations, tracking health behaviours during the early days the lockdown: of the 1,044 participants involved, 30% had a ‘COVID-19 at risk health condition’, 37% were classed as deprived and 6% self‐reported a mental health condition, yet relative to pre‐pandemic levels, participants’ drank more alcohol on average and did so more often (British Journal of Health Psychology, 06 Jan).The second, a much bigger study (of more than 30,000 adults, published in Drug and Alcohol Dependence journal) found that roughly the same proportion of drinkers admitted to drinking more as those who reported drinking less (26·9% versus 25·7%) than usual during the first lockdown (The Independent, 14 Jan).The one in four who were more likely to report upping their intake were younger women with post-16 educational qualifications and a household income over £30,000. The University College London research team also found that having an anxiety disorder, being stressed about finances or about catching or becoming seriously ill from COVID-19 were factors associated with drinking more. The authors noted that it is possible that people with anxiety disorders are changing their drinking behaviour to self-medicate or as an unhelpful coping mechanism during a period of increased anxiety. Lead author Dr Claire Garnett said:Women might be more likely to drink more than usual during lockdown because they have been more negatively affected by the pandemic through increased gender inequalities as women are more likely to lose their jobs and carry the burdens of increased childcare and housework.Co-author Dr Melissa Oldham stressed the importance of ‘targeted approaches to provide support for certain groups who are more likely to drink more is needed, particularly with the start of this third lockdown.’Meanwhile, some health experts had some sobering advice for those in line for the COVID-19 vaccine. On BBC Panorama, emergency medicine specialist Dr Ronx Ikharia demonstrated how three glasses of prosecco (4·5 units) was enough to reduce the levels of white lymphocyte cells – crucial for warding off viruses and other pathogens – in the blood by up to 50%, therefore weakening the body’s immune response to the vaccine (06 Jan). However, the message was somewhat undermined by BrewDog’s stunt to offer its closed outlets across the United Kingdom as COVID-19 vaccination centres where those vaccinated could walk away with a ‘special commemorative beer’ (Lonely Planet, 20 Jan).The craft beer brewer is one of many alcohol industry actors looking to exploit the pandemic, according to a report commissioned by Movendi International that provides ‘a comprehensive picture of the individual, societal and policy dimensions of the interaction between alcohol and the coronavirus crisis’.‘Alcohol and the coronavirus pandemic: individual, societal and policy perspectives’ offers the following solutions for governments to reduce the alcohol burden and mitigate the pandemic (26 Jan):Maintain and improve alcohol policy measures;Limit alcohol availability and affordability and make use of evidence-based alcohol pricing policies;Ensure effective public health messaging on alcohol and COVID-19 from health authorities;Make clinical and treatment provisions for people experiencing all types of alcohol-related problems; andIncrease access to mental health services, including online services.In the UK, given the difficulty of accessing treatment services and of maintaining a healthy relationship with alcohol for many adults in 2020 due to the threat of COVID-19, the British Liver Trust fear that the pandemic could lead to tens of thousands more liver disease cases in 2021. They call ‘for every person in the UK to consider their liver health and take a simple quiz to assess their risk’ (04 Jan).Vanessa Hebditch, director of policy and communications said: In early 2020, our Love Your Liver health screening roadshow was ready to tour the nation, offering free liver health checks to the general public at high streets up and down the country.Unfortunately, COVID-19 forced us to postpone the roadshow. That meant that around 4,000 people will have missed out on a free liver health check. If we look at the statistics from previous Roadshows, around 650 of those would have shown signs of possible liver damage.We are very concerned that while thousands will have missed out on valuable liver health advice, some of those people will already have undiagnosed liver disease which won’t show symptoms until the very late stages when treatment options are limited.2020 was a really stressful year for everyone. We know from our research that a lot of people drank more alcohol and ate unhealthier food last year – two major risk factors for liver disease. We also know that some people have missed out on appointments and treatment while healthcare resources have been diverted elsewhere as a result of the pandemic.The Adrian Chiles effect – a natural experiment🎵 Podcast feature 🎵The celebrity influence of broadcaster Adrian Chiles on the Drink Less app caused a spike in middle-aged men engaging with the app, according to a study published in BMC Public Health (06 Jan).Researchers at University College London found that the weekly average of 179 downloads between May 2017 and mid-August 2018 rose to 14,866 total downloads in the week commencing 20 August 2018, when Chiles’s show Drinkers Like Me was first broadcast. He also advised: ‘I encourage anyone, don’t judge yourself, don’t panic you’re not going to drop dead, but go on an app like “Drink Less” and measure what you’re drinking, be honest with yourself for three weeks.’The study reported a ‘step-level increase in app engagement – number of sessions and number of days used – which continued to increase over time’. No effect of media coverage was detected on employment type or on the percentage of at-risk drinkers, though the mean Alcohol Use Disorders Identification Test score was lower after the media coverage.In our podcast interview, lead researcher Dr Claire Garnett said of the findings:It shows that celebrity influence and the subsequent national media coverage that comes with it can clearly have a really substantial impact on who uses an app or additional intervention and how they engage with it.In other researchHigher smoking frequency at admission is associated with higher illicit opioid and alcohol use frequency after six months of specialist addiction treatment, according to research released in Drug and Alcohol Dependence (01 Jan).Two cross-lagged panel models* estimated (separately for opioid and alcohol use disorder patients) the relationships between smoking at admission and change in main drug over six months, and between main drug use at admission and change in smoking over six months. Within the alcohol use disorder cohort, alcohol use frequency fell from 21·2 days to 14·4 days while smoking tobacco reduced from 12·6 days to 11·5 days. Higher smoking frequency at admission was associated with a relative increase in alcohol use at six months (0·03 days), and each additional day of alcohol use at admission increased on average the tobacco use reported at six months by an estimated 0·04 days.A study of over 309,000 regular drinkers from the UK Biobank UK has found that different patterns of alcohol consumption could be associated with a lesser risk of alcohol-related negative health outcomes (BMC Medicine, 12 Jan).Researchers from the University of Glasgow found that regular spirits and beer/cider drinkers had a higher adjusted risk of death, major cardiovascular events, liver cirrhosis and accidents/self-harm when compared to those who drank red and white wine, after adjusting for alcohol amount consumed overall. Similarly, drinking alcohol without food was associated with a 10% higher adjusted relative mortality and cardiovascular risk when compared to alcohol consumed with food.The results also showed that spreading alcohol consumption over three to four days in a week was associated with lower adjusted relative mortality, cardiovascular and cirrhosis risk than consuming alcohol daily; and lower mortality and cardiovascular risk than binge drinking similar amounts of alcohol.Commenting on the study’s findings, Dr Bhautesh Jani, clinical senior lecturer in general practice at the university's Institute of Health and Wellbeing, also warned of the health risks of regular alcohol consumption above the low risk guidelines: Of the regular alcohol drinkers we studied, less than half reported consuming the recommended amount for low risk alcohol consumption, so our first suggestion would be for regular drinkers to follow the recommended government guidelines. Other ways to further lower the alcohol consumption related health risks, based on our findings, might be to spread consumption over the course of three or four days – whilst being careful not to increase their overall intake – and consider… drinking with meals where possible.People with epilepsy are at increased risk of dying from alcohol misuse, according to a study published in Frontiers in Neurology journal (21 Jan).An analysis of the relative risk of alcohol-specific mortality in people with epilepsy, and the extent to which problematic alcohol use was previously identified in the patients' medical records, identified a five-fold increased risk of alcohol-specific mortality in people with epilepsy vs. those without the condition.The research team delineated cohort studies in two population-based datasets, the Clinical Practice Research Datalink (CPRD GOLD) in England and the Secure Anonymised Information Linkage (SAIL) Databank in Wales between 2001 and 2015, linked to alcohol-related hospitalisation and alcohol-specific mortality records. They concluded that the causality between alcohol misuse and epilepsy could run either way, and stressed the importance of accurately quantifying the risk of death among epilepsy sufferers.England and Scotland have topped the international rankings for drunkenness again (25 Jan). The Global Drugs Survey (GDS) for 2020 suggests the UK’s drink problem is far more dangerous than any other country: more than 5% of people under 25 years of age reported having sought hospital treatment after getting drunk, compared with the international average of 2%.The survey questioned more than 110,000 people from more than 25 countries between November 2019 and February 2020.It repeated last year’s finding that UK drinkers get drunk most often of all countries’ individuals: people in Scotland and England said they had got drunk on average more than 33 times in the last year, more than twice the rate of several European countries, including Poland, Hungary, Germany, Greece, Romania, Spain, Italy and Portugal. Only 7% of Scottish and English people surveyed reported not having been drunk at all in the past 12 months. Only Danes and Australians had a lower proportion, at 5%.Professor Adam Winstock, the chief executive and founder of the GDS, said: ‘We don’t have a culture that is honest about the impact of intoxication. Drinking is a lousy coping strategy and it is putting a higher burden on the NHS. British people have never really embraced moderation when it comes to drinking. While many other cultures regard alcohol as an accompaniment to a social event and frown upon public drunkenness, we’ve often embraced it as a cultural identity. The challenge is making people realise drinking a bit less does not make you boring. In fact, you’ll probably have a better night. It’s like as a country we need to leave our adolescence behind.’Professor Winstock urged the government to stand up to the alcohol lobby and introduce mandatory health warning labels and minimum pricing, and lowering the drink-drive limit, remarking that they were all ‘incredibly sensible things that have been recommended by several commissions, but have been ignored in the face of resistance from the alcohol lobby.’* a cross-lagged panel model is a type of structural equation model that measures two different variables (smoking vs alcohol use disorder) at two points in time (admission vs six months later).Dry January 2021 – attempts at abstinence come under pandemic’s influenceOrganisers of the country’s biggest alcohol abstinence campaign, Alcohol Change UK, rang in the new year with a record number of participants ready to ‘forego booze’ for the first month of 2021, according to The Guardian (31 Dec 2020):The charity Alcohol Change UK said its polling shows more than 6·5 million adults intend to participate in Dry January – up from 3·9 million last year. That is the equivalent of one in five of people who drink alcohol.However, some media coverage cast doubt on the impact of the nationwide initiative. Trade mag Drinks Business quoted a snap poll from ‘creative insight agency’ KAM Media claiming that 2·7 million out of 10.8 million participants who began the challenge on the first of January gave up by the end of the first week (06 Jan).And writing in Prospect Magazine, philosopher Julian Baggini suggested that Dry January would do little to stop the problematic consumption patterns inherent in British drinking culture (13 Jan):Dry January merely replicates the source of the problem it is supposed to be solving. It reinforces the idea that we need to go through a period of complete abstention to make up for our festive excesses. It perpetuates the binge-purge cycle rather than short-circuits it… if you want to change your habits, it is better to start a routine you can sustain, such as limiting drinking days and quantities, rather than going through a one-off challenge in which no new habits are learned.  Away from notions of ‘falling off the wagon’ and purges doing more harm than good, Alcohol Change UK’s chief executive Richard Piper took to social media to explain that the true message of Dry January is less about pursuing an unattainable mode of perfection in abstinence and more about drinkers becoming more aware of their alcohol habits in order to help control them, acknowledging that reducing your drinking is a process, not an event.No more alcohol multibuys and discounts for Irish shoppers The days of discounted alcohol sales by supermarket voucher schemes and multibuy deals in Ireland are over, as the government brings into force another element of its Public Health (Alcohol) Act 2018 (Irish Times, 08 Jan).Popular deals such as ‘buy six bottles for €50’ or ‘buy six and get 25% off’ will no longer be permitted. Offering loyalty points on alcohol sales will also be prohibited, while short-term promotions, of three days or less, can no longer take place. Discounts on the price of individual bottles of alcohol will still be allowed.Commenting on the development, Eunan McKinney, Alcohol Action Ireland’s head of communications, said: We welcome this latest step on what is a very long journey to implementing the Public Health Alcohol Act; the operation of these regulations now ensures that people are not further incentivised, or rewarded, for using alcohol.The fundamental action that is required next is the immediate implementation of minimum pricing of alcohol products, which has been interminably delayed by government inertia, yielding to the concerns of the alcohol producers.The country’s chief medical officer Dr Tom O’Connell also welcomed the move, as he considered limiting off-licence opening hours to help stop the spread of COVID-19.Other newsNo more stalling on the drink drive limit: A lower drink drive limit ‘would have a totemic impact’ on UK road safety, according to the Parliamentary Advisory Council for Transport Safety (PACTS) in a new report, ‘Drink Driving: Taking Stock, Moving Forward’ (25 Jan).In their comprehensive review of UK drink-driving, PACTS analysed casualty and crime drink drive data, and conducted interviews with 30 drink drivers, concluding that with no progress made in several drink drive policy areas – such as the annual number of drink drive deaths stalling at roughly 240 for the last decade – the UK’s drink-driving legislative framework is no longer adequate, recommending several interventions to save lives in future.Commenting on the report, David Davies, executive director of PACTS, said: Drink-driving is often cited as a road safety success story, yet it remains a major killer and progress has ground to a halt since 2010. Not only is better enforcement important but also the problems of mental health and alcohol dependency need to be recognised.Scotland introduced a reduced drink drive limit in 2014, in line with most other countries in Europe. It has been accepted by the public; it has not significantly impacted pubs and restaurants or overloaded the police or the courts. Northern Ireland plans to go further, with a zero limit for novice and professional drivers.A lower limit is not a magic bullet but government polices to reduce drink driving will lack credibility as long as they avoid this change.New Year, New APPG chair: Member of Parliament for Bury South, Christian Wakeford, will become the new chair of the All-Party Parliamentary Group on Alcohol Harm (20 Jan). The next public event will take place on 10 March and will be sponsored by Alcohol Change UK.Racy alcohol ad cleared by watchdog: The Advertising Standards Authority (ASA) have rejected calls to ban a television advert said to link alcohol with sex (06 Jan).The complainant challenged whether the ad for Laphroaig whisky was irresponsible because: it linked alcohol to sexual activity; and it portrayed alcohol as indispensable.The ASA ‘considered that the ad clearly showed people’s reactions to tasting Laphroaig whisky, which was well known for its unusual taste'‘ and ‘noted the reference to “You’ll always remember your first” alongside the facial expressions, which showed various reactions after tasting the whisky’.However, despite acknowledging that one could interpret the advert’s catchphrase as a reference to losing one’s virginity, the regulator decided that the ad actually gave an illustration of the different reactions people had encountering a distinctive taste for the first time, and so ‘did not imply any link between drinking Laphroaig whisky and sexual activity, sexual success or seduction’. They also considered that the ad did not portray alcohol as being indispensable, based on the fact that a key scene appeared to be more of ‘a light-hearted expression of [the actor’s] enjoyment of the whisky’s flavour’.The ad watchdog found that the ad was not in breach of its newly updated alcohol rules of the CAP (rule 18·9) and BCAP (rule 19·10) Codes, which now include minor amendments to ‘clarify the language used to describe the ABV [Alcohol By Volume] thresholds at which drinks are subject to the alcohol rules and what strength a “low alcohol” drink is considered to be’.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

Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies. In this edition:Home drinking increasingly becomes the new normal during lockdownEconomics think tank study says a reformed duty system would improve MUP’s effectivenessAlcohol Health Alliance UK pricing survey finds that alcohol is still being sold at pocket money pricesScottish Health Action on Alcohol Problems call for all MSP candidates to promise a total ban on alcohol advertising ahead of the 2021 electionsIAS to hold an online event presenting new findings on alcohol policy and nudge theory 🎵 Podcast feature 🎵The Scottish Government launches a free FASD eLearning resourceWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.Lockdown: home drinking becomes the new normalNovember saw the UK enter into a second lockdown, as ministers realised that the tier system for controlling the virus could no longer contain the rising R rates throughout the UK. As a result, all pubs were forced to close from 05 November until 02 December (Morning Advertiser, 31 Oct), and anticipated bans such as that of alcohol consumed on ScotRail trains came into force (STV News, 16 Nov).The penultimate month of the calendar year was also a time for reflecting on how people’s drinking habits had changed since the first lockdown.A study from alcohol industry-funded body Drinkaware found that women were a bigger influence than men out of the 26% of people whose alcohol intake increased between March and June (Daily Mail, 02 Nov), the primary reason for doing so being that they had ‘more free time available’.The Royal College of Psychiatrists observed that nearly half (45%) of its psychiatrists had seen a rise in patients whose alcohol or drug use had contributed to a deterioration in their mental health during the pandemic (The Telegraph, 15 Nov), Dr Katherine Severi, IAS chief executive, explained that ‘the closure of bars and restaurants had driven people into drinking at home, which meant it was not only cheaper than buying in a restaurant but also that people were consuming more.’Data from Public Health England (PHE) also showed that older age groups all significantly increased their alcohol intake during lockdown, with a fifth of those aged 45 to 74 years drinking more than 21 units a week. Those aged 55 to 64 who drank at least a pint a day (three units) jumped from 17·4% to 20·6% with one in 20 consuming more than 50 units weekly, almost three pints a day.And an Opinion Matters poll of more than 1,000 people aged over 50 years, commissioned by We Are With You found that: 20% were drinking more since March; 10% earlier in the day; and more than half drink at a level that could cause health problems now or in the future, a cause of great concern for 35% of those surveyed who are children of those parents. Projected tax receipts and sales data appeared to confirm that off-licence vendors of alcohol have profited substantially from the pandemic. The Office for Budget Responsibility’s economic and fiscal outlook revised alcohol duties upward by an average £1 billion a year, as receipts in 2020/21 held up much better than assumed (24 Nov):The loss in receipts from closures of pubs and restaurants has been more than offset by higher sales in supermarkets and other shops. Alcohol consumption has therefore been one of the few tax bases left relatively unscathed by the virus.The 2020 British Lifestyles Report from consumer research group Mintel estimated that annual retail value sales of alcoholic drinks will grow at its fastest rate for at least a decade – 16% – to reach £25.5 billion in 2020, ‘as people trade nights out for evenings in’ (20 Nov). Spending per household on alcohol is expected to average £129 in 2020.Jack Duckett, Mintel associate director of consumer lifestyles research, also wrote of the potential for further growth from drinks makers appealing to the mature drinker:The growth in the size of the older population over the next five years, and the fact that they are most likely to be insulated from the financial impact of the pandemic, makes targeting the ‘grey pound’ particularly timely for all brands including alcoholic drinks.In Ireland, the Revenue discovered a slump in drinking outside the home, as their sales data recorded a 4.5% fall in alcohol consumption since the start of the year, mainly because of pubs forced to close for lockdowns. Alcohol Action Ireland warned that drinkers ‘had largely substituted their on-trade activity with unregulated home drinking’, a sentiment echoed by the Vintners’ Federation of Ireland chief Padraig Cribben. He told the Irish Sun it was ‘obvious that because of the pandemic a massive volume of alcohol is now consumed at home’ (03 Nov).And where drinking patterns have moved indoors, so have increased risks of alcohol-related harm. Consultant psychiatrist Rebecca Lawrence wrote in The Guardian that although it is difficult to determine the exact picture of British drinking habits during lockdown, we can ‘intuit’ some things (18 Nov):I worry about those who were drinking just a bit too much before who have now tipped into problem drinking. It doesn’t take a lot, and there are many on this uncertain edge. Stress levels are high, with fears about infection or economic insecurity taking their toll.Many of my patients who are already alcohol-dependent tell me they have relapsed due to boredom, and, even more importantly, lack of any human contact. When we talk about relapse prevention, we talk about seeing people, talking to people, going to groups, and all this is up the spout at present. There are groups online, but not everyone can access these. In any case, it’s not the same, as those of us who are all Zoomed out will testify to.Sometimes too much contact is the problem: families are forced together, something that can be hard even for the most loving partners or parents. Alcohol can be a form of mental, if not physical, escape.Whether newly dependent or relapsed, what’s clear is that people need help to get through this.Funding public health: Winter plans and ‘Spending Reviews’In the final week of lockdown, Prime Minister Boris Johnson revealed the government’s post-lockdown winter plan to the House of Commons: a return to the tier system, with the added detail of businesses to be permitted to serve alcohol ‘only as part of a substantial meal’ in designated tier 2 zones of the country, a move unlikely to curb increasingly routinised home drinking habits and their potential harms (23 Nov).Furthermore, the lack of sufficient services for the rising numbers of people struggling with alcohol dependency and other substance misuse problems led to calls from the Local Government Association (LGA) – which represents councils responsible for public health – for the chancellor to invest in vital public health services ahead of the Spending Review (LGA, 21 Nov):COVID-19 [has] exposed existing health inequalities which need to be levelled up if we are to protect our communities in future, and so to address this divide, the Spending Review ought to have reversed the £700 million of public health funding reductions experienced by councils over the previous five years.Chancellor of the Exchequer Rishi Sunak authorised the provision of £254 million of additional resource funding in 2021/22, to ‘bolster’ substance misuse and frontline support services, for tackling homelessness and rough sleeping (HM Treasury, 25 Nov).As we head into the winter, with alcohol-related health outcomes worsen for many drinkers across the UK because of the drastic change to consumption habits induced by the pandemic, the calls of local authorities to support public health services may yet grow louder.Reformed duty system would improve MUP’s effectivenessEconomics think tank the Institute for Fiscal Studies (IFS) have published new research showing that while minimum unit prices for alcohol (MUP) are reasonably well targeted at heavy drinkers, they may come at the cost of reducing tax revenues (20 Nov).Using data on millions of alcohol purchases made by Scottish and English households, the analysis shows that:Prior to the introduction of the minimum unit price, half of all transactions for alcohol bought in shops in Scotland were below 50p per unit. The minimum unit price led to a 5% increase in the average price per unit, but some very cheap products saw their prices double, while more expensive products were unaffected.This led to an 11% fall in units purchased per adult per week, with larger falls for more heavily drinking households.However, the IFS fear that MUP creates windfall revenues for the alcohol industry, while reducing revenue for HM Treasury:The analysis finds that if the 50p minimum unit price were extended to the whole of the UK under the existing system of alcohol taxes, then tax revenue would fall by around £390 million per year.This is in addition to projected annual losses from recent changes to alcohol duties averaging £200m to 2024/25.The report’s authors conclude that ‘a minimum unit price, combined with a more coherent set of taxes on alcohol, would be just as well targeted at heavy drinkers and would limit the fall in revenue for the exchequer’.Alternatively, they propose replacing the current system of duties with ‘a two-rate structure that taxes alcohol in proportion to its alcohol content, with a higher rate on strong spirits’, which would lead to an increase in tax revenue of over £70 million.One of the report’s authors, associate director Kate Smith, said:The current system of alcohol duties is incoherent – for example, if you prefer a pint of beer to cider, you may currently pay more than twice as much tax for a drink with the same alcohol content. Brexit offers a valuable opportunity to improve the way we tax alcohol. A simple reform that taxes drinks in proportion to their alcohol content, with a higher rate on strong spirits, targets the purchases of heavy drinkers while raising tax revenue.Public health experts from Alcohol Health Alliance UK, the Foundation for Liver Research, the House of Lords, and the pro-vice-chancellor of health and life sciences at the University of Bristol, welcomed the report, stating that the measures proposed by the IFS could save more than 5,000 lives over the next decade.In a letter to The Times (23 Nov), they wrote:Although the money from minimum unit pricing alone stays with the retailer, the saving of costs to the NHS of reduced drinking outweighs that loss. Also, if combined with a scaled and consistent alcohol duty system to offset some of the wider costs of alcohol harm to society, these measures could save more than 5,000 lives in the next decade.Alcohol prices are ‘small change’ to drinkers, survey findsAdapted from the Alcohol Health Alliance UK press releaseAlcohol continues to be sold at pocket money prices in England, with it being possible to drink the weekly low-risk drinking guideline of 14 units of alcohol for less than the price of a cup of high street coffee, according to a new report from the Alcohol Health Alliance (AHA) UK, a coalition of more than 55 organisations including medical royal colleges and health charities (10 Nov).Comparing the prices of alcoholic drinks sold in shops and supermarkets across England, Scotland and Wales, researchers found the cheapest products were all sold in England, the only nation of the three not to have a minimum unit price of 50 pence.Cider is the cheapest available product in England and is being sold for as little as 19p per unit of alcohol, meaning that consumers can reach the weekly low-risk drinking guideline of 14 units of alcohol for just £2·68 – about the price of a large coffee in high street coffee chains. A single bottle of the cheapest cider also contains more alcohol than eight pints of beer – and costs 8 pence less than a single pint in a pub.For the price of a standard cinema ticket (£7·11), you could buy two bottles of wine, containing 19·5 units and have 13 pence change leftover, and a one-litre bottle of vodka, which contains 37·5 units, is cheaper than a large pizza at Dominos (£14·99).In light of the findings, the AHA calls on the government to commit to tackling cheap, high-strength alcohol in its review of the alcohol duty system and through introducing minimum unit pricing in England. AHA chair, professor Sir Ian Gilmore, said:The low price of high strength alcohol continues to cause immeasurable damage to the health of our nation. Alcohol is linked to 80 deaths in the UK every day, as well as seven types of cancer and stroke.To tackle the harm alcohol causes, we need to urgently address its price. Alcohol duty is currently too low to cover the costs of alcohol harm to the NHS and other public services. Public Health England estimates that alcohol costs the UK at least £27 billion a year. Yet over the past five years, alcohol duty has raised just £10·5-£12·1 billion annually. To pay for the costs to society that alcohol imposes, stronger drinks should be taxed more. Reforming alcohol duty will help create a fairer system for everyone as well as improving our nation’s health.With alcohol-related hospital admissions at record highs, and liver disease rates on the rise, we can’t afford for alcohol to remain at such low prices.In other researchNew annual mortality and morbidity statistics for Scotland showed a mixed outlook: there was a substantial improvement for the former, but not so for the latter.The number of alcohol-specific deaths was 1,020 deaths in 2019, 10% down on the previous year’s tally of 1,136 (National Records of Scotland (NRS), 24 Nov).2019 represents the first substantial decrease in recent years, after a period of generalincrease since 2012, and is only the fourth occasion when there has been a reduction in alcohol-specific deaths of around 10% or more in a single year (in 2007, 2009 and 2012) since records began. However, the NRS was quick to note that ‘although an annual decrease of this magnitude is notable, further years will be required to see if this reduction continues and conclude that this is a sustained shift in alcohol-specific deaths in Scotland.’In comparison, annual alcohol-related hospital statistics show incremental changes in admissions (35,781) and patient (23,685) numbers to general acute hospitals in 2019/20 compared with the previous year (Public Health Scotland, 17 Nov). There has been no significant improvement in numbers since 2012/13.Researchers from the Behaviour and Health Research Unit at the University of Cambridge have developed a preliminary typology of drinking behaviours from existing evidence of the impact of glassware design on those behaviours, as a basis for reducing alcohol consumption to improve population health (Health Psychology Review, 18 Nov).Despite the ‘paucity of evidence’ over the issue, the team were able to cut a distinction between macro (measures of drinking outcomes involving consumption, or proxies for consumption) and micro (a form of short-term influence on drinking) -drinking behaviours. They also explored the roles of two sets of possible underlying mechanisms – perception and affordance – in determining a drinker’s actions.The study’s authors concluded that using this typology as a framework and starting point for understanding the micro-structure of a drinking episode may harness important insights for developing interventions aimed at reducing consumption, such as how an intervention works to reduce intake, plus other important effects on drinking behaviours ‘that may not be captured by a “macro” measure of drinking in a given study’.Almost three quarters of 15 and 16-year-olds in Ireland have tried alcohol, with around half of these using alcohol 'to make social gatherings more fun', according to the new iteration of the European Schools Project for Alcohol and Other Drugs (ESPAD) (Irish Health, 17 Nov). The survey of almost 2,000 secondary schoolchildren found that 73% of respondents had tried alcohol, while 41% had drunk alcohol in the previous 30 days. 49% said drinking made social gatherings more fun, while almost as many (48%) did so to enjoy a party. The most common age that teenagers began drinking alcohol was 15 (52%), and a sixth (16%) said they had been drunk in the previous 30 days.The survey also found that increased alcohol use among the teens was associated with lower parental education levels and lower parental monitoring, truancy and lower school grades.Nearly two in three people feel the current ‘drink responsibly’ message on bottles is too vague and should be replaced with specific health warnings, specialists at the Priory Group addiction and mental health service found (LBC, 18 Nov).In a poll of 1,000 adults for Alcohol Awareness Week, 59% said beverages should display a cancer warning and eight in ten feel the UK ‘has a problem’ with binge drinking.The 2019/20 adult substance misuse treatment statistics report published by Public Health England suggests that an estimated 82% of adults in need of specialist treatment for alcohol do not receive it (26 Nov).Alongside small year-on-year changes to the numbers of adults in treatment, the figures showed that people in treatment for alcohol only are the second largest group (28%) of all adults in treatment, the majority of people (59%) who started treatment for drug and alcohol problems in 2019/20, said they had a problem with alcohol, with 65% (50,957) reporting that it was their only problem substance, and although still relatively high, the proportion of people with alcohol only problems leaving treatment free of dependence has fallen three percentage points since 2015/2016 (from 62%), hinting at the start of a declining trend.SHAAP manifesto calls for total ban on alcohol advertisingAlcohol control campaign group Scottish Health Action on Alcohol Problems (SHAAP) have urged every candidate in next year’s Holyrood election to support a ‘total ban’ on alcohol advertising (STV News, 19 Nov).Publishing their manifesto ahead of the vote in May, they list four ‘focus areas’ aimed at reducing alcohol-related harms that all parties should support:Affordability, availability and attractivenessInvesting in and improving treatment and support servicesSupporting recovery and reducing health inequalitiesProtecting children and young peopleThe manifesto states that ‘as we approach the Scottish parliament election of 2021, it is more important than ever that we do not lose sight of long-term public health measures that can improve the health and wellbeing of everyone in Scotland, build the resilience of our NHS and local care services, and benefit the economy’.SHAAP chair Dr Peter Rice said: Covid-19 has shone a light on the patchy and often disjointed nature of alcohol treatment service provision, even prior to lockdown, and we do not yet know what long-term impact the pandemic will have on people’s drinking behaviours, though research so far indicates that heavier drinkers have increased their consumption.Our 2021 manifesto highlights cost-effective, evidence-based policies that, if properly implemented, will work to ensure that Covid-19 does not exacerbate alcohol-related harm and health inequalities in Scotland and that we are able to meet long-term public health goals that are essential if we are to build a healthier, fairer future.Online event on alcohol policy and nudge theory🎵 Podcast feature 🎵The Institute of Alcohol Studies (IAS) is holding a seminar exploring the latest evidence on nudge theory in alcohol policy, in conjunction with a new report (02 Dec).Using a case study of UK Government alcohol policy since 2017, IAS research and policy officer Lucy Bryant examined the framing of individuals and alcohol industry actors within public health nudge policy interventions, revealing ways in which nudge theories risked undermining support for better evidenced public health alcohol measures such as pricing interventions in practice. Bryant’s findings will be presented alongside new research from Professor Mark Petticrew (London School of Hygiene and Tropical Medicine), as well as insights from the gambling field from Philip Newall PhD (postdoctoral researcher at CQUniversity's Experimental Gambling Research Laboratory).Dr Gillian Shorter of Queen's University Belfast, who is chairing the event, said:With alcohol implemented in over half the Sustainable Development Goals, now really is a good time to act with responsible policies to preserve health… so we posit to you: to what extent can we use nudge policies for effective behaviour change, and to what extent do they crowd out other potentially more effective policy options? We invite you to come along, have your say, and tell us what you think.For more details of the event and to register your attendance, please view the image below, or click on this link.FASD: Invisible, Not InconsequentialAdapted from the Queen's Nursing Institute Scotland websiteThe Scottish Government has launched a free FASD eLearning resource on the NHS Education for Scotland (NES) website, a move that could have significant benefits for professionals and the individuals/families affected if widely used and shared.Foetal Alcohol Spectrum Disorder (FASD) is both the most common and the most overlooked neurodevelopmental condition in Scotland. The Scottish Government estimates that approximately 172,000 children, young people and adults across the country have their lives and life chances adversely affected by FASD. And yet, only a small proportion of people with FASD have been diagnosed, actively assisted or effectively supported.Created by a Scottish Government Expert Group, the eLearning resource aims to help overcome the longstanding misdiagnosis, misunderstanding and mistreatment of people with this life-altering condition. For further information, please contact one of the members of the group, Dr Jonathan Sher, at jonathan.sher@qnis.org.uk or on 0744 333 1953.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

Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies.In this edition:COVID-19: Latest lockdown measures leave pubs in tiersIAS second briefing on COVID-19 alcohol consumption warns of the hidden harm from the rise in increasing and higher risk drinking 🎵 Podcast feature 🎵ScotRail considers a blanket ban on alcohol on Scottish trainsGovernment in call for evidence for review of alcohol dutyResearch finds that NoLo beers have a small impact on alcohol purchasesScottish and Irish governments face challenges over minimum unit pricing legislationSobriety tag scheme reaches WalesHeineken fined £2m for breaching Pubs CodeWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.COVID-19: Latest lockdown measures leave pubs in tiersAs the UK began to experience an upturn in coronavirus case numbers, so policymakers in the devolved administrations started looking at tackling the sources of the dreaded second wave of COVID-19, and pubs have come under close scrutiny in all quarters.ScotlandScotland decided to close pubs across its central belt for a 16-day period, and limit the opening hours of other licensed premises, as part of a ‘circuit breaker’ lockdown (Scottish Government, 07 Oct).* Quoting her chief medical officer’s evidence, first minister Nicola Sturgeon drew a correlation between the ‘more than one fifth of people contacted by Test and Protect’ who reported visiting a hospitality setting, and the increase in the R rate above 1 ‘approximately three weeks after the hospitality sector opened up’:* subsequently extended to 02 November (STV News, 21 Oct)WalesIn Wales, where a 10PM curfew on selling alcohol for licensed premises was introduced last month, first minister Mark Drakeford proceeded to issue a ‘firebreak’ lockdown of his own – turning pubs into takeaway taverns only between 23 October and 09 November (Welsh Government, 19 Oct).EnglandThe same curfew applies to England. However, lawmakers decided to adopt the novel approach of localising management of the lockdown with a tier system, which has resulted in curious outcomes such as a legal definition of what a ‘substantial’ meal is, for the purpose of allowing some licensed premises to continue to operate under the most severe tier restrictions (The Mirror, 12 Oct).For some venue owners, the new rules also mean that in addition to pressure from law enforcement to check IDs for names and addresses in a bid to stop households mixing (EuroWeekly, 21 Oct), those situated in ‘high’ and ‘very high’ tier areas are either subject to the inevitability of fewer customers paying a visit, or temporary closure for wet-led pubs. One Financial Times article predicts the end of chains whose main custom is serving alcohol (13 Oct):On the face of it, the most affected of the UK’s listed national inn groups are Marston’s, JD Wetherspoon and M&B. It looks like last orders.Large proportions of Marston’s and JD Wetherspoon’s hostelries are wet-led. Food as a percentage of JDW’s total sales rank among the lowest in the sector. More than two-thirds of Marston’s pubs are old-fashioned boozers.All three groups are loaded with debt, which even last year was many times ebitda. Earnings of all three are expected to at least halve this year. Marston’s stood at about £1·4bn at the last count or £1·2bn including the cash coming in from the brewing joint venture with Carlsberg opportunely signed this summer. That could be more than 10 times this year’s ebitda. Pub earnings of many groups will barely cover interest bills this year.The resulting uncertainty has only served to anger licensees and those sympathetic to the plight of the industry. Some have pulled stunts, such as a retaliatory ban (Telegraph, 30 Sep); others have sought further evidence for the 10PM curfew’s effectiveness and whether it represents a threat to the health of people thrown out of pubs and restaurants at the same time (London Evening Standard, 06 Oct); but The Night Time Industries Association has launched legal action to try to prevent the new lockdown measures entirely (Daily Mail, 12 Oct).Whatever the outcome, the reality of the current measures will most likely be a further loss of jobs in the hospitality sector, like Greene King (Sky News, 07 Oct), and a permanent shutdown of licensed premises – as many as one in five, according to real estate adviser Altus Group (Morning Advertiser, 08 Oct).Northern IrelandHaving already set a curfew time for licensed premises of 11PM as opposed to 10PM in other areas of the UK, the Stormont executive decided to do lockdown a little differently from the other Home Nations too. Their first minister, Arlene Foster, announced a four-week shutdown of the hospitality sector apart from deliveries and takeaways for food only during trading hours. Uniquely, Northern Ireland is the only nation to address the availability of alcohol in the off-trade too: off-licences and supermarkets will not be permitted to sell alcohol after 8pm (Northern Ireland Executive Office, 14 Oct) during the period.Too much focus on pubs?In the row between government and the hospitality sector over the COVID-19 restrictions, the deputy chief medical officer for England was reported to have said that he ‘could not guarantee’ the 10PM curfew would ‘bring the virus under control’ (The Telegraph, 18 Oct, £wall), instead preferring a mandatory closing time of 6PM.But while much has been made of the impact of the latest round of restrictions on licensed premises, supermarkets have benefited from the increase in alcohol purchases in the four weeks to 04 October: Kantar data reported Britons spent an extra £261m on alcohol in grocery stores (Guardian, 13 Oct).Data from Public Health England Wider Impacts of COVID-19 on Health (WICH) monitoring tool indicates the influence of pandemic-induced home drinking on the intake of increasing and higher risk drinkers.COVID-19 briefing warns of rising health risks to heavy drinkers🎵 Podcast feature 🎵The second Institute of Alcohol Studies briefing on alcohol consumption during the COVID-19 pandemic (08 Oct) warns of the hidden harm from the rise in increasing and higher risk drinking and highlights the need for the UK Government to find public health solutions to the issue.Speaking on the podcast, Dr Sadie Boniface, IAS head of research, who authored the briefing, hinted at the impact that increased consumption among the heaviest drinkers may have on treatment providers for substance problems:In terms of treatment for substance use problems including alcohol, there’s been a bit of a fall compared with the same time period last year, but I have read some other statistics as well that say it’s starting to pick up now, so what’s really concerning is that problems to do with increased drinking during the pandemic might be being stored up for the future.Alcohol ban on Scottish trains under considerationAccording to The Scotsman, national train operator ScotRail have informed the Rail Maritime and Transport (RMT) Union of the possibility of bringing in ‘a full all-hours drinking ban on trains in a bid to tighten up on COVID-19 safety measures’ (17 Oct).It comes after the nation’s first minister Nicola Sturgeon said more stringent travel rules ‘need to be considered’.However, the move is rumoured to have been put on hold after the British Transport Police (BTP) called for more time to consider the resource implications, and the RMT have expressed some concerns about enforcement of the new rules.Mick Hogg, regional organiser for the RMT in Scotland, said: ‘We have been told by ScotRail that there will be a full ban on alcohol on trains as a COVID-19 measure. We welcome that.‘But it has to be resourced or it puts more pressure on our staff. It’s a double whammy for them. They can’t enforce the wearing of masks or police passengers drinking alcohol. That has been a big issue for a while. We know the BTP don't have enough staff as it is.’ScotRail’s current alcohol byelaws state that passengers can't drink alcohol on their trains between 21:00 and 10:00hrs, and they may not allow you to board if you are extremely drunk. But this has not stopped it happening. One conductor told the newspaper: ‘Busy weekend nights haven't calmed down in recent weeks. People from Edinburgh and Glasgow have been piling on trains across to Fife to go to the pub. I've seen packed trains with the vast majority of passengers drunk’.Government in call for evidence for review of alcohol dutyPublic health and trade organisations are lining up to submit evidence to the Alcohol duty review, as per the government’s Budget announcement earlier this year (Gov.uk, 01 Oct).The review has been widely welcomed by stakeholders, as the UK gains the power to reform alcohol taxation following their departure from the European Union. HM Treasury’s call for evidence will also ask whether:the method of alcohol taxation should be standardisedthe duty categories should be changed or unifiedproducts should be consistently distinguished by their strengthdistinctions should be made based on the place of retailsmall producer reliefs should be extended or standardisedduties could be uprated for inflation in a more consistent mannera single process for approvals, declarations and payments should be introducedmore could be done to tackle avoidance and evasion of dutyThe deadline for responses is 29 November.NoLo beers have small impact on alcohol purchasesResearch published in BMJ Open has found that there were significant but small reductions to alcohol sales following the introduction of new no and low alcohol beers during 2017–2018 and reformulation of existing beers to contain less alcohol during 2018 (12 Oct).Using purchase data from Kantar Worldpanel’s household shopping panel for 2015–2018, researchers looked at the purchasing habits of 64, 286 British households following a period which saw 46 new low and no alcohol beer beverages and 33 beer beverages reformulated to contain less alcohol. A step-jump in volume bought was noticed for both beverage types at the beginning of March 2017 and during mid-March 2018 respectively. Interrupted time series analyses found a combined associated impact of both events with relative reductions of alcohol by volume of beer between 1·2% and 2·3%; purchases of grams of alcohol within beer between 7·1% and 10·2%; and purchases of grams of alcohol as a whole between 2·6% and 3·9%. The reductions were greater for reformulation than for the introduction of new low and no alcohol products. Reductions were independently higher for younger age groups of shoppers and for households that bought the most alcohol.The research team conclude that the fact that the volume of purchases for both new low and no alcohol beer products (2·6% of total beer volume purchased during 2018) and of new reformulated beer products (6·9%) was very small ‘indicates that there are future opportunities to increase the volume of such products so as to reduce the harm done by alcohol’.In other newsA 30-year review of global disease burdens published in The Lancet finds alcohol use was the leading risk factor for those aged 25–49 years (17 Oct). Overall, alcohol use was one of the fastest growing burdens, at more than 0·5% per year. When split by sex, ‘there were large differences between attributable deaths in males and females due to alcohol use, which accounted for 2·07 million (1·79–2·37) deaths in males and 0·374 million (0·298–0·461) deaths in females in 2019’. The national picture estimated alcohol to be the cause of approximately 4% of deaths and 5% of Disability Adjusted Life Years in 2019 (illustrated).A team of researchers will establish the effectiveness and cost‐effectiveness of the Drink Less app at reducing alcohol consumption among hazardous and harmful adult drinkers, in what will be the first randomised controlled trial of an alcohol reduction app for the general population in the UK (17 Oct). The result of the study will inform the decision on whether it is worth investing resources in large‐scale implementation.Alcohol screening and supportive interventions from primary care practitioners can help older people make healthier decisions about their alcohol use, according to a qualitative study published in the British Journal of General Practice (19 Oct). A total of 24 older adults aged ≥65 years and 35 primary care practitioners in northern England participated in interviews and focus groups. Researchers found that they were motivated to make changes to their alcohol use when they experienced symptoms, and if they felt that limiting consumption would enable them to maintain their quality of life.Minimum unit pricing – the latest from Scotland and IrelandScotland: is a legal challenge possible?The Scottish Parliament voted 90 to 28 to refuse legislative consent to the UK Internal Market Bill (BBC News Scotland, 07 Oct), fearing that the legislation could cause a constitutional rift that would open bold public health measures such as minimum unit pricing for alcohol (MUP) to another legal challenge.The Westminster government is not bound by the vote in Holyrood, but the Scottish constitution secretary notes that it formalises the nation’s ‘explicit’ and comprehensive rejection of the bill. Last month, Michael Russell said in a statement (Scottish Government, 08 Sep) that the bill would ‘open the door to a race to the bottom on food standards, environmental standards and will endanger key public health policies such as minimum unit pricing.’The Secretary of State for Scotland Alister Jack issued a rebuttal denying the ‘false claims’ made by First Minister of Scotland Nicola Sturgeon about the bill, assuring in point four of his statement that MUP would still have been introduced:But devolution expert Jess Sargeant states that the internal market bill could be interpreted in a way that ‘inevitably will place greater limits on devolved competence than present arrangements’, which could also ‘impede key benefits of devolution “as a policy lab”, allowing new policies to be tried in one jurisdiction before being adopted elsewhere’. (Institute for Government, 14 Sep)This opinion was supported by an advisor to Holyrood's Constitution committee, who told The Scotsman that ‘issues may arise if minimum pricing is considered in the context of “indirect discrimination”’, and this may give rise to a court challenge (12 Oct).He explains in a paper: ‘A Scottish rule that applies Minimum Unit Pricing to all alcohol whether domestic or imported could be indirectly discriminatory if it impacts more on imported alcohol than it does comparable Scottish-produced alcohol’. Rules will be assessed on three conditions, including on the grounds of whether it ‘cannot reasonably be considered to be a necessary means of achieving a legitimate aim’.Although the ‘protection of public health’ is recognised in the bill as a legitimate aim, the advisor warns there could be questions raised around whether MUP will be ‘reasonably’ considered to be ‘necessary’ to achieve this aim, and so a challenge based on the new conditions may be brought.Irish MUP still on ice two years on from the Public Health (Alcohol) ActThe Irish Times reports that on the second anniversary of the Public Health (Alcohol) Act, MUP is still to be implemented (12 Oct). Alcohol Action Ireland’s head of advocacy Eunan McKinney went further, saying that there is ‘no starting date for the “difficult stuff”… including labelling on all alcohol products of the links to cancer, the 9PM broadcasting watershed for alcohol advertising, and restriction on the content of advertising to make it “utilitarian” with “no hero, no glamour”’.The news comes as the Budget 2021 statement made no direct reference to alcohol, meaning duties were left unchanged (Government of Ireland, 13 Oct). While Alcohol Action Ireland (13 Oct) welcomed ministers for not acquiescing to ‘the extensive lobbying of the alcohol industry, who had sought a 15% reduction’, they regretted the missed opportunity ‘to introduce a Cost-of-Living index to excise rates’, amongst other plans outlined in their Pre-Budget submission.Responding to the Budget, Alcohol Action Ireland chief executive Dr Sheila Gilheany (listen to the podcast for her full statement) said that ‘everyday that delays these measures being introduced can be counted in lives unnecessarily lost and endless public expenditure that could be saved, if implemented they will undoubtedly achieve better public health outcomes. Left dormant on the statute books, they are useless. ‘What’s required now, two years on, is a firm timeline from Taoiseach and his government that commits to the implementation in full of the suite of measures whose effectiveness relies on coherent and cohesive actions.’Sobriety tag scheme reaches WalesOffenders convicted of alcohol-related crimes in Wales can now be banned from drinking and ordered to wear a sobriety tag by judges (Gov.uk, 21 Oct).The ankle tags will monitor offenders’ sweat every 30 minutes and alert probation staff if alcohol is consumed. Those found in breach of their drinking bans can face fines or be sentenced in court. The tags can be given out when courts impose an alcohol abstinence order, a new power which serves a drinking ban on an offender for up to 120 days. The Ministry of Justice says treatment referrals for alcohol use will continue to be made for those with more serious alcohol addictions who commit crimes.The Welsh scheme follows two pilots in London and across Humberside, Lincolnshire and North Yorkshire, both of which showed that offenders were sober on 97.4% of the days monitored, although their apparent success is qualified by the fact they involved fewer than 500 people, and only six participants agreed to be interviewed about the tags in the Humberside, Lincolnshire and North Yorkshire pilot (NatCen, Oct 2019).Secretary of State for Wales Simon Hart said: ‘Alcohol can have a devastating impact on lives and figures show it is a key factor behind far too many crimes.‘I am encouraged to see Wales at the forefront of implementing this new technology, which we believe will contribute towards lowering reoffending rates, making our streets safer and supporting those who need help.’Heineken fined £2m for breaching Pubs Code The pubs code adjudicator (PCA) has found Heineken guilty of forcing tenants of its public houses to sell ‘unreasonable’ amounts of their own beers and ciders (Gov.uk, 15 Oct).Following a three-year investigation ending in July 2019, Fiona Dickie concluded that Heineken – via its pubs business, Star – had ‘seriously and repeatedly’ breached laws that protect publicans from company behaviour aimed at prohibiting pubs selling competitor brands. This was despite repeated regulatory interventions and clear arbitration rulings from the adjudicator.Dickie said: ‘The report of my investigation is a game-changer. It demonstrates that the regulator can and will act robustly to protect the rights that parliament has given to tied tenants.’The PCA’s assessment of industry malpractice found Heineken had committed a total of 12 breaches with the result that it had frustrated the principles of the Pubs Code. As well as identifying how the company had offered stocking terms that had acted as a deterrent to pub tenants pursuing a free-of-tie tenancy, the PCA highlighted systemic corporate failures by Star in its approach to compliance.The news comes weeks before the conclusion of a government review into the Code itself. The tie element of the Code has long been criticised by pub owners and campaigners, who say it is being routinely abused by deep-pocketed pubcos able to flout the spirit of the code that governs it (Guardian, 15 Oct).The PCA also discovered that the company rewrote the job description of Code Compliance Officer ‘to ensure the Code is interpreted to the commercial benefit of Heineken UK’. This breached the Code requirement to appoint a compliance officer whose role is to verify compliance.Dickie decided upon ‘the imposition of a sanction’ to ‘change the company’s mindset’ towards compliance and ‘serve as a deterrent to future non-compliant conduct by Star and other pub-owning businesses’.As well as imposing the fine – which can account for up to 1% of the relevant pub-owning group’s annual UK turnover – the PCA has also ordered Star to make all its free-of-tie tenancies Pubs Code compliant and to ensure future Code compliance. In response, Star pubs managing director, Lawson Mountstevens, said in a statement: ‘We are deeply disappointed and frustrated at the outcome of this investigation.‘There are many aspects of the report that we fundamentally disagree with and we are actively considering an appeal.‘This penalty is unwarranted and disproportionate, and comes at a time when the entire sector is in serious financial crisis as we work around the clock to support our pubs and licensees to keep their businesses afloat.’Dickie has given Heineken six weeks to provide a detailed response to how it will implement her recommendations, and has ordered them to write to all its tenants explaining her findings, the measures Star is taking to respond to them and how these will affect tenants in practical terms.‘I will be holding discussions with all the companies I regulate following my findings about how they will ensure they are code-compliant,’ Dickie said. ‘My message is that if anyone previously had any doubts about my resolution to act when I find breaches, they can have no doubt now.’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:A round-up of how alcohol drinkers, producers and retailers have fared as the prospect of a second coronavirus wave loomsThink tank finds NoLo drinks have limited impact 🎵 Podcast feature 🎵SHAAP and IAS launch the Men and Alcohol reportNumbers of alcohol-related admissions to English hospitals continue to risePoll shows almost half of Scots surveyed now back minimum pricing for alcoholBacklash over NICE plans to record pregnant womens’ consumptionWe announce the winners of our Small Grants SchemeWe hope you enjoy our roundup of stories below: please feel free to share. Thank you.Drinking in the second wave of a pandemicCoping with COVID-19: Alcohol offers little comfort to solitary drinkers One of the enduring stories of 2020 has been the question of how some people use alcohol to cope with new ways of living in the time of COVID-19. One of the many research attempts to find this out, the Global Drug Survey (GDS), found that almost half (48%) of Brits have so far upped their alcohol intake during the pandemic, ‘due to loneliness, depression and anxiety’ (Guardian, 09 Sep). Furthermore, 30% of drinkers said increased alcohol consumption had worsened their mental health and 47% disclosed that their physical health had deteriorated.Researchers found that increased use of both alcohol and cannabis due to anxiety, loneliness or depression was significantly higher among people with a pre-existing mental health or neurodevelopmental condition. That group of respondents were at least twice as likely to report worse mental health (38%) due to drinking more alcohol than those without such conditions (19%).The study also highlighted the limitations of a substance perceived as having some social purpose: when the venue for consuming alcohol is removed from people’s lives, drinking for some doesn’t simply stop, but instead manifests in other potentially unhealthy ways. The number of people drinking alone at home while on audio or video calls, such as Zoom meetings, or during ‘watch parties’, where friends view and discuss films and TV programmes together via group chat, increased from 17% to 38%.Comparing alcohol with cannabis, professor Adam Winstock, GDS chief executive, observed: ‘People’s drug use is hugely dependent upon being able to socialise and when that ability goes away, people turn to drugs that they’re already familiar with – cannabis and alcohol. But the impact of increases of those two drugs is quite distinct, and those drinking more alcohol come off worse.’Closing time for COVID? Pubs on curfewSome spending data indicated the desire on the part of some to resume pre-pandemic habits, but the results were mixed, ‘with like-for-like [August] sales down 3·6%’ against the same month last year (This is Money, 28 Sep).Signs of economic recovery were likely the focus of discussions between Hospitality Ulster and Stormont ministers about the prospect of reopening drink-only pubs (BBC News Northern Ireland, 07 Sep).But with an uptick in the number of coronavirus cases in September, attention turned to whether and how pubs – the symbol of a nation trying to return to some kind of normal – were keeping customers safe (BBC News Business, 13 Sep)?In England, hospitality businesses (including pubs) became legally mandated to take customers’ contact details so they can be traced if a potential outbreak is linked to the venue. These rules were in addition to the new ‘Rule of Six’, which limits the number of people allowed to meet each other.Some pubs experienced small outbreaks within their own workforce: the JD Wetherspoon chain reported 60 Wetherspoon staff across 50 branches had tested positive for COVID-19 (Mirror, 14 Sep).Meanwhile, rumours spread of the possibility of implementing curfews on pub opening hours if the number of new coronavirus cases did not fall over the next few weeks (Daily Star, 14 Sep). A survey of more than 4,000 UK adults found that 69% would be favour of a 9PM curfew (YouGov, 15 Sep).And so, the government made plans to shut the pubs… at 10PM (BBC News, 22 Sep). While BBC health correspondent Nick Triggle wondered whether the move would be of marginal benefit in staving off the threat of the virus, chair of the Public Accounts Committee Meg Hillier asked the prime minister how the government was able to square their proposal with extending alcohol licensing provisions for pubs to acquire pavement licences for eating and drinking on the public highway?For all the government’s desire to strike a balance, representatives of the hospitality industry still claim that a curfew will neither help curb the virus nor the commercial viability of their businesses, which are ‘still on life support’. Talking to trade outlet Morning Advertiser (22 Sep), Fuller’s chief executive Simon Emeny called pubs ‘the home of responsible socialising’ and said his company had worked hard to implement safety measures across its pubs, to be rewarded with unnecessary restrictions, while Peter Borg-Neal, chief executive at multiple operator Oakman Inns, said he saw little public health benefit but ‘lots of economic damage’ instead.Can addiction treatment services survive a second wave?Whatever happens in the coming weeks, it is clear that our addiction services can ill afford to combat the swelling number of high risk drinkers seeking treatment alongside a second wave of COVID-19 cases. Royal College of Psychiatrists analysis of Public Health England’s latest data on the indirect effects of COVID-19 found that over 8·4 million people are now drinking at higher risk, up from just 4·8 million in February. But the multi-million-pound cuts made to addiction services since 2013/14 mean they could miss out on life-saving treatment (14 Sep).Professor Julia Sinclair, chair of the college’s addictions faculty, said: ‘COVID-19 has shown just how stretched, under-resourced and ill-equipped addiction services are to treat the growing numbers of vulnerable people living with this complex illness.Drug-related deaths and alcohol-related hospital admissions were already at all-time highs before COVID-19. I fear that unless the government acts quickly we will see these numbers rise exponentially.’Think tank: NoLo drinks have limited impact🎵 Podcast feature 🎵A report on no and low alcohol beverages (‘NoLo’) from the Social Market Foundation finds limited evidence for their impact on health outcomes (08 Sep). Sponsored by Alcohol Change UK (ACUK), the publication finds that whilst NoLo products may help individuals reduce their consumption, they are unlikely to produce the aggregate level reductions in alcohol-related harms public health experts would desire.The key findings were:The market for NoLo drinks – whilst brands continue to release new products into the NoLo drinks category – worth around £110 million in 2018/19 – it is thought NoLo products comprised just 0·2% of the total market for alcoholic drinks in that year. The report estimates that annual sales growth of NoLo drinks would have to exceed over 40% per annum for market share to stand above 10% by 2030Consumers in the NoLo market – survey results commissioned specially for this study found that one in five people (21%) have consumed an alcohol-free beer, cider, wine or spirit in the last year. Including low-strength drinks (up to 1·2% alcohol content), this rises to 27%. Young people and those in higher income socioeconomic groups were more likely to have tried a NoLo productThe regulation of the NoLo market – Guidance and ABV descriptors issued by the Department of Health and Social Care contains elements of ambiguity and are often out of step with other European countriesThe presentation of NoLo products – press coverage of NoLo drinks typically centres on the ‘new sensibility’ of younger people and NoLo as a ‘community’ or ‘movement’. Some producers have tapped into this by promoting their NoLo products as substitutes for stronger products. Others prefer to market them as additional to existing drinks on the marketThe impact on alcohol-related harms – survey results for this report indicate that among those that have consumed NoLo drinks over the past 12 months, about four in ten have cut back on their alcohol consumption. However, a similar number reported no change. A significant proportion of consumers of NoLo also indicated that they do so on top of, rather than instead of, stronger products. This raises concerns about how NoLo products can tackle alcohol-related harms at the population levelConsiderations for policy – whilst the Government has indicated that NoLo products will be key to reducing alcohol-related harm, this report cautions that NoLo drinks must form part of a much wider harm prevention strategy. Government should also consider reforming ABV descriptors for NoLo and legislate to protect against alibi marketing.Commenting on the findings, ACUK director of research and policy Lucy Holmes said (you can listen to our interview on NoLo drinks in our podcast):MPs and peers call on government to urgently address Britain’s alcohol harm crisisAbridged from the Alcohol Health Alliance UK press releaseAs the leading risk-factor for ill health, death and disability among those aged 15 to 49 in England, alcohol is inflicting long-lasting harm across all areas of society and family life, yet not enough is being done to tackle the problem, say a group of cross-party parliamentarians, who are calling on the government to develop an alcohol strategy to get to the heart of the nation’s drink problem.Under the independent Commission on Alcohol Harm was set up by alcohol health experts and parliamentarians to examine the full extent of alcohol harm across the UK. Evidence submitted to the Commission highlights the serious impact alcohol harm has on family life, with children living with an alcohol dependent parent five times more likely to develop eating disorders, twice as likely to develop alcohol dependence or addiction, and three times as likely to consider suicide. The accompanying online launch also saw moving testimony from those whose lives have been harmed by alcohol.The Commission concluded that a new UK-wide alcohol strategy is required urgently. Recommendations from the final report include (summary):The new alcohol strategy must include targeted measures to support families and protect children from harm, including alcohol-fuelled violenceThe new alcohol strategy must be science-led and adopt the World Health Organization’s evidence-based recommendations for reducing the harmful use of alcohol. This includes measures on affordability – such as the introduction of minimum unit pricing in England – and restrictions on alcohol advertising and marketing – such as ending sports sponsorship, better information for consumers, advice and treatment for people drinking at hazardous and harmful levels, and action to reduce drink-drivingReducing the £3·5bn cost of alcohol to the NHS would help to relieve pressure on the service and free up capacity to respond to the consequences of COVID-19Changing the conversation and challenging alcohol’s position in our culture. This means addressing the stigma around alcohol use disorders, encouraging conversations about drinking to take place more easily and creating space for people to be open about the effects of alcohol on their health and those around them.Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance said (you can also hear his thoughts on the report in the podcast): ‘When people think about alcohol harm, they often think about liver damage – but its impact goes much further than this. This report highlights the very real ways that alcohol can devastate not just the life of the drinker but those around them. If we wish to emerge from the coronavirus pandemic as a healthier society, we must address the ongoing health crisis of alcohol harm.’If you want to help the Alcohol Health Alliance reach decision makers so they take action to reduce alcohol harm, you can – follow the link below to share the report with your local MP.Launch of Men and Alcohol reportScottish Health Action on Alcohol Problems (SHAAP) and the Institute of Alcohol Studies (IAS) have launched a new report presenting key findings and recommendations for policy and practice from their 2019/2020 Men and Alcohol seminar series (09 Sep), along with a webinar discussion of key themes raised.The report highlights how alcohol consumption is closely connected to male identity, and that alcohol-related harms, both mental and physical, remain a significant issue for men in the UK, with men less likely to seek help for mental health problems.Key recommendations for policy include: calls to strengthen restrictions on alcohol availability; to enforce bans on alcohol advertising, sponsorship and promotion; to make alcohol less affordable via taxation and pricing policies, and to invest in youth services and ‘alcohol-free’ spaces to help prevent alcohol-related harm.The report’s recommendations for practice address the need for all services to be joined-up, trauma-informed and exercising professional optimism, and emphasise that services should be guided by the expertise of individuals with lived experience in order to reduce the stigma of seeking help.Alcohol-related admissions to hospitals risingNHS Digital’s latest release on patient care activity in English NHS hospitals (17 Sep) has found that there were nearly 670,000 admissions by diagnosis for the three most common alcohol-related case types (Mental and behavioural disorders due to use of alcohol, Alcoholic liver disease, and Toxic effects of alcohol) in 2019/20.The number of admissions marks a 4% increase on the previous year: there were approximately 644,000 admissions in 2018/19. As the main diagnosis, the three main case types totalled just over 120,000 admissions, 2% up on the previous period, when there were almost 118,000.When split by case type, the majority (69%) of the three major alcohol-related admissions were for Mental and behavioural disorders due to use of alcohol (459,468), of which it was the main diagnoses for 68,128 admissions. A quarter were for Alcoholic liver disease (170,031), of which it was the main reason for 50,561 admissions. 6% were for the Toxic effects of alcohol (40,337), of which it was the main reason for 1,329 admissions.The majority of cases were male (67%), and when split by age, those in their fifties were most frequently admitted to English hospitals in 2019/20. There were across-the-board increases in admissions for patients aged 50 years and above compared with 2018/19. In other researchAlmost half of Scots surveyed now back minimum pricing for alcohol: 49·8% of 1,022 people surveyed by Public Health Scotland supported the measure (22 Sep).The survey comes as research published in Health Economics finds that minimum unit pricing (MUP) has had a successful initial impact on increasing alcohol prices (thus reducing affordability) and reducing alcohol sales (and consumption by proxy). The paper found that the impact of MUP on alcohol prices and sales is most pronounced on off‐premise venues (15 Sep).And in Wales, polling commissioned by Alcohol Change UK Cymru found that three quarters of 1,000 respondents knew about MUP compared with just half of drinkers in Wales when asked a year ago, and that of those who were aware of its implementation six months ago, 10% were drinking less alcohol because of it (Bro Radio, 28 Sep).Using publicly available national data (including Hospital Episode Statistics), a study conducted by the University of Hull reported that a decrease in admissions to specialist alcohol inpatient services subsequently marked an increase in admissions to acute hospital services (Alcohol and Alcoholism, 04 Sep). This decrease in admissions to specialist treatment centres has been associated with significant reductions in public health funding to such services since the introduction of the Health and Social Care Act 2012. However, these reductions have resulted in a shift of service use, particularly placing increasing pressures on emergency departments due to a larger number of patients with chronic alcohol disorders accessing care.A new paper conducted by the London School of Hygiene and Tropical Medicine, Dark Nudges and Sludge in Big Alcohol: Behavioral Economics, Cognitive Biases, and Alcohol Industry Corporate Social Responsibility, evaluates the roles of dark nudges and sludges in the alcohol industry (Milbank Quarterly, 15 Sep; video summary here). It shows how alcohol industry bodies such as Drinkaware use dark nudges and sludges to influence consumers’ views, often against their best interests. In particular, messages promoting the ‘social norms’ of drinking are frequently distributed, for example the technique of ‘omission biases’ in the infographic ‘Alcohol and the body’ from Drinkaware Ireland, which, by omitting women, consequently fails to highlight that breast cancer is also a major hazard of alcohol consumption.A multicohort study conducted by University College London has shown that those who have reported losing consciousness due to alcohol consumption (regardless of their weekly intake) have double the risk of developing dementia, compared with moderate drinkers who never lost consciousness (JAMA Network, 09 Sep). Overall, those who were moderate-to-heavy drinkers had a 1·2-fold greater risk of developing dementia in the long-term. Alcohol misuse was seen to cause brain atrophy and neuronal loss in several areas of the brain, such as the frontal cortex. Other side-effects of heavy drinking, such as hypertension, can also be attributed to dementia. Plans to record pregnant womens’ consumption not so NICEPregnancy rights’ advocates have criticised a proposal from National Institute for Health and Care Excellence (NICE) of a Quality Standard to record pregnant women’s alcohol consumption on their child’s medical records in England (Guardian, 16 Sep).NICE’s proposal was drawn up as part of a consultation to cement guidelines for doctors to diagnose and prevent foetal alcohol spectrum disorder (FASD). Proponents argue that the risk of FASD – a range of physical and mental conditions caused by drinking in pregnancy – to an unborn child should be the reason for prioritising their needs.However, pregnancy charities including the British Pregnancy Advisory Service (BASP) and Birthrights suggested that the guideline on recording alcohol consumption could be a breach of the expectant mother’s confidentiality, and therefore fall foul of data protection regulations.A quarter of adopted UK children may have symptoms of FASDThe results of an Adoption UK survey of nearly 5,000 adopters underscore FASD campaigners’ concern about drinking habits during pregnancy: one in four adopted children are either diagnosed with or suspected to have a range of conditions caused by drinking in pregnancy (Guardian, 29 Sep).8% of children had a diagnosis, and a further 17% were suspected by their parents to have foetal alcohol spectrum disorder (FASD),The survey also showed 55% of families polled had waited two years or longer for an FASD diagnosis, and 78% felt healthcare professionals lacked basic knowledge about the condition.Maria Catterick, director of the FASD Network UK, said the statistics were unsurprising given that ‘alcohol, drugs and domestic abuse are major reasons why children are placed into the care system’.Small Grants Scheme awards announced!We are delighted to announce that we will be funding three projects led by early career researchers in the alcohol field through the new IAS Small Grants Scheme.Proposals were considered in a two-stage process and reviewed externally. This was a highly competitive round and the standard of applications overall was extremely high. Feedback was provided to all applicants. We will be funding the following projects in the coming months:Dr Elena Dimova, Glasgow Caledonian University: Exploring men’s alcohol consumption in the context of becoming a father: A scoping reviewJessica Muirhead, Wrexham Glyndŵr University: Effective online age gating using MCC codesDr Emily Nicholls, University of Portsmouth: Rewriting the rules or playing the game? An investigation into the ways in which social norms around gender & drinking are challenged &/or reinforced through the promotion, marketing & consumption of Alcohol-Free drinksThe 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. 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