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October 2016

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Editorial – October 2016

Welcome to the October 2016 edition of Alcohol Alert, the Institute of Alcohol Studies newsletter, covering the latest updates on UK alcohol policy matters.

In this month's issue, the Scottish Court of Session rules that minimum unit pricing is legal – again. Other articles include: new Home Office figures show personal licences for alcohol on the rise; Road safety and health groups call for a lower drink driving limit; and a study finds a narrowing gender gap among drinkers.

Please click on the article titles to read them, or alternatively download a PDF version of our newsletter by clicking on the cover image. We hope you enjoy this edition.

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Personal licences for alcohol continue to rise

Licensing reviews drop sharply; now under 1,000 a year (01 October)

The number of personal licences increased by 11% since 2014, contrasting with a bigger fall in the number of licenced premises reviewed over the same period, says the new Home Office ‘Alcohol and late night refreshment licensing, England and Wales’ release.

There were 646,500 personal licences, 63,000 more compared with 31 March 2014. This continues the increasing trend seen since 31 March 2010, when there were 434,200 licences.

The headline figures as at 31 March 2016 show that:

  • there were 210,000 premises licences, which represents a 3% increase (up 5,500) compared with 31 March 2014
  • there were 14,700 club premises certificates, which represents a 5% decrease (down 700) compared with 31 March 2014
  • there were 646,500 personal licences, which represents an 11% increase (up 63,000) compared with 31 March 2014 (see right)
  • there were 86,500 premises licences with late night refreshment, which represents a 0.1% decrease (down 100) compared with 31 March 2014
  • there were 8,300 premises with 24-hour alcohol licences as at 31 March 2016, which represents a 1% increase (up 100) compared with 31 March 2014

The increase in personal and premises licences is in line with the broadly increasing trend seen since 31 March 2010, when there were 434,200 personal* and 202,000 premises licences. Among premises licences, the biggest increases for were off-sales alcohol only; there were 55,700 premises licences authorised for that purpose, an increase of 4% (up 2,100) compared with 31 March 2014. There was an increase of 3% (up 1,300) in premises licences authorised for on-sales of alcohol only (to 38,600), and a slight increase of 0.5% (up 400) licences that authorised both on- and off-sales of alcohol (to 80,100 premises licences) compared with 31 March 2014.

On the contrary, there was a decline in the number of licensed club premises. There were 14,700 club premises certificates in England and Wales as at 31 March 2016. This represents a decrease of 5% (down 700) compared with 31 March 2014 and continues the decline seen since 31 March 2010 when there were 17,000 certificates.

There were 8,300 premises with 24-hour alcohol licences as at 31 March 2016. Since 31 March 2010 there has been an increase of 6% (up 500); however, the number of premises with 24-hour alcohol licences has remained steady since 31 March 2012, ranging between 8,200 and 8,400.

The Home Office figures also showed that fewer reviews were taking place annually. A local authority can be asked to review a licence on the grounds of it having an adverse impact on the licensing objectives (i.e. the prevention of crime and disorder, public safety, the prevention of public nuisance, and the protection of children from harm). In the year ending 31 March 2016, 700 reviews were completed, representing a decrease of 13% (down 100) compared with the year ending 31 March 2014. This continues the decline seen since 31 March 2010, when there were 1,300 reviews (see left).

The reason for the decline in reviews is uncertain. In his Alcohol Policy UK blog, James Morris speculates that the continued pressure seen on Local Authority and police budgets resulting in fewer licensing roles and resources to engage in potentially expensive legal proceedings may be a factor.

“It may also be worth noting a downward trend in violent crime, although (this is) unlikely to account for the significant falls in reviews”, he writes.

NB: Alcohol and late night refreshment licensing, England and Wales contains statistics on authorisations and licensing authority powers under the Licensing Act 2003. Specifically, it includes figures on premises licences, club premises certificates, personal licences, late night refreshment, 24-hour alcohol licences, temporary event notices, early morning alcohol restriction orders, late night levies and late night refreshment exemptions. It also includes statistics on cumulative impact areas, reviews, hearings and appeals.

* The Home Office states that the increase does not necessarily reflect an increase in the employment of active personal licence holders, as individuals who are authorised to supply alcohol are not required to surrender their personal licences when they leave or retire from the alcohol industry.

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Booze sold at “pocket money prices”

Cost of cinema ticket buys 7½ litres strong white cider (06 October)

Research released this month shows there is an abundance of high strength alcohol sold for pocket money prices in shops and supermarkets across the UK.

A review of alcohol prices in a range of retailers found products like high strength white ciders, which are predominantly drunk by dependent and underage drinkers, available for as little as 16p per unit, while attracting under a third of the duty on a can of beer the same strength. This means that for the cost of a standard off-peak cinema ticket it is possible to buy almost seven and a half litres of high strength white cider, containing as much alcohol as 53 shots of vodka.

The findings are released in a report by the Alcohol Health Alliance UK (AHA), a group of medical royal colleges, alcohol organisations and health bodies. It argues that recent cuts in alcohol taxes allow supermarkets to sell alcohol at rock bottom prices, but have done little to benefit pubs and their customers. AHA chair, leading liver doctor and formewr President of the Royal College of Physicians, Professor Sir Ian Gilmore said:

“In spite of a government commitment to tackle cheap, high-strength alcohol, these products are still available at pocket money prices. Harmful drinkers and children are still choosing the cheapest products: predominantly white cider and cheap vodka.

“We need to make excessively cheap alcohol less affordable through the tax system, including an increase in cider duty. It’s not right that high strength white cider is taxed at a third of the rate for strong beer.

“In addition, we need minimum unit pricing. This would target the cheap, high strength products drunk by harmful drinkers whilst barely affecting moderate drinkers, and it would leave pub prices untouched. In fact, pubs could benefit from minimum unit pricing, as it would prevent the proliferation of cheap alcohol in our supermarkets.

“It’s time the government took action and made all high strength alcohol less attractive to vulnerable drinkers.”

Each year there are almost 23,000 deaths and more than one million hospital admissions related to alcohol in England and Government figures estimate that alcohol harm costs UK society more than £21billion.

The former Coalition government committed to tackling problems caused by cheap alcohol and in 2012 proposed the introduction of a minimum unit price for alcohol. However, these plans remain under consideration and no action has been taken to progress with the policy. In the same year, the alcohol duty escalator – which increased duty by 2% above inflation – was scrapped. Subsequently, alcohol duty has been cut and / or frozen in the last four annual Budgets.

The report, Cheap alcohol: the price we pay, warns that unless action is taken on the availability of cheap alcohol, harms associated with alcohol consumption will continue to rise, increasing the burden on the NHS and public services.

 

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Road safety and health groups call for lower drink driving limit

Public opinion polls show 77% of public in favour (10 October)

A coalition of road safety charities, emergency services and health experts have made fresh calls for MPs to reduce the drink driving limit in England and Wales.

The call comes after statistics show progress on drink driving stalling since 2010, with 240 deaths and more than 8,000 casualties reported each year.

The latest transport figures also show that the number of motorists involved in accidents who subsequently failed a drink-drive breath test rose for the first time in a decade. The number of breath tests failed / refused by drivers / riders involved in personal injury road accidents rose to 3,884 in 2015, up from 3,681 the year before. The greatest increase was among car drivers, 3,450 of whom were found to have failed the test in 2015, up 7% on the previous year.

England and Wales have one of the highest legal drink-drive limits in the world, set in 1965 at 80mg of alcohol per 100ml of blood. It is higher than Scotland, the rest of Europe, Australia, New Zealand and South Africa.

When Scotland lowered its limit to 50mg in December 2014, police figures showed a 12.5% decrease in drink-drive offences in the first nine months. Northern Ireland is set to follow suit by lowering its drink driving limit before the end of 2016.

And now Malta, the only other nation in Europe with as high a limit, published proposals to lower legal limit to 50mg/100ml earlier this month, as part of a new National Alcohol Policy.

However, the UK Government has stated categorically that it has “no plans to change the legal blood alcohol limit for driving in England and Wales” preferring instead to wait on an evaluation about the impact of the changed limit in Scotland, while in the meantime maintaining that “rigorous enforcement and serious penalties for drink drivers” is a more effective deterrent.

Drink driving costs Great Britain £800million each year and the majority (60%) of those killed or injured are people other than the driver, according the the Department for Transport. Drivers who drink up to the current limit are six times more likely to be killed in an accident as drivers who have not consumed alcohol.

Several polls in the last few years have consistently shown widespread support for a move, most recently in the British Attitudes Social Survey, which found that 77% of the public are in favour. A host of motoring, emergency services and medical organisations (including the RAC Foundation, BRAKE, the Police Federation, Royal College of Emergency Medicine, Allianz, and others) have joined popular support for a lower limit.

Katherine Brown, Director at the Institute of Alcohol Studies, said:

“Recent decades have seen great improvements in road safety, but progress on drink driving has ground to a halt. With hundreds of lives lost each year, we can’t afford to let England and Wales fall behind our neighbours in road safety standards.

“It’s time the Government looked at the evidence and what other countries are doing to save lives and make roads safer. We need to make drink driving a thing of the past, and to do this we need a lower drink drive limit.”

Steve Gooding, director of the RAC Foundation, said:

“Policy in this area hasn’t moved for half a century, but in the face of mounting evidence it increasingly falls on opponents of a limit reduction to defend the status quo, rather than asking those who support a cut to keep making their case.”

A short animation by The Institute of Alcohol Studies ‘Save lives, safer roads, lower the drink-drive limit’ (below) explains how drink driving deaths have flatlined since 2010, and that lowering the legal limit to 50mg alcohol per 100ml blood would save at least 25 lives per year. For more information on the campaign, please visit our #lowerlimit webpage.

 

 

IAS – Lowering the drink-drive limit from The Institute of Alcohol Studies on Vimeo.

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Parental absence linked to pre-teen drinking risk

Findings lead to calls for greater support intervention for children at an earlier age (11 October)

A new study has linked parental absence to an increased risk of underage drinking. While there was substantial previous evidence that growing up with both biological parents reduces the likelihood of drinking and drinking heavily in adulthood, this is the first such analysis of the effect on pre-teens.

The research, published earlier this month in the journal Archives of Disease in Childhood, drew on data from the Millennium Cohort Study, a project which periodically follows up a panel of children born between 2000 and 2002. Using the most recent wave of surveys, the study found that children who had experienced the absence of a parent by the age of seven were 46% more likely to have tried alcohol and over twice as likely to have ever felt drunk by the age of 11.

Lead author Rebecca Lacey was reluctant to claim that the children’s drinking was the direct result of their parents’ absence, noting that “We know these things are associated but don’t know that one causes the other”. Adjusting for a range of confounders including parental education level, ethnicity, mother’s age, smoking during pregnancy and birth weight reduces the size of the effect, so that children with absent parents are 27% more likely to drink and 75% to have been drunk. However, it remains possible that there may be other differences in family background that pre-dispose the children of absent parents to drinking which are not accounted for in the research.

 

Intriguingly, the study found that children whose parents had died were less likely to take up drinking than those whose parents were absent for other reasons. However, they were more likely to report being drunk, suggesting that bereaved children who drink are liable to drink more heavily.

The researchers also looked at whether losing a parent at an earlier age influenced the risk of drinking, or whether there was a difference between having an absent mother or father. However, they were unable to find any statistically significant relationships.

The article suggests its finding that pre-teen children of absent parents are at increased risk of drinking implies a need for earlier intervention to support such children.

Prof Russell Viner, officer for health promotion for the Royal College of Paediatrics and Child Health, told The Guardian that the new evidence bolsters the case for compulsory PSHE classes in schools:

“Significant changes early in life are already known to have an impact on a child’s development, their later health and risky behaviours, so this latest paper not only adds to an already increasing wealth of knowledge telling us that our life trajectories are partially set very early on, but also that we need to do everything we can to put our children onto trajectories towards positive health. Early intervention can be particularly important for children who have suffered a bereavement or parental separation.

“With personal, social, health and economic education (PSHE) currently lacking from school curriculums, not all children are receiving the education required early in life to raise awareness and deter them from some of these risky behaviours. Therefore it is vital that the government makes PSHE compulsory for all schools”.

Results and limitations

Whilst in intoxicated and in drinking environments, people base judgements regarding their drinking on how their level of intoxication ranks relative to that of others of the same gender around them, not their actual levels of intoxication. On average, people perceived themselves as moderately drunk and moderately at risk, although their BrAC exceeded standard US and UK drink driving limits (35 micrograms of alcohol in 100 millilitres of breath). Thus, drinkers were found to be more likely to underestimate their own level of drinking, drunkenness and associated risks. Men on average had higher BrAC levels than women.

This study was observational, so it can increase our understanding of possible links between perceived drunkenness and drinking environments, but it cannot show cause and effect because other factors may play a role. An experimental study would be needed to show a cause and effect.

The study may be limited by the assumption that people in the same environment who are drinking influence each other, even though most of the people within the eight groups studied here are unlikely to have a social relationship.

The knowledge that people’s decisions on whether or not to drink more may be influenced by their environment and their observation of others around them should inform future alcohol harm reduction strategies, according to the researchers. However, factors that influence drinkers’ choices about whether or not to keep drinking are complex and only a few may lend themselves to intervention. The researchers suggest further investigation into the influences of more immediate social groups on drinking perception.

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Smirnoff #whatwebring video deemed safe to view

Watchdog rejects complaints over online ad (11 October)

The Advertising Standards Authority (ASA) has allowed Smirnoff to continue broadcasting its latest online advert, dismissing a trio of complaints submitted on behalf of the Youth Alcohol Advertising Council (YAAC).

The complaints were made in relation to a video promoting Smirnoff Vodka featuring young people preparing to party while consuming the spirit, followed by scenes including the hashtag #whatwebring’.

The YAAC challenged whether the video, first shown on Smirnoff Europe’s YouTube channel in June, implied that alcohol was a key component of social success, was likely to appeal to under-18s, and breached alcohol advertising rules because it featured a female who looked under 25 years of age.

The advertising watchdog responded that it did not consider the ad to depict (in an obvious way) drinking alcohol as a key component of the success of the social events shown; that the events which occur during the disputed scenes “did not appear juvenile in nature and were events likely to be attended by adult guests”; and that the characters in the advert to look older than 25.

It therefore concluded that the ad was not in breach of CAP Code rules 18.1, 18.14, 18.16, and 18.3 (Alcohol).

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Volume markings lead to slower drinking

Studies find strong correlation (20 October)

Volume marking on glassware can lead to slower drinking, according to a team of researchers writing in European Journal of Public Health.

Two small n studies of social alcohol drinkers aged between 18 and 40 years found that total drinking time was slower from glasses with both midpoint and multiple volume marking compared with unmarked glasses.

In Study 1, 159 male and female participants were randomly assigned in roughly equal measure to drink 12 fl oz of low / standard strength lager from either a curved glass marked with yellow tape at the midpoint or an unmarked curved glass.

Study 2 repeated the exercise with 160 participants, the difference being the curved glass was marked with 1/4 and 3/4 volume points, versus unmasked curved glasses.

The results (see table below) showed that although both marked glasses slowed the rate of drinking among participants, the difference for implicit midpoint volume information was minimal, and that multiple marks indicating volume explicitly may have increased influence on the drinking time of an alcoholic beverage.

 

The researchers concluded:

“If findings are replicated in larger studies, glass markings indicating volume have the potential to be implemented as a viable choice architecture intervention in drinking environments as part of evidence-based, cost-effective alcohol public policy.”

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Women closing the drinking gap on men

Trend most evident among young adults, international analysis shows (25 October)

Women are catching up with men in terms of their alcohol consumption and its impact on their health, finds an analysis of the available international evidence, spanning over a century and published in the online journal BMJ Open.

This trend is most evident among young adults, the findings show. Historically, men have been far more likely than women to drink alcohol and to drink it in quantities that damage their health, with some figures suggesting up to a 12-fold difference between the sexes. But now evidence is beginning to emerge that suggests this gap is narrowing.

In a bid to quantify this trend over time, a research team pooled the data from 68 relevant international studies published between 1980 and 2014. The studies calculated male-to-female ratios for 3 broad categories of alcohol use and harms (any alcohol use, problematic alcohol use and alcohol-related harms) stratified by 5-year birth cohorts ranging from 1891 to 2001, generating 1,568 sex ratios.

Sixteen of the studies spanned 20 or more years; five spanned 30 or more. All the studies included explicit regional or national comparisons of men’s and women’s drinking patterns across at least two timeperiods.

Results

The pooled data showed that the gap between the sexes consistently narrowed across all three categories of any use, problematic use, and associated harms over time.

Men born between 1891 and 1910 were twice (2.2) as likely as their female peers to drink alcohol; but this had almost reached parity among those born between 1991 and 2000 (1.1, illustrated). The same patterns were evident for problematic use, where the gender gap fell from 3 to 1.2, and for associated harms, where the gender gap fell from 3.6 to 1.3.

After taking account of potential mathematical bias in the calculations, the gender gap fell by 3.2% with each successive five-year period of births, but was steepest among those born from 1966 onwards.

Associated health harms fall disproportionately on female drinkers

The calculation used was not designed to address whether alcohol use is falling among men or rising among women, the researchers caution.

But among the 42 studies that reported some evidence for a convergence of drinking levels between the sexes, most (n = 31) indicated that this was driven by greater use of alcohol among women, and 5% of the sex ratios were under 1, suggesting that women born after 1981 may actually be drinking more than their male peers, the researchers claimed.

Conclusions

The researchers wrote: “Findings confirm the closing male–female gap in indicators of alcohol use and related harms. The closing male–female gap is most evident among young adults, highlighting the importance of prospectively tracking young male and female cohorts as they age into their 30s, 40s and beyond.”

While they did not set out to explain the reasons behind their observed findings, they emphasised that their results “have implications for the framing and targeting of alcohol use prevention and intervention programmes.”

They concluded: “Alcohol use and alcohol use disorders have historically been viewed as a male phenomenon. The present study calls this assumption into question and suggests that young women in particular should be the target of concerted efforts to reduce the impact of substance use and related harms.

“These findings (also) highlight the importance of further tracking young male and female cohorts as they age into their 30s, 40s and beyond”, they added.

Institute of Alcohol Studies director Katherine Brown said: “The findings from this study illustrate a trend that has been in the making for decades. Women are increasingly subjected to heavily targeted marketing practices by alcohol companies enticing them to drink more. This is a global phenomenon, with drinks manufacturers producing sweet, often pink, fizzy alcoholic beverages that appeal to young women, with glamorous advertising campaigns.

“Another major driver of alcohol consumption is price, with very cheap products commonly on sale for as little as 16 pence per unit in shops and supermarkets. We are no longer a nation of pub goers, with two-thirds of all UK alcohol drunk at home. Pre-loading on cheap shop bought alcohol before a night out is common practice and police have reported strong links to crime, disorder and vulnerable behaviour in towns and city centres.

“Alcohol places a huge strain on our NHS and emergency services, with the total costs to society at £21 billion each year. We need to take this issue seriously and introduce evidence-based measures such as minimum unit pricing and marketing restrictions in order to protect out future generations and improve the health and wellbeing of our most vulnerable communities.”

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SALSUS: Drunkenness among Scottish 13-year-olds rises

Friends and family at home most likely sources for obtaining alcohol (26 October)

The proportion of pupils who have ever had an alcoholic drink continues to fall, but there has been an increase in the proportion of 13-year-olds who reported being drunk in the past week.

That is the headline finding from the new Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS), which also found that in 2015, 28% of 13-year-old pupils (28%) and two-thirds (66%) of 15-year-olds in Scotland had consumed alcohol at least once.

Less than half of 13-year-olds (45%) who had ever had alcohol had been drunk at least once, rising to around two-thirds of Scottish schoolchildren (68%) by the time they had reached 15 years of age.

Among those who had a drink in the last week, just under half of 13-year-olds (47%) and over half of 15-year-olds (57%) had been drunk over the same period. However, the proportion of 13-year-olds in this bracket who had been drunk in that time rose since the previous SALSUS in 2013 (illustrated below). Girls were also more likely than boys to have been drunk in the same period.

 

The survey also revealed that pupils were most likely to get alcohol from their home, a friend, or a relative. Direct purchase of alcohol from a business was rare; the majority of pupils who had ever consumed alcohol, never tried to buy it from either a ‘shop, supermarket, or off-licence’, or a ‘pub, bar or club’ (pictured, below).

Overall, the long-term picture is one of declining consumption levels. Underage drinking in the last week in Scotland has fluctuated since 1990 but has been decreasing, for the most part, since 2002. Drinking in the last week has remained unchanged between 2013 and 2015, with the exception of a small decrease among 15-year-old boys: 19% drank in the last week in 2013, compared with 16% in 2015. However, the rise in the proportion of 13-year-olds who reported being drunk in the last week over the same period threatens to reverse these trends.

 

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