New NICE guidance for schools published to prevent and reduce alcohol use in children and young people

The National Institute for Health and Clinical Excellence (NICE) has issued national guidance on effective ways to encourage children not to drink, delaying the age at which young people start drinking and reducingthe harm it can cause among those who do drink.The guidance is aimed at anyone who works with children and young people in schools and other education settings. It gives advice on incorporating alcohol education into the national science and personal, social and health education (PSHE) curricula, and helping children and young people access the right support. In 2006, 21 per cent of pupils in England aged 11-15 reported drinking alcohol in the previous week.

Launching the new guidance, Andrew Dillon, chief executive of NICE said: “Many different factors have an influence on alcohol consumption among children and young people, including peer pressure, the media and the availability and cost of alcohol. It is important that we now have national guidance for tackling this issue so that we can do everything possible to delay the onset of drinking and reduce the harmful effects of alcohol use.”

Key recommendations of the guidance include:

• Head teachers, teachers, school governors and others who work in (or with) schools should ensure that alcohol education is an integral part of the national science, PSHE and PSHE education curricula, in line with Department for Children, Schools and Families (DCSF) guidance. Education programmes should increase knowledge of the potential damage alcohol use can cause and provide the opportunity to explore attitudes to - and perceptions of - alcohol use.

• Where appropriate, parents or carers should be offered information about where they can get help to develop their parenting skills. This includes problem-solving and communication skills, and advice on setting boundaries for their children and teaching them how to resist peer pressure.

• If children and young people are thought to be drinking harmful amounts of alcohol, teachers, school nurses and school counsellors should offer brief, one-to-one advice on the harmful effects of alcohol use, how to reduce the risks and where to find sources of support.

• Head teachers, school governors, healthy school leads, school nurses and extended services should maintain and developpartnerships to support alcohol education in schools as part of the national science and PSHE education curricula.

Change of direction?
The NICE guidance begins to put into effect the objectives in relation to preventing harm to the under- 18s contained in the revised national alcohol harm reduction strategy for England, ‘Safe. Sensible. Social’. The Strategy document refers to evidence showing that children and adolescents are drinking alcohol at a younger age and those who do so are drinking in greater quantities than ever before. The evidence also shows, the document explains, that alcohol has serious consequences for young people both now and later in life, and the Strategy goes on to outline three objectives:

• Delaying the onset of regular drinking, primarily by changing the attitudes of 11-15 year olds and their parents about alcohol;

• Reducing harm to young people who have already started to drink.

• Creating a culture in which young people feel they can have fun without needing to drink.

No more ‘sensible drinking’ for teenagers?
The objective of delaying the onset of regular drinking appears to represent a departure from the idea of teaching children to ‘drink sensibly’, and possibly introducing children to alcohol early in life in family settings in the hope of inoculating them against excessive consumption.

The merits of this view were expressed to NICE by ‘Alcohol in Moderation’ (AIM), an advocacy group strongly linked to the alcohol industry. In its submission to NICE, AIM argued that the new guidance to children and adolescents “should include a message to encourage responsible use and sensible drinking patterns. AIM went on to state that “evidence shows parental introduction of small amounts of alcohol in the home with meals does not encourage irresponsible use…”

In response, NICE said it would be grateful if AIM would provide the references for this evidence. So far as is known, no references were forthcoming.

However, the present Government has itself often appeared to favour the AIM approach, notably in relation to its licensing law reforms which were in part designed to make licensed premises more family-friendly and to encourage children, even those unaccompanied by adults, into licensed premises. In preparing what finally became the Licensing Act 2003, the Government also clearly considered reducing the legal age for purchasing and consuming alcohol in public places to 16 or 17, though it finally decided against doing so.

Gearing national policy to delaying introducing alcohol to children thus seems to represent a significant change of direction. No explanation of this change has been provided but an obvious possibility is that the idea of positively encouraging children and adolescents to drink ‘sensibly’ has lost some of its plausibility as a preventative measure, given that the current anxieties about binge drinking concern primarily a generation raised on the very ‘sensible drinking’message that is supposed to prevent such problems.