Scotland: alcohol deaths down - but still a long way to go

An evaluation of the Scottish alcohol strategy by NHS Scotland shows recent improvements in alcohol-related mortality but Scotland’s alcohol-related mortality rate still being over two and a half times higher than in the early 1980s. Scottish alcohol deaths remain nearly twice as high as in England and Wales, and this represents one of the highest alcohol mortality rates in Western and Central Europe.

The social patterning of harms caused by alcohol is also shown. People living in the most deprived areas of Scotland are over 5 times more likely to die from an alcohol-related cause than people in the least deprived areas. Nevertheless, there has been a 24% reduction in alcohol-related deaths in the most deprived fifth of the population between 2007 and 2011, while the rates in the least deprived fifth of the population remained static. The inequality in alcohol-related deaths in Scotland has, therefore, narrowed.

The report also highlights the adverse alcohol-related health consequences for children using findings from the 2010 Scottish Schools Adolescent Lifestyles and Substance Use Survey (SALSUS). These show that among the 60% of 13- and 15-year-old Scottish schoolchildren who reported having ever drunk alcohol, 31% of those had vomited in the past year as a result of drinking alcohol.

The reduction in alcohol-related harms has coincided with a recent decline in the volume of alcohol sold per adult, which fell by 5% between 2009 and 2011. Despite this decline, alcohol sales in Scotland remain 10% higher than they were in 1994. In 2011, 11.2 litres of pure alcohol were sold per adult in Scotland, an average of 21.6 units per adult per week. This means that 20% more alcohol was sold per adult in Scotland than in England & Wales, where 9.3L of pure alcohol was sold per adult (or 17.9 units per adult per week). This difference was mainly due to higher off-trade sales of lower priced spirits in Scotland, particularly vodka.

Clare Beeston, Principal Public Health Adviser at NHS Health Scotland, said:

“It is good news that we are seeing these improvements and our analysis suggests that policy interventions such as the delivery of over 272,000 Alcohol Brief Interventions may have had a modest impact. The analysis also supports the well established relationship between alcohol affordability and consumption, and some of these improvements are likely to be the result of the recession rather than permanent changes in consumption patterns, which history shows tend to reverse when the economy improves. It is important to ensure that Scotland continues to implement the comprehensive alcohol strategy to ensure that these improvements are sustained.”

The Alcohol (Minimum Pricing) (Scotland) Act 2012 was passed by the Scottish Parliament in May 2012 and has yet to be implemented. It legislates for a minimum price per unit of alcohol to be applied to all alcohol sold through licensed premises in Scotland. The Scottish Government has proposed that the initial price will be set at 50 pence per unit). The report shows that this would have affected 66% of all off-trade alcohol sold in 2011. However, this has declined from 81% in 2008, highlighting the importance of the Scottish Government’s proposed two-year review process of the level at which the minimum price for alcohol is set. The UK Government has announced it is taking similar measures to control the level of alcohol consumption and related harm.