Today marks the 35th anniversary of the Road Traffic Act (1988) which made it an offence to drive under the influence of alcohol. The legislation is responsible for saving countless lives – since official records began in 1979, the number of deaths caused by drink driving per year has fallen by a staggering 88%.
However, in the same time period, the prevalence of alcohol consumption has risen, posing an increasing threat to public health.
To mark the anniversary of this important piece of public health legislation, the Association of Directors of Public Health (ADPH) has published a new position statement on alcohol setting out a series of recommendations that would see the number of alcohol related deaths fall even further and protect individuals, families, and communities from harm.
Since 2019, the number of people dying every day due to alcohol consumption has risen by almost a third to 70, with alcohol responsible for killing twice as many people living in deprivation than in affluence.
It is the leading factor for death, ill-health, and disability amongst 15-49-year-olds in England, and linked to at least seven types of cancer. As well as physical and mental ill-health, alcohol is responsible for millions of crimes and accidents with half of all police workload and 40% of ambulance time spent on alcohol related incidents.
This demand on the NHS and emergency services, together with the 17 million working days lost each year because of alcohol related sickness, costs the UK economy between £27 and £52 billion.
The human cost is unquantifiable with lives lost, health problems, financial worries, relationship breakdowns and long-lasting effects on families. In England alone, 200,000 children live with an alcohol dependent parent making them six times more likely to experience domestic abuse, three times more likely to consider suicide and twice as likely to develop an alcohol use disorder themselves.
Over time, alcohol has become increasingly acceptable, accessible, and affordable – all of which have contributed to creating an alcogenic society.
Of course, external factors like the pandemic and the cost-of-living crisis have had an impact on individual people’s levels of consumption, and patterns of drinking have changed, but we must look at the wider picture and consider how and why these changes have happened.
I have spoken many times about the role of the alcohol industry in creating an environment where alcohol consumption is considered desirable and the norm. With billions of pounds behind clever marketing strategies, an alarmingly high level of political influence and a stake in a wide range of businesses, industry giants have a unique foothold in our lives.
The alcohol industry targets children with attractive, brightly coloured alcohol products, facilitates drinking with low price promotions and over the last decade, real terms cuts to alcohol duty have made it 14% more affordable.
Industry is also ever present through sponsorship of sports and music events, giving exposure not just to adults, but to children and young people too. Meanwhile, much of the research behind drinking habits is partly funded by industry and even school education packages are often backed by big industry names.
All this creates a situation where the individual, far from having freedom of choice, finds themselves only being able to wield their ‘freedom’ in a highly biased environment.
To ensure that those being harmed, or are at risk of harm, are supported now, we need good quality, well-funded alcohol treatment that is easy to access and stigma free. However, continued cuts to public health funding have had an impact and while effective treatment does exist, over 80% of people who need treatment aren’t currently being supported. To provide treatment to these – and more – people, more funding is desperately needed.
We also need to think longer term to prevent people from experiencing harm in the first place. By having a clear national strategy to reduce alcohol harm in all four nations we can begin to turn the tide. Instead of focussing on individual choice, we need measures that protect health policy from industry influence and instead take an evidence-based approach which tackles affordability, and marketing alongside decreasing the availability of alcohol.
One key measure is minimum unit pricing (MUP). Following its introduction in Scotland, MUP has reduced alcohol consumption, related deaths, and hospital admissions with the largest reductions in those living in the 40% most deprived areas. The evidence is clear, and the next Government must make the introduction of MUP a priority for England.
In addition to tackling price, because self-imposed voluntary agreements by industry have been ineffective, we need to establish an independent body free from industry influence to regulate alcohol promotion and drive public awareness. Clear, effective labelling is also needed, and children must be protected from advertising of a product which is both illegal for them to consume and incredibly harmful.
We have seen how effective regulation is with tobacco control and we are beginning to see similar advances for public health in restricting advertising of unhealthy foods, so we know this approach works – we just need to do it!
The cry of ‘no to the nanny state’ is often heard when this type of regulation is suggested but there is actually widespread public support for such measures.
As well as being ADPH’s Policy Lead for Addiction and an IAS Trustee, I am Director of Public Health for Gateshead where we are working in partnership with other organisations to highlight the issues and find out the public’s views. In a survey in 2020, over half of those asked believed the Government should be doing more to tackle alcohol harm and would welcome the introduction of MUP. Meanwhile 75% said there should be measures to limit children and young people’s exposure to alcohol advertising.
So, 35 years on from the so-called nanny state intervening to reduce the number of people dying from drink driving, we once again need the Government to act to protect us all from alcohol harm.
Written by Alice Wiseman, Policy Lead for Addiction, Association of Directors of Public Health (ADPH).
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.