Issue 3 2008

Licensing reforms branded an expensive failure by Local Government Association

In a survey of 51 local authorities, 49 primary care trusts and twenty police authorities, the Local Government Association (LGA) found that the government’s promise to reduce alcohol-related disorder through the Licensing Act 2003 has “failed dismally”.

In introducing the new Act, the government insisted that the old licensing laws actually caused alcohol-related disorder by encouraging binge drinking and bringing about a peak of disorder at fixed and ‘artificially early’ closing times. The government’s promise was that longer drinking hours would, of themselves, therefore, bring about significant reductions in crime and disorder.

However, over three quarters of the authorities in the LGA survey believed that the number of alcohol-related incidents had risen or stayed the same. The LGA survey found that nearly one in three primary care trusts has reported an increase in alcohol-related incidents. Half of police authorities reported that the Act had merely resulted in the incidents occurring later in the night. In addition, more than three quarters of health authorities felt that they have had to spend more, largely owing to a rise in accident and emergency admissions, while council taxpayers have paid £100 million to administer the new regulations.

“An overhaul of alcohol licensing was long overdue and the new system has been very effective in pulling together archaic licensing laws that dated back to the First World War.” said Sir Simon Milton, Chairman of the LGA. However, he added: “The new drink laws have made no impact whatsoever on reducing the alcohol-related violence that blights town centres and turns them into no-go areas on a Friday and Saturday night.

“The vast majority of local councils, police and hospitals have reported no change at all, with violent incidents generally just being shifted later into the evening.

“The Government was always going to fall short on its promises to curb excessive drinking because new licensing laws alone were never going to be enough to change this endemic culture of alcohol and violence. The new system was burdened with exaggerated expectations. as it was never a single solution to alcohol-related disorder.

“There needs to be a wide-ranging national debate about how freely available alcohol is, how the nation views social drinking and how we can go about reducing consumption. It seems that we have a deep rooted social and cultural problem in this country in the way that we view alcohol that cannot be addressed by one simple piece of legislation. It will take years, possibly decades, of concerted action across the board.

 

“The report also clearly shows the real financial strain that the new laws have had on councils, hospitals and other local services. Hospitals and the police are finding that they are called into action 24 hours a day, stopping disruption, breaking up fights and patching up the walking wounded.

“Town halls have been landed with an accumulated bill of £100m from the new laws and have been left with little option but to pass the cost on to the council taxpayer. It is totally unacceptable that the hard-pressed council taxpayer should be forced to pick up the bill for something that the Government said would not cost them a penny.”

A Home Office report this year suggested that there had been a 25 per cent rise in serious violent offences in the early hours of the morning. The report also showed that the café culture, which the Licensing Act was supposed to encourage, had not actually materialised.

That survey – of thirty police forces – showed that crimes between 3am and 6am were up by 22 per cent, with more than 10,000 extra offences being committed during those hours.

A Department for Culture, Media and Sport spokesperson said: “This report needs to be seen in the context of other research. The government’s own research, published in March, showed that, overall, crime and alcohol consumption are down since the introduction of the Act. Serious violent crime at night is down five per cent and less serious wounding at night is down three per cent. The government has never said that the Licensing Act alone would tackle the deep-seated problems of alcohol-related crime and disorder.”

Dominic Grieve, the shadow Home Secretary, commented: “This is more evidence of how the government’s rushed decision to unleash 24- hour drinking on our towns and communities has impacted negatively on local communities.

“Alcohol-fuelled disorder has either increased or been displaced with frontline services bearing more of the brunt. At the same time the council tax-payer has been left to pick up the bill.

“This shows why they should have listened to our calls to pilot the scheme, assess its consequences and then apply it appropriately and at local discretion.”

Key findings of the survey are:

• Seven out of ten police authorities, PCTs and councils reported an increase or no change in alcohol-related incidents

• Nearly one in three PCTs have reported an increase in alcohol related incidents

• Half of police authorities report that the Act has simply led to alcohol-related disorder occurring later at night than previously

• 86% of health authorities and 94% of councils reported an increased pressure on resources, mainly through a rise in A & E admissions

• Council taxpayers are footing a bill of £100m to implement the new laws

Smoking ban hits sales of alcohol

The Publican newspaper has reported that the smoking ban that came into effect in England on 1st July 2007, having already been introduced into the other UK countries, has significantly reduced pub sales of beer and spirits. According to market analysts Nielsen, around 175 million fewer pints have been drunk in the last year as a direct result of the smoking ban.

In the nine months from July to March volume sales of alcohol in the on-trade in England and Wales fell eight per cent – before the ban the rate was falling at three per cent.

With other factors such as the credit crunch also being taken into account Nielsen estimates that half of the eight per cent drop can be attributed to the ban.

Jake Shepherd, marketing director at Nielsen, said: “The winter months were particularly bad – sales fell 9.3 per cent through November to January when smokers would have been reluctant to stand outside in the cold to have a cigarette.”

Sales of wine were also reduced, but by a lesser amount. They dropped four per cent after the ban compared to two per cent beforehand.

Shepherd added: “Wine has held up somewhat better than other drinks, probably benefiting from the increasing importance of food and women to the on-trade. In Scotland we have seen the sales of both tobacco and alcohol (out of home) stabilise during the second year of the ban being in force so we do not expect these decline rates to continue in the long term. Investment into outdoor smoking areas has been considerable and most consumers have now adapted to the change.”

In addition cigarettes sales are reported to have dropped six per cent since July 1 last year with smokers buying 2.1billion fewer cigarettes between July 1 2007 and April 2008.

Paradoxically, however, research conducted on behalf of The Publican found that although 52 per cent of licensees reported suffering a drop in trade since the smoking ban, the number of licensees supporting it actually increased, with 64 per cent now supporting it compared to 57 per cent before the law came into force.

Government alcohol campaigns launched

Two government publicity campaigns began over the summer as part of the National Alcohol Harm Reduction Strategy in England. A key stage of the government’s `Know Your Limits’ campaign began in May, focusing on the number of units of alcohol contained in a range of drinks. In June an anti-binge drinking advertising campaign was launched. Also announced was the Youth Alcohol Action Plan.

Know your limits

The Know Your Limits campaign on alcohol units and the strength of alcoholic drinks was prompted by research showing that there is widespread public confusion. A YouGov poll found that whilst most people (82%) thought that they knew what a unit of alcohol was, the majority (77%) were unable to say how many units were contained in a large glass of wine.

The campaign was welcomed by the Institute of Alcohol Studies as a small step in the right direction. In particular, IAS supported the planned change in terminology from ‘sensible drinking’ to a scale of risk, indicating an acceptance that no level of drinking is without risk. The IAS said that whilst alcohol education campaigns had a poor record of success when used in isolation, they could form an important part of an integrated strategy to improve public health. It added that it would like to see a lowering of the drink-drive limit as part of this larger strategy.

Knowing your units

One reason for the confusion about alcohol units is the gradual increase in strength of both wine and beer. HM Revenue and Customs recently reviewed its estimate of the strength of wine, and found that it had been getting stronger at a faster rate than previously thought. The average strength of wine, previously believed to be 12%, is now thought to be closer to 13%. This compares with 11.4% in 1995. Beer has also increased in strength, from an average of 4.05% in 1995 to 4.2% in 2006, though the latter estimate is also thought to be a little low.

The centrepiece of the new campaign is a series of advertisements for television and radio designed to inform people how many units are in a range of drinks, for example, three units in a large glass of wine, two to three units in a pint of beer (depending on strength) and one unit in a (single) gin and tonic. The emphasis is very strongly on giving people information to make their own decisions about their drinking habits. Public Health Minister, Dawn Primarolo, said, “This is a sophisticated audience. They can handle it.”

In addition to the advertisements, material is being provided to GPs, local councils and other interested groups to provide additional support for people at risk of alcohol-related problems, or who are worried about their drinking.

The way the guidelines are expressed is also changing, though the guidelines themselves stay the same. The terms, ‘sensible,’ ‘hazardous’ and ‘harmful’ drinking are being replaced by ‘lower risk,’ ‘increasing risk’ and ‘higher risk’. This draws attention to the fact that there is a continuum of risk associated with drinking and that even a small amount of alcohol increases the risk of a number of health problems.

The guidelines specify quantities that should not regularly be exceeded, where ‘regularly’ means most days of the week. The ‘lower risk’ guidelines are no more than 3-4 units per day for men and 2-3 units per day for women. An ‘increased risk’ occurs between 3-4 units and 8 units per day for men and between 2-3 units per day and 6 units per day for women. Drinking more than this is classified as ‘higher risk’.

Anti-Binge Drinking campaign

The national advertising campaign to drive home the serious consequences of binge drinking to 18 to 24 year olds was unveiled by Home Secretary Jacqui Smith.

The £4 million campaign, which includes a range of television, radio, print and online adverts, is designed to challenge prevailing attitudes and change behaviour among young adults who binge drink. It poses the question: ‘You wouldn’t start a night like this, so why end it that way?’

The centrepiece of the campaign is two new television adverts that graphically highlight the consequences of binge drinking by reversing the sequence of a night out gone wrong. The adverts show a man and woman getting ready at home for a night out. They end with the man leaving home bloody and damaged and the woman closing her front door with smeared make-up and vomit in her hair.

The television adverts appeared in youth programming before and after a night out to capture people when they were considered to be more responsive, as well as on sport and music channels. The radio adverts targeted youth programming on national and regional stations. Print advertising featured in men’s and women’s magazines such as Nuts, Zoo, NME, FHM, and Loaded and Heat, Closer, Now, Reveal, Cosmopolitan, and Glamour.

Home Secretary Jacqui Smith said:

“I am not prepared to tolerate alcohol-fuelled crime and disorder on our streets and this new campaign will challenge people to think twice about the serious consequences of losing control.

“Binge drinking is not only damaging to health but it makes individuals vulnerable to harm. People who are drunk are much more likely to be involved in an accident or assault, be charged with a criminal offence, contract a sexually transmitted disease or have an unplanned pregnancy.

“This campaign reinforces Government action already underway to deal with excessive drinking, including tougher sanctions for licensees who sell to young people, new powers for the police to disperse disruptive drinkers and better education and information for everyone.”

The new adverts were unveiled alongside an innovative window display on Long Acre in central London, which re-enacts scenes from the television campaign. The display ran for two weeks and was complemented by a viral video downloadable via a Bluetooth connection at the site. A team of street marketers were on hand to engage the target audience face-to-face to reinforce the campaign messages. There are plans to recreate the shop window display in town centres up and down the country.

Youth Alcohol Action Plan

At the start of June the government launched its Youth Alcohol Action Plan, also promised in the National Alcohol Harm Reduction Strategy. The Plan was announced by Ed Balls, Secretary of State for Children, Schools and Families, Jacqui Smith, Home Secretary and Alan Johnson, Secretary of State for Health.

The Action Plan sets out what the Government intends to do to address drinking by young people. It outlines three main approaches:

• Working with police and the courts to stop underage drinking, making it clear that unsupervised drinking by young people under 18 in public places is unacceptable.

• Recognising that drinking by young people in the home is clearly the responsibility of parents and families, but providing clearer health information for parents and young people about how consumption of alcohol can affect children and young people. The Chief Medical Officer, Sir Liam Donaldson, will produce clear guidelines for families.

• Working with the alcohol industry to continue the good progress made to reduce the sale of alcohol to under-18s but also in marketing and promoting alcohol in a more responsible way.

The government says that while the proportion of young people who drink regularly has fallen, the consumption of alcohol by those who do drink has risen sharply, and the ways in which young people are drinking have changed. There is a rising trend of young people drinking unsupervised in public places. This puts them and their communities at greater risk, so new measures will be introduced to give the police powers to tackle young people who harm themselves and their communities by persistently drinking unsupervised in public places. This includes the use of Acceptable Behaviour Contracts and Parenting Orders. The government will legislate to make it an offence for under-18s persistently to possess alcohol in public places.

In regard to parental responsibility, the Government’s Chief Medical Officer will develop a new set of guidelines on young people and alcohol. The government says he will work with experts, parents and young people themselves “to consider the age at which children and young people can start to drink alcohol, how much it is sensible for young people to drink, and how far young people’s drinking of alcohol should be supervised by parents.”

Announcing the new package, Ed Balls said: “Tougher enforcement powers are needed to tackle under-age binge drinking but enforcement measures alone are not the solution. We need a culture change about drinking with everyone from parents, the alcohol industry and young people all taking more responsibility.

“We need to fundamentally influence young people’s behaviour and attitudes towards alcohol. This will involve talking to young people themselves but, crucially, parents tell us they want better, clearer information as they bring up their children.”

Home Secretary Jacqui Smith said:

“If you can’t buy alcohol you shouldn’t be able to drink it in public either. Underage drinking erodes the safety and well being of communities as well as damaging young people’s health. It’s not right and I am determined to put a stop to it.”

Call time on Britain’s damaging drink habits say Directors of Public Health

Act now to reduce drink-related harm, says Faculty of Public Health and Association of Directors of Public Health Recommendations to UK Government include:

• Tighten regulation on marketing, promotion and pricing of alcohol.

• Ensure clear and consistent labelling of alcohol content.

• Give more consideration of public health issues when processing licensing applications.

A range of measures are needed to get to grips with the UK’s ever worsening problem with alcohol misuse, says the Faculty of Public Health and Association of Directors of Public Health. Both are calling for firm action at both national and local level to address the devastating impact of Britain’s drinking habits on the nation’s health and economy in its new Alcohol Position Statement launched at its annual conference in Cardiff.

The Problem

The Doctors say that Britons are drinking twice as much as they did 40 years ago, a period which has seen the death rate from liver cirrhosis more than quadruple. Alcohol is also a significant contributory factor in many other health conditions including coronary heart disease, obesity and depression as well as several cancers. It is also a factor in around half of all domestic violence and violent crime incidents as well as up to 70 per cent of peak time admissions to hospital A&E departments. The financial costs to both the health service and the wider economy are immense and growing all the time.

Evidence from around the world shows that the most effective efforts to tackle alcohol misuse are those that combine measures aimed at the whole population – increasing price, reducing availability and targeting those vulnerable and disadvantaged groups who may be at increased risk.

Therefore the Faculty of Public Health and Association of Directors of Public Health are calling on the government to take decisive action to tighten regulation on the marketing and promotion of alcohol – particularly the enormous discounts offered by supermarket chains, which can often see alcohol sold below cost price – and address the clearly ineffective industry self-regulation around promoting alcohol as a glamorous and exciting product, particularly to the young.

They want to see tax levers used to increase price, the introduction of a clear and consistent labelling policy for alcohol content, better screening for alcohol-related problems and more consideration of public health issues by local licensing authorities, particularly in areas with high levels of alcohol related disorder and ill health. They also want to see better education on alcohol issues, both in schools and for the public as a whole, and a reduction of the legal blood alcohol limit to cut the number of drink driving incidents.

‘Every week we seem to be hit with yet another shocking statistic about the damage done by alcohol misuse to individuals and society,’ said Faculty President Professor Alan Maryon Davis. “All of us, especially government, have to stop tiptoeing around this problem and really get to grips with it. We need firm action now.”

“Despite a number of governmental strategies, problems related to alcohol are getting worse, not better,” said ADPH President Dr Tim Crayford. “‘It’s time to turn this tide and help people back to safer levels of drinking.”’

New court focuses on family problems, including alcohol and drugs

By Jonathan Goodliffe, Solicitor

Background to the foundation of the new court

Alcohol and drug misuse is at the heart of many family problems. In more serious cases parents may become unfit to look after their children. Action taken by local authorities may result in the children being taken into care.

At a later stage children may be placed for adoption. The parent may oppose this and rely on the right to respect for family life under article 8 of the European Human Rights Convention. But that right is not absolute. The longer adoption is deferred the more difficult it may become to find a placement. Adoption may be the best ultimate outcome in many cases. Children of parents misusing alcohol are at risk of harm. Children brought up within the care system usually have poor educational performance and prospects in adult life.

Judges commonly direct (usually with reluctance) that children be taken into care or adopted where there is a history of serious substance misuse. This course may be inevitable unless convincing evidence of recovery from addiction and success in addressing other problems is forthcoming. These cases are dealt with at private hearings and do not usually get into the public domain until they reach the Court of Appeal. Even then the identity of the parents and children is withheld.

Court procedure as a problem in its own right

The court procedure may also be a problem in its own right. The case may take months or years to reach a conclusion. It may be heard at different stages by different judges, some of whom may not have the appropriate experience. The adversarial court procedure usually involves the examination and cross-examination of a variety of different expert witnesses instructed by the parties rather than the court. By the time the case is decided the children’s problems may have got worse rather than better¹.

Judge Nicholas Crichton has been one of the leading advocates for a radical change in the law’s approach to these problems. He draws on experience in the USA with specialist problem solving courts. Others involved in his initiative include the Interdisciplinary Child Focused Research Centre at Brunel University, the Tavistock and Portman NHS Foundation Trust and the children’s charity, Coram.

The Family Drug and Alcohol Court

This initiative led to the creation of the London Family Drug and Alcohol Court (FDAC) earlier this year. It is funded by three boroughs, Camden, Islington and Westminster and has central Government support. It sits within the Inner London Family Proceedings Court in Wells Street, London W1. Its aim is to support families affected by substance misuse so that children can, wherever possible, remain with or return to their parents.

Judge Crichton sits at the FDAC with 3 other judges specialising in child care cases. Where care proceedings are referred to his court, they will generally be heard by the same judge throughout. Support for parents (in relation to substance misuse as well as other problems) and expert reports to the judge will be provided or arranged by a steering group operating within the court. The judge will hold regular hearings to review the family’s progress with a view, wherever possible, to keeping parent and child together. In most cases parents and children will be represented by lawyers who are members of specialist Law Society or Bar panels and who will themselves receive appropriate training.

So, to the extent that these aims are achieved, the court procedure may be transformed from an obstacle to progress into a part of the solution.

Mentors

Further help may be provided by ‘mentors’. Mentors are parents who have themselves had experience of losing children or nearly losing children through care or adoption proceedings. Parents brought before the court may be able to draw on their advice and support, which will be entirely confidential. Mentors will not have any duty to report to the Court. The support they provide may need to continue after the proceedings are concluded, particularly if the proceedings result in a care order being made.

Interview with the judge

Further information about the court’s aims is provided in a BBC ‘Woman’s Hour’ interview in December 2007 which can be listened to online. Participants included Judge Crichton himself, one of the mentors, and Trevor Moores of Westminster’s Local Children’s Services. There is also a full research paper², describing the aims and methods of the project, by Professor Judith Harwin of Brunel and child care expert and solicitor Mary Ryan.

Evaluation

The FDAC will run as a trial for three years from January 2008. At this stage it will only involve parents and children from within the three boroughs mentioned above. The project will be evaluated by a separate team led by Professor Harwin. If it proves a success it may lead to more FDACs being established in other parts of the country. It may also, perhaps, influence the approach of family courts in other disputes where substance misuse is a factor.

References:

1 For an example of a case decided under the traditional procedure see In the matter of N (Freeing Order Application) [2005] NIFam 5 (31 May 2005)

2 ‘The role of the court in cases concerning parental substance misuse and children at risk of harm’ Judith Harwin and Mary Ryan, Journal of Social Welfare and Family Law, Sept- December 2007

Contact the author on: info@jgoodliffe.co.uk 

Under twenty-ones to be banned from buying alcohol in off-licences?

A proposal to ban under 21s from buying alcohol in supermarkets and other off licensed premises while continuing to allow those aged 18 and over to buy and consume alcohol in pubs is one of the more radical measures proposed in a new Framework for Action published by the Scottish Government, which is under the control of the Scottish National Party. Other proposals include minimum pricing of alcohol and separate drinks departments in supermarkets. Launching the discussion paper, Cabinet Secretary for Health and Wellbeing Nicola Sturgeon said:

“People across all sections of society, of all ages, are drinking ever greater quantities of stronger alcoholic drinks. It should come as no surprise that alcohol-related health problems have risen hand-in-hand with this increased consumption.

“The cost of alcohol misuse to our health service, our justice services and our economy is enormous and growing. The cost to our families, our communities and our society is incalculable.

“Now is the time for action to defuse the health timebomb alcohol misuse is storing up for the future.

“We believe that by raising the age for off-sales purchase of alcohol to 21, together with better enforcement, we will reduce excessive consumption among young people.

“Setting a minimum price for a unit of alcohol will mean price better reflects the strength of alcoholic drinks. This will end the heavy discounting which allows strong drink to be sold cheaper than bottled water.”

Some of the Scottish Government’s plans have implications for policy in England. For example, it is difficult to see how setting a minimum price per unit of alcohol could work on only one side of the Scotland/England border. Indeed, soon after the launch of the discussion paper, supermarket chain ASDA threatened to undermine the plans by building distribution centres over the border in England and selling discounted drink on the internet. ASDA said there was nothing to stop it and other supermarkets putting up new warehouses in northern England and transporting alcohol to purchasers in Scotland.

Paul Kelly, ASDA’s Corporate Affairs Director, said:

“The big point here is that these measures will actually hurt the poorest. Low income Scottish consumers will pay for this. These plans could create two classes of customer, some who are reliant on the local supermarket because they use cash and others who will get deals over the internet……. It is about a £10,000 a year person being punished for wanting to have a drink at the end of a week. That is the unintended consequence of what is being proposed.”

However, a spokeswoman for the Scottish Government said ASDA’s comments simply “strengthened the case for government action” against irresponsible promotions and pricing. She added: “We encourage the UK Government to follow our lead and take action on cheap alcohol across the country. High-strength, low-cost alcohol is not a right. It’s fuelling the damage to our communities, costing over £2 billion a year and having a huge effect on our health service and criminal justice system.”

‘Crusade’ controversy

The proposals were immediately condemned by the opposition parties and representatives of the alcohol industry and business organisations. Critics condemned it as illogical to ban under 21s from buying alcohol in off licenses as long as the age to enter a bar or pub remained at 18. It would mean, they said, that young people who were entitled to vote, marry, drive, buy cigarettes and fight in the armed forces would not be able to drink at home. However, the Framework for Action was launched in Armadale, West Lothian, which had recently run a successful six-week pilot in which the purchase of off-sales alcohol was restricted to over-21s at weekends. It is reported that the trial resulted in reduced levels of antisocial behaviour, youth drinking and vandalism.

Critics also questioned whether all the proposals were legal, in particular the plan for minimum pricing which has already been questioned by the Office of Fair Trading as possibly inconsistent with competition law.

An important indication of the potential legal complications surrounding attempts to set minimum prices and restrict special cheap alcohol promotions is that the British Beer and Pub Association has told the government it has decided to withdraw its guidance on ‘happy hours’ over fears that administering the rules could breach competition laws.

After the suspension of the guidance, pubs and clubs will have independently to decide whether to avoid certain ‘irresponsible’ promotions, rather than sign up to common standards.

The BBPA said it will continue to encourage its members to act responsibly. But it feared the standards would have been written into agreements between authorities and pubs when most licences were reviewed in 2008. The decision to withdraw the common standards is a particular setback for ministers as they near the conclusion of a cross-departmental review of ways to tackle cut-price alcohol and drinks promotions. It is reported that implementing several options favoured by ministers, including setting a minimum price for a unit of alcohol, may pose significant legal challenges. Some retail and pub industry insiders argue that implementing such restrictions while complying with competition law is all but impossible.

An independent review of the link between drinking behaviour, pricing and promotions by Sheffield University is awaited.

Labour attack

The Scottish Labour Party accused the SNP Government of being in ‘crusade mode’ over alcohol. Labour’s Pauline McNeill criticised, in particular, Kenny McGaskill, the Justice Secretary, for comments in which he likened policies on alcohol harm reduction to the campaign against child pornography. Ms McNeill complained that no attempt had been made to achieve a cross-party consensus on the alcohol issue, and said that Labour did not want to be part of a crusade. Shona Robison, the Public Health Minister, said the government was not against alcohol, only alcohol abuse.

Doctors’ support

However, The British Medical Association in Scotland welcomed the proposals, which they said appeared to reflect some of the key recommendations in its own publication Alcohol Misuse: tackling the UK epidemic. The BMA commented that while past approaches to tackle the problem “led to increased consumption levels and alcohol-related problems and demonstrated a failure in the political drive to improve public health and order”, the new consultation document seeks to reverse that approach and outlines a number of bold strategies that will, if developed in partnership and appropriately resourced, help to turn around our relationship with alcohol.

The BMA particularly welcomed efforts to address the pricing of alcohol. Since 1997, taxes on wine and beer in the UK have only increased in line with inflation while taxes on spirits have not increased at all. There was strong and consistent evidence that price increases result in reduced consumption. The government needs to act on this evidence. “The BMA has been calling for an end to irresponsible promotional activities such as deep discounting, loss leading and ‘two-for-one’ offers. This encourages excessive drinking and retailers must be more responsible about how they market alcohol, particularly those drinks that are most attractive to teenagers.

“Mass public awareness campaigns may be politically attractive and increase knowledge about alcohol misuse but they are very expensive and ultimately ineffective if unsupported by broad based policy. Targeted approaches are vital, including measures to reduce alcohol availability and thus consumption by young people and children. “We welcome the suggestion of raising the purchase age for off sales to age 21. However, this move will only be effective if it is rigorously enforced.”

The proposals

The Framework for Action sets out the Scottish Government’s strategic approach to tackling alcohol misuse, which it says is no longer a marginal problem, nor one that affects only binge drinkers or those who are dependent on alcohol.

Increasing trends in alcohol consumption mean that many Scots are now drinking above `sensible guidelines’. The paper says that over recent years, increased consumption has been influenced by factors such as a decline in the relative cost of alcohol, increased availability, and changing cultural attitudes. To deliver the long-term sustainable change required, it is essential that Government works in partnership with a wide range of partners.

Based on knowledge and understanding of alcohol misuse, its drivers, and evidence-based interventions, the discussion paper says that sustained action is required in four broad areas:

• reduced alcohol consumption

• supporting families and communities

• positive public attitudes towards alcohol and individuals better placed to make positive choices about the role of alcohol in their lives

• improved support and treatment for those who require it

The Framework for Action sets out measures to reduce alcohol-related harm in Scotland, forming the basis of a comprehensive strategic approach. The discussion paper is in the form of a consultation document on which the views of stakeholders and the general public are being sought. In particular, the Government is seeking views on:

• further action to end irresponsible promotion and below cost selling of alcoholic drinks in licensed premises

• the introduction of minimum retail pricing of alcohol

• what particular information parents would find helpful in relation to alcohol

• raising the minimum purchase age to 21 in off-sales

• the introduction of a ‘social responsibility fee’ applied to some alcohol retailers to offset the costs of dealing with the consequences of alcohol misuse

• further restrictions on promotional material in licensed premises

• the desirability of separate checkouts for alcohol sales

The consultation period will run until 9 September.

Following the consultation, the Scottish Government envisages legislating in time for many of the measures to coincide with the new Scottish Licensing Act coming into force on 1 September 2009.

 

Jack Law, Chief Executive – Alcohol Focus Scotland :

In response to ASDA’s threat to undermine the Scottish government’s alcohol strategy, Jack Law, chief executive of Alcohol Focus Scotland, the Scottish national charity on alcohol issues, wrote a hard-hitting letter to the newspaper Scotland on Sunday in which he described ASDA’s stance as just “the latest in a series of actions by the supermarkets which leads us to question their attitude to the retailing of alcohol”.

He continued:

“The sale of alcohol is not a simple transaction between the buyer and seller. All of us are affected by our problem drinking culture. The Government’s approach recognises that when we talk about selling alcohol we are talking about more than price – we are talking about the nation’s health and wellbeing and a positive future for our children. This is about more than ASDA’s profits.

“The evidence that increasing price reduces consumption is clear. At a population level, this approach works. But this isn’t the blunt instrument which your article suggests. The two most price sensitive groups are young people and heavy drinkers – two of the key groups for the Scottish Government’s alcohol strategy.

“Publicans, producers and some retailers have publicly expressed concern about cheap alcohol, yet one of the supermarkets is once again denying that their retail practices are contributing to the problem. We would wish to have the same mature dialogue with our supermarkets about Scotland’s alcohol consumption as we have had with our pubs and clubs, but none of the supermarkets have taken steps to end cheap price promotions voluntarily so the Scottish Government has been left with no option but to use legislation.

“Alcohol is a different type of product to anything else on the supermarket’s shelves which is why a licence is required to sell it and has been for over 200 years. In Scotland we updated our licensing laws two years ago and the Act comes into force in 2009. Protecting public health is one of the key objectives of the new legislation.

“Holding a licence is a privilege, not a right. Privileges carry responsibilities and views such as these do little to make us feel confident about the willingness of supermarkets such as ASDA to meet them.

“The Scottish Government has sparked off a national debate about alcohol. Parliament has already passed a Licensing Act banning price based promotions in pubs and we now have a consultation on the same measures in off-sales. People will express their views over the next 3 months. We would urge ASDA to pay heed to the views of the population and our elected representatives and to comply with the spirit and the letter of the law.”

British children are amongst drunkest in Western world

British children, Welsh children in particular, are among the most likely to drink and to get drunk in the Western world. The figures are contained in a report from the World Health Organisation on health behaviour in 11-15 year-old school children in Europe and North America. In relation to alcohol, three measures were taken: frequency of drinking, incidence of drunkenness and (for 15 year-olds only) whether they had been drunk before the age of 13.

The report also covers behaviour in relation to smoking, illegal drugs, diet, exercise and other risk factors as well as family relationships and economic circumstances.

The tables show the findings on alcohol for England, Wales, Scotland and Ireland, together with the figures for whichever countries had the lowest and highest percentages (based on boys and girls combined) and the average across all countries.

 

Good Childhood Inquiry highlights concern about values children learn from adults

Adults are increasingly concerned about the values children are learning from those around them, according to evidence submitted to The Good Childhood Inquiry. Two-thirds (66%) of adults thought that the moral values of children today are not as strong as when they were children, according to a public opinion poll for The Children’s Society.

The poll, conducted by GfK NOP, is the last in a series called Reflections on Childhood commissioned by The Children’s Society, to complement the launch of a summary of evidence submitted to the inquiry on its sixth and final theme – values.

Professionals responding to the inquiry emphasised that children learn most of their values from adults, and expressed apprehension about how certain trends in society are affecting the values children are learning. The rise in materialism, a preoccupation with celebrity, and declining networks of support from community and extended family were all cited as negative factors. Seven out of ten polled (69%) said that community values among children today were not as strong as when they were young.

Although not explicitly covered in this report, there is much concern at the heavily publicised alcohol and drug fuelled antics of pop stars and other celebrities. Writing in the Independent on Sunday, journalist Jonathon Owen reported that “Health professionals look with concern at the antics of high-profile figures who appear to glamourise excessive boozing. Daily coverage of celebrities such as Amy Winehouse, Girls Aloud’s Sarah Harding and Lily Allen looking worse for wear does nothing to help matters, particularly among impressionable young girls. Professor Ian Gilmore, President of the Royal College of Physicians, said: “Even I’ve heard of Amy Winehouse. Clearly it’s highly inappropriate for young pop stars, looked upon as role models by young people, to be celebrating or boasting about their misuse of alcohol, and the ‘Amy Winehouse factor’ isn’t helping the situation.”

Generation Gap

Increasing tension between adults and children emerged as a particular area of concern in the Good Childhood Enquiry. Over half of adults responding to the poll (55%) thought there was more conflict between adults and children now compared to when they were young. Just a third (32%) thought that attitudes towards young people in their local neighbourhood were mostly positive.

Children responding to The Good Childhood Inquiry reported a lack of positive interaction with adults in their communities. In a national survey of young people aged 14 to 16, only one in five (20%) agreed with the statement ‘My area cares about its young people’. Forty per cent were not sure and the remaining 40% disagreed. In response to questions on The Good Childhood Inquiry and BBC Newsround websites, 11% said adults in their community were ‘never’ friendly to them, and 37% said only ‘sometimes’.

Considering the issue of how children learn values from adults, Bishop Tim Stevens, Chair of The Children’s Society and a panel member, said: “What came through strongly from both adults and children is the golden rule: ‘treat others as you want to be treated’. Values are caught as well as taught.

“Many respondents to the inquiry expressed concern about how children can learn positive values from adults around them when communities are increasingly segregated and young people are often regarded with suspicion. It is crucial that our children are valued and respected by adults around them, so they can learn how to behave towards others.”

Bob Reitemeier, Chief Executive of The Children’s Society said: “We reap what we sow when it comes to teaching children values. Every adult plays a vital role, which we should nurture as much as we can.

“Unfortunately, it is easier to criticise children than to invest in them, and it is the children most in need of positive role models who are becoming disconnected from their communities and wider society. Where troubled young people challenge us, our responsibility is to bring them closer and help them, not push them away.”

Other findings from the GfK NOP poll include:

• Twenty nine per cent of adults think that the Government’s attitudes to young people are mostly negative, with only 23% thinking they are mostly positive.

• Forty per cent of adults think that the political values of children today are not as strong as when they were children.

The Children’s Society has already released evidence summaries on the inquiry’s previous five themes: friends, family, learning, lifestyle and health. The inquiry will publish its final report and recommendations in early 2009.

Hope UK – Phoenix from the ashes

Hope UK has a long pedigree in alcohol education. Beginning life in the nineteenth century as the Band of Hope, providing an educational and social resource for generations of children, Hope UK has now adopted a new name and a new approach to tackling the alcohol and drug problems of the twenty-first century. Here, George Ruston, Director of Hope UK, describes its contribution.

Attending the finals of the Global Rock Challenge means listening to loud music and stunning performances from students who are there because the organisers want them to have a natural high whilst performing on stage. The idea is that young people are given alternatives to the artificial highs produced by alcohol, tobacco or illegal drugs.

Hope UK, like the Global Rock Challenge, has a vision of enabling young people to make drug-free choices. There is no artificial separation made between alcohol, tobacco and illegal drugs, although, obviously, account has to be taken of legal status. Are Hope UK’s activities — and those of the Global Rock Challenge — a postmodern version of what used to be called the temperance movement? What seems to be lacking from the government alcohol strategy is a significant realisation that people are going to have to drink less — or not at all — and also pragmatic solutions that offer alternatives. In January 2008, Kevin Brennan MP, stated that the government was going to deliver a social marketing campaign in order to foster a culture where it is socially acceptable to young people to choose not to drink, and, if they do, to do so later and more safely¹.

Social marketing on its own will not foster that culture — it requires practical action and significant peer influence and role modelling. Literally, people have to stop drinking alcohol products. How will the shareholders of drinks businesses feel about this? It may be easier for government to focus on criminal justice issues, although the recent initiative to increase price is to be welcomed. At the end of the day, people make their own choices. And, however it is dressed up, alcohol-free options need to be given a higher profile.

Professor Virginia Berridge, in her review of the temperance movement² and the lessons that can be learned for current and future alcohol policy, debunked the idea that it had little relevance to the present. She outlined how the movement was part of a general social change. Professor Griffith Edwards once described the Band of Hope as a ‘social event’, which held its adherents by virtue of the social enjoyment of being together. This is a long way from any worthy but dull presentation of facts about alcohol. One of Berridge’s key conclusions is that temperance history showed that the issue of cultural change is central. Hope UK’s response in a postmodern world is built around such holistic views.

Hope UK was 150 years old in 2005. Formerly, it was the UK Band of Hope Union with a history that includes Queen Victoria as its patron, and over 3 million members in the late 1890s — all enjoying what Griffith Edwards described as a social event. Today, its focus is on providing voluntary Drug Educators who will work directly with children and young people as well as providing training for those adults who have responsibility for them. Last year, these Educators reached over 50,000 young people — either directly or via responsible adults. This year, Hope UK has launched a step change plan which will see it reaching 500,000 young people, with 1,000 trained Drug Educators by the end of 2011. (Training is provided by a 120-hour Open College Network accredited course, developed by Hope UK’s training team.)

Postmodernism may have started as an architectural concept, and there is still much debate as to what it really means. However, it recognizes that we are in a society where individual choice is important — we have moved a long way from Henry Ford offering a colour choice for his model T car of black or…. black… or black. Behaviour and attitudes need to be examined interactively in ways that make people think for themselves and beneath the surface of myths and misunderstanding. So many individuals still think that illegal drugs are responsible for more deaths than alcohol and tobacco – and very few people appreciate that one in every 10 children are suffering because of their parents’ alcohol or illegal drug use — most because of drinking.

Hope UK is bringing something new and something old to the party. Old in the sense that it focuses on people and seeks to communicate with them at the level of everyday life. New, because training voluntary Drug Educators means that there is a growing workforce available to meet people where they choose to meet — in evenings or at weekends, particularly. At present, there are 209 Educators throughout the UK, either trained or in training. There is a traditional emphasis on alcohol-free options (as part of the drug-free option) with a postmodern approach that features a holistic emphasis, which goes far beyond looking at the facts.

At the same time, changes in culture and civil society — as identified in Robert Putnam’s book Bowling Alone³ — mean that many of the traditional sources of people to speak to (churches and membership groups) are finding their numbers diminishing. New ways have to be found to communicate with people. Hope UK’s involvement in the recent Pentecost Festival in central London saw its Educators offering members of the public the chance to walk a white line wearing beer goggles. Those who were a little shy were offered the chance to play Jenga instead. Conversations start from these activities.

Thirst for life

The thirst for life campaign encourages individuals to try to go alcohol free for 40 days. Typically, people find this hard. They are also encouraged to try the 10 point self-audit test to check out their drinking levels. One individual recently e-mailed to say that he had been shocked to realise how much he actually drank and took ‘time out’ by going 40 days without alcohol. thirstforlife has been run on a shoestring, but it illustrates an attempt to communicate in practical ways that individuals can respond to — a historian might recognize elements of signing the pledge, albeit for a temporary period.

One of the key elements to Hope UK’s revitalised activity is in recognizing the potential that exists within the voluntary and community sector. Although 50% of its work is outside Christian networks, Hope UK’s Christian basis is enabling it to mobilise churches and their organisations to include alcohol and drug prevention activities within their programmes. There are 50,000 local churches within the UK. All of them have some form of community presence and their members live and work alongside people who will have or develop issues with their alcohol and drug use. By equipping them with knowledge and confidence in the effectiveness of peer influence and role modelling, change can be brought about. This is a long-term project. It is also work that targets everybody who is concerned with children and young people and seeks to involve organisations for which alcohol and other drug education may be peripheral or non-existent — yet which have a huge potential for influencing their clientele.

Hope UK’s focus on universal prevention fits within the Government’s Youth Strategy and the Every Child Matters policy framework. The publication (in 2007 and 2008 respectively) of the Government’s Alcohol and Drug Strategies for England highlighted the need to reduce the level of harm related to substance use. Similar Government strategies for Northern Ireland, Scotland and Wales all point in the same direction.

Hope UK’s step change Plan, launched at its Annual Meeting in May, 2008, is centred on a strategy that will make a Hope UK Educator available locally to every community within the UK. This will mean training 1,000 voluntary Drug Educators who will be able to reach 500,000 children and young people each year by the end of 2011. It was put together with assistance from the Pilotlight capacity building charity.

A new Hope UK is arising from the ashes of the temperance movement. But the journey is only just beginning, and it will be fascinating to see how much of the old remains, in reforming and strengthening the new work that is being developed by means of the voluntary Educator workforce.

References:

1 Hansard 8 Jan 2008

2 Temperance – The history and impact on current and future alcohol policy Virginia Berridge, JRF Drug and Alcohol Research Programme

3 Bowling Alone: The collapse and revival of American community Robert D Putnam Published by Simon & Schuster

Young people are intentionally taking drink and drugs for better sex

Teenagers and young adults across Europe, including the UK, drink and take drugs as part of deliberate sexual strategies. A study carried out by a team of researchers, led in the UK by Professor Mark Bellis of Liverpool John Moores University, found that a third of 16-35 year old males and a quarter of females surveyed are drinking alcohol to increase their chances of sex, while cocaine, ecstasy and cannabis are intentionally used to enhance sexual arousal or prolong sex.

More than 1300 people aged between 16 and 35 and who routinely socialise in nightlife settings completed anonymous questionnaires. Virtually all of the survey participants had drunk alcohol, with most having had their first drink when 14 or 15 years old. Three quarters of the respondents had tried or used cannabis, while around 30 percent had at least tried ecstasy or cocaine.

Overall, alcohol was most likely to be used to facilitate a sexual encounter, while cocaine and cannabis were more likely to be utilised to enhance sexual sensations and arousal.

Despite these perceived sexual “benefits”, drunkenness and drug use were strongly associated with an increase in risk-taking behaviour and feeling regretful about having sex while under the influence of alcohol or drugs. Thus, participants who had been drunk in the past four weeks were more likely to have had five or more partners, sex without a condom and to have regretted sex after drink or drugs in the past 12 months. Cannabis, cocaine or ecstasy use was linked to similar consequences.

“Trends in recent decades have resulted in recreational drug use and binge drinking becoming routine features of European nightlife,” commented Mark Bellis. “Millions of young Europeans now take drugs and drink in ways which alter their sexual decisions and increase their chances of unsafe sex or sex that is later regretted. Yet despite the negative consequences, we found many are deliberately taking these substances to achieve quite specific sexual effects.”

Individuals were significantly more likely to have had sex under 16 years of age if they had used alcohol, cannabis, cocaine or ecstasy before that age. Girls, in particular, were as much as four times as likely to have had sex before the age of 16 if they drank alcohol or used cannabis under 16.

“Sexual activity accompanied by substance use is not just incidental, but often sexually motivated,” says co-author, consultant psychiatrist Amador Calafat. “Interventions addressing sexual health are often developed, managed and implemented independently from those addressing substance use, and vice versa. However, young people often see alcohol, drugs and sex all as part of the same social experience and addressing these issues requires an equally joined up approach.”

Support for parents of children with foetal alcohol problems

Julia Brown and her husband adopted a daughter whom they discovered suffered from Foetal Alcohol Syndrome. They sought help but couldn’t find any so they started their own charitable trust to provide the sort of advice needed. Here is their story.

One can easily find a great deal of material about the continuing concerns surrounding the increasing amount of alcohol being drunk by women, particularly younger women, the so-called “ladette” culture, the weekend binges, the professional women competing in a “man’s world”, but there is relatively little mention about the damage being done to the unborn babies these ladies are carrying.

Indeed, there also still seems to be mixed advice being given on alcohol consumption during pregnancy, to pregnant women and those contemplating having children.

So, what is the issue here? Why is it important that a clear message to avoid alcohol in pregnancy should be given to women and why should we teach this to our young people in school before they embark on relationships?

The answer is FASD – Foetal Alcohol Spectrum Disorders. Alcohol passes freely across the placenta into the unborn child’s system and it can cause to the unborn child a range of irreversible brain damage and physical damage that lasts a lifetime. There are many factors, including when in the pregnancy a woman drinks alcohol, how much she drinks, her overall state of health and the genetic make-up of both the mother and the unborn child, as to whether any damage is or is not done to the foetus.

However, it is a myth that to drink at the end of the pregnancy – or even after the 12th week – is “safe”. This is because the brain and central nervous system continue to develop throughout the pregnancy, therefore remaining vulnerable to damage at any time.

There has been a great deal of debate, some quite heated, here in the UK, about how much a woman can drink before any damage is done. The answer to that question is still unknown, but research in the USA and elsewhere has consistently shown that even a low intake can be, for example, sufficient to stunt physical growth. The best and safest option is to remove all risk and not consume any alcohol during the pregnancy.

Indeed, on this issue, the UK lags behind the rest of the world. Women in the USA have been advised to avoid alcohol in pregnancy since 1981, which is 27 years ago. In France, as in the USA, they now label alcohol bottles advising of the potential dangers of drinking when pregnant.

This lack of information and awareness is what led my husband and myself to start The FASD Trust. We have an adopted daughter with FAS (Foetal Alcohol Syndrome) and whilst we could find some amazing Canadian Government websites, a fabulous support group in Australia, we could find hardly anything here in the UK.

We rapidly discovered there were a number of families in our situation, caring for a child with FASD, feeling isolated, unsupported and misunderstood. We have found birth parents struggling with their guilt and their children’s anger, fearful of society stigmatising them. The Trust now runs a number of support groups around the country to give them a voice and a safe place to share. We have a telephone helpline and a website to give information that is relevant to life in the UK.

We are aware that the families we are supporting are just the “tip of the iceberg” as WHO estimates 1 in 100 children born in the UK each year have FASD, with 1 in a 1000 being severely damaged by prenatal alcohol exposure.

We are also noticing that the babies born during the binge-drinking spike of 2003 are now 5 and entering school, where they cannot sit still or concentrate, cannot follow instructions, struggle with speaking appropriately, have poor social skills, throw temper tantrums, and we are increasingly receiving calls from teachers for assistance.

It is important that we talk about this subject, not only so that those, like our daughter, can be understood and receive appropriate support, but also to prevent another generation being born needlessly damaged in this way. If we do not educate the upcoming generation, then as someone recently commented, “it will not be their fault, but it will be their legacy.”

For more information or to contact The FASD Trust, go to www.fasdtrust.co.uk or call 0560 268 9478.

Giving your child the best start in life

The dangers of drinking alcohol in pregnancy feature in a new report from the BMA in Scotland. The report, entitled ‘Getting the Best Start in Life’, focuses on the health impact of smoking and alcohol consumption on the unborn child. The report also highlights how existing health inequalities lead to an increased risk for certain groups of Scotland’s children.

The report states that one in every seven babies born each year in Scotland requires some form of special care. Two of the main reasons for requiring this care are premature birth and low birth weight. Smoking and drinking alcohol during pregnancy both increase the risk of these.

• 25% of women in Scotland smoke during pregnancy, affecting 12,500 babies

• 55% of women in the UK report drinking alcohol during their pregnancy

Dr Peter Terry, Chairman of the BMA in Scotland said,

“Smoking during pregnancy has been linked to Sudden Infant Death Syndrome (SIDS), an increased risk of the child developing diabetes and an increased risk of attention deficit disorder. If the child continues to be exposed to smoke during infancy there is an increased risk of asthma and ear infections. These risks are increased for those living in the most deprived areas of Scotland.

“Heavy drinking during pregnancy can lead to Fetal Alcohol Spectrum Disorder (FASD). FASD is a term used to encompass a wide range of physical, mental and behavioural effects that can occur in the children of mothers who consume alcohol during pregnancy. However, the affects of maternal alcohol consumption are not limited to FASD. Alcohol can also increase the risk of infertility, miscarriage and has been linked to an increased risk of SIDS. Alcohol consumption during pregnancy is a problem across all of Scotland and its effects are not limited to socially deprived areas.”

Dr Sally Winning, a member of the BMA’s Scottish Council who, at this year’s Annual Representatives meeting in Edinburgh, put forward a motion calling for clear advice to pregnant women, said,

“There are strong links between low income, social deprivation and poor infant health and continued efforts are needed to address the factors that underlie the health inequalities affecting the least advantaged sections of the population in Scotland.”

The paper calls on the Scottish Government to act assertively to improve infant health in Scotland.

Key recommendations in the paper include:

• For certain groups – in particular, those with young children and those on low incomes – attendance at smoking cessation services may present barriers. Smoking cessation outreach programmes aimed at reaching such groups should be established. Pregnant women and their partners should be targeted.

• Breastfeeding should be promoted for the health of the mother and baby. The effects of smoking on breastfeeding should be highlighted.

• Government should issue clear and consistent advice on alcohol consumption during pregnancy. The BMA believes women who are pregnant, or who are planning a pregnancy, should be advised not to consume any alcohol.

• Comprehensive and long-term research on FASD in Scotland should be undertaken.

• Media personalities and celebrities should be aware of their influence on young people, and should not promote or glamourise smoking and drinking.

• Promotion of tobacco and alcoholic drinks, especially through channels directed at young people, such as films, fashion, music and sport, should be banned.

Issue 3 2008

New publication

Alcoholism – The Family Guide by Samantha Harrington-Lowe

Published by:
Need2Know
Remus House
Coltsfoot Drive
Peterborough
PE2 9JX
Telephone 01733 898103
Fax 01733 313524

ISBN 978-86144-050-1