Editorial – June 2019

Welcome to the June 2019 edition of Alcohol Alert, the Institute of Alcohol Studies newsletter, covering the latest updates on UK alcohol policy matters.

This month, a new IAS report calculates that hangovers cost the UK economy £1.4 billion. Other articles include: Scottish alcohol sales fall to 25-year low, with minimum unit pricing thought to play a role, a survey from the Alcohol Families Alliance finds great support among parents for restrictions on alcohol advertising, and a BBC Panorama episode shines a light on the alcohol industry’s inability to add update alcohol labels with current guidelines, three years after they were introduced.

Please click on the article titles to read them. We hope you enjoy this edition.

COVER STORY – Hangovers cost the UK up to £1.4bn a year


IAS report, ‘Financial headache’

New figures reveal the economic toll of hungover and intoxicated workers

25 June 2019 – As many as 89,000 people may be turning up to work hungover or under the influence of alcohol every day, costing the economy up to £1.4 billion a year, according to a new report ‘Financial Headache: The cost of workplace hangovers and intoxication to the UK economy’ from the Institute of Alcohol Studies (IAS).

The findings come from a survey of 3,400 British workers that found:

  • 42% had ever been to work hungover or intoxicated, and 9% had done so in the past six months
  • Working hungover or intoxicated was most common in the hospitality and leisure sector, where 52% of people had ever done so. Rates were also high in retail and construction
  • Higher earners were more likely to have gone to work hungover or under the influence. 29% of people earning under £10,000 a year had ever done so, compared to 55% of people earning over £60,000

Respondents to the survey also reported being affected by others’ drinking at work: 36% suspected that one or more of their colleagues had been hungover or intoxicated in the last six months, reporting reduced productivity, greater stress and a negative effect on team morale.

On average, respondents believed themselves to be 39% less effective when they were drunk or hungover. Based on average labour costs, and how frequently people are impaired at work, this implies a cost to the UK economy of between £1.2 billion and £1.4 billion a year.

These findings suggest that the UK Government currently underestimates the cost of alcohol to the British economy by almost 20%. The government’s official analysis excludes the impact of working intoxicated or hungover due to a lack of robust data on the issue. The new IAS figures suggest that the government’s estimate of the economic costs of alcohol should rise from £7.3 billion to £8.7 billion.

Aveek Bhattacharya, policy analyst at the Institute of Alcohol Studies, and the author of the report said:

‘Discussions of the economic impact of alcohol tend to focus on employment in the alcohol industry. Yet alcohol is also a drag on the economy, taking people out of the workforce through sickness, unemployment and premature death. Even among those drinking at less harmful levels, working through intoxication and hangovers can reduce productivity. Prior to this survey, we did not have a clear idea of how widespread and costly drunkenness and hangovers at work are. These findings should encourage the Government to revise its official estimates of the cost of alcohol to society, which are now woefully out of date.

‘Hopefully, these results will help shift the conversation on alcohol and the economy. Policies to reduce harmful drinking, such as raising alcohol taxes and minimum unit pricing, are often resisted on the basis that they are “bad for business”. Yet our research suggests that these measures will lead to a more productive workforce – and that we will feel the benefits in our pockets.’

Dr Sally Adams, assistant professor in Health Psychology at the University of Bath, and an expert adviser to the project, said:

‘Hangover is the most commonly reported negative consequence of alcohol use with significant health and economic implications. Whilst previous research has estimated the costs associated with hangover-related absenteeism in the workplace, the cost of reduced productivity of being hungover “on the job” has not been explored.

‘This new research from IAS reveals the true economic costs of alcohol hangover in the workplace, with evidence of hangover “Presenteeism” and associated impairments in productivity and team morale as reported by individuals and their colleagues.

‘These results also complement our research on the cognitive effects of hangover, which suggests that processes such as attention, co-ordination and memory required in workplace are compromised during hangover. Together these findings indicate that the effects of hangover in the workplace have been underestimated and require greater attention from employers and policy makers.’

You can hear author Aveek Bhattacharya’s summary of the report’s findings in our Alcohol Alert podcast.

Scottish alcohol sales fall to 25-year low

Positive signs of minimum unit pricing’s impact on alcohol sales

19 June 2019 – The volume of alcohol sold per adult in Scotland in 2018 has fallen to its lowest level since 1994, according to the first expert analysis of alcohol sales data, produced for NHS Health Scotland.

At 9.9 litres of pure alcohol per adult, the volume of alcohol sold per adult in Scotland in 2018 was 9% higher than in England and Wales (9.1 litres), the smallest gap between nations since 2002.

Results of the Monitoring and Evaluating Scotland’s Alcohol Strategy (MESAS) programme, published just over a year since Scotland became the first country in the world to introduce minimum unit pricing, also show a 3% fall in alcohol sales per adult in Scotland from the previous year. This is in contrast to England, where consumption increased by 2% over the same period. Scotland introduced minimum unit pricing (MUP) in May 2018, which has since pushed the price of alcohol sold over 50 pence per unit (ppu), most commonly sold in the off-trade.

As a result, 87% of the total difference in per adult sales between Scotland and England & Wales in 2018 was due to higher off-trade sales in Scotland.

The total volume of pure alcohol sold below 50ppu in Scotland in 2018 (1.5 litres per adult) was less than half that sold in 2017 (3.1 litres per adult), and for the first time in the available time series, less alcohol was sold under 50ppu in Scotland than in England & Wales (2.3 litres per adult).



Responding to the news, Scotland’s Health Secretary Jeane Freeman said:

‘This is a promising start following our world-leading action to introduce minimum unit pricing, and with this 3% fall we are moving in the right direction.

‘There are, on average, 22 alcohol-specific deaths every week in Scotland, and 683 hospital admissions, and behind every one of these statistics is a person, a family, and a community badly affected by alcohol harm.

‘Given the clear and proven link between consumption and harm, minimum unit pricing is the most effective and efficient way to tackle the cheap, high strength alcohol that causes so much harm to so many families.’

Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK, commented: ‘It is highly encouraging to see the drop in alcohol sales in Scotland to their lowest in 25 years.

‘When minimum unit pricing for alcohol was introduced in Scotland just over a year ago, it was a significant breakthrough for the public’s health. The MESAS figures show that the policy is beginning to result in less harmful drinking.

‘In England and Wales, where MUP has not been implemented, consumption has gone up, meaning levels of harm are likely to continue to rise. Wales will introduce MUP early in 2020 and it is vital that England does not get left behind.

‘The decrease in sales especially impacted off-sales while the trend in on-sales remains largely unchanged. This suggests that MUP is an effective way to tackle the cheap, high-strength alcohol that causes so much harm to so many families. To protect some of our most vulnerable communities, we urge the UK Government to follow Scotland’s example and bring in MUP in England too.’


Northern Ireland: Middle-aged alcohol misuse costly for health services

Alcohol-related deaths also at an all time high

05 June 2019 – A Queen’s University Belfast report commissioned by the advice and support programme Drink Wise, Age Well found that alcohol misuse among over those aged over 50 years of age costs Northern Irish healthcare services £125m every year.

This comes after reports that the number of alcohol-related deaths reached their highest level since records began in 2001, with middle-aged drinkers between 45 and 64 years of age worst hit.

In addition to this, it seems that a better collaboration with service providers is needed as availability may not be obvious to those who might benefit most. Those over 55s are least likely to seek help from service providers but are most likely to succeed if they do.

Joanne Creggan from Drink Wise, Age Well said the numbers ‘were shocking to hear, but not a surprise for those working in the field’.

‘We have an ageing population and as we age, we experience a lot of life events that may attribute to maybe a lot of difficulties in our lives,’ she said. ‘As a result, we may turn to alcohol as a coping mechanism. Those in the 45-54 age group may have missed a bit of education, as they were growing up in their 20s and 30s at a time when alcohol was becoming more acceptable and used sociably. This may all contribute to greater use and greater problems later in life.’

Creggan also suggested that lawmakers and policy experts ‘probably haven’t been treating alcohol with the respect it deserves. It’s a drug and any other mood enhancing drug would be treated with a lot of different policies than alcohol has been.’

The report coincides with the publication of Calling Time for Change, a charter for politicians and policy makers about how to reduce alcohol harm among people over 50. The charter was co-designed with people and families affected by alcohol problems and alcohol and ageing experts from the Drink Wise, Age Well programme.

Professor Ciaran O’Neill from the Centre for Public Health, Queen’s University Belfast said: ‘The issue of alcohol misuse has received increased attention in recent months arising in part from the publication of mortality statistics showing a sharp rise in alcohol-related deaths.

‘This report highlights the significant burden to the health service of managing alcohol misuse related morbidity. Our estimate of £125 million per year is conservative but serves to underscore the magnitude of the problem.

‘The scale of the issue suggests there is a need to consider public health measures such as the adoption of minimum unit pricing among broader public health measures and the provision of support services to those seeking to quit drinking.’

Pilot relieves pressure off emergency departments

06 June 2019 – The King’s Health Partners Alcohol Care Team (ACT) has helped divert two thirds (65%) of alcohol-related admissions away from one of London’s busiest A&E departments. The ACT, which was initially launched as a pilot, provides assessments for patients who present at emergency departments and offers treatment options as well as referrals to community services where suitable.

When patients present at A&E, often for another serious medical need, the team also manages and reviews withdrawal symptoms and provides psychosocial interventions. It refers patients to community alcohol and drug services and provides an outpatient detox pathway for discharged patients.

Since its launch in October 2018, it is estimated that the team freed 718.5 bed days for staff and other patients. Moreover, where patients have been admitted to hospital, the service has additionally reduced the average stay to 38% below the national average.

The service has now secured funding to continue as a permanent service, and its success chimes with the observation made in the NHS Long Term Plan, that alcohol-related hospital admissions are on the rise and multidisciplinary ACTs should be a national priority.

Three years and counting: Guidelines missing from alcohol labels

BBC Panorama investigation reveals extent of the delay

10 June 2019 – Three years after health experts issued new guidelines, the BBC has found that the alcohol industry has still not updated health information labelling.

In 2016, the UK’s Chief Medical Officers determined that advice on how much adults could safely drink in a week was cut, from 21 units a week for men and 14 for women, to 14 for both (link: A brief history of the low risk drinking guidelines). But a BBC Panorama investigation found just 14 of 100 alcoholic products carried that information.

In response, the alcohol industry said it had until September 2019 to make the change. There is no mandatory regulation governing what health information the alcohol industry puts on its products.

Health professionals and campaign groups say the delay proves self-regulation has failed, and that the government should compel industry to inform consumers with accurate details of their beverages.

Chief Executive of the Institute of Alcohol Studies, Katherine Severi, told the programme: ‘We believe consumers should have information about the chief medical officers’ low risk drinking guidelines.

‘It’s not acceptable to be displaying the old guidance on products because they could inadvertently be putting consumers at greater risk.

‘I think this self-regulatory system is failing.’

Former Public Health Minister Steve Brine also admitted the alcohol industry ought to be subject to ‘more stick than carrot’ from the government.

‘I would agree it [self-regulation] is completely not working at the moment with industry for the simple reason that it’s all a voluntary arrangement,’ said the MP for Winchester and Chandler’s Ford.

He went on to add that ‘working with industry, with the stick – backed up by legislation – is what we have seen make a change in the obesity space, for example… [for the alcohol industry] it’s all carrot at the moment, and there is no stick behind it.’

Labour Party: ‘If the government won’t introduce mandatory alcohol labelling, then we will’

Days after the BBC’s broadcast, Shadow Health Secretary Jonathan Ashworth took to the stage at the first annual Alcohol Change UK conference (19 June) to announce that alcohol labelling containing up-to-date drinking guidelines and nutritional information would be mandatory under a Labour government. ‘Tackling alcohol abuse must be at the heart of the prevention agenda yet there’s more nutritional information on a carton of milk than a bottle of wine,’ he told attendees.

This voluntary approach was ‘simply not fit for purpose’, said the MP for Leicester South. ‘The industry hasn’t moved at a pace to keep up with consumers’ expectations. It’s an utter abdication of responsibility for government to task the chief medical officer with updating the guidelines and then not oblige the industry to display this vital information on their products.’ Alongside the guidelines, a Labour government would also make labelling information on unit content, pregnancy warnings and nutritional information compulsory, Drink and Drugs News reports.

Research by the Alcohol Health Alliance UK last year found that 67% of people thought that the government should be responsible for ‘communicating the health risks and harms associated with alcohol’, whereas under the current system labelling information is subject to self-regulation by the alcohol industry.

‘Alcohol producers are being allowed to pick and choose what information to include on their labels, and it is consumers who lose out, as we are not being given the information we need to make informed decisions about our drinking,’ said Alcohol Change UK Chief Executive Dr Richard Piper. ‘The alcohol industry’s interests are being placed above the health of citizens. We hope that the government also makes the common-sense commitment to make improved alcohol labelling mandatory.’

YouGov poll: 73% of known addictions are to alcohol

High prevalence across-the-board exposes extent of nation’s addiction issues

10 June 2019 – 60% of Britons know someone with an addiction problem, according to a YouGov survey commissioned by Action on Addiction ahead of Addiction Awareness Week (10-16 June), and the figure rises to 73% for those who know someone whose addiction is to alcohol.

Furthermore, more than two thirds believe that individuals with addiction problems should be offered more support, and 70% believe that support should also extend to their families.

More than a quarter of respondents reported that they had a family member with addiction problems, and out of all of those who knew someone with addiction, 73% cited alcohol as the most prevalent substance, followed by nicotine (40%), illicit drugs (35%) and gambling (25%).

At the same time the research points to a fall in spending on alcohol and drug treatment from £877m in 2013-14 to £716m in 2017-18, with the cut funding ‘estimated to have contributed to a rise in addiction-related deaths’.

‘This poll highlights the widespread and far-reaching impact of addiction,’ said Action on Addiction Chief Executive Graham Beech. ‘The survey shows that most people (60%) know someone who has suffered from an addiction – a relative, a friend or a work colleague – and think that more support should be done to support people affected by this life-stopping condition which appears to be growing in both scale and complexity.

‘Unfortunately, this comes at a time when society’s ability to address the problems associated with addiction is diminishing and people are finding it more and more difficult to access the treatment they need.’

Permissive parents encourage drinking

Children see alcohol as an adult drink from as young as four

11 June 2019 – Parents happy for their children to try alcohol are more likely to see them become drinkers, according to a study published by the Cambridge Institute of Public Health for the journal Addiction.

Researchers reviewed the data of nearly 16,500 children aged seven to 18 years old and more than 15,000 parents, looking at parents’ attitudes on their children ‘sipping’ alcohol, and whether they approved of children drinking or found it acceptable.

Results from 29 studies found that children of permissive parents are more likely to binge drink more frequently and to consume alcohol frequently. The review also found that parents happy for their children to try alcohol are more likely to see them become drinkers. The children of the most lenient parents were 58% more likely to report having got drunk, and 52% more likely to consume alcohol frequently.

Researchers led by the University of Cambridge identified that many parents believe it is the ‘social norm’ to allow children to try alcohol, in an effort to give them independence. But in doing so, argues lead researcher Mariliis Tael-Oeren, they may unintentionally be encouraging drinking.

Tael-Oeren said: ‘There are many myths related to children’s alcohol use, such as the old “forbidden fruit” idea that if alcohol is forbidden by parents it becomes much more appealing.

‘Because of this, parents might allow children alcohol at a dinner party, at New Year’s Eve or their own birthday party if they turn 13 or 14.

‘It is easy to see why parents think their children are not that far from adulthood, or that it is fine to give them a bit because everybody else is doing it.

‘But one of the reasons why this might lead to greater alcohol use in children is that it sends mixed messages – without them alcohol is not allowed, but with them it is fine. It is much better to have a clear message for children.’

Tael-Oeren added: ‘Ideally alcohol use should be initiated when the brain is fully developed, ie around the age of 25.

‘Alcohol use can be problematic, particularly among young people. It’s important that parents and children understand the short and long-term consequences of drinking.

‘If parents don’t want their children to drink, then our study suggests they need to be clear about the message they give out.’

Parents want limits on alcohol advertising

Findings headline Alcohol and Families Alliance parliamentary forum

12 June 2019 – A YouGov poll for the Alcohol and Families Alliance (AFA) suggests the majority of parents want better alcohol advertising restrictions in order to protect their children.

Out of 1,179 parents with children aged 18 years or under, 71% want alcohol ads restricted on television, with the same number wanting restrictions on social media and the internet.

The survey also found that 52% of parents believe that alcohol ads should not be seen by children under 18 at all, while 67% think that alcohol advertising ‘normalises’ drinking for all.

Additionally, 56% of ads seen by children aged four to 15 years of age aired before the traditional watershed time of 9pm.

Currently, existing restrictions relate to programmes, films or websites which are deemed to be ‘of particular appeal to children’. However, it does not cover content often watched by children but not aimed at them.

George Freeman MP speaking
at the Alcohol and Families Alliance parliamentary fair

Vivienne Evans, from the AFA, said of the findings: ‘We know from research that exposure to alcohol advertising makes children more likely to drink at an earlier age and to drink more when they do.

‘Children and young people deserve protection from harmful products. We’re urging the Government to include advertising in the restrictions it is considering for junk food.

‘The current “self-policing” regulatory framework for alcohol marketing is ineffective. It’s vital that tighter regulations are introduced for TV, radio, online, social media and apps advertising – including a watershed to protect young people.’

The news came as ministers from several political parties gathered at a parliamentary fair hosted by the Alcohol and Families Alliance to hear campaigners speak about the impact of alcohol upon families.

George Freeman MP (pictured) gave a notable speech in which he recalled the impact alcohol had upon his childhood when having to care for his mother, who became dependent on drink. Shadow Health Secretary Jonathan Ashworth also spoke about how sharing his story about the relationship with his alcohol-dependent father in 2016 led to positive change, by sparking at least one family’s conversation about alcohol harm.

The AFA is urging people to write to their MP asking for alcohol to be included in the unhealthy food restrictions, as well as a watershed to protect children when they are most likely to watch television.

Low content alcohol may extend the drinking experience

Survey finds weak beers and wines fail to replace a regular strength tipple

12 June 2019 – The target market and advertising of set piece occasions of low strength alcoholic beverages is in doubt, thanks to the results of an experiment conducted by the Behaviour and Health Research Unit (BHRU).

3,390 weekly wine and beer drinkers from a nationally representative UK panel were randomly assigned to see different wines and beers marked with various verbal descriptors representing lower alcohol strengths, with or without a number marking the percentage alcohol by volume (% ABV). Participants stated their perceptions of the type of person that would find the drink they have been randomised to see tempting and the type of occasion on which it was likely to be consumed.

Men, women, and those aged over 18 years were seen as the target groups for products marked with higher % ABV. On the other hand, pregnant women, sports people and those aged 6-13 years old were seen as target groups for products marked with %0 ABV or the verbal descriptors ‘Low’ or ‘Super Low’.

Lower strength alcohol products were also seen as targeting consumption on weekday lunches, parties, holidays and celebrations, ultimately being seen as ‘targeting non-traditional consumers (pregnant women) and occasions (weekday lunchtimes), suggesting these products may be perceived as extensions to regular strength alcoholic drinks rather than as substitutes for them.’

The researchers argued that alcohol consumption and associated harms at population level can be decreased through the development and promotion of lower strength alcohol products.

The London Metal Exchange bans day drinking

Moves follows Lloyd’s of London

13 June 2019 – The London Metal Exchange (LME) has introduced a ban on alcohol consumption that prohibits floor traders from drinking during the working hours. The floor traders who hold a responsibility to set global benchmark prices for industrial metals have been informed that they are expected to apply a zero-tolerance alcohol policy with the exchange imposing fines and trading bans for those who breach the rules.

‘The LME has broad powers under its rulebook to ensure fit and proper behaviour,’ the exchange said in a statement. ‘The LME appreciates the high standards upheld by its members and has formalised the general position that ring-based personnel should not consume any alcohol prior to conducting business.’

Although the LME already prohibits dealers from engaging in drunken behaviour on the floor, the policy would extend further to break the bourse’s historic association with heavy drinking dating back to the Victorian times, according to a Bloomberg article on the subject.

The new rule comes into force as the LME seeks to stamp out sexist entertainment that has long been a feature at some LME events, by following in the footsteps of a similar zero-tolerance policy introduced by Lloyd’s of London seeking to stamp out the culture of sexual misconduct in London’s insurance market. Before moving office in 2016, the LME was situated on the same road as Lloyd’s, with metals traders often frequenting the same pubs as Lloyd’s dealers in the city’s historic Leadenhall Market.

Portman Group criticises lack of support from big brands

Alcohol watchdog pours scorn on silent partners

17 June 2019 – Sir Martin Narey, the chairman of the Portman Group said large alcohol producers that refuse to support the alcohol watchdog ‘should be ashamed’ as he proposed better health advice to address the’ acute dangers’ of excessive alcohol consumption, according to Spirits Business.

Sir Narey spoke at the Manchester Metropolitan University in England and addressed the need to improve the health advice available to consumers.

‘We could have done more, and done so more quickly, if more alcohol producers were as courageous and as responsible as the eight companies which currently fund us’, Sir Narey said. ‘I’m not being critical here of small producers who might genuinely not be able to afford to support us, but there are large drinks producers in the UK who fail to support the only organisation which regulates their industry, which takes harmful products out of the market, and, through informal advice, stops the appearance of so many more. Frankly, those companies should be ashamed.’

Narey also stressed the need to deter drinkers who drink a ‘relatively modest’ amount of alcohol at present from increasing their consumption. He said that better health advice for consumers across the industry was needed.

‘Most of us drink responsibly but a small proportion of the population do not. Drinking overall in the UK has fallen during the last decade and binge drinking is in decline,’ he added. ‘But the worry is that about a third of the alcohol consumed in England is drunk by just 4% of drinkers.

‘If we are to reduce the proportion of the population who seriously harm themselves through drinking, if we are to discourage those drinking relatively modestly at the moment from drinking more and harming themselves and often those around them, we need health guidance which addresses the acute dangers of excessive drinking. We don’t have that at the moment.

‘Such guidance would certainly say that adults should seek to drink less than 14 units a week. It might also say that, occasionally, drinking a little more than this is unlikely to be dangerous. But it might warn you that regularly drinking much more than this is hazardous and is likely to lead to early death and a miserable quality of life along the way. Such guidance, effectively marketed, could do much to alleviate the harm, including harm to families, caused by those who drift into alcohol abuse.’

Heineken cider brands to display calorie labelling

Elsewhere in the trade, global brewer Heineken announced its intention to add calorie and nutritional information labelling to their cider packaging.

This follows moves by spirits producer Pernod Ricard to display ingredients and energy values on its products as from June after signing a Europe-wide memorandum of understanding (MoU). Pernod Ricard said in a statement that consistent with EU predictions, ingredients and calorie information will be labelled on a quarter of spirit bottles on the EU market by 2020, increasing to 50% in 2021 and 66% by 2022.

Alcohol dominates UK reality TV

References to, possession, and consumption of 40 alcohol brands appear in all episodes viewed

18 June 2019 – A new study in the Journal of Public Health finds that tobacco and alcohol usage are extremely common in British reality television shows, with alcohol references especially frequent in Love Island and Geordie Shore.

Researchers from the UK Centre for Tobacco and Alcohol Studies measured depictions of alcohol and tobacco products on Celebrity Big Brother, Made in Chelsea, The Only Way is Essex, Geordie Shore and Love Island, all airing on UK channels for a total of 112 episodes between January and August 2018.

The researchers measured the number of one-minute intervals containing tobacco and/or alcohol imagery, including actual use, implied use, tobacco or alcohol related materials, and product-specific branding, and estimated viewer exposure to the imagery on screen.

They also combined audience viewing figures with mid-year population estimates for 2017 to estimate overall and individual impressions – separate incidents seen – by age group for each of the coded episodes.

Alcohol content appeared in all 112 episodes and in 2,212 one-minute intervals, or 42% of all intervals studied. 18% of intervals included actual alcohol consumption, while 34% featured inferred consumption, predominantly characters holding alcoholic beverages. The greatest number of intervals including any alcohol content occurred in Love Island. Alcohol branding occurred in 1% of intervals and was most prevalent in Geordie Shore (51 intervals, 69% of episodes). 40 brands were identified, the most common being Smirnoff vodka (23 intervals, all but one of which occurred in Geordie Shore).

When all the data were combined with audience viewing figures and population estimates, the researchers estimate that the 112 episodes delivered 4.9 billion overall alcohol impressions to the UK population, including 580 million to children under the age of 16.

‘Recent data shows that 44% of 11-15-year-olds in England have had an alcoholic drink, and 19% have tried smoking. Starting to smoke or drink alcohol at a young age is a strong predictor of dependence and continued use in later life,’ said the study’s lead author, Alexander Barker.

‘Given that seeing alcohol or tobacco imagery in the media promotes use among young people, this study therefore identifies reality television shows as a major potential driver of alcohol and tobacco consumption in young people in the UK.

‘Tighter scheduling rules, such as restricting the amount of content and branding shown in these programmes, could prevent children and adolescents from being exposed to the tobacco and alcohol content.’

Patients would like to learn more; health care professionals less keen to deliver lessons

Reducing alcohol consumption is one of the best things women can do to lower their breast cancer risk, and many would welcome advice on cancer prevention at NHS breast screening or clinic attendances, according to research published in the online journal BMJ Open.

However, only one in five women attending a breast cancer clinic knew it was a risk factor, and staff interviewed were ambivalent about discussing alcohol use with women who came to screening or symptomatic breast appointments.

205 women who either attended screening or having their symptoms checked took part. Only 16% of women in the screening groups – and 23% in the symptoms group – were aware that alcohol was a risk factor.

Additionally, more than half of those who drank alcohol (88 out of 152) believed that they could accurately estimate the alcohol content in drinks, but a little over a quarter failed to do so for a standard glass of wine, and almost half did so for the correct amount in a pint of beer.

In the UK around half a million women attend screening clinics to check out potential breast cancer symptoms. But women know too little about alcohol’s role in increasing breast cancer risk, and alcohol consumption is estimated to be responsible for 5% to 11% of cases, in part because of the lack of knowledge of the issue.

Professor of Addiction Psychiatry at the University of Southampton (and honorary consultant in alcohol liaison at University Hospital Southampton) Julia Sinclair, who led the study, said it was an opportunity to provide women with information that could help decrease their chances of developing the disease.

‘94% of them don’t have breast cancer. If you have a family history, you would be referred for monitoring. But if you’re overweight or drinking more than you should be, people don’t say “there’s something you could do about that. Alcohol increases the risk by three per 100 so it’s a low absolute risk, but it’s something that’s modifiable. This is about empowering women to have the knowledge, so they can make decisions.”’

Welsh MUP delayed until ‘at least’ 2020

Portugal raises ‘detailed’ objection

19 June 2019 – Exactly a year on from the day the Welsh Government passed minimum unit price legislation (MUP) through the Senedd, plans for a 50p per unit minimum price of alcohol are being delayed until at least early 2020 after an EU member state held up the process.

It was expected that Wales would be able to follow in Scotland’s footsteps as early as the summer.

But the proposal has brought to a standstill after Portugal intervened with a ‘detailed opinion’ on the policy, the reasons for which have yet to be made clear.

Portugal were one of five countries that objected to the Scottish Government’s plans in 2013. The others were France, Italy, Spain and Bulgaria.

They argued that it breached European free trade law by discriminating against imported alcohol products – saying the policy was illegal, unfair and ineffective.

However, after years of legal argument, the UK’s Supreme Court eventually gave the go-ahead for the policy in 2017, ruling that EU countries can restrict imports on public health grounds but only if it does not constitute a ‘means of arbitrary discrimination or a disguised restriction on trade between member states’.

A Welsh Government spokesperson said: ‘We will be considering the detailed opinion received from the EU member state (Portugal) and will report to the EU Commission with a response in due course.’

Vaughan Gething, Wales’ health minister, has told AMs that he anticipates the regulations will be laid in the autumn and the minimum price coming into in force by ‘early 2020’.

Neuroscience research questions current alcohol limit

Even one pint of beer can compromise a person’s feeling of being in control

21 June 2019 – New research by neuroscientists from the University of Sussex shows that drinking only one pint of beer or large glass of wine is enough to significantly compromise a person’s sense of agency.

Sense of agency is the feeling of being in control of our actions. It is an important aspect of human social behaviour, as it implies knowledge of the consequences of those actions.

This new study, Effect of alcohol on the sense of agency in healthy humans, is the first to test the effect of alcohol on sense of agency. The study focused on low doses of alcohol, typically consumed during social drinking, that do not produce a large impairment of behaviour. Until now, research has mostly focused on the loss of inhibitory control produced by obvious drunkenness, characterised by impulsivity, aggression, and risky behaviour.

Dr Silvana De Pirro, lead author of the research paper, said: ‘Our study presents a compelling case that even one pint of beer is enough to significantly compromise a person’s sense of agency. This has important implications for legal and social responsibility of drivers, and begs the question: are current alcohol limits for driving truly safe?’

Explaining how the study was conducted, Dr De Pirro said: ‘Measuring a person’s sense of agency is tricky. When people are explicitly asked to tell how in control they feel, their answers are affected by several cognitive biases, such as poor introspection, the desire to conform to researchers’ expectations, or even the inability to understand the question correctly.’

Sussex researchers relied therefore on an indirect measure called ‘intentional binding’, which has been developed to investigate the unconscious mechanisms of ‘volition’. When physical stimuli (such as sounds or lights) follow voluntary actions (such as moving a finger or a hand), people judge actions as occurring later and stimuli as occurring earlier than in reality, hence ‘binding’ the two. The neural mechanisms responsible for this phenomenon are thought to participate in creating the sense of agency.

In the experiments, subjects drank a cocktail containing doses of alcohol proportional to their BMI to produce blood alcohol concentrations within the legal limits for driving in England and Wales. These doses of alcohol, corresponding to one or two pints of beer, produced tighter binding between voluntary actions and sensory stimuli. This suggests that small amounts of alcohol might exaggerate the sense of agency, leading to overconfidence in one’s driving ability and to inappropriate, potentially dangerous behaviour.

Professor Aldo Badiani, director of the Sussex Addiction Research and Intervention Centre (SARIC), said: ‘It’s important to note that in our experiments, all the participants stayed within the legal alcohol limit for driving in England, Wales, the US and Canada. And yet we still saw an impairment in their feeling of being in control.

‘In England, Wales and North-America, the argument to lower the limit has much momentum. The results of our study support the implementation of such a change in the law.’

The legal limit for driving in England and Wales is currently 80 mg/100 ml. The legal limit for driving in Scotland and most European countries is 50 mg/100 ml.