Mongan, Deirdre (2008) Tackling alcohol misuse in the UK. Drugnet Ireland, Issue 27, Autumn 2008, pp. 5-6.
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The British Medical Association recently published a report, Alcohol misuse: tackling the UK epidemic,1 which describes drinking patterns and indicators of alcohol-related harm in the UK, and considers a range of evidence-based policies to tackle problematic levels of alcohol misuse.
The UK is among the heaviest alcohol consuming countries in Europe, with consumption rising from 3.9 litres per capita in 1950 to 8.9 litres in 2006. The prevalence of alcohol consumption varies considerably by ethnic group. Only 9% of the White British population are non-drinkers, whereas 48% of people of Black African origin and 90% of those of Pakistani and Bangladeshi origin abstain from alcohol. While the majority of individuals who consume alcohol do so in moderation, 23% of men and 12% of women drink above the UK recommended limits. The report estimates that 7% of the adult population are alcohol dependent.
Alcohol is causally related to over 60 different medical conditions and, in the majority of cases, the risk of disease increases with a higher volume of consumption. It has been estimated that alcohol misuse accounts for more than 22,000 premature deaths per year in England, of which 1,000 are suicides. The alcohol-related death rate in the UK almost doubled between 1991 and 2005, from 6.9 to 12.9 per 100,000 population. The burden of alcohol-related mortality is shifting to younger age groups in both men and women, and toward the most socially deprived groups. In England, the rate of mortality from liver cirrhosis trebled between 1970 and 1995, while the rate in the EU decreased by 30%. In addition, alcohol was implicated in 17% of road deaths in 2006.
Alcohol misuse is a major cause of admission to hospital in both emergency and non-emergency settings. It has been estimated that 70% of all admissions to emergency departments at peak times are alcohol related. In England, the number of hospital admissions of adults aged 16 and over with a primary or secondary diagnosis related to alcohol use more than doubled, from 89,280 in 1995/96 to 187,640 in 2005/06.
Alcohol misuse can lead to many harmful social consequences. Approximately half of homeless people are alcohol dependent. Parental alcohol misuse is correlated with child abuse and significantly impacts on a child’s environment. In 2004, it was estimated that between 780,000 and 1.3 million children were affected by parental alcohol problems in England. It has been estimated that alcohol misuse results in 17 million working days lost annually in England. The total annual societal cost of alcohol misuse in England has been estimated at £55.1 billion.
There has been considerable deregulation and liberalisation of alcohol control policies in the UK, which has been accompanied by an increase in consumption levels and alcohol-related problems. This report criticises the focus of the UK government on interventions that are popular but ineffective, such as educational programmes and media campaigns, and the rejection of policies such as increased taxation and reduced availability that have been found to reduce alcohol consumption and related problems. It also criticises the UK government’s emphasis on partnership with the alcohol industry and self-regulation, which has at its heart a fundamental conflict of interest that does not adequately address individual and public health. In the Licensing Act 2003, which permits 24-hour opening in England and Wales, public health was not considered as one of the licensing objectives.
The report calls on the government to show leadership and implement a full range of effective evidence-based policies that will reduce the burden of alcohol misuse, including:
- Higher taxes on alcoholic drinks, proportionate to the amount of alcohol in the product. The affordability of alcohol in the UK increased by 65% between 1980 and 2006. Levels of alcohol consumption (particularly among heavy drinkers and young drinkers) and related problems are responsive to price; it is estimated that a 10% increase in alcohol price would lead to a 10% fall in consumption.
- Reducing availability. Availability of alcohol should be regulated through a reduction in licensing hours for on- and off-licensed premises. The density of alcohol outlets should be taken into account when considering planning or licence applications.
- Responsible retailing and industry practices, including strict enforcement of legislation prohibiting the sale of alcohol to intoxicated customers and people under the age of 18, and the abolition of irresponsible promotional activities such as happy hours and two-for-one offers.
- Measures to reduce drink-driving. The legal limit for the level of alcohol permitted while driving should be reduced from 80mg/100ml to 50mg/100ml, and random breath testing should be introduced.
- Early intervention and treatment of alcohol misuse. The detection and management of alcohol misuse should be an adequately funded and resourced component of primary and secondary care and include formal screening for alcohol misuse, referral for brief intervention and specialist alcohol treatment services, and follow-up care and assessment at regular intervals.
This report describes the situation regarding alcohol in the UK; similar trends can be observed in Ireland, where the levels of per capita consumption are even higher. It is clear that alcohol misuse is a serious problem in both countries and that action must be taken to significantly reduce alcohol-related harm. This report provides a range of recommendations that must be collectively implemented in order to effectively tackle alcohol misuse and its associated harms; however, this requires strong political commitment and leadership.
1. BMA Board of Science (2008) Alcohol misuse: tackling the UK epidemic. London: British Medical Association.
Item Type
Article
Publication Type
International, Open Access, Article
Drug Type
Alcohol
Issue Title
Issue 27, Autumn 2008
Date
2008
Page Range
pp. 5-6
Publisher
Health Research Board
Volume
Issue 27, Autumn 2008
EndNote
Accession Number
HRB (Available)
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