Background

The first Health Research Board (HRB) conference solely dedicated to alcohol research was held on 14 September 2023 in partnership with the Department of Health. The event was opened by the HRB CEO, Dr Mairéad O’Driscoll, who welcomed the support of the Department of Health, which, along with the HRB, recognises the importance of and is committed to progressing alcohol-related research.

One of the objectives of the HRB Strategy 2021–2025 is to collect and report alcohol-related data for policy and service planning purposes, and the event included speakers from across the organisation presenting the work of the HRB.1 The strategy (key action 3.4) also promotes primary research and secondary data analysis to support drug and alcohol strategies at a national and European level. The HRB also has a responsibility to ‘assist the Department of Health to monitor the Public Health Alcohol Act through data collection, validation, analysis and dissemination’ (implementation action 3.4.4). This important obligation is achieved through the work of the team in the HRB Evidence Centre and through the alcohol overviews published periodically. Dr O’Driscoll acknowledged the work of the HRB, particularly that of the evidence team and the drugs and alcohol policy team, whose work has been instrumental in providing evidence to influence policy. An important example given was of collating key evidence of alcohol-related harm directly influential in the eventual passing of the Public Health (Alcohol) Act in 2018.2

L to R: Dr Sheila Gilheany, Alcohol Action Ireland CEO; Dr Mairéad O’Driscoll, HRB CEO; Professor Frank Murray, Alcohol Health Alliance chair; and Anne Doyle, HRB research officer
 

Why hold an alcohol-themed conference?

Alcohol continues to pose a significant public health problem, and throughout the course of the day, accounts were given of the profound impact of alcohol on individuals, families, and the wider community. This was the primary motivation for organising the conference, along with the concern that many of the key public health advocates who played a crucial role in the passage of the 2018 legislation have since retired, changed roles, or moved on for various reasons. In light of this, fear exists that the momentum may be lost in this transition period and that the implementation of the Public Health (Alcohol) Act 2018 may lead to the perception that alcohol-related harm has been effectively addressed, potentially hindering further action.

As such, alcohol as a public health issue runs the risk of falling down the Government’s agenda as other public health issues take precedence, such as illicit drugs, vaping and smoking, obesity, mental health, and social deprivation, all of which are interrelated with alcohol but tend to be treated in silos. There are also conflicting priorities and pressure on the Government, particularly concerning the economic and cultural consequences of intervention, a concern that has intensified since the Covid-19 pandemic in terms of the night-time economy and the closure of pubs. These factors make it increasingly challenging for those advocating for public health to attract Government attention, with the danger that those with a vested interest in alcohol profits may exert more influence using arguments that further action or legislation is no longer required or is actively harming economic and cultural assets.

However, we know that there is public support for the legislation and that alcohol-related harm is not going away. Hospitalisations for alcohol-related liver disease reached the highest rates ever recorded in 2021; the numbers receiving treatment for alcohol use have increased; and at least three people die every day due to alcohol use.3,4 Hence, the purpose of the conference was to showcase the ongoing work of those involved in this space; to demonstrate that there are many working hard to continue the groundbreaking efforts of our predecessors; to encourage more alcohol-related research; and to hear about and learn from the experiences of those who work in the community, who are the voice of the people experiencing alcohol-related harm.

Presentations at the conference

Chair of the Alcohol Health Alliance, Professor Frank Murray, presented and chaired the first part of the day and reinforced the importance of evidence-informed alcohol policy and how this evidence led to the eventual implementation of the Public Health (Alcohol) Act 2018. Dr Helen McAvoy, director of policy with the Institute of Public Health in Ireland, outlined the existing and proposed legislation governing alcohol use and raised concerns about the proposed Sale of Alcohol Bill 2022, which seeks to increase the availability of alcohol in our communities.5 Dr Frank Houghton, director of Social Sciences ConneXions at the Technological University of the Shannon, discussed the importance of research integrity and how to ensure impartial and trusted research when faced with an industry that acts as commercial determinants of health and who will often go to great lengths to prevent or dilute alcohol policies.

Chaired by Dr Nathan Critchlow, an academic fellow for the Society for the Study of Addiction based at the Institute for Social Marketing and Health, University of Stirling, the day continued with Dr Zubair Kabir, senior lecturer in public health at University College Cork, presenting evidence of alcohol-related harm in Ireland using data from the Global Burden of Disease (GBD) data source.6 As the HRB is home to the National Drugs Library, to give an overview of the wealth of information that can be accessed there, chartered information specialist Mary Dunne and chartered information officer Mairea Nelson talked the audience through how to stay up-to-date with the latest national and international alcohol-related research.

The afternoon session was chaired by Alcohol Forum Ireland CEO Paula Leonard and began with Dr Catherine Gill, HRB programme manager, advising on the various schemes provided by the HRB to potentially fund alcohol-related research. This was followed by Anne Doyle, HRB research officer, who provided a snapshot of the sources of alcohol-related data to encourage further alcohol-related research.

Ireland often looks to other jurisdictions to understand best practices for monitoring policy effectively. Hence, to give the Scottish experience, Professor Niamh Fitzgerald, professor of alcohol policy and director of the Institute for Social Marketing and Health at University of Stirling, spoke of her experience there in prioritising alcohol as a public health issue. Finally, Dr Susan Calnan, a postdoctoral researcher in the School of Public Health at University College Cork, reflected on how alcohol use can impact not only the individual but the entire family and wider community.

Poster presentations

• Poster presentations provided a synopsis of the array of studies carried out, including:
• Alcohol use of women between 50 and 62 years, associated biopsychosocial factors, and primary care utilisation
• Rural hospitals’ inpatient data on substance use
• Effective interventions and approaches in the delivery of integrated alcohol services in community settings
• Association of alcohol per capita with national, regional, and global prevalence of alcohol use during pregnancy and foetal alcohol syndrome
• A survey of Irish healthcare, social care, and education professionals’ knowledge, attitudes, and experience of foetal alcohol spectrum disorders (FASD)
• Prenatal alcohol exposure
• Association between parental factors and adolescent alcohol consumption
• Risk factors for heavy episodic drinking in adolescents
• Evaluation of the school-based substance use prevention programme – Know the Score.

Conclusion

Ireland took the lead on a global scale with the introduction of the Public Health (Alcohol) Act 2018, and many countries worldwide are watching with great interest to see how we perform. It is crucial therefore that those involved in public health work together to ensure its success and be proud of what has collectively been achieved.

1    Health Research Board (2021) Strategy 2021–2025: Health research – making an impact. Dublin: Health Research Board. Available from: https://www.hrb.ie/about/strategy-2025/

2    Office of the Attorney General (2018) Public Health (Alcohol) Act 2018. Dublin: Irish Statute Book. Available from: https://www.drugsandalcohol.ie/33698/

3    O’Dwyer C, Mongan D, Doyle A and Galvin B (2021) Alcohol consumption, alcohol-related harm and alcohol policy in Ireland. HRB Overview Series 11. Dublin: Health Research Board. Available from: https://www.drugsandalcohol.ie/33909/

4    Calnan S, Millar SR and Mongan D (2023) Support for evidence-based alcohol policy in Ireland: results from a representative household survey. Eur J Public Health, 33: 323–330. Available from: https://www.drugsandalcohol.ie/38321/

5    Department of Justice (2022) General Scheme: Sale of Alcohol Bill 2022. Dublin: Government of Ireland. Available from: https://www.drugsandalcohol.ie/37347/

6    Institute for Health Metrics and Evaluation (2020) Global Burden of Disease (GBD). Seattle, WA: University of Washington. Available from: https://www.healthdata.org/gbd