Health First: an alternative alcohol strategy for the UK. Linda Bauld

Transcription

1 Health First: an alternative alcohol strategy for the UK Linda Bauld

2 Outline Why is a comprehensive strategy needed? Strategy development Recommendations Public opinion Next steps

3 Change from baseline (1970 = 100) Deaths among people aged under 65 in the UK for major conditions, compared to liver disease circulatory disease ischaemic heart disease cancer respiratory disease diabetes Source: WHO, 2011

4 Alcohol-related hospital admissions per 100,000 population Alcohol-related hospital admissions per 100, population in England Source: ONS, 2013

5 % who drink alcohol at least once a week Weekly drinking by 13-year-olds and 15-year-olds in Great Britain, 2009/10 40% 35% 30% 25% 20% 15% 10% 5% boys girls 0% Europe England Scotland Wales Europe England Scotland Wales 13-year-olds 15-year-olds Source: WHO, 2011

6 Number of violent crimes (1,000s) Source: Chaplin et al, 2011 (British Crime Survey) Proportion under influence of alcohol Violent crimes and the role of alcohol: England and Wales number of violent crimes (000s) % under influence of alcohol 60% 50% 40% 30% 20% 10% 0%

7 Strategy Development Meeting of tobacco and alcohol researchers, clinicians and advocates in September 2010 Concern about the Responsibility Deal and perceived need for an independent voice Funding secured from Cancer Research UK, the British Liver Trust and 6 other organisations Strategy group formed, chaired by Sir Ian Gilmore

8 Strategy Development Health First developed over two years through regular meetings of the strategy group, reviews of the literature and consultation with a wider group of stakeholders A UK public opinion survey to inform the strategy was conducted by Yougov in June 2012 Publication and work with the media in March 2013

9 Recommendations 30 Recommendations developed focusing on price, promotion, place, product and other policy areas 10 chosen as key recommendations Positioned as a long term strategy for all of the UK.

10 Price A minimum unit price of 50p per unit of alcohol should be introduced for all alcohol sales, together with a mechanism to regularly review and revise the price Tax on an alcohol product should be proportionate to the volume of alcohol it contains

11 Index: 1980 = 100 Increases in alcohol prices, household incomes and the affordability of alcohol in Britain, (ONS) Alcohol price index Households' disposable income Retail prices index Affordability of alcohol index

12 Market share: beer sales Beer sales in Britain, by sector market share 100% 90% 80% On sales Off sales 70% 60% 50% 40% 30% 20% 10% 0% Source: BBPA, 2011

13 Products and Packaging The sale of alcohol products that appeal more to children and young people than adults should be prohibited At least one third of every alcohol product label should be given over to an evidence-based health warning Every alcohol product label should describe the product s nutritional, calorie and alcohol content

14 Packaging

15 October 2002 May 2003 U.K. Canada Australia U.S.

16 Enhancing warning labels increases label salience/noticing The enhancement of warning labels in the U.K. had a huge impact on labels salience/noticing, way above even Canada. Hammond et al, 2007

17 Relationship Between Labels and Quitting Labels Make You Think About Risks Quit Attempt Successful quit attempt Smokers who report that the labels make them more likely to think about risks of smoking were: more likely to attempt to quit (OR = 1.14)* more likely to successfully quit (OR = 1.89)* * Statistically significant at p <.05 Controlling for Gender, Age, Income, Education, Ethnicity, Prior Quit Attempts, Intentions to Quit

18 Do warning labels increase knowledge? Smoking causes impotence: Canada Aus. U.K. U.S. Wave Wave 2 Only Canada had a warning label about impotence at Wave 1, but then U.K. added an impotence label between Wave 1 and Wave 2 Hammond et al, 2007

19 Do warning labels increase knowledge? Smoking causes impotence: Canada Aus. U.K. U.S. Wave Wave Substantial increase in knowledge about impotence in the U.K. compared to the other three countries after the label on impotence was introduced in the U.K. Hammond et al, 2007

20 Caveats: Warning labels Research on cigarette pack warning labels has also found that: Amongst young people, labels have more impact on non smokers or those experimenting with smoking than regular smokers Visual warnings on the back of packs are not as effective as on the front Visual health warnings need to be changed every few years salience diminishes over time Source: Moodie et al, 2013

21 Promotion Health First recommends that all alcohol advertising and sponsorship should be prohibited (with a phased introduction)

22 Place Public health should be a statutory obligation of licensing Licensing legislation should be comprehensively reviewed Restrictions on place and time of sale Local authorities need to develop comprehensive alcohol strategies that prioritise public health and community safety

23 Early identification and treatment All health and social care professionals should be trained to provide early identification and brief advice People who need intensive interventions should be routinely referred to specialist alcohol services Greater investment in specialist community-based alcohol services Every acute hospital should have a specialist, multidisciplinary alcohol care team tasked with meeting the alcohol-related needs of those attending the hospital and preventing readmissions.

24 Assessment of the British people s relationship with alcohol unhealthy relationship neutral healthy relationship Northern Ireland 76% 15% 9% Scotland 71% 24% 5% North East 65% 23% 12% North West 64% 29% 6% London 63% 28% 9% South East 61% 30% 10% East of England 61% 30% 9% Yorkshire and the Humber 59% 30% 10% South West 54% 37% 10% Wales 54% 39% 7% East Midlands 53% 38% 9% West Midlands 53% 38% 10%

25 Respondents views of the effects of alcohol a great deal a fair amount a little not at all health 50% 39% 11% 1% anti-social behaviour 65% 27% 8% 1% costs to the NHS 59% 32% 8% 1% costs to policing 53% 36% 10% 1% harm to children and families 36% 44% 19% 1%

26 Respondents support for minimum prices for alcohol products based on a MUP of 50p per unit of alcohol. support neutral object 1.98 for a 440 ml can of super strength lager 46% 29% 26% for a 70cl bottle of branded vodka 46% 29% 25% 7.50 for a 2 litre bottle of strong cider 43% 28% 29% 0.88 for a 440 ml can of normal strength beer 43% 32% 25% 4.69 for a 750ml bottle of wine 41% 29% 30% for a 70cl bottle of supermarket value vodka 40% 29% 31%

27 Support for policies It is important (1) / not important (5) to have public information campaigns to raise awareness of harms from alcohol 67% 24% 9% It is important (1) / not important (5) to provide treatment and support for people who are addicted to alcohol 64% 26% 11% Alcohol adverts should not (1) / should (5) be allowed on TV before 9pm 60% 23% 17% Alcohol products should (1) / should not (5) have warning labels on them to warn people about the harms from alcohol 57% 29% 14% There should be more (1) / fewer (5) restrictions on the way that alcohol is advertised 49% 38% 13% The price of alcoholic drinks should (1) / should not (5) take into account how much alcohol they contain 49% 31% 21% The opening hours of pubs/bars should be reduced (1) / extended (5) 41% 44% 15% The age at which people can legally buy alcohol should (1) / should not (5) be increased 37% 30% 33% Drinks companies should not (1) / should (5) be allowed to sponsor sport 35% 33% 32% Alcoholic drinks should be more expensive (1) / cheaper (5) 35% 44% 22% 0% 20% 40% 60% 80% 100% Support (scores 1-2) Indifferent (3)

28 Next steps Health First is currently being used by members of the Alcohol Health Alliance as their key national strategy and to inform lobbying efforts for party manifestos The strategy s recommendations are similar in scope to those set out in the 1962 RCP report Smoking and Health, which described policies and interventions to reduce the harm from smoking. Those took 50 years to implement in full. Our sincere hope is that action to reduce the harm from alcohol in the UK will not take so long.

29 Thank you Acknowledgements: Strategy group members, Will Anderson, Gerard Hastings, Martine Stead, Richard Purves, Katherine Brown, Crawford Moodie, Ann McNeill