Types of Alcohol-related harm
• Common distinction: Health vs. crime/social– Relevant to who pays to clear up the mess
– 'Social' is flexible: public disorder through to workdays lost
• Alternatively: Short-term vs. long-term– Relevant to the kind of behaviour that causes the harm
– Groups short-term health, e.g. hospital admissions for intoxication, with short-term crime, e.g. assault
Trends: A note on Survey Estimates of Quantity Consumed
• To calculate quantity consumed from answers to survey questions, we need to know how many units are in each of many kinds of drink
• In 2007, the numbers for these calculations were changed– This was a good thing, as they were very wrong at that time
• Wine was most affected, so women were most affected, as women drink more wine than men– Before: 1 glass of wine = 1 unit of alcohol
– After: 1 glass of wine = 2 units of alcohol (or more if larger glass)
• This change makes it difficult to interpret trends from surveys
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Trend: Quantity of Alcohol Consumed, GHS
Changes mostly occurred in 16-24 yr-olds. Other age groups were more stable
Trend: Quantity of Alcohol Consumed, GHS
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 20060
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Changes mostly occurred in 16-24 yr-olds. Other age groups were more stable
Trend: Convergence in Adolescent DrunkennessEmmanuel Kuntsche and colleagues
• Health Behaviour in School-aged Children survey: 80,000 15 year-olds in 24 countries; Europe and America
• Compare results from 1997/98 with 2005/06
• How many times have you been drunk in your life?
• Results: Convergence between boys and girls, and between countries• e.g. in the UK, both boys and girls reported less drunkenness in 2005/06
and the decrease was greater for boys
• In countries with lower levels of drunkenness, increases were found
Trend: Alcohol-related Hospital Admissions
Trend: Quantity of Alcohol Sold per Adult, HMRC
Affordability: Important, but not Straightforward
• Standard measure of affordability shows alcohol getting ever more affordable
• This is based on the price of alcohol relative to Retail Price Index
• BUT:• If alcohol is cheap relative to a new TV, maybe you’d go to the pub
instead of getting a new telly
• If alcohol is cheap relative to food, maybe this means food has got expensive and you can’t afford that bottle of wine in the weekly shop
Predicted Effects of a Minimum PricePetra Meier and colleagues
• Overall, a minimum price of 40p per unit of alcohol would reduce consumption by 2.6%, an average of 22 units per person per year
• Only the cheapest drinks are affected, so who buys these?• Those who drink a lot: young, binge and harmful drinkers
• Reductions in consumption would be greatest for 11-18 year-olds (4%) and harmful drinkers of all ages (4.5%)
• The impact would be less on 18-24 year-old hazardous drinkers as they tend to drink in pubs, which would not be affected unless a two-tier minimum price was introduced
Polydrug use: Mixing Alcohol with Other DrugsGillian Smith
Moderate
39%
Abstinent or very low
26%
Heavy, memory loss
16%
Mild, some 7% probs
Heavy, many 6% probs
Heavy, some 6% probs
Multiple drugs 1.1%
Some cannabis 5.4%
No drug use 13.5%
Multiple drug use 1.5%
Increased risk of anxietydisorder
Increased risk of suicide attempts
Increased risk of suicide attempts
Some thoughts for discussion
• Consumption and binge drinking may be reducing, especially amongst young people• Convergence?
• Immigration?
• Economics?
• Hospital admissions are still going up• Most admissions are for long-term health consequences; maybe the
result of drinking in previous years
• Drug use is an issue we need to be increasingly aware of• Cannot be separated from alcohol use; need to look at the whole picture