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Page 1: 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.
Page 2: 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.

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

Page 3: 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.
Page 4: 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.
Page 5: 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.
Page 6: 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.

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

Page 7: 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.

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 20060

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Trend: Quantity of Alcohol Consumed, GHS

Changes mostly occurred in 16-24 yr-olds. Other age groups were more stable

Page 8: 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.

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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menm, revisedwomenw, revised

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Changes mostly occurred in 16-24 yr-olds. Other age groups were more stable

Page 9: 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.
Page 10: 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.
Page 11: 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.

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

Page 12: 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.

Trend: Alcohol-related Hospital Admissions

Page 13: 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.

Trend: Quantity of Alcohol Sold per Adult, HMRC

Page 14: 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.

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

Page 15: 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.

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

Page 16: 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.

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

Page 17: 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.

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


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