Over 200,000 children in England are living with Dependent Drinkers!

New figures released today reveal that over 200,000 children in England are living with dependent drinkers who could benefit from receiving specialist alcohol treatment.

The data from Public Health England estimates that there are 600,000 dependent drinkers who would benefit from treatment, yet only just over 100,000 are currently receiving the help they need.

These figures only cover adults who are most seriously dependent on alcohol. It is currently estimated that around 1.5 million adults in England and Wales have some form of alcohol dependence, and that there are 2.5 million children living with an adult drinking at risky levels.

The PHE data is released alongside a report from the Department for Work and Pensions (DWP) focused on improving the life chances and job prospects of the least well-off. The Department has said it will increase access to grant funding and introduce peer mentors for those in alcohol treatment to help them get back into work.

The report comes at a time when politicians are increasingly recognising the harm cheap alcohol is doing to the most vulnerable in society. The March budget included a consultation on the introduction of a new tax band designed to increase the price of strong white cider, a product which is predominantly consumed by children and heavy drinkers.

And earlier today a report published by the House of Lords Licensing Committee following an enquiry into the operation of the 2003 Licensing Act recognised the damage being done by cheap alcohol. The report calls for the introduction of a minimum unit price (MUP) for alcohol across the UK if it is introduced in Scotland and proves to be successful. Its introduction is being stalled by legal action being taken by sections of the alcohol industry. The report also calls for an end to multi-buy deals such as three for the price of two, a measure which has proved to be successful in Scotland.

Alcohol health experts welcomed the measures announced by the DWP today and the focus on the most vulnerable and lowest paid, pointing to studies which have shown that the least well off are around five times more likely to die from alcohol-related causes than those at the top of the income bracket.

Experts also called, however, for a wider, population-level approach to improving life and employment opportunities for dependent drinkers alongside greater support for individuals.

Liver physician Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK (AHA), said:

“We welcome the Government’s recognition that cheap alcohol is damaging some of the most vulnerable groups in society. The revelation that 200,000 children in England are living with adults in need of specialist help is deeply worrying. We need to make sure people get the support they need once they have a problem with alcohol, for their own sakes and for the sake of their children. But people don’t set out to become dependent drinkers and we need to stop more people from reaching that stage.

“For the greatest impact, the measures announced today should be combined with
measures like minimum unit pricing of alcohol. Studies have shown that setting a minimum price for alcohol would reduce unemployment and bring substantial numbers of unemployed drinkers back into the workforce.

“The government is already taking steps to tackle alcohol dependence in this broader way, with the recent announcement that it will be consulting on increasing the tax on high- strength ciders, drinks which are known to be drunk by the most vulnerable and do disproportionate harm.

“Studies also indicate that MUP would help address health inequalities, with over 80 per cent of lives saved coming from the lowest income groups. At the same time, the measure would not increase the price of alcohol sold in pubs and clubs.”

The Public Health England figures can be found here.
The DWP report, entitled Improving Lives: helping workless families, is available here.


About the Alcohol Health Alliance UK
The Alcohol Health Alliance UK (AHA) is a group of 50 organisations including the Royal College of Physicians, Royal College of GPs, British Medical Association, Alcohol Concern and the Institute of Alcohol Studies. The AHA works together to:
– Highlight the rising levels of alcohol-related health harm
– Propose evidence-based solutions to reduce this harm
– Influence decision makers to take positive action to address the damage caused by alcohol misuse

Thinking about Drinking: A Year in the Life of an Alcohol Researcher at Stirling

Niamh was active in helping the media understand the implications of theniamhfitzgerald 2016 new alcohol guidelines. In this blog post she discusses what happened as a result of the publication of the new guidelines and how the media portray the facts in their own way.

By Niamh Fitzgerald, Research Profile, @NiamhCreate

Journalists love a good alcohol story, especially at this time of year, and January 2016 gave them the ideal ammunition with the publication of new advice from the UK’s Chief Medical Officers (CMOs) designed to provide people with ‘accurate information and clear advice about alcohol and its health risks’.  For the first time, the guidance advised that ‘no level of regular drinking can be considered completely safe’ and advised the same limit for both men and women – not to regularly drink above 14 units of alcohol (about 1 and a half bottles of wine) per week, at the same time moving away from the previous daily limits.  The guidance was based on a lengthy process involving experts from around the UK including Prof. Gerard Hastings (from Stirling) and followed emerging evidence on the links between alcohol and cancer – kicking off a furore of media coverage.

Media coverage following the publication of the new guidelines

The Daily Mail led with the news that the guidelines would ‘put a stop to the belief that red wine is good for you in moderation, while the Sun also focused on this ‘plonk lovers’ shock’ as the CMO’s ‘rubbished’ the supposed health benefits of wine.

alcohol-daily-mail

Others focused on the cancer risk, with the Scotsman leading with ‘drinkers at risk of cancer from single glass of wine’; whereas the Telegraph headline was ‘health chiefs attacked for nanny state alcohol guidelines’.  It was a frantic week for colleagues and I at the Institute for Social Marketing (ISM) as we sought to capture all of the newspaper, television and radio coverage for future analysis.  As Lecturer in Alcohol Studies at ISM, and lead for teaching and public engagement on alcohol for the UK Centre for Tobacco and Alcohol Studies (UKCTAS), I was interviewed about the new guidelines on BBC News for their ‘Ask This’ feature, which takes questions from viewers.  I also had a comment piece published in The Scotsman. Continue reading

Teenagers who play video games with alcohol & tobacco content are more likely to drink & smoke.

Images and references to alcohol and tobacco in popular video games may be influencing UK teens who play the games and the age restriction system is not working, according to a new study. 

Experts from the UK Centre for Tobacco and Alcohol Studies at The University of Nottingham have carried out the first ever analysis of best-selling video games to find out the extent to which the games include this content and to assess the link between playing the games and drinking and smoking behaviour.

They found that teenagers who play video games featuring alcohol and tobacco references appeared to be directly influenced because they were twice as likely to have tried smoking or drinking themselves.

‘Cut scenes’ on YouTube

The research examined the content of 32 UK best-selling video games of 2012/2013 and carried out a large online survey of adolescents playing games with alcohol and tobacco content. An analysis of ‘cut scenes’ uploaded by gamers to YouTube from the five most popular games was also carried out. All the games studied were from the genres of stealth, action adventure, open world, shooter and survival/horror because they involve avatars that look and act like real people.

The study, published in the journal Cyberpsychology, Behavior and Social Networking, found alcohol and tobacco content in 44% of the most popular video games. They also found this content was not reported by the official regulator, the Pan-European Games Information (PEGI) system which informs the Video Standards Council age ratings that help parents decide whether game content is suitable for their children.

Subliminal messages

The researchers used YouGov survey tools to ask 1,094 UK adolescents aged 11-17 whether they had played any of the most popular video games identified as containing either tobacco or alcohol imagery. They were also asked whether and to what extent they smoked or drank alcohol. The study found that adolescents who had played at least one game with tobacco or alcohol content were twice as likely to have tried smoking or consumed alcohol themselves.

Out of the top five most popular games, Grand Theft Auto V & VI contained the highest level of alcohol and smoking content using fictitious brands only. The other top games containing these references were Call of Duty:Black Ops II, Call of Duty:Modern Warfare 3 and Assassin’s Creed III. There was no electronic cigarette content.

Video and Film
FIG. 1.  Percentage of total coding intervals containing alcohol content by category in the five games.
Video and Film
FIG. 2.  Percentage of total coding intervals containing tobacco content by category in the five games.

 

Psychologist Dr Joanne Cranwell from the UK Centre for Tobacco and Alcohol Studies, said:

”Although around 54% of UK adolescents play video games online, parental concern over exposure to inappropriate content while playing video games seems to be lower than for other media, like movies for example. While 80% of children aged 10-15 play packaged or online video games with an age rating higher than their age, more than half of British parents are unaware of the harmful content this exposes them to.

Video games are clearly attractive to adolescents regardless of age classification. It appears that official PEGI content descriptors are failing to restrict youth access to age inappropriate content. We think that the PEGI system needs to include both alcohol and tobacco in their content descriptors. Also, game developers could be offered incentives to reduce the amount of smoking and drinking in their games or to at least reference smoking and drinking on their packaging and websites.

As a child protection method it is naïve for both the games industry and the Interactive Software Federation of Europe, who regulate the PEGI system, to rely on age ratings alone. Future research should focus on identifying the levels of exposure in terms of dose that youth gamers are exposed to during actual gameplay and the effects of this on long- term alcohol and smoking behaviour.”

A copy of the full paper is online here: Alcohol and tobacco content in UK video games and their association with alcohol and tobacco use among young people.

News Reports:

Teenagers influenced by video games with alcohol, smoking content – ScienceDaily

Nottingham study finds teenagers ‘are influenced’ by smoking and alcohol in video games – NottsTV

GRAND THEFT WARNING – Teenagers who play video games are ‘TWICE as likely to smoke and drink alcohol’ – TheSUN

Teens who play Grand Theft Auto are ‘twice as likely to smoke or drink alcohol’ – AngleNews

Does YOUR teenager play Grand Theft Auto? They are ‘twice as likely to smoke or drink alcohol’ – DailyMail

New research from ASH Wales Cymru shows e-cigarettes are not a gateway to smoking for young people

New research released today shows no evidence that e-cigarettes are a ‘gateway’ for young people to start smoking. The annual survey, by tobacco control campaign group, ASH Wales Cymru, questioned more than 830, 11 to 18 year olds across Wales.

free-vape-vector-icons-2
For the third year running the survey shows there is no link between youths vaping and starting smoking tobacco.

It has been a concern among health professionals since the rapid emergence of e-cigarettes that they would ‘renormalise’ smoking and act as a ‘gateway’ towards tobacco for young people.

Of the young people who reported using both e-cigarettes and tobacco cigarettes at some point, 90% had used tobacco first, suggesting the absence of any ‘gateway’ theory. The report confirms e-cigarette use is confined to current smokers or ex-smokers and they are rarely used among ‘never’ smokers.

It also showed more than 30% of the e-cigarette users had quit smoking altogether. Reasons for using e-cigarettes varied from taste, to friends using them, to wanting to know what they were like.

Young people from the poorest parts of Wales were 25% more likely to have used an e-cigarette compared to their counterparts in the least deprived areas of the country.

These statistics around use by young people match recent results around adult usage from the Welsh Health Survey 2015.

This was the first time the Welsh Health Survey had looked at e-cigarette use. It revealed that 6% of over 16’s stated they currently use an e-cigarette – 140,000 of the Welsh population. Use among never smokers was negligible at 0.06%.

Suzanne Cass, Chief Executive of ASH Wales:

“For the third year in a row our research confirms young people are not using e-cigarettes if they’ve never smoked before.”

“E-cigarettes can contain highly addictive nicotine and there is no need for young non-smokers to use the devices. We are pleased to see these latest results confirm that e-cigarettes are being used as a smoking cessation device, similar to nicotine patches or gum and at the moment are not acting as a gateway towards tobacco.  E-cigarette users are now reducing the harm to their bodies caused by poisonous and cancer-causing tobacco smoke.”

Professor Linda Bauld from the University of Stirling and UK Centre for Tobacco and Alcohol Studies:

“There is a lot of confusion about the relationship between e-cigarettes and smoking in young people. Surveys from other countries do keep claiming there is a link despite youth smoking rates continuing to fall in the countries where these studies take place. This new data from Wales should reassure people that although young people are experimenting with e-cigarettes, we are not seeing regular use in never smokers. Meanwhile, youth smoking rates in Wales continue to decline, which is key to preventing cancer and other diseases that smoking causes.”

Ruth Coombs, Head of British Heart Foundation (BHF) Cymru:

“We are pleased that latest ASH Wales Cymru findings highlight encouraging trends to show that young people in Wales are not turning to e-cigarettes as a way to start smoking but rather as a way to reduce harm caused by intake of tobacco by cigarettes.”

 

Principal Findings:

  •  In terms of awareness of e-cigarettes, a large majority of respondents (90.7%) were aware of e-cigarettes. When stratified by age and gender the awareness of e-cigarettes remained extremely high. As many as 88.5% of respondents under the age of 13 were aware of what an e-cigarette is.
  • The most common sources of finding out about e-cigarettes were: seeing strangers using them in public (45.9%), reading or hearing about them on the internet or social media (42.6%), being told about them by friends (42.5%), and seeing them or hearing about them in the media (42.5%). By contrast only a very small proportion of respondents found out about e-cigarettes from a youth worker (3.3%) or health professional (3.0%).
  • The majority of respondents (68.6%) have never used an e-cigarette, with 13.7% only using an e-cigarette once and just 10% currently using an e-cigarette. A higher percentage of males reported currently using e-cigarettes every day (6.8%) relative to females (2.2%).
  • Respondents from the most deprived parts of Wales were far less likely to have never used an e-cigarette (48.6%) relative to respondents located in the least deprived areas of the country (75.4%).
  • The vast majority of never smokers have also never used an e-cigarette (88.9%), with a further 8.2% only ever having tried an e-cigarette once. Just 0.6% of never smokers currently use e-cigarettes regularly (i.e. more than once a week).
  • The main reasons for using e-cigarettes for the first time were to see what they tasted like (48.7%), because friends were using them (40.1%), and for a bit of fun (30.7%). 22.1% of respondents cited using e-cigarettes to reduce their intake of tobacco cigarettes.
  • The vast majority of respondents (90.3%) who had used e-cigarettes and smoked tobacco cigarettes reported starting to smoke tobacco cigarettes first.
  • Of the respondents who had used e-cigarettes and smoked tobacco cigarettes at some point (n = 172) 25.0% smoked fewer tobacco cigarettes since starting to use e-cigarettes, with 34.3% of respondents ceasing to smoke tobacco cigarettes altogether.

View the reportSee more on e-cigarettes | Other research from ASH Wales

Prescribed alcohol drug ‘Nalmefene’ was licensed despite insufficient evidence to prove its effectiveness

A study from the University of Stirling’s Institute of Social Marketing showed that a drug being used to treat alcohol problems in the UK was licensed for use, despite insufficient evidence to prove its effectiveness.

The drug nalmefene, marketed as Selincro®, was approved in Europe in February 2013 and was subsequently recommended by the UK National Institute for Health and Care Excellence (NICE).

Yet a team of scientists have found problems with the way clinical trials were conducted and analysed, making it impossible to know how much the drug actually helps to reduce drinking in patients dependent on alcohol.

Outlined in the journal Addiction, a group of experts analysed the published studies of nalmefene that formed the basis for the licensing and NICE decision. They concluded that evidence of its effectiveness was weak, and any possible effect on patients was small at around a one drink per day reduction on average. Continue reading

Dr Crawford Moodie [@Stirling_Health] speaking about plain packaging and E-cigs to Good Morning Scotland

The first results from Australia – which has introduced plain packaging – show that smokers found plain packaged cigarettes to be “less satisfying and poorer quality” and “were more supportive of plain packaging and more likely to think about and to prioritise quitting”.

Writing in the BMJ, three academics from the University of Stirling  – Dr Crawford Moodie, Professor Linda Bauld, and Martine Stead – ask how much more evidence is needed before the UK Government makes a decision on plain-packaged cigarettes.

Hear Crawford speaking on BBC Good Morning Scotland on 20/05/2016 below:

“Standardised packaging in the UK was first considered as a possible policy measure in the previous Labour government’s consultation on the future of tobacco control in 2008, which cited four studies from North America. By 2011, when the current government launched a consultation on the issue, its evidence review included 37 studies, six of which were from the UK. Since that review at least 12 additional studies have been published, including three more from the UK.

“This growing body of research is consistent in its findings: that plain packaging would reduce the appeal of tobacco products to consumers; would increase the effectiveness of health warnings; and would reduce the ability of packaging to mislead consumers about the harmful effects of smoking.” Continue reading

New RCP report says ecigs should be promoted to smokers to help them quit

A new report released today from the Royal College of Physicians, ‘Nicotine without smoke: tobacco harm reduction’ concludes that e-cigarettes are likely to be beneficial to UK public health. Smokers can therefore be reassured and encouraged to use them, and the public can be reassured that e-cigarettes are much safer than smoking.

Tobacco smoking is addictive and lethal. Half of all lifelong smokers die early, losing an average of about 3 months of life expectancy for every year smoked after the age of 35, some 10 years of life in total. Although smoking prevalence in the UK has reduced to 18%, 8.7 million people still smoke. Harm reduction provides an additional strategy to protect this group of smokers from disability and early death.

Since e-cigarettes became available in the UK in 2007, their use has been surrounded by medical and public controversy.  This new 200-page report examines the science, public policy, regulation and ethics surrounding e-cigarettes and other non-tobacco sources of nicotine, and addresses these controversies and misunderstandings with conclusions based on the latest available evidence:

  • E-cigarettes are not a gateway to smoking – in the UK, use of e-cigarettes is limited almost entirely to those who are already using, or have used, tobacco
  • E-cigarettes do not result in normalisation of smoking – there is no evidence that either nicotine replacement therapy (NRT) or e-cigarette use has resulted in renormalisation of smoking. None of these products has to date attracted significant use among adult never-smokers, or demonstrated evidence of significant gateway progression into smoking among young people
  • E-cigarettes and quitting smoking – among smokers, e-cigarette use is likely to lead to quit attempts that would not otherwise have happened, and in a proportion of these to successful cessation. In this way, e-cigarettes can act as a gateway from smoking
  • E-cigarettes and long-term harm – the possibility of some harm from long-term e-cigarette use cannot be dismissed due to inhalation of the ingredients other than nicotine, but is likely to be very small, and substantially smaller than that arising from tobacco smoking. With appropriate product standards to minimise exposure to the other ingredients, it should be possible to reduce risks of physical health still further. Although it is not possible to estimate the long-term health risks associated with e-cigarettes precisely, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure.

The report acknowledges the need for proportionate regulation, but suggests that regulation should not be allowed significantly to inhibit the development and use of harm-reduction products by smokers. A regulatory strategy should take a balanced approach in seeking to ensure product safety, enable and encourage smokers to use the product instead of tobacco, and detect and prevent effects that counter the overall goals of tobacco control policy.

Professor John Britton, chair of the RCP’s Tobacco Advisory Group, said:

‘The growing use of electronic cigarettes as a substitute for tobacco smoking has been a topic of great controversy, with much speculation over their potential risks and benefits. This report lays to rest almost all of the concerns over these products, and concludes that, with sensible regulation, electronic cigarettes have the potential to make a major contribution towards preventing the premature death, disease and social inequalities in health that smoking currently causes in the UK. Smokers should be reassured that these products can help them quit all tobacco use forever.’

RCP president Professor Jane Dacre said:

‘Since the RCP’s first report on tobacco, Smoking and health, in 1962, we have argued consistently for more and better policies and services to prevent people from taking up smoking, and help existing smokers to quit. This new report builds on that work and concludes that, for all the potential risks involved, harm reduction has huge potential to prevent death and disability from tobacco use, and to hasten our progress to a tobacco-free society. With careful management and proportionate regulation, harm reduction provides an opportunity to improve the lives of millions of people. It is an opportunity that, with care, we should take.’

Alison Cox, director of prevention for Cancer Research UK, said the charity believes e-cigs have a “real promise” in helping to reduce the death toll from tobacco.

She added: “This important report is an accurate summary of the latest scientific evidence on e-cigarettes and will help dispel the increasingly common misconception that they’re as harmful as smoking. They’re not.

“Tobacco kills more than 100,000 people in the UK every year, we should grasp every opportunity to encourage as many people as possible to stop smoking for good.”

And Duncan Selbie, chief executive at Public Health England, said the report highlights the “important role” of e-cigarettes in reducing the deadly harms smoking causes.

He added: “The best thing a smoker can do, for themselves and those around them, is to quit completely, now and forever.

“E-cigarettes are the most popular quitting aid in England and local stop smoking services are the most effective route to giving up, we encourage smokers to combine these, giving them an extremely good chance of quitting smoking successfully.”

Five researchers from the University of Nottingham were involved in the report.

These were Ilze Bogdanovica, research fellow; John Britton, professor of epidemiology; Tessa Langley, assistant professor in health economics; Sarah Lewis, professor of medical statistics; and Opazo Breton, research statistician.

News stories:

New York Times – Smokers Urged to Switch to E-Cigarettes by British Medical Group

Wall Street Journal – U.K. Report Advocates Substituting E-Cigarettes for Tobacco

Motherboard – Vaping Is About Reducing Harm, Not Being Harmless

Nottingham Post – Experts and doctors believe e-cigarettes should be offered to smokers