Study finds poorest of us at greater risk of harm from heavy drinking.

Drinking heavily is more harmful to the poorest people in society, who are at greater risk of illness or death because of alcohol consumption, according to a recent medical study. Published in medical journal The Lancet Public Health on Wednesday, it found there is a marked link between socio-economic status and the harm caused by drinking alcohol excessively.

Researchers taking part in the study found increased alcohol consumption was “disproportionately harmful” to the poorest in society. Compared with light drinkers in advantaged areas, excessive drinkers were seven times at risk of an increase in alcohol harm.

This contrasted with excessive drinkers in deprived areas, who were 11 times at risk of an increase. Harmful impacts of alcohol are higher in socio-economically disadvantaged communities. However, until now it was unclear whether those were as a result of
differences in drinking or as a result of other factors.

Lead author Dr Vittal Katikireddi, of the University of Glasgow, said:

“Our study finds that the poorest in society are at greater risk of alcohol’s harmful impacts on health, but this is not because they are drinking more or more often binge drinking.

“Experiencing poverty may impact on health, not only through leading an unhealthy lifestyle but also as a direct consequence of poor material circumstances and psychosocial stresses. Poverty may, therefore, reduce resilience to disease, predisposing people to greater health harms of alcohol.

The authors linked different sets of data to bring together information from Scottish Health Surveys with electronic health records, studying more than 50,000 people.
It suggested that even when other factors are accounted for, including smoking and obesity, living in deprived areas was consistently associated with higher alcohol-related harms. Researchers defined harm from alcohol consumption based on deaths, hospital visits and prescriptions that were attributable to alcohol.

Study co-author Dr Elise Whitley said:

“Heavier drinking is associated with greater alcohol-related harm in all individuals. However, our study suggests that the harm is greater in those living in poorer areas or who have a lower income, fewer qualifications or a manual occupation.

Responding to the study published on Wednesday in The Lancet Public Health which found that drinking heavily is more harmful to the poorest people in society. Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK (AHA), said:

“The findings in this study are worrying if not altogether surprising. It is clear that the way alcohol is being sold and promoted in Scotland and elsewhere in the UK is harming some of the most vulnerable people in society. On the other hand, we know what needs to be done, in particular to tackle the scourge of cheap alcohol. In real terms, alcohol is 60% cheaper than it was in 1980 and measures like strength based pricing would disproportionately benefit the poorest groups, in terms of reduced deaths, illness and hospital admissions.

Studies have shown that 82% of the lives saved through minimum unit pricing would come from the lowest income groups. Overall, in the first year alone minimum unit pricing in Scotland is expected to save 60 lives and lead to 1,600 fewer hospital admissions and 3,500 fewer crimes, yet its introduction has been held up for years by alcohol industry legal challenges.

Importantly, minimum unit pricing would leave pub prices untouched, and moderate drinkers would spend only about £2.25 extra per year with a 50p minimum price.”

This is even more evidence of the Alcohol Harm Paradox, which refers to observations that lower socioeconomic status (SES) groups consume less alcohol but experience more alcohol-related problems. However, SES is a complex concept and its observed relationship to social problems often depends on how it is measured and the demographic groups studied. A study published in 2016 hoped to deconstruct this idea and assessed socioeconomic patterns of alcohol consumption and related harm using multiple measures of SES and examined moderation of this patterning by gender and age. You can read the research article here: Deconstructing the Alcohol Harm Paradox: A Population Based Survey of Adults in England



Citation of original research article:

Socioeconomic status as an effect modifier of alcohol consumption and harm: analysis of linked cohort data. 

Dr Srinivasa Vittal Katikireddi, Elise Whitley, Jim Lewsey, Linsay Gray, Prof Alastair H Leyland. Published: 10 May 2017 – Open Access DOI: http://dx.doi.org/10.1016/S2468-2667(17)30078-6


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Alcohol-related Hospital Admissions are at a Record High!

New figures released this week shows that hospital admissions due to alcohol are at their highest ever levels.

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The data, summarised in a release from NHS Digital, shows that alcohol-related hospital admissions in England have increased by 64% over the last decade, with an extra 430,000 people being admitted due to alcohol-related causes in 2015/16 compared with 2005/06.

This takes the total number of alcohol-related hospital admissions to over 1.1 million in 2015/16.

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Alcohol is linked to over 60 illnesses and diseases, including heart disease, liver disease and cancer. Figures from the local alcohol profiles for England show that admissions due to liver disease have gone up 57% over the last decade, and that the number of people diagnosed with alcohol-related cancer has increased 8%.

In contrast, separate data released today by the Office of National Statistics shows that the proportion of adults drinking is at its lowest level since 2005, with younger people more likely to be abstaining from alcohol. However, 7.8 million people admit to binge drinking on their heaviest drinking day.

In response to the figures, alcohol health experts called for more to be done in the UK to tackle the health harm done by alcohol.

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

“These figures show that the UK continues to have a dysfunctional relationship with alcohol. We know that over the long term, rates of binge drinking are falling, and more people are choosing to abstain from alcohol. Worryingly, however, these trends do not appear big enough to stop alcohol harm from continuing to rise, and the sharp increase in alcohol-related hospital admissions over the last few years means hundreds of thousands more people each year are experiencing the misery associated with harmful alcohol consumption.

“The data released today should be sobering reading for whoever wins the upcoming general election, and we would urge the next government to make tackling alcohol harm an immediate priority to save lives, reduce harm, and reduce the pressure on the NHS.”

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 The data is available via the following links.

Research Report | Foul Play? Report highlights how Alcohol industry bent the rules on advertising during UEFA Euro 2016

A new report highlights how alcohol producers worked to circumvent legislation designed to protect children during the UEFA Euro 2016 football tournament. Researchers at the Institute for Social Marketing, University of Stirling, found over 100 alcohol marketing references per televised match programme in three countries – France, the UK and Ireland. Most marketing appeared in highly visible places, such as pitch-side advertising during the matches. This was the case, despite the fact that the tournament was held in France, where alcohol TV advertising and sports sponsorship is banned under the ‘Loi Évin’.

The report, Foul Play? Alcohol marketing during UEFA Euro 2016, will be launched at the European Healthy Stadia conference at Emirates Stadium on Thursday 27th April.

An analysis of broadcast footage found that alcohol marketing appeared, on average, once every other minute. The majority took the form of ‘alibi’ marketing, whereby indirect brand references are used to promote a product, rather than a conventional logo or brand name. Carlsberg was the most featured brand, accounting for almost all references in each of the three countries, using their slogan ‘Probably the best in the world’ while avoiding the mentioning the product name. ‘Alibi’ marketing was a common practice of tobacco companies in sporting events when advertising restrictions were introduced.

Dr. Richard Purves, Principal Investigator, Institute for Social Marketing, University of Stirling said:

“Beamed to audiences across the world, major sporting events such as the UEFA EURO tournament, present a prime opportunity for alcohol companies to market directly to a global audience.  In order to continue to protect children and young people from exposure to alcohol marketing, laws such as those in France need to be upheld and respected by all parties involved and not seen as something to be negotiated.”

Katherine Brown, Director of the Institute of Alcohol Studies said:

‘There is strong evidence that exposure to alcohol marketing encourages children to drink earlier and in greater quantities. The findings of this report show that alcohol companies are following in the footsteps of their tobacco colleagues by bending the rules on marketing restrictions putting children’s health at risk.’

Eric Carlin, Director of Scottish Health Action on Alcohol Problems (SHAAP), said:

‘Sport should be an alcohol-free space. The presence of alcohol marketing during UEFA EURO 2016 highlights that organisers of sporting events need to hold out against tactics of big alcohol companies to flout legal regulations designed to protect children.’

Read the full report here: https://bit.ly/alcfoulplay

The research was carried out by the Institute for Social Marketing, University of Stirling, and funded by the Institute of Alcohol Studies (IAS), Scottish Health Action on Alcohol Problems (SHAAP), and Alcohol Action Ireland.

 

 

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.

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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.

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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