Women & Alcohol | Edinburgh and London-Based Seminar Series | 2017

The Institute of Alcohol Studies (IAS) and the Scottish Health Action on Alcohol Problems (SHAAP) are co-hosting a four part seminar series to discuss issues relating to women and alcohol.

Each session will be chaired by an eminent academic, who will invite three guest speakers to present their personal responses to three pre-set questions, which are relevant to the topic.

These events will provide an opportunity for policy makers, academics, activists, and media representatives to critically discuss topics related to women and alcohol use. The intention is to stimulate thinking, challenge some attitudes and perceptions, and to think about future research and policy priorities.

Seminar 1: Friday, 10th March 2017

Women, Alcohol, and Globalisation.
Royal College of Physicians, London, 2 – 4pm

Chair: Dr. Cecile Knai, Associate Professor of Public Health Policy, London School of Hygiene and Tropical Medicine.

  • How does alcohol marketing influence women’s behaviours?
  • How does alcohol marketing influence attitudes towards women?
  • How does alcohol affect women in different social and cultural contexts?

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How safe is vaping? Media coverage, dilemmas and solutions in work and social spaces

As part of on-going work in relation to tobacco harm reduction, Knowledge-Action-Change is organising a series of dialogues, to examine the often contentious issues that attach to the use of electronic cigarettes, or vaping, in workplaces, places of entertainment and public spaces.

The series entitled ‘How safe is vaping? Media coverage, dilemmas and solutions in work and social spaces’ will take place:
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Why these dialogues now?

There is still a lot of debate between scientists and policy makers about the nature, use and safety of nicotine containing products. The media has produced a lot of stories about e-cigarettes, not all of them either accurate, or supported by scientific evidence. Nonetheless these stories have an impact and can influence peoples’ thinking and reactions on issues. This dialogue is a place where everyone can bring their concerns, air them and hopefully become better informed about the products and their use.

Most vapers are former smokers who have switched to this safer way to use nicotine. Professionals working in public health largely accept that this is a much safer form of behaviour – for users and those around them – but there remain concerns about the impact of their use in some circumstances and in this dialogue we aim to identify some of these and try to address them.

What are the dialogues?

These short events are designed to enable interactive discussion and debate – involving public health professionals, academics and scientists, policy makers, consumers, owners and managers of premises and members of the public – on a range of issues surrounding the increasing use of safer nicotine products (including e-cigarettes) as an alternative to smoking.

During each dialogue a panel of speakers, representing different interests, each make short presentations, addressing different issues relating to e-cigarette use. Q&A and discussion involving the audience follow the presentations.

The dialogues are filmed with the proceedings posted on the web, with the aim of providing information to those who might be interested in the subject and to assist those charged with making policy in having a cross-section of views to draw upon.

Previous dialogues: Knowledge-Action-Change has produced a number of dialogues to date and some of these can be viewed here.

Healthier central England or North–South divide? Analysis of national survey data on smoking and high-risk drinking

In England, around 20% of the population are smokers and 13% drink excessively. These behaviours are leading risk factors for several non-communicable diseases, including cancer, diabetes and chronic respiratory and cardiovascular conditions. It is estimated that around 8000 deaths/year are alcohol-related and 80 000 deaths of adults aged 35 and over are attributed to smoking annually. The prevalence and adverse effects of high-risk drinking and tobacco use are not equally distributed across the country, with large regional variations.

A North–South divide exists for smoking, with higher rates of tobacco use, smoking-related deaths and smoking-related harm in northern regions. 

In contrast, excessive alcohol consumption tends to be lowest in central and eastern regions, while an East versus West divide is seen in the prevalence of alcohol dependency and alcohol sales. These regional variations in consumption do not always map onto experienced harm, a phenomenon known as the Alcohol Harm Paradox. In 2014, alcohol-related death rates were significantly higher among regions in the north of England compared with those in the south.

Objectives: This paper compares patterns of smoking and high-risk alcohol use across regions in England, and assesses the impact on these of adjusting for sociodemographic characteristics.

Design: Population survey of 53 922 adults in England aged 16+ taking part in the Alcohol and Smoking Toolkit Studies.

Measures: Participants answered questions regarding their socioeconomic status (SES), gender, age, ethnicity, Government Office Region, smoking status and completed the Alcohol Use Disorders Identification Test (AUDIT). High-risk drinkers were defined as those with a score of 8 or more (7 or more for women) on the AUDIT.

Results: In unadjusted analyses, relative to the South West, those in the North of England were more likely to smoke, while those from the East of England, South East and London were less likely. After adjustment for sociodemographics, smoking prevalence was no higher in North East (RR 0.97, p>0.05), North West (RR 0.98, p>0.05) or Yorkshire and the Humber (RR 1.03, p>0.05) but was less common in the East and West Midlands (RR 0.86, p<0.001; RR 0.91, p<0.05), East of England (RR 0.86, p<0.001), South East (RR 0.92, p<0.05) and London (RR 0.85, p<0.001). High-risk drinking was more common in the North but was less common in the Midlands, London and East of England. Adjustment for sociodemographics had little effect. There was a higher prevalence in the North East (RR 1.67, p<0.001), North West (RR 1.42, p<0.001) and Yorkshire and the Humber (RR 1.35, p<0.001); lower prevalence in the East Midlands (RR 0.69, p<0.001), West Midlands (RR 0.77, p<0.001), East of England (RR 0.72, p<0.001) and London (RR 0.71, p<0.001); and a similar prevalence in the South East (RR 1.10, p>0.05)

Figure 2Figure 2: Association between Government Office Region and high-risk drinking: (A) unadjusted;
(B) adjusted for gender, age, ethnicity and socioeconomic status (reference region: South West). Note: this shows the relative risk difference for each region relative to the South West (dotted reference region). Increasing red tones reflect increasingly higher significant risk and increasing blue tones reflect increasingly lower significant risk. Regions shaded white have a similar risk to the South West. Online supplementary figure S9 labels the Government Office Regions in England.
Expand Image – More diagrams in the main report

Conclusions: In adjusted analyses, smoking and high-risk drinking appear less common in ‘central England’ than in the rest of the country. Regional differences in smoking, but not those in high-risk drinking, appear to be explained to some extent by sociodemographic disparities.

Strengths and limitations of this study

  • Used a representative survey about smoking and drinking conducted on a large sample of the adult population in England.

  • Based on the most up-to-date information in England on regional differences in smoking and high-risk drinking accounting for disparities in gender, socioeconomic status (SES), ethnicity and age.

  • Respondents may have underestimated or failed to report their drinking and smoking.

  • Patterns of smoking and alcohol use were only available at the Government Office Region level, whereas important variation may occur at a more micro-geographical level.

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Copyright information:
Published by the BMJ Publishing Group Limited.

 

Read the full report here!

Cheap cider and an alcohol duty system that incentivises harmful practice

APE: Alcohol Policy and Epidemiology

Cheap alcohol and its association with harmful drinking have been at the centre of UK alcohol policy debate for almost a decade. Public health advocates have presented minimum unit pricing as a solution, but legal wrangles, political U-turns and the fine detail of devolution mean that the policy remains unimplemented in any UK country.

With their first choice policy on hold and a budget on the horizon, the Alcohol Health Alliance has, instead, turned its attention to taxation. The focus is on strong cider and the UK’s quirky system of alcohol duties which levies a uniquely low tax rate on some high strength ciders. This means that products such as Frosty Jack’s can be sold at budget prices. Indeed, you can help yourself to three litres of the stuff (equivalent to 24 shots of vodka or 22.5 units) from Iceland today for £3.50. These high strength, low cost ‘white…

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Cigarette smoking increases coffee consumption: findings from a Mendelian randomisation analysis

Marcus Munafò and his colleagues at the University of Bristol, have looked into the smoking and drinking habits of about 250,000 people. They found that smoking makes you drink more caffeinated drinks, possibly by changing your metabolism so that you break down caffeine quicker, pushing you to drink more to get the same hit.

It’s impossible to do a randomised controlled trial (the most rigorous kind of scientific trial) when it comes to smoking, because it would be unethical to ask a randomly selected group of people to smoke. The next best thing is to study huge biobanks of health data. These biobanks contain information about people’s genes, diets and lifestyles.
coffee-cigarettes-smoking-400x400.jpgTo explore the relationship between smoking and caffeine, Munafo and his colleagues analysed data from biobanks in the UK, Norway and Denmark. They were particularly interested in people who had inherited a variant of a gene that has already been shown to increase cigarette smoking.

Chain drinking

The team found that people who had this gene variant also consumed more coffee – but only if they smoked. British people with the same variant also drank more tea, although their Danish and Norwegian counterparts didn’t. This is probably due to cultural differences, says Munafò. “People in Norway and Denmark don’t chain drink tea in the same way that people in the UK do,” he says.

The genetic variant seems to influence how much nicotine a person consumes. You can have zero, one or two copies – and each additional copy is linked to an increase in smoking of about one cigarette per day. Each copy also appears to increase coffee consumption by 0.15 cups per day.

“You could extrapolate from that and say that if you smoked 10 cigarettes per day more than the next person, you would be drinking the equivalent of about one and a half extra cups of coffee per day,” says Munafò. He is wary of doing so, though, because the amount of nicotine a person gets from a cigarette will depend on the type of cigarette and the way it is smoked.

The gene variant codes for a nicotine receptor, which is not known to directly interact with caffeine. This suggests that cigarette smoking increases caffeine consumption and not the other way around.

“The team have used a rather clever technique to establish causality, which normally you wouldn’t stand a cat in hell’s chance of doing with an epidemiological study,”

Robert West – University College London.

What’s the link?

There’s a chance that cigarette smoking and caffeine consumption are linked through habit – that smokers tend to pair the two. But Munafò thinks that the nicotine in cigarettes might also influence the way a person metabolises caffeine. “It’s possible that smokers metabolise caffeine more quickly,” he says. If that is the case, smokers might need to consume more caffeine to get the same effects that a non-smoker would experience.

It’s also possible that the apparent link between smoking and coffee drinking could be down to some unknown function of the genetic variant, says West. “It evolved for a purpose, and it wasn’t to smoke,” he says.

A relationship between smoking and coffee might make it harder for smokers to quit, says Munafò. If a smoker stops smoking, but continues to drink plenty of coffee, they might start to experience unpleasant side effects, such as jitteriness. This might be misinterpreted as a symptom of smoking withdrawal, says Munafò. His team plans to investigate this.

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By Jessica Hamzelou

Journal reference: bioRxiv, DOI: 10.1101/107037

Participants needed: A pilot study into the determinants of behaviour change in alcohol use disorder.

Queen Mary University is looking for people with problematic drinking who are currently trying to stop drinking, but unable to do so.

A pilot study into the determinants of behaviour change in alcohol use disorder.

We would like to invite you to be part of this research project.  It is entirely up to you if you want to take part. If you choose not to take part there won’t be any disadvantages for you and you will hear no more about it.

Please read the following information; this will tell you why the research is being done and what you will be asked to do. Please ask if anything is not clear or you would like more information.

The Study.

Achieving and maintaining abstinence from alcohol can be difficult. Scientific study into the reasons behind these difficulties has identified a number of factors which may play a role in the inability to stop drinking. This project examines several of these to further clarify their role.

Why have I been invited to take part?

We are looking for two groups of people. Those who have successfully managed to stop drinking for 12 months or more, and those who cannot maintain abstinence for more than 30 days, despite a desire to stop.

What will happen if I take part?

If you wish to participate we will arrange an appointment that will take about 1-1.5 hours. This will consist of a series of questionnaires and behavioural tasks including holding your breath for as long as you can; a hand grip task; and a computer task where you will trace the outline of a shape. You will receive £10 to put towards any travel costs you may incur.

If you live outside of London you will be able to complete the study remotely and will receive payment by mail.

The session will be conducted by PhD student Daisy Thompson-Lake who is under the supervision of Professor Peter Hajek and Professor De La Garza.

If you agree to give contact details we will also contact you in the future to ask you for your breath holding time via email or telephone. This is not compulsory and you will receive the compensation should you decide to give no contact details.

What are the risks of taking part?

There are no risks associated with taking part in the study.

What are the benefits of taking part?

There are no direct benefits to you for taking part. However, the information you provide may contribute towards better understanding of factors contributing to stopping drinking, and future treatments.

Will my data be kept confidential?

Yes, if you agree to take part all information you give us will be kept confidential and only study staff will have access to this data. All data will be anonymised and there will be no information included in the study which could identify you.

What if I want to leave the study?

Your participation is entirely voluntary, and you are free to leave the study at any time for any reason. We will request your permission to keep the information you have given us until the time you decide to leave the study.

What happens if you are concerned or have any questions?

You will be able to contact Daisy Thompson-Lake (02078828244, d.g.y.thompson-lake@qmul.ac.uk ) if you are worried about anything or have any questions.

The Chief Investigator of this study is Professor Peter Hajek, Tobacco Dependence Research Unit, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, 2 Stayner’s Road, Stepney Green, E1 4AH, Email: p.hajek@qmul.ac.uk Tel:  020 7882 8230.

A summary of the report from this study will be available upon request.

We would like to thank you for your interest in this study.

 

If interested please call or email Daisy on :

02078828244 or d.g.y.thompson-lake@qmul.ac.uk

Experts call for action on HIGH STRENGTH CIDER to protect the homeless and the vulnerable.

The Alcohol Health Alliance and Thames Reach, the homelessness organisation, are today calling for duty increases on high-strength cider, which is a leading cause of death and ill-health among the homeless.

Experts will present evidence on this issue at an event taking place in the House of Commons today, sponsored by David Burrowes MP, aimed at highlighting the impact of alcohol on the homeless and vulnerable.

High-strength ciders, including products like Frosty Jack’s and White Ace, are nearly all drunk by homeless and dependent drinkers, and studies show these ciders are a favourite among children receiving treatment for alcohol dependence. Studies have found that 75-85% of high-strength cider drinkers choose it because of its low price. At typically 7.5% ABV, three-litre bottles of these ciders, which contain the same amount of alcohol as 22 shots of vodka, can be bought for as little as £3.49. This equates to just 16p per unit.

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The calls will put further pressure on the government to act on cheap, high-strength ciders in the budget in March.

In December, 43 organisations and experts from drinkingthe health, homelessness, children’s and religious sectors wrote to the Chancellor urging him to increase the duty on cider, and earlier this month polling was released which showed that 66% of the public back a cider tax. In addition, the Institute for Fiscal Studies has previously called for reform to address “the very low levels of duty charged on strong cider”.

Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance, said:

“A can of 500ml cider at 7.5% is taxed less than a third of the amount taxed on a can of beer the same size and strength. There can be no justification for the low rates of tax on high-strength cider.

“Our calls today are not about the drinks consumed by moderate drinkers. Dependent and vulnerable drinkers account for nearly all sales of high-strength ciders, meaning increased duty would be targeted at them. Indeed, we know that 80% of total cider sales would be left unaffected by duty increases on these high-strength ciders.

“The budget in March represents an ideal opportunity for the government to protect the homeless and vulnerable through increased cider duty.”

Jeremy Swain, Chief Executive of Thames Reach, said:

“98% of the homeless people we work with who have alcohol problems primarily drink bottles and cans of these high-strength ciders and super-strength beers, which are far stronger than regular and premium drinks. A survey of deaths among hostel residents over the past year showed that 10 out of 16 were directly attributable to high and super-strength drinks. This is not a one-off figure. An earlier survey showed 11 out of 14 deaths (78%) were caused by high and super-strength drinks.

“By increasing the tax on these high-strength and dangerous products, the harm done to the vulnerable people we work with will diminish, and the opportunity to reduce, and ultimately end, dependence on alcohol will increase.”

David Burrowes MP is sponsoring the event in Parliament and has long-campaigned locally and nationally about the harms of alcohol. Mr Burrowes said:

“The government has rightly put social justice at the heart of everything they do, and this commitment should extend to preventing the damage done by cheap, high strength drinks, which blight the lives and health of those who need our support – the homeless and vulnerable.

“An increase in the duty on high strength cider at the upcoming budget would represent a step in the right direction to tackling the burden of cheap alcohol on some of our most vulnerable communities.”

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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

For further information, please contact Matt Chorley, the AHA’s Policy and Communications Officer, at matt.chorley@rcplondon.ac.uk.

About Thames Reach

Thames Reach is one of the UK’s leading homelessness charities. Its vision is to end street homelessness and its mission is to provide decent homes, encourage supportive relationships and help people lead fulfilling lives.

Thames Reach runs a range of services in London including street outreach services helping people sleeping rough escape homelessness, a variety of hostels and supported housing projects, and schemes which prevent homelessness and help people develop new skills, re-engage with family and friends, and get back into work.

Thames Reach has been campaigning for over a decade to raise taxation on the dangerous high-strength ciders and super-strength beers – all the major studies on alcohol indicate the price is one of the key factors in influencing what people drink – and have also called on the drinks industry to behave more responsibly.

Successes include the consumption of 9% super-strength beer falling by a quarter in the UK, after we successfully lobbied the Government to create a higher band of duty in 2011, while the drinks manufacturer Heineken removed all of its high-strength cider from sale in the UK after visiting one of our hostels.

See thamesreach.org.uk For further details, contact Thames Reach communications manager, Mike Nicholas, on mike.nicholas@thamesreach.org.uk.