Enough alcohol was sold in Scotland in 2016 for every adult to significantly exceed safe drinking levels each week

New figures published this week reveal that enough alcohol is being sold in England and Wales for every drinker to consume 21 units of alcohol a week – far more than the low-risk level of 14 units per week for both men and women recommended by the UK’s chief medical officers. The figures reveal that the situation is even worse in Scotland, with enough alcohol being sold for every drinker to consume 24 units a week. The data was released by NHS Health Scotland, who also looked at consumption in England and Wales in order to compare patterns across the UK. In 2016 10.5 litres of pure alcohol were sold per adult in Scotland, equivalent to 20.2 units per person per week!

“As a nation we buy enough alcohol for every person in Scotland to exceed the weekly drinking guideline substantially” Lucie Giles (author of the report)

The annual report from NHS Health Scotland brings together data on alcohol retail sales, price and affordability, self-reported consumption and alcohol-related deaths, hospital admissions and social harms. It found that in 2015 an average of 22 people per week died in Scotland due to an alcohol-related cause, a figure 54 per cent higher than that recorded in England and Wales. In the most deprived areas of Scotland alcohol-related death rates were six times higher than in the wealthiest areas. Rates of alcohol-related hospital stays were also nine times higher.

However, the report said there were some signs that Scots were curtailing their drinking habits, with self-reported data showing that the proportion of tee-totallers has also risen.

“This has harmful consequences for individuals, their family and friends as well as wider society and the economy. The harm that alcohol causes to our health is not distributed equally; the harmful effects are felt most by those living in the most disadvantaged areas in Scotland.” Lucie Giles

To tackle high levels of alcohol-related deaths and illness, Scotland is set to introduce a minimum unit price for alcohol; designed to target cheap, high-% alcohol drinks favoured by vulnerable and harmful drinkers.. The Scottish government passed minimum unit pricing over 5 years ago, though implementation of the measure has so far been delayed due to legal challenges from the alcohol industry. Minimum unit pricing formed part of the Westminster government’s alcohol strategy in 2012, though has yet to be implemented in England and Wales. 

“This report shows that, whilst some progress has been made in tackling alcohol misuse, we need to do more. Over the last few years, more than half of alcohol sold in supermarkets and off-licences was sold at less than 50p per unit, and enough alcohol was sold in the off-trade alone to exceed the weekly drinking guideline by a considerable amount. That is why we need minimum unit pricing, which will largely impact on the off-trade and will increase the price of the cheap, high strength alcohol.”  Public Health Minister Aileen Campbell

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

“These figures are shocking and show why minimum unit pricing is needed in Scotland, as well as in the rest of the UK. As a result of the legal challenges from the alcohol industry, lives will undoubtedly have been lost in Scotland. We hope and expect minimum unit pricing to be ruled legal in the final court hearing in this case in July, so that implementation in Scotland can follow.

“If minimum unit pricing is ruled legal in Scotland, a decision by Westminster to delay would be a death sentence for some, including many from the lowest income groups. The evidence is already clear – minimum unit pricing saves lives, prevents illness and lowers hospital admissions.”

The NHS Health Scotland figures are available here.

For more information on Minimum Unit Pricing, check out a report from the University of Sheffield’s Alcohol Research Group.

More posts related to this one:
Alcohol-related Hospital Admissions are at a Record High!
“Government has ‘no sense of direction’ in reducing devastating alcohol harm” Lord Brooke
Experts call for action on HIGH STRENGTH CIDER to protect the homeless and the vulnerable.

 

 

The Cochrane Tobacco Addiction Group’s 20th anniversary priority setting project report.

Cochrane TAG anniversary Twitter banner
The Cochrane Tobacco Addiction Group (TAG) conducts and facilitates systematic reviews and meta-analyses of the research evidence for tobacco cessation and prevention interventions. The group was founded in 1996 and in 2016 they conducted a stakeholder engagement project to celebrate the 20th anniversary of TAG and to identify future research priorities for the group and the wider tobacco control community.
 
 

The objective of the project was to:

  • Raise awareness of Cochrane TAG and what has been achieved so far.
  • Identify areas where further research is needed in the areas of tobacco control and smoking cessation.
  • Identify specific goals for Cochrane TAG
  • To explore novel ways to disseminate the findings of tobacco research, and Cochrane TAG’s findings.

The survey and workshop resulted in 183 unanswered research questions in the areas of tobacco, quitting smoking and eight priority research areas, including:

  • ‘addressing inequalities’
  • ‘treatment delivery’
  • electronic cigarettes’
  • ‘initiating quit attempts’
  • ‘young people’
  • ‘mental health and substance abuse’
  • ‘population-level interventions’
  • ‘pregnancy’

_NAS8348_web

Stakeholders who attended the workshop also discussed ways that the public health community and Cochrane TAG could act to move the field of tobacco control forward.

Through this report, Cochrane TAG want to share the identified unanswered questions with the wider tobacco research community to help them to decide the most important research to focus on in the future, and to decide the most important things to work on for Cochrane TAG.

This will involve updating existing reviews, beginning reviews on new topics, and looking in more detail at Cochrane TAG’s research methods.

Contrary to popular belief there are still many important unanswered questions in the field of tobacco control. In addition, it has been noted that many of the results of tobacco control questions are not always reaching their intended targets. Tobacco control stakeholders provide a rich source of information on how these uncertainties should be prioritised; by using this resource the likelihood that the findings of research are useful and will be implemented is much greater. The project was carried out with the hope that researchers and research funders will be able to use the priorities identified to inform their future practice, in the same way that Cochrane TAG are using them to inform new review topics, updates of reviews and methods development.

Cochrane TAG’s findings and implementation suggestions should be considered alongside the existing evidence base and clinical expertise.

 
Here is the full report of the CTAG taps project!
 
You can open the report and the appendices by clicking on the covers below:
ctag_taps_final_reportctag_taps_final_report_appendices
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Discussing the future of tobacco addiction research with the Cochrane Tobacco Addiction Group:

The CTAG taps project ran from January-December 2016. Activities carried out from April 2016-December 2016 were funded by the NIHR School for Primary Care Research (SPCR)

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.

bmj

Copyright information:
Published by the BMJ Publishing Group Limited.

 

Read the full report here!

Report launch: New issues and age-old challenges: a review of young people’s relationship with tobacco | 27/02/17

launch.PNG

Join Prof Amanda Amos and Prof Marcus Munafo to discuss the current landscape, challenges and opportunities including a focus on young people, tobacco and mental health.

Please book your free please here>

The face of youth smoking in the UK is evolving.  Young people are growing up in a society radically disrupted by new technologies and societal norms, which are reshaping their perceptions of personal health, image, and values.

New issues and age-old challenges: a review of young people’s relationship with tobacco, brings together the available evidence on youth smoking and articulates a clear demand for action across the system.

Martin Dockrell from Public Health England will chair the panel session.

Full agenda is available here>

Cheap alcohol: the price we pay and the road to Minimum Unit Pricing!

It has been five years since alcohol partners from across the UK carried out their last comprehensive price survey. A lot has happened in that time. The Coalition Government committed to introduce a minimum unit price (MUP) to tackle the harm caused by the cheapest alcohol. Then, with encouragement from sections of the alcohol industry, they decided to postpone its introduction until the outcome of a legal challenge to minimum unit pricing in Scotland had been resolved. The alcohol duty escalator – which increased duty by 2% above inflation – was scrapped. Wider duty rates were cut. And alcohol harm continued to rise.

Four member organisations of the Alcohol Health Alliance (AHA) – the Institute of Alcohol Studies; Alcohol Focus Scotland; Balance, the North East Alcohol Office; and Healthier Futures – decided to check how those changes had affected the price of alcohol that is available in communities across England and Scotland.

As part of the survey, the partners visited a range of off-sales premises looking for the nation’s cheapest booze. Almost 500 products were examined and the conclusion is clear – alcohol continues to be sold at pocket money prices in supermarkets and off-licences across the UK.

Chairman of the AHA and former president of the Royal College of Physicians, Professor Sir Ian Gilmore, said:

“In spite of a government commitment to tackle cheap, high-strength alcohol, these products are still available at pocket money prices. Harmful drinkers and children are still choosing the cheapest products – predominantly white cider and cheap vodka.

We need to make excessively cheap alcohol less affordable through the tax system, including an increase in cider duty. It’s not right that high strength white cider is taxed at a third of the rate for strong beer. 

In addition, we need minimum unit pricing. This would target the cheap, high strength products drunk by harmful drinkers whilst barely affecting moderate drinkers, and it would leave pub prices untouched.”

Each year, there are almost 23,000 deaths and more than 1 million hospital admissions related to alcohol in England.

More than two-thirds of alcohol sold in the UK is purchased in supermarkets and off-licences.

Headline Findings

  • Alcohol continues to be sold at pocket money prices, with white cider dominating the market for cheap, high-strength drinks.
  • High-strength white cider products, which are predominantly drunk by dependent and underage drinkers, are sold for as little as 16p per unit of alcohol.
  • For the cost of a standard off-peak cinema ticket you can buy seven and a half litres of 7.5% ABV white cider, containing as much alcohol as 53 shots of vodka.
  • Recent cuts in alcohol taxes allow shops and supermarkets to sell alcohol at pocket money prices but have done little to benefit pubs and their customers.
  • High-strength white cider is taxed at the lowest rate of all alcohol products. A can of 7.5% ABV white cider attracts less than one-third of the duty on a can of beer that is the same strength.

fig

Recommendations

The Government needs to:

  1. Increase duty on high-strength cider
  2. Reinstate the alcohol duty escalator
  3. Upon leaving the EU, tax all alcoholic drinks categories in proportion to strength
  4. Implement a minimum unit price for all alcoholic drinks.

Minimum unit pricing and tax – dispelling the myths

A minimum unit price would only target the highest strength drinks that cause the most harm. There are many myths surrounding minimum unit pricing, which the alcohol industry uses to dissuade people from supporting it. We have included here just a few of those myths and our responses.

Myth: An MUP would affect moderate drinkers too.
Moderate drinkers would experience very little impact from minimum unit pricing, which makes it one of the most effective measures, as it only targets the most harmful drinks of the kind deliberately sought out in this survey. The price of a pint of beer in a pub, for example, would not be affected by minimum unit pricing.
Myth: Taxation would be more effective than an MUP.
Recent research from the University of Sheffield found that, to achieve the same level of impact as an MUP of 50p, a 28% increase in all alcohol duty would be needed, which is outside the realms of possibility when it comes to what the Government will do. Everyone would be affected by these measures, whereas minimum unit pricing only targets the cheapest, strongest drinks.
Myth: Tax and minimum unit pricing cannot be used together.
Increasing duty and introducing an MUP are often presented as alternative solutions, when they can in fact be used to complement each other. Minimum unit pricing is targeted at the cheapest alcohol that is consumed by the most harmful drinkers but there are limits to its impact on wider population alcohol consumption and health, which increases to duty overall would help to tackle.

Tax rises and tougher rules on alcohol promotions work well,
but they will always work better when combined with minimum unit pricing.

Read the full report here.

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