Serving smaller alcoholic drinks could reduce the UK’s alcohol consumption | Research Report | University of Liverpool

New research published in Addiction, conducted by researchers from the Universities of Liverpool and Sheffield, highlights the potential benefits of reducing the standard serving size of alcoholic beverages.

It is well known that alcohol consumption contributes to premature death and ill health, and alcohol-related harm places a substantial burden on society. Many drinkers find it hard to cut down and attempts to cut down often do not lead to actual reductions in alcohol consumption. Therefore, changes to the environment that make it easier for people to drink less could have a substantial impact on public health.

One potential environmental influence on alcohol consumption is serving size. Nutrition research consistently shows that portion sizes affect how much a person eats. People eat more if they are given a relatively large portion of food compared to smaller portions, but they do not compensate for this by eating less later on. However, the effect that serving size has on alcohol consumption has not been examined until now. The present research aimed to investigate if reducing the serving size of alcoholic beverages would reduce alcohol consumption.

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Standard vs Reduced serving sizes:

The researchers, led by Dr Inge Kersbergen from the University of Liverpool, tested the effects of reducing the serving size of alcohol on how much alcohol participants drank in two studies.

In the first study, participants were randomized to consume alcohol from standard or reduced serving sizes whilst watching a one-hour TV programme in a laboratory that looks like a living room. Standard serving sizes contained 2.07 units per serving (equivalent to a pint of weak lager) and reduced serving sizes contained 25% less than the standard serving.

In the second study, participants were invited to one of four pub quiz nights in a local bar which only sold standard vs. reduced serving sizes. Standard servings were pints and 175ml of wine (‘typically served as a medium glass in pubs’) and reduced servings were 2/3 pints and 125ml of wine (‘small glass’). Drink prices were adjusted to make sure that the standard and reduced serving sizes were the same value for money. Researchers observed how much alcohol each participant drank.

In both experiments, participants could order as many drinks as they wanted for the duration of the experiment. This means that participants drinking from reduced servings could compensate for the smaller serving size by ordering more drinks if they wanted to.

The researchers found that participants who were served relatively smaller servings drank less alcohol in a single drinking session than participants who were served standard servings. In the first study, reduced serving sizes led to a 20.7% – 22.3% decrease in alcohol consumption over a one-hour drinking period in the ‘living room’ lab. In the second study, reduced serving sizes led to a 32.4% – 39.6% decrease alcohol consumption over a longer drinking period (up to three hours) during the real-life pub quiz.

Based on the results the researchers used the Sheffield Alcohol Policy Model to estimate that reducing the standard serving size of beer, wine and cider in bars and restaurants by a quarter would lead to 1,400 fewer deaths and 73,000 fewer hospital admissions every year.

Public health intervention:

Dr Kersbergen, said: “These studies are the first to demonstrate that reducing the serving size of alcoholic beverages prompts reductions in alcohol consumption.

The typical serving size of beer in the UK of a pint is larger than many other countries and the size of wine servings in UK bars and restaurants has increased in recent decades, so there is room for serving sizes to be reduced without making them unrealistically small. Reducing the standard serving size of alcohol in bars and restaurants may be an effective way to reduce alcohol consumption at the population level and improve public health.”

Professor Matt Field, who leads the Addiction research group within the Department of Psychological Sciences at the University of Liverpool, added: “Reducing the standard serving size of alcoholic drinks could automatically prompt people to drink less, even if they are not motivated to cut down. But at the same time, the total amount that people consume would remain completely their own choice”.

Dr Eric Robinson, a University of Liverpool researcher who was also involved in the study, said: “Our research showed that people do not seem to compensate for the smaller servings by ordering more drinks on a single night and it seems unlikely that any further compensation would happen, but future research is needed to find out if people may compensate in other ways, such as drinking more often or getting stronger drinks.”

The full study, entitled ‘Reducing the standard serving size of alcoholic beverages prompts reductions in alcohol consumption’, can be found here and was funded in part by an MRC research grant awarded to Dr Eric Robinson.

Original post 14/05/2018: University of Liverpool News

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UKCTAS welcome the introduction of Minimum Unit Pricing for alcohol in Scotland

It’s been a long road but doctors and health experts are finally welcoming a minimum unit price for alcohol as the pioneering law comes into force in Scotland. The new 50p floor price aims to tackle Scotland’s unhealthy relationship with drink by raising the cost of cheap,  ­high-strength products.

The Scottish ­Government warned retailers they will have no grace period to alter prices and shops will be targeted for spot checks.

Minimum pricing was delayed for a decade by opposition MSPs and a legal ­challenge led by the Scotch Whisky ­Association. Holyrood opponents eventually changed their minds and the Supreme Court upheld the ­legislation last November.

Research by Sheffield University suggested the 50p price floor will save 60 lives in its first year, rising to 300 lives a year after a decade.

If your drink of choice is already being sold for more than the minimum price, then it will likely remain unchanged. But if it is currently being sold for less than the minimum price, you can expect the cost to rise to at least the minimum level.

For example, if a 9.8 unit bottle of wine is currently being sold for £3.50 in your local supermarket, it will set you back at least £4.90.

Dr Peter Bennie, chairman of the British Medical Association in Scotland, said:

“It has been a long road but I am delighted that the ­persistence of alcohol campaigners, with strong BMA support, has paid off and minimum pricing has finally taken effect. 

Minimum unit pricing is a policy that will help to save lives and reduce alcohol harms in ­Scotland. It will help to reduce the burden of alcohol on our health service, on society, and most ­importantly on ­individuals and their families. 

This is an important milestone for Scotland. Other parts of the world will now be watching the implementation with great interest.”

Bennie said the alcohol industry discovered it cannot expect to block ­policies designed to protect health.

“Alcohol causes 1100 cases of cancer every year in ­Scotland. The less alcohol you drink, the lower your risk of cancer. A minimum unit price is one action among many that will help reduce how much alcohol is consumed in ­Scotland.”

Professor Linda Bauld, Deputy Director of UKCTAS

The law only covers Scotland, leading to ­loopholes for online purchases. Guidance last month stated that supermarket meal deals where wine is included are unlikely to be affected. Retailers are also advised that “click-and-collect” purchases won’t be covered by the law if cheap drinks are first sent from outside Scotland. Customers can buy over the internet or by phone from a business in England. A delivery firm down south would be allowed to send drink to customers in Scotland.

“I am proud the eyes of the world will once again be on Scotland with the introduction of this legislation.”

First Minister Nicola Sturgeon

“Scotland has the highest rate of alcohol-related deaths in the UK. I hope we will see that change.”

Health Secretary Shona Robison

Doctors and health experts welcome minimum pricing for alcohol as law comes into force – Daily Record

Minimum Unit Pricing implemented – WiredGov

Minimum unit pricing for alcohol: Everything you need to know – Edinburgh Evening News

New Publication from the Sheffield Alcohol Research Group: Model-based appraisal of the comparative impact of Minimum Unit Pricing and taxation policies in Wales

Three quarters of all alcohol consumed in Wales is drunk by less than a quarter of the adult population who are hazardous or harmful drinkers and spend up to £2,882 per year on booze, research has revealed.

A report looking into the potential impact of minimum unit pricing and taxation policies in Wales was published Thursday 22nd February by the Sheffield Alcohol Research Group at the University of Sheffield.

The publication, which found that the 3% of the population who are harmful drinkers, account for 27% of all alcohol consumed, comes after the Welsh Government announced a new Bill that, if agreed by the National Assembly, will introduce a minimum price for the sale of alcohol.

The Bill, which is designed to reduce hazardous and harmful drinking would make it an offence for alcohol to be supplied below that price.

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Health Secretary, Vaughan Gething said: “People who drink alcohol at hazardous and harmful levels drink 75% of the alcohol consumed in Wales.

“The introduction of a minimum unit price would be effective in reducing alcohol consumption among these groups, as well as reducing the number of alcohol-related deaths and hospitalisations.”

The availability of cheap, strong alcohol is estimated to lead to 50,000 alcohol-related hospital admissions a year, costing the Welsh NHS £120 million annually and, in 2015, there were 463 alcohol-related deaths in Wales.

The report reveals the population of Wales buys 50% of its alcohol for less than 55p per unit, 37% for less than 50p per unit and 27% for less than 45p per unit, with heavier drinkers being more likely to buy alcohol sold below these thresholds.

Mr Gething said: “The report shows the greatest impact of a minimum unit price would be on the most deprived harmful drinkers, while moderate drinkers would experience only small impacts on their alcohol consumption and spending.

“This is because moderate drinkers tend to buy alcohol which would be subject to little or no increase in price under the policy.

“If passed, this law will potentially save lives.”

The research also shows harmful drinkers spend an average £2,882 a year on alcohol, or around £7.80 per day, compared to £1,209 for hazardous drinkers and £276 for moderate drinkers.

The Sheffield Alcohol Research Group, commissioned by the Welsh Government in June 2017 to update a 2014 appraisal of the likely impact of a range of minimum unit pricing policies, concluded a minimum unit price set at between 35p and 70p would be effective in reducing alcohol consumption among hazardous and, particularly, harmful drinkers.

Research highlights:

  • Moderate drinkers drink an average of 211 units of alcohol per year compared to 1,236 for hazardous drinkers and 3,924 for harmful drinkers.
  • Harmful drinkers spend an average £2,882 a year on alcohol compared to £1,209 for hazardous drinkers and £276 for moderate drinkers.
  • Alcohol-attributable deaths and hospital admissions are concentrated in hazardous and particularly harmful drinkers who are more deprived.

External news coverage:

75% of alcohol in Wales is drunk by just over a fifth of the population according to new report – ITV News

Minimum alcohol price help call for ‘hazardous’ drinkers – BBC News

75% of alcohol drunk in Wales consumed by 22% of the population, report says – Guernsey Press

Report conducted at the University of Sheffield provides ‘clear and compelling’ new evidence on the effectiveness of minimum unit pricing.

Alcohol consumption will cause 63,000 deaths in England over the next five years according to a new report from the University of Sheffield Alcohol Research Group.

alcoholThe report, published by the Foundation for Liver Research, predicts that 32,475 of the deaths – the equivalent of 35 a day – will be the result of liver cancer and another 22,519 from alcoholic liver disease.

In its new report, Financial case for action on liver disease, endorsed by the independent Lancet Commission on Liver Disease, the Foundation for Liver Research urges the Government to implement a suite of policy measures designed to mitigate the rising health and financial burden of alcohol, including the introduction of minimum unit pricing (MUP), re-institution of alcohol duty escalator and advertising restrictions.

  • Between 2017 and 2022 the total cost to the NHS of alcohol-related illness and deaths will be £17 billion.
  • Study shows introduction of minimum unit pricing for alcohol could significantly reduce the burden.

Providing evidence in support of Government intervention, new modelling shows that within five years of its introduction in England, a 50p MUP alone would result in:

  • ian gilmore quote21,150 fewer alcohol-related deaths
  • 74,500 fewer alcohol-related hospital admissions
  • Savings of £325.7m in healthcare costs
  • Savings of £710.9m in crime costs

The total financial savings to the public purse of MUP is forecast to be £1.1 billion – the equivalent cost of the Government’s recently announced investment package for Northern Ireland.

Colin Angus, Research Fellow at the University of Sheffield and part of the Sheffield Alcohol Research Group who conducted the research, said:

“These new findings show there will be 35 deaths and 2,300 hospital admissions due to alcohol every day in England over the next five years. We estimate this will cost the NHS £17 billion at a time when healthcare resources are already overstretched. Our research also shows that policies such as Minimum Unit Pricing have the potential to significantly reduce this burden.”

Liver disease is one of Britain’s biggest killers, claiming about 12,000 lives a year in England alone. The number of deaths associated with it has risen by 400% since 1970. It is estimated that 62,000 years of working life are lost every year as a result of it. People who develop serious liver problems also suffer some of the worst health outcomes in western Europe.

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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!

Kettil Bruun Society 43rd Annual Alcohol Symposium | Sheffield 5-9th June, 2017

The 43rd annual symposium of the Kettil Bruun Society is hosted by the School of Health and Related Research (ScHARR) at the University of Sheffield. The symposium will be held in the Inox Dine area of the Student’s Union building.

For information about the Kettil Bruun Society, the Symposium, and to register, submit abstracts and book social tours, please click here.

To go straight to registration, please click here.

The conference is generously supported by the Insitute for Alcohol Studies, Alcohol Research UK, and the Society for the Study of Addiction.

The Kettil Bruun Society (KBS):

The principal aims of the Kettil Bruun Society (KBS) are to investigate social, epidemiological and cross-cultural research on alcohol use, to promote the exchange of scientific knowledge and experiences among researchers from various disciplines and to encourage international collaboration. The comparison of social and epidemiological developments found in different countries makes it possible to disentangle major trends from underlying patterns of alcohol use. This is particularly useful for the development of effective strategies to regulate alcohol use – an aspect which is of great interest to many countries.

The Symposium:

The primary purpose of the symposium is to provide a forum for researchers involved in studies on alcohol to exchange ideas about their ongoing research. The scope of the symposium includes studies of determinants and consequences of drinking, drinking culture and drinking patterns, social and institutional responses to drinking related harms, prevention and care. Empirical research, theoretical papers and reviews of the literature are welcome. Social and epidemiological studies have to be interpreted in a broad context as they include research in a variety of disciplines, such as psychology, sociology, criminology, economics, history and other sciences. Papers on other forms of substance use such as tobacco and drugs are also accepted, particularly papers considering the way they relate to alcohol use.

The symposium focuses on the discussion of papers that are pre-circulated electronically on this website. The author introduces the paper in a 10-minute segment, followed by prepared comments from a discussant and general audience participation. Any person submitting a paper may be asked to be a discussant or chair of a session.

Abstracts:

Please submit an abstract by 20 January 2017. The word limit for the abstract is 250 words and you should also include a conflict of interest statement and a maximum of three keywords (these are not included in the word count). For reports of empirical research, the abstract should be structured into sections: introduction, methods, results and conclusion.

All abstracts must include a conflict of interest statement. This should identify any author who has a relationship (financial or otherwise) which could be viewed as presenting a potential conflict of interest and give a full disclosure of this relationship.  If there are no conflicts of interest to report, please write ‘None’.

If you know in advance that you will only be able to attend the conference on certain days then please use the option in the submission form to indicate this and we will try to accommodate you when scheduling sessions.

 

Landmark report reviewing #alcohol policies across the UK! @NiamhCreate @VictimOfMaths @UK_AHA @A4UEvidence

UK Government’s alcohol policies are weaker than devolved nations!

The UK Government’s alcohol policies are weaker than those implemented by the devolved nations, a landmark report from the Universities of Stirling and Sheffield has found. Alcohol policies across the four UK nations vary widely in the extent to which they are grounded in scientific evidence, with political considerations appearing to have significant bearing, the research shows.

The report was commissioned by the Alliance for Useful Evidence and reviewed policies from the UK Government and devolved administrations against recommendations from Health First, the independent expert-devised UK alcohol strategy, in the first such audit of its kind.  Overall strategy, pricing, marketing and availability of alcohol were amongst the areas examined.

Scotland had the strongest approach overall, seeking to implement the most evidence-based policies, working to clear outcomes, and with a taskforce in place to monitor and evaluate the Scottish Government’s alcohol strategy.

By contrast, the UK Government did not support the most effective policies, made inconsistent use of evidence, and was the most engaged with the alcohol industry.

While Wales and Northern Ireland took strong positions in areas such as taxation and restrictions on young drivers, they have fewer legislative powers than the Scottish Parliament.

The report was co-authored by Dr Niamh Fitzgerald, at the University of Stirling and Colin Angus at the University of Sheffield.

Dr Niamh Fitzgerald, University of Stirling – Lecturer in Alcohol Studies

“Alcohol policy at UK Government level is in disarray, with it choosing to reduce taxation despite evidence that consumption and alcohol-related harms will increase as a result, putting even greater pressure on NHS and emergency services.

In contrast to the UK Government, the devolved administrations – especially Scotland – are taking steps to address the widespread harms due to alcohol, recognising that they are a ‘whole population’ issue. All four nations, however, engage in partnership with the alcohol industry, despite clear conflicts of interest and its history of failure to support those policies most likely to work.

Colin Angus, University of Sheffield – Sheffield Alcohol Research Group

“A clear illustration of the gap in effective policy across the UK relates to the marketing of alcohol. The devolved administrations have indicated support for mandatory action on product labelling, but the UK government has favoured self-regulation which has proven ineffective, with over 40 percent of products on the shelf still failing to meet the industry’s own best practice guidelines.

On alcohol advertising, a reserved matter, the devolved administrations have called for stronger regulation to protect children, but this approach has been rejected by the former UK coalition government. The Scottish Government is currently updating its alcohol strategy while the other devolved nations continue to progress evidence-based policies to reduce alcohol harms. It may be that they will call for greater powers to go it alone in bringing in effective policy options, if Westminster is not prepared to act.”

Peter O’Neill, Alliance for Useful Evidence – Evidence Exchange Manager

“Devolution in the UK provides opportunities for exchange of evidence and learning about what works through experimentation with different policies across the four nations. This report calls on administrations to support such learning, by engaging openly and maturely with the alcohol policy evidence, being honest about reasons for policy decisions, and robustly evaluating policy initiatives. Unfortunately, the report also suggests that alcohol policy may sometimes be underpinned by ideology more than by evidence, and is likely to be less effective as a result.”

Four Nations: How Evidence-based are Alcohol Policies and Programmes Across the UK? has been presented to representatives of the four administrations as part of the work of the British-Irish Council, which meets later this month.