Demos Daily: Sobering Up
It’s official. After months without being able to go for a pint at the local with friends, the Prime Minister has announced that pubs will finally be re-opening at the beginning of July. Pubs are an integral part of communal life in British culture – and for many, this will be a moment of joy with a chance to reignite social lives, celebrate special occasions, or simply to regain the feeling of freedom. But as the sector opens its doors again, we shouldn’t forget some of the alcohol-related problems that can come with it. Back in 2013, our report Sobering Up looked into some of Britain’s alcohol-related problems such as binge drinking, dependent drinkers and underage drinking. We argued that local partnerships are fundamental in tackling Britain’s drinking culture.
Read the introduction of Sobering Up below, or the full report here.
Introduction
It is often argued that Britain has a drinking problem. The most frequently cited statistics to demonstrate this are a rise in hospital admissions where alcohol is the primary factor by 40 per cent since 2002/03, and a rise of alcohol-related deaths by 22 per cent since 2001.5 According to the National Treatment Agency, 1.6 million people in the UK have some form of alcohol dependency, though it is unclear how this figure is arrived at. (1) Alcohol-related harms are estimated to cost the UK around £21 billion each year according to an impact assessment by the Home Office. (2) Of this amount £11 billion is the cost of alcohol-related crime, and most of the remainder is the cost of short-term and long-term health treatments for alcohol-related illness.
However, Britain’s relationship with drink is more complicated than these figures suggest. Recent stats show that alcohol consumption in the UK is actually declining overall. According to the General Lifestyle Survey (by the Office for National Statistics) the number of men who reported drinking alcohol in the last week fell from 72 per cent in 2005 to 66 per cent in 2011, while the number of women drinking in the last week fell from 57 per cent in 2005 to 54 per cent in 2011. The most dramatic decline can be seen among young men aged 16–24 for whom this proportion fell from 64 per cent in 2005 to 52 per cent in 2011. (3) There is also evidence that there is a fall in levels of underage drinking. According to a 2010 NHS report the percentage of pupils aged between 11 and 15 who drank alcohol in the last week fell from 26 per cent in 2001 to 13 per cent in 2010. (4) Some of this may be due to the changing demographics of the UK – including the rising percentage of young British Muslims who do not drink alcohol – but the decline is nonetheless significant.
This important decline in the numbers of people drinking in Britain too often goes unnoticed amid the headlines of binge drinking. It is also important to bear in mind that the alcohol industry generates a huge amount of consumption and export business in the UK. Alcohol is deeply ingrained in British culture as an integral part of celebration and communal life, and most people consume alcohol responsibly and in a way that enhances their quality of life.
Yet, it is clear that there are some areas of the UK that suffer from very high levels of consumption, and high levels of particular harms, such as underage drinking, alcohol-related crime and antisocial behaviour as part of the night-time economy, or chronic alcoholism. For example, the 2012 local authority profiles revealed that Birmingham, Manchester and Leeds experience the highest numbers of alcohol-related crimes in the country, while County Durham, Liverpool, Birmingham and Leeds rank the worst for the number of under 18s admitted to hospital with alcohol-specific causes. (5)
Frequently the issues that generate the most headlines are the harms associated with binge drinking and the night-time economy. It is often argued that the current generation of young people drinks to excess and considers the exploits of their excessive drinking as a badge of honour. A number of reasons are given for this phenomenon, from increasing numbers of women drinking to excess, to the role of social media. The Government and many in the health industry blame the easy availability and cheap price of certain alcohols. At the very least, they argue that increasing the price of some alcohols and restricting availability could help to mitigate the culture of excessive drinking. The Government also blames a preloading culture, whereby young people drink at home before going out. This is arguably reflected in the alcohol-related harms that appear to be on the rise over the past decade, including alcohol- related hospital admissions, alcohol-related crime and chronic alcoholism. In 2010/11 over 1 million alcohol-related violent crimes were recorded, and there were 1,168,300 alcohol-related hospital admissions, (6) although the link between the preloading phenomenon and these harms is not necessarily clear.
In the first chapter of this report, we set out the policy options under consideration by the UK Government, the Scottish Government and local authorities to tackle these alcohol-related harms. The centrepiece of the UK Government’s latest national alcohol strategy was a minimum unit price for alcohol of 45p, following the Scottish example of a minimum unit price of 50p. The policy was recently put on hold amid debates over its effectiveness and the disproportionate impact it would have on those on lower incomes.
In its place, the Government is pushing for alcohol producers and retailers to make changes to the way alcohol is produced and sold. With the creation of Public Health England, the Government has also devolved alcohol policy to local author- ities and local health and wellbeing boards. This raises the possi- bility of a diversity of different approaches, each tailored to a local area’s particular issues. This makes it more important than ever that local authorities and those responsible for alcohol policy are aware of the evidence about the most effective approaches.
This report highlights the evidence of effectiveness for the three core problems cited above: underage drinking, binge drinking and the night-time economy, and dependent street drinking. We do not claim that these issues are rampant or widespread across all of the UK. Rather they can be unique and specific to certain local areas and neighbourhoods. Where these issues exist, it is important that efforts to tackle them are targeted and evidence-based as far as possible. We were also particularly interested in the role of local shops in tackling these problems. Local shops are sometimes forgotten, or considered as an afterthought, in the pitched battles of national debates over issues like minimum unit pricing, but this may be about to change as advocates on regulatory intervention shift their focus from issues of price to availability.
This report
Overall, there is very little research into the role of the off-licence trade in tackling alcohol-related harms. This report addresses this evidence gap. In addition to a detailed review of pre-existing evidence, we undertook original primary research with local shops across the country in order to look at what local shops are doing to tackle some of these problems. As licensed retailers, local shops are required to undertake certain actions consistent with being responsible retailers. But there are very few hard data looking specifically at how well local shops adhere to and go above and beyond these commitments.
Because of the place-based nature of alcohol harms, we conducted fieldwork in four case-study locations: Ipswich, Blackpool, Manchester and Edenbridge (Kent). We interviewed a number of key stakeholders in each location, including police, trading standards officers, councillors and public health officials, as well as local shop owners. In each interview we asked a range of questions about local alcohol-related problems and initiatives to tackle them, how local shops contribute to these efforts, and what more they should be doing.
The case-study locations were chosen for their size, geographical spread, experience of specific alcohol-related problems, as well as interesting initiatives in the area involving off-licence shops that aimed to tackle a specific issue. We wanted to learn what were the driving factors behind those initiatives, and how could they be replicated elsewhere.
Ipswich is home to the campaign Reducing the Strength, where local shops are invited by Suffolk police to remove from their shelves the cheap, high-strength alcoholic drinks associated with the town’s problem with dependent drinking. Areas of Ipswich suffer from high levels of deprivation, and Ipswich is the 72nd most deprived local authority out of 294. The Reducing the Strength campaign is often cited as a model for tackling what are seen as problematic alcohol products in lieu of a minimum unit price.
Blackpool was chosen because of its reputation and substantial night-time economy, often involving stag and hen parties. It also has significant issues with dependent drinking and poverty, especially in the Bloomfield ward where we concentrated our research. It has the highest alcohol-specific mortality for males and females in the UK. There are a total of 1,900 licensed premises in Blackpool, which is approximately 1 for every 72 residents.
Manchester is the largest of our case-study areas. As with any city of its size, Manchester has a mix of alcohol-related problems including those related to its vibrant night-time economy. We concentrated our research in the city centre, and also the Fallowfield ward, which has a high student population. The city ranks 9th worst for binge drinking across 326 local authorities.
Edenbridge is a small rural town in Kent with a population of less than 8,000. It served as a pilot site for a Kent Community Alcohol Partnership in response to problems of underage drinking. It has only a small number of licensed premises, and compared with our other case-study areas it has relatively low levels of alcohol-related problems.
Across our case-study areas we interviewed a total of 30 stakeholders, and 26 local shop keepers. We conducted an additional 17 telephone interviews with off-licence retailers across the country, including small independent shop owners and the managers of larger chain stores and branches of the Co-operative. We also added six questions to the ACS Voice of Local Shops national survey of August 2013, which reached 1,116 independent shops (both symbol group franchises and non- affiliated independents). These questions were on the extent to which shops experienced alcohol-related problems as well as their relationships with key stakeholders.
(1) NHS, ‘Alcohol Treatment in England, 2011–12’, 2013, www.nta.nhs.uk/uploads/alcoholcommentary2013final.pdf (accessed 18 Nov 2013).
(2) House of Commons Library, ‘A minimum price for alcohol?’, Commons Library standard note, SN/HA/5021, 2013, www.parliament.uk/briefing-papers/SN05021/a-minimum-price- for-alcohol (accessed 13 Nov 2013).
(3) ONS, General Lifestyle Survey, 2011, Office for National Statistics, 2013, www.ons.gov.uk/ons/rel/ghs/general-lifestyle- survey/2011/index.html (accessed 18 Nov 2013).
(4) E Fuller (ed), Smoking and drinking and drug use among young people in England in 2010’, National Statistics and NHS Information Centre, 2011, https://catalogue.ic.nhs.uk/ publications/public-health/surveys/smok-drin-drug-youn-peop- eng-2010/smok-drin-drug-youn-peop-eng-2010-rep1.pdf (accessed 9 Oct 2013).
(5) Local Alcohol Profiles for England, 2012, www.lape.org.uk/ data.html (accessed 18 Nov 2013).
(6) House of Commons Health Committee, Government’s Alcohol Strategy: Third Report of Session 2012–13, HC 132, London: House of Commons, 2012, www.publications.parliament.uk/ pa/cm201213/cmselect/cmhealth/132/132.pdf (accessed 18 Nov 2013).