Taking Action on Alcohol Harm the role of legislation Thursday, - PowerPoint PPT Presentation

Taking Action on Alcohol Harm the role of legislation Thursday, April 15, 2010 - Stobart Stadium, Widnes

A local perspective of the impact of alcohol Andrew Bennett NHS Wirral and Centre for Public Health 3

Taking steps to rethink Taking steps to rethink drink drink ‘The cause of death is birth, and on your way there ‘The cause of death is birth, and on your way there you might want to enjoy things ….” you might want to enjoy things ….” David Hockney, David Hockney, 4

Balanced picture? Balanced picture? 126,000 cases of Each year alcohol is a factor in: Around 1 million assaults 33,000 admissions to 5 Domestic Violence a year hospital for liver disease BCS, Kershaw et al 2008; Jones et al, 2008

That was then … That was then …   Alcohol available in Alcohol available in pubs and off licences pubs and off licences only only   Lower strength Lower strength   Relatively more Relatively more expensive expensive   First drink tasted nasty First drink tasted nasty   Drunkenness in public Drunkenness in public frowned on particularly frowned on particularly for women for women   Drinking and driving Drinking and driving was legal was legal 6

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We’re drinking more We’re drinking more alcohol… alcohol… …strength & volume …strength & volume One small glass wine (125ml) 8% = 1 Unit Standard pint beer One large glass wine 4%=2 Units (250ml) 14% = 3.5 Units Strong pint beer 6.5%=3.5 Units 8

It’s more available It’s more available Number of on- and off-licensed premises: England & Wales, 1963-2004 170,000 160,000 150,000 Number of premises 140,000 130,000 120,000 110,000 100,000 90,000 Year Fierce competition between supermarket chains has led to discounts and promotions 9

It’s cheaper in real terms It’s cheaper in real terms Since 1980 the real price of alcohol has fallen by nearly 70% in the UK. Alcohol can now be bought for as little as 11p a unit 10

Drunkenness is encouraged Drunkenness is encouraged • Sales from off-licenses and supermarkets increasing • Social acceptability of drunkenness • Price and availability • Promotions Bar = £2.50–£3.00 Supermarket = £0.60- 11 £0.70

Home drinking Home drinking  Research limited  Growing trend  Women are a key growth area  Now more popular than the pub 12

Unsafe levels Unsafe levels   33% of men and 16% of women (24% of 33% of men and 16% of women (24% of adults) drink above the NHS’s sensible adults) drink above the NHS’s sensible drinking guidelines. drinking guidelines.   This includes 6% of men and 2% of women This includes 6% of men and 2% of women estimated to be harmful drinkers, which estimated to be harmful drinkers, which means that damage to health is likely. means that damage to health is likely.   Among adults aged 16 to 74, 9% of men and Among adults aged 16 to 74, 9% of men and 4% of women show some signs of alcohol 4% of women show some signs of alcohol dependence. dependence. 13

40% women & 45% men drink to unwind after stressful day 14 Of women that drink hazardously - 81% do so to relieve stress Know Your Limits/YouGov; Netmums, 2008

Going out to get drunk 70 70 Females Males Females Males 60.7 60.7 60 60 51.1 51.1 50 50 44.6 44.6 37.6 37.6 40 40   30 30 Pilot study in three UK Pilot study in three UK cities cities 20 20   Heaviest drinkers are Heaviest drinkers are 10 10 excluded excluded 4.3 4.3 1.7 1.7   53.3% pre-loaded 53.3% pre-loaded 0 0   1 in 10 plan to consume 1 in 10 plan to consume In daily In daily In weekly In weekly Over Over limits limits weekly limits limits weekly over 40 units over 40 units limits limits 15 Planned consumption in one nig Planned consumption in one nig

Alcohol harm in the UK Alcohol harm in the UK  9000 deaths per year - increasing by 10% each year  Alcohol-related illness or injury currently accounts for nearly a million hospital admissions per year - also increasing  Most people who will die from drinking are not alcoholics. Their health is damaged from regularly drinking too much over a number of years 16

Diseases attributable to alcohol  Cancer of the  Lip/Oral Cancer Larynx 29% 28%  Haemorrhagic  Breast Cancer Stroke 24% 7%  Fire Injuries  Cardiac 38% Arrhythmias 25%  Alcoholic Liver  Disease 100% Spontaneous  abortion 22% Epilepsy 54%  Intentional Self- Harm 34% 17

Every minutes …… someone in the North West is admitted to hospital because they have drunk too much alcohol 18

What’s the true cost of a drink? What’s the true cost of a drink?   1.2m violent incidents (around 1.2m violent incidents (around 50% of all violent crimes) 50% of all violent crimes)   One in 3 intimate partner violent One in 3 intimate partner violent incidents committed under incidents committed under alcohol. 125,000 cases a year alcohol. 125,000 cases a year   Up to 1,000 suicides Up to 1,000 suicides   39% of deaths in fire 39% of deaths in fire   15% of drownings 15% of drownings   One in seven road traffic deaths One in seven road traffic deaths   Up to 1.3m children affected by Up to 1.3m children affected by Alcohol costs the economy up to £20 billion a year 19 parental alcohol problem parental alcohol problem

Children and young people Children and young people   By 15 years most children have drunk By 15 years most children have drunk alcohol alcohol   Hospital admissions among 15-19 year Hospital admissions among 15-19 year olds from alcohol increased 68% olds from alcohol increased 68% between 2003 and 2007 between 2003 and 2007   The majority of 15-16 year olds (71%) The majority of 15-16 year olds (71%) associate alcohol consumption with associate alcohol consumption with • Early age of starting drinking is positive consequences and having fun positive consequences and having fun associated with higher rates of problematic drinking in adulthood and a wide range of other adverse consequences 20

How much do we really drink? How much do we really drink?  31% men & 20% women exceed weekly limits  Of all drinkers, 1 in 4 men & 1 in 5 women exceed by twice the sensible daily limit   Abstainers - approx 14% adults Abstainers - approx 14% adults   Drinkers weekly units (mean) Drinkers weekly units (mean)   by Survey = 16 by Survey = 16   by Sales (Taxation) = 26 units by Sales (Taxation) = 26 units Excludes - Illegal sales, personal imports, consumption abroad, home Excludes - Illegal sales, personal imports, consumption abroad, home brew (last estimated at 4 units/week) brew (last estimated at 4 units/week) 21 Bellis et al , In prep, HM Revenue and Customs, General Household Survey 2006

What do adults recommended limits mean? What do adults recommended limits mean? Daily consumption and Lifetime Risk of dying from an Alcohol Related Disease 10 Lifetime risk per 100 drinkers Males Females 9 8 3 doubles 7 a night 6 for 2 5 Sensible means 4 1 in 100 die 3 2 1 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 units pure alcohol per day I gnores risks associated with accidents, violence, other collateral damage 22 Australian National Health and Medical Research Council ,2009

NHS campaign reveals unseen alcohol damage You are 50% more likely to get breast cancer and twice as likely to have high blood pressure, which could lead to a stroke or a heart attack, if you’re a woman regularly drinking two glasses of wine or more a day You could be three times more likely to have a stroke and three times more likely to get mouth cancer if you’re a man regularly drinking more than two pints of lager a day 23

Our alcohol challenge Our alcohol challenge   Consumption has risen steadily during Consumption has risen steadily during the last two decades the last two decades   Women now drink as much as men Women now drink as much as men   Acceptability of drunkenness Acceptability of drunkenness   Alcohol is very cheap Alcohol is very cheap   Heavily advertised Heavily advertised   Drink at home Drink at home   Available 24/7 Available 24/7 24