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Minimising harm from alcohol misuse: Challenges to the development of effective policy
nTrance used under a Creative Commons 2.0 license
UNDERSTANDING HARMS AND COSTS OF ALCOHOL USE
John Moriarty
What harms accrue from Alcohol use?
Routes to estimation
• Aggregating individual-level harms
• Aggregating cost to the exchequer
• Comparing the harms born by the individual themselves to those born by others
Work Colleagues
Strangers
Family
Drinker
Friends
Household
Reproduced from Laslett et al. 2010, p.5
Which others are harmed?
What’s still missing?
• Peer influence and feedback loops
Work Colleagues
Strangers
Drinker
Friends
Children in Household
/ Family
Adults in Household
/ Family
Direct Harm
Social Influence
What’s still missing?
• Peer influence and feedback loops
• Thresholds where use becomes harmful
Work Colleagues
Strangers
Drinker
Friends
Children in Household
/ Family
Adults in Household
/ Family
Harm Threshold
What’s still missing?
• Peer influence and feedback loops
• Thresholds where use becomes harmful
• Harms born in the long versus short run
TRANSLATING RESEARCH ON ALCOHOL RELATED HARMS INTO EFFECTIVE POLICY
Andrew Percy
Reducing complexity
1. Reduce diversity2. Downplay continuity3. Dismiss social context
Do different patterns of teenage drinking produce different adult outcomes?
Hazardous drinkers
Heavy drinkers
Moderate drinkers
Occasional drinkers
Limited drinkers
UnitsHeavy
sessional drinking
Mental health SES
@ age 16 @ age 26
Controlling for a large range of childhood and adolescent confounders
Limited drinkers Occasional drinkers Moderate drinkers Heavy drinkers Hazardous drinkers-150
-100
-50
0
50
100
150
200
250
300
Fig 1: Differences in adult drinking across adolescent drinking groups (Males only)
Adolescent drinking group
Diffe
renc
es in
uni
ts co
nsum
med
at a
ge 2
6
How different is teenage drinking from adult drinking?
Teenagers drink to be sociable, to celebrate, to commiserate, to relax, to have a good time with friends.
Just like adults
How different is teenage drinking from adult drinking?
For most teenage drinkers, passing out, being sick, getting into fights, having to be looked after by your friends are all highly embarrassing incidents.
Just like adults
How different is teenage drinking from adult drinking?
Teenage drinkers use a range of strategies to regulate their consumption developed through trial and error.
Does social context (people and places) matters in alcohol related harms?
We collect data from individuals, we analyse individuals, we graph individuals, we design interventions for individuals.
BUT
Teenage drinking is done in groups
Implications?
Implications
Teaching drinking skills to moderate teenage drinkers to reduce harms associated with acute intoxication
Reducing consumption amongst heavy and hazardous drinkers
Providing interventions for groups of teenagers
Recognise and embrace the complexity of
teenage development
St Stev creative commons license