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THE NORTH EAST ALCOHOL OFFICE
Tackling Alcohol Harm in Durham
12 May 2015
Colin ShevillsDirector
THE NORTH EAST ALCOHOL OFFICE
THE NORTH EAST ALCOHOL OFFICE
Tackling alcohol harm
• The problem with alcohol
• Levels of harm
• Impact on the economy
• What the evidence says
• What the public thinks
• How we can work together
THE NORTH EAST ALCOHOL OFFICE
The trouble with alcohol …• World’s third leading cause of ill health and
premature death
• Linked to 60 different medical conditions – same cancer causing group as tobacco
• Significant contributor to crime and disorder
• One-third of offenders in NE alcohol dependent
• Linked to domestic abuse, child protection and self-harm
• Liver disease could overtake stroke and coronary heart disease as cause of death within 20 years
THE NORTH EAST ALCOHOL OFFICE
Biggest impact on vulnerable
• As many as 1 in 100 births affected by FASD
• 1 child admitted to hospital every day in NE
• Highest numbers under 18s in treatment
• Quarter male deaths 16-24 years due to alcohol
• Alcoholic liver admissions up 300% in under 35s
• Over 65 admissions doubled in 10 years
• Least affluent more likely to suffer harm• 45% more likely to suffer alcohol related death
• Almost three times more likely to end up in hospital
• 36% domestic violence cases - likely to be under -estimate
THE NORTH EAST ALCOHOL OFFICE
Industry vs Public Health
INDUSTRY MODEL
Problem – few bad people who can’t control themselves
Solution – partnership, education, enforcement
PUBLIC HEALTH MODEL
Problem – addictive drug irresponsibly produced, priced, promoted, sold
Solution - regulation
THE NORTH EAST ALCOHOL OFFICE
Impact in Durham
• 2 in 5 drinking at risky levels
• Alcoholic liver disease admissions up 46% in 6 years
• Wholly attributable admissions up 54% in 6 years
• Related admissions up 64% in 6 years
• Some improvement in last year:• Men’s specific admissions fell 8.7%
• Women’s specific admissions fell 6.4%
• Under 18 specific admissions fell 20.6%
• Effect of tax and duty cuts?
THE NORTH EAST ALCOHOL OFFICE
NHS: £50.35mCRIME & LICENSING: £51.82mWORKPLACE: £94.97m SOCIAL SERVICES: £16.70m
TOTAL COST+: £211.72m
+Total cost excludes crime related healthcare costs. The crime cost minus healthcare figure used for the adjacent pie chart is £49.71m
OVERALL COST PER HEAD COUNTY DURHAM: £413NORTH EAST: £419PUBLIC HEALTH ENGLAND(PHE) NORTH REGION: £413ENGLAND: £402
£98 £101
£185
£33
£102
£114
£169
£38
£88
£129
£168
£34
£77
£131
£167
£32
NHS Crime Workplace Social Services
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DDES costs for alcohol specific admissions –• Total - £3.5m• Ave per practice - £82,114• Total admissions – 2,096
All alcohol related admissions – • Total - £11.9m• Ave per practice - £282,519• Total admissions – 7,068
Economic Impact
THE NORTH EAST ALCOHOL OFFICE
What the Evidence SaysAFFORDABILITY
• Alcohol 61% more affordable than 1980
• NICE: “Making alcohol less affordable is the most effective way of reducing alcohol related harm”
• MUP (50p):• Targets children and heavy drinker
• Doesn’t penalise moderate drinkers or poor –80%+ lives saved from less affluent
• Would help community pubs
• Deaths down 960; crimes down 50,700; hospital admissions down 35,100
• Deaths fell 32% in British Columbia
after 10% increase in minimum price
THE NORTH EAST ALCOHOL OFFICEBBPA handbook
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Trends in liver deaths and alcohol consumption
Liver deaths %Packaged strong lager %Cider consumption %Wine consumption %White spirits consumption %Beer consumption %Whisky consumption %
% change since 1980
THE NORTH EAST ALCOHOL OFFICE
What the Evidence Says
AVAILABILITY
• Places selling alcohol doubled since 1950s
• NICE: “…making it less easy to buy alcohol … is another effective way of reducing alcohol related harm”
LICENSING ACT• Presumption to approve
• Move to off sales, pubs closing
• More inappropriate locations – soft play, multiplex cinemas
THE NORTH EAST ALCOHOL OFFICE
What the Evidence Says
PROMOTIONNICE: “…children and young people should be protected as much as is possible by strengthening the current [marketing] regulations”
LATEST
• 1 in 4 cinema ads for alcohol
• Children see more TV alcohol ads than adults
• Football on TV – 111 visual references to alcohol an hour
• UK has some of laxest regulation in Europe
THE NORTH EAST ALCOHOL OFFICE
What the Evidence Says
SCREENING and BRIEF ADVICE• NICE: “NHS professionals should routinely carry out alcohol
screening as an integral part of service provision …non-NHS professionals should focus on groups that may be at an increased risk of harm”
SPECIALIST TREATMENT• Treatment effective and cost effective – 1:5 ROI
• NICE, DH, Alcohol Concern all recommend c15% dependent drinkers should be in treatment
THE NORTH EAST ALCOHOL OFFICE
What does the public think?
• 50% support MUP – 31% oppose
• 7 in 10 support 9pm watershed TV ban and no ads in cinema unless showing 18 film
• 45% support restricting sports sponsorship – 32% oppose
• 99% say enough or too many places selling alcohol
• 80% support health warnings on product labels
THE NORTH EAST ALCOHOL OFFICE
What is NHS view?
Five Year Forward View:
• “The NHS will back hard-hitting national action on obesity, smoking, ALCOHOL and other major health risks”
• “NHS … can and should now become a more activist agent of health-related social change”
• “… we will actively support comprehensive, hard-hitting and broad-based national action to include information and labeling, targeted personal support and wider changes to distribution, marketing, pricing and product formulation.”
THE NORTH EAST ALCOHOL OFFICE
What can we do?• Support national action on pricing, marketing,
licensing, drink driving and labeling:
• Sign up to Local Alcohol Declaration
• Write to ministers
• Contact/meet your MP
• Write to media
• Support our campaigns: alcohol and cancer
• Promote on websites and in surgery
• Act as spokesperson
• Find case studies
• Make alcohol screening integral to service provision