Alcohol Awareness Week 2023

Every year, Alcohol Change UK organise Alcohol Awareness Week. This year, the theme is ‘cost’.

The cost of alcohol to society is unacceptably high. These costs shouldn’t – and wouldn’t – be so high with the right interventions and, as ADPH Policy Lead for Addiction, I want to highlight some of the key issues currently preventing us from tackling both the financial – and human – cost.

First though, it is worth outlining the sheer scale of the issue. Billions of pounds are lost every year in costs associated with the police, ambulances, NHS care and absence from work – all as a result of alcohol use.

The statistics are shocking. For example, 17 million working days are lost each year in the UK because of alcohol-related sickness, costing the economy around £7 billion. Half of police workload is alcohol related. At peak times, 70% of Emergency Department attendance is estimated to be alcohol related and 40% of ambulance time is spent on alcohol related incidents.

Not only does it cost in terms of staffing and resources, but it also means our emergency services are unable to respond to other calls in a timely way.

In total, picking up the pieces from alcohol is estimated to be costing the UK economy between £27 – £52 billion.

There is also of course an unquantifiable human cost of lives lost and health problems as a direct result of alcohol use, along with financial worries, relationship breakdowns and more.

Alcohol kills 70 people per day – a figure that has increased by almost a third since 2019. Alcohol is also a big driver of health inequalities, killing twice as many people living in more deprived areas than in affluent parts of the country.

It is the leading risk factor for death, ill-health, and disability amongst 15–49-year-olds in England and is linked to at least seven types of cancer. In fact, recent data suggests that 4% of all new cancer cases are caused by drinking alcohol.

It is important to remember that it is not just people who drink who are at risk. One in five children live with a parent who has an alcohol use disorder, and these children are six times more likely to experience domestic abuse, three times more likely to consider suicide and twice as likely to go on to develop an alcohol use disorder themselves.

These staggeringly high societal – and personal – costs have increased significantly since the start of the pandemic and, as we grapple with the cost-of-living crisis, it shows no sign of abating. In fact, early evidence has already indicated that there has been a further increase in harmful drinking for those already drinking at higher levels.

Why then is the situation so bad? Currently, we live in an alcogenic society, where the interests of the alcohol industry are put ahead of the population’s health needs.

Of course, alcohol brings certain economic benefits, particularly for the night-time economy. However, as I’ve outlined, the negative impact far outstrips the £12 billion revenue gained from alcohol duties (HMRC, 2019).

Interestingly, since the pandemic, the pattern of drinking has also changed with people saying they are much more comfortable drinking at home alone. Real terms cuts to alcohol duty over the last decade have made alcohol 14% more affordable and 42% of people now say they only drink at home and tend to buy cheap supermarket bulk buys – doing nothing for the night-time economy.

There is no single silver bullet. Interventions are needed so that we can help those people who are being harmed, or who are at risk of harm, right now as well as preventing future harm. To do this, we need to ensure that changes are made that transform our society into one where health, as opposed to industry profit, is put at the heart of decision making.

These sorts of interventions should not be based on individual choice or ‘responsible drinking’. Rather, they need to be population-level measures that limit the influence of industry, tackle affordability, decrease availability and curb promotion of alcohol.

There is now clear evidence from Scotland, where Minimum Unit Pricing was introduced in 2018, that MUP saves lives, reduces hospital admissions and reduces overall alcohol consumption. In addition, health inequalities are reduced, with the majority of lives saved in Scotland among people living in the country’s most deprived areas.

Furthermore, despite concern from the alcohol industry, the evidence shows that there have been no significant negative impacts on alcohol producers or sellers because of MUP.

Evidence also shows that exposure to marketing encourages children and young people to start drinking at an earlier age, increases the likelihood of engaging in riskier drinking habits, and can trigger relapses in those with alcohol dependence.

Yet, despite the clear link between marketing to children and resulting harm, our children are exposed to alcohol advertising and promotions on a daily basis – on tv, on the radio, on the internet, at sports and music events and at the entrance and checkouts of countless shops up and down the country.

Labelling too is important. Currently, only a small minority of alcohol products display the up-to-date guidelines from the Chief Medical Officer (CMO) meaning that many people drink alcohol without knowing, or understanding, the potential for harm.

There is also a wealth of evidence to demonstrate that public awareness campaigns should be at the heart of any population wide, preventative approach to alcohol harm reduction.

In the North East, where I am a Director of Public Health for Gateshead, campaigns to highlight the links between alcohol and health harms have resulted in a significant increase (from around 17% to 39%) in unprompted rates of awareness of the links between alcohol and cancer (2019).

Of course, as well as creating the right environment for the future, we need to support people now. To do that effectively, we need good quality, well-funded alcohol treatment that is stigma free and easy to access. While such treatment exists, numbers accessing it are now lower than 2013/14 and over 80% of people who need treatment aren’t currently being supported. More funding is desperately needed to be able to provide treatment to these – and more – people.

None of these changes can be made while the alcohol industry exerts the degree of influence it currently does. However, there is hope. We have been in this situation before – with tobacco.

We knew smoking killed, we knew the tobacco industry used clever tactics to promote its products and together with the public, we called them out. Governments across the world listened and, although there is still further to go, as a result, tobacco harm is significantly reduced.

Alcohol has similarly devastating impacts on public health and is similarly driven by an industry that profits by causing harm, with two thirds of alcohol sales made to heavy drinkers.

As was the case with tobacco, the public agree.

In a survey in the North East in 2020, over half of those asked believed the Government should be doing more to tackle the social harms caused by alcohol, 76% saying that alcohol labelling should include health warnings and 75% there should be measures to limit children and young people’s exposure to alcohol advertising. Meanwhile, over half said they would welcome the introduction of an MUP.

So, this week as too many families mark Alcohol Awareness Week by remembering loved ones who have died, our ask to Government is simple.

Listen – and act.

Listen to the evidence, listen to the public and listen to the thousands of health and social care workers who have seen first-hand the devastating effects alcohol harm has on individuals, families, communities and the economy.

Now Act. Restrict marketing, restrict promotions and increase price and together, we can drive down the unacceptable – and spiralling – cost of alcohol harm.