Take action to reduce admissions for alcohol-related conditions
Stricter licensing laws can effectively reduce the consumption of alcohol among citizens. Alcohol is sometimes used by people to manage symptoms of anxiety and depression, but excessive drinking is likely to make those symptoms worse.
Overuse of alcohol can worsen the symptoms of many mental health problems and can lead to low mood and anxiety. Using alcohol in this way can mean that the underlying mental health issues aren’t addressed.
Depression is one of the most common mental health problems, with around one in ten people suffering in the UK in any year. Depression and heavy drinking have a mutually reinforcing relationship – meaning that either condition increases a person’s chances of experiencing the other.
Action for Central Government
1. Publish an Alcohol Strategy
Publish an Alcohol Strategy which should be based on the Alcohol Charter signed by 30 health bodies and includes calls to:
- Introduce Minimum Unit Pricing
- Launch a comprehensive review of alcohol duties
- Develop a government-funded programme of health campaigns
- Improve alcohol product labelling
- Introduce tighter alcohol marketing restrictions
- Improve alcohol licensing
- Invest in public health and treatment
Action for Local Authorities
1. Develop and deliver your own local alcohol strategy focused on licensing conditions.
Since 2013 upper tier local authorities in England have been responsible for public health, including the commissioning of substance misuse services, in addition to their existing powers to license premises for selling alcohol.
Many councils have used this combination to advance a ‘health in all policies’ approach to alcohol that has sought to support healthier drinking by imposing new conditions on alcohol licenses including:
- Restricting opening hours to 11am to 10pm
- Banning sale of ‘super-strength’ beer and cider, single cans of beer and cider and miniature bottles of spirits
Middlesbrough has an excellent five year alcohol strategy which draws on Public Health England’s evidence review, The public health burden of alcohol and the effectiveness and cost effectiveness of alcohol control policies, which summarises the research evidence for tackling alcohol related harm at a national, regional and local level. The review highlighted alcohol related harm is determined by alcohol consumption at an individual and at population levels. These are heavily dependent on availability (how easy it is to purchase alcohol, affordability (how cheap alcohol is), and its acceptability (social norms surrounding alcohol consumption).
Whilst local areas have a key role to play in addressing these three factors, the PHE review concluded that local action needs to be supported by policy changes at a national level. These include minimum unit pricing, alcohol taxation and price regulation, regulating availability, inclusion of health as a licensing objective, controlling the strength of alcohol, changes to drink driving limits.
This strategy has led to local actions that have improved alcohol related outcomes
2. Introduce minimum unit pricing on alcohol purchases
A study carried out by the University of Sheffield calculated that setting a minimum cost of 50p per unit would lead to ‘98,000 fewer hospital admissions, 3,000 lives saved and 40,000 fewer crimes[i].
Minimum Unit Pricing was (MUP) was introduced in Scotland in May 2018. An evaluation by NHS Scotland (2019) found that MUP was successful in reducing the amount of alcohol purchased by Scottish households particularly with lower cost higher unit alcohol beverages and in households that purchased the largest amount of alcohol[ii].
As a result, alcohol sales in Scotland fell to their lowest level since records began in 1994 in the first year that ministers set a minimum price of 50p per alcoholic unit, while in 2018, the volume of alcohol sold in Scotland fell 3 % from 2017.The Scottish Government estimates that if trends continue its minimum unit pricing (MUP) strategy will save 392 lives over its first five years.
What’s more, the price increases were greatest in households that bought the largest amount of alcohol (just under £3 per adult per week) and among the lower income groups, supporting the idea that MUP effectively targets those most at risk of harm from alcohol with a minimal impact on household budgets.
Newcastle City Council (2013) updated its licensing policy to encourage business owners applying for new licenses to introduce a minimum unit to all alcohol products of 50p per unit[iii].
A member of Newcastle City Council’s public health team was seconded for three days a week to the licensing department to support the review of the Statement of Licensing Policy (SLP). This provided extra capacity to carry out the review, which included gathering a range of alcohol harm data from responsible authorities, such as alcohol-related crime, violence and anti-social behaviour, domestic violence, hospital admissions, A&E attendances for assaults. For the first time, the review also looked at the numbers of premises licensed for alcohol and late night refreshments in different geographical areas. This triangulation of data helped determine which areas had the highest numbers of outlets and alcohol-related harm, thus enabling the SLP to incorporate five new cumulative impact policy areas in the city. Through an extensive consultation with the public the team were able to develop a stronger understanding of the impact of licenced premises on the community.
The MUP has been voluntarily adopted by a number of licensed premises with a positive impact on the city though of course this would be greatly strengthened if the UK government legislated to introduce MUP across England as it is in Scotland.