But officials believe the 40p rate strikes the right balance, hitting the sale of cheap drink while not being too punitive for consumers. Nonetheless, the SNP faces a struggle to get its plans through parliament, with neither the Tories, the Liberals or Labour yet having committed to the principle of minimum pricing. The 40p rate may also fail to satisfy medics, many of whom believe only a 50p per unit rate will adequately cut drinking. A report in the medical journal the Lancet found last week that such a rate would cut heavy drinkers' intake by 10%".  Full story here.

The University of Sheffield last year carried out a review of alcohol pricing and promotion for the Department of Health.  Reports here (under Research).  The government says it is 'evaluating the findings' but seems reluctant to come to the same conclusions as the SNP.

• 1 in 20 (2,882) deaths in Scotland in 2003 were estimated to be attributable to alcohol, twice as many as previously reported
• Men were more likely to die an alcohol attributable death - 6.8% of all male deaths were estimated to be alcohol attributable compared to 3.3% for women
• Deaths were proportionately higher in younger age groups with 1 in 4 of men and 1 in 5 of women aged 35-44 dying an alcohol attributable death
• Over a thousand deaths were in people under the age of 55 (1080). Younger people were more likely to die from an acute consequence (such as injury) whereas older people were more likely to die from a chronic condition. However, 1 in 10 of all deaths in those aged 35-44 were due to alcoholic liver disease.
• Alcohol problems also cause a considerable burden to the health care system, accounting for over 1 in 20 of all patient-specific (hospital) discharges in 2003.  This is 50% higher than routine statistics which are based on wholly attributable conditions
• Men were more likely to have an alcohol attributable hospital discharge than women, 1 in 10 of all male discharges in Scotland were estimated to be alcohol attributable compared to 1 in 20 for women

• Module 1-Policy & Practice
• Module 2-Understanding & Evaluating Addiction Treatment

Details of current fees, pre-course workshops and availability are available here.

From today we will be posting more frequently on APUK, to coincide with the development of the AERC Alcohol Academy which launched last month (full details to come shortly).  If you can't get to the site every day, you can get these posts by email (max one per day) by signing up here.  Alternatively, we can email you a weekly digest; simply email us to request this.  Our RSS feed is http://feeds.feedburner.com/AlcoholPolicyUk.  We have also started Twittering again now that more people are using this service.  Follow us at alcoholpolicyuk or Vodafone users can text "follow alcoholpolicyuk" to 86444.

Alcohol Academy discussion list

We have set up a discussion list/forum for local alcohol coordinators and strategic leads.  It is restricted to those people at present, and has had a lot of interest and good debate.  To subscribe, send an email with your details to forum-subscribe@alcoholacademy.net

Alcohol Misuse discussion list

Rowdy Yates from the Scottish Addictions Studies unit at Stirling University runs this list, and posts frequently with research news and information.

This is a free list, open to anyone with an interest in alcohol-misuse and its treatment, including:

• staff working in alcohol treatment services
• service users in alcohol treatment services
• academics and students studying alcohol misuse

Joining the list is free and allows you to contact over 100 list members with an interest in alcohol misuse. The list is useful for: keeping in contact with friends and colleagues;  discussing issues; receiving e-mail alerts for all English-language addiction journals;  announcing conferences, events, job vacancies etc; asking for information and advice.  Sign up here.

Rowdy has also asked us to mention The Scottish Addiction Studies On-line Library, a major internet-based resource for: policy makers,  service planners, managers, practitioners, teachers, researchers, students and service users.  Initially established as a resource for on-line students at the University of Stirling in Scotland, the library was made publicly available 7 years ago. It offers access to over 7,500 full-text documents.  Unlike many other on-line libraries, the Scottish Addiction Studies On-line Library specialises in full text documents, reports and books.  During the course of the next two years, the library collection will be increased and the structure will be enhanced to include a section on journal articles and a section on therapeutic communities. 

Also see:
European Federation of Therapeutic Communities (EFTC) on-line discussion list  details here


European Working Group on Drugs Oriented Research details here

However many groups such as the BMA reject this argument based on research that shows the limited impact a minimum price would have on moderate drinkers - in research drawn up by the university of Sheffield "Moderate drinkers would only pay an extra £12 a year, whereas a harmful drinker, because they buy so many more units, would pay an extra £163 a year." (see story here).

However not all GPs at the BMA conference supported the motion with accusations of 'nanny-state politics', as highlighted in reports from the Daily Telegraph and The Guardian.

Earlier in the year the Chief Medical Officer called for a minimum price in his annual report which was widely backed by health professionals. Scotland are also set to move forward with minimum pricing measures.

Instead Brown's government have focused on increasing duty and a new mandatory code. The code plans to ban irresponsible promotions  and take other measures such as ensuring pubs and bars offer smaller measures. The proposals are currently out for consultation until 5th August 2009. A short Alcohol Concern survey is also available on the code.

See here for the BMA's 'Memorandum of evidence from the BMA to the Health Select Committee inquiry on alcohol'

• Alcohol Co-ordinator (Ref: CA0656C)
• Salary: PO1 £27,573 - £35,953 per annum
• Hours: 37 per week
• Location: Gun Wharf, Chatham
• Closing date: 17 July 2009.

01634 333147

01634 333333

01634 332843

These events "will inform the future development of this policy in order to ensure that it gets the balance right by achieving reductions in alcohol related harms such as nuisance, crime and disorder, public safety, protection of children and the health impact, in a targeted and proportionate way that does not harm businesses that are behaving responsibly."

The dates are:

• Newcastle 7 July
• Hull 9 July
• Liverpool 14 July
• Nottingham 16 July
• Birmingham 21 July
• Cambridge 23 July
• Portsmouth 28 July
• Cardiff 30 July
• Weymouth 4 August
• London 6 August

Details and registration here.

The APPG report largely considers the ongoing challenges for alcohol treatment as it continues to be under-resourced to varying degrees across the country. This comes despite the increased profile of alcohol-related harm though does recognise some gains for alcohol provision. However the report estimates that on average only 0.1% of Primary Care Trusts' total annual expenditure is spent on alcohol services.

Last year the National Audit Office produced an extensive review of alcohol treatment services with similar findings and recommendations to improve strategic planning and resourcing for alcohol services.

Key recommendations of the All Party Parliamentary Group:

• Government needs clear cross-departmental leadership to tackle England's growing alcohol problem.
• Government needs to measure alcohol harms differently, by targeting a reduction in heavy drinking amongst all age groups and a reduction in alcohol-related crime as well as hospital-related admissions. All primary health care services should understand and be able to deliver Screening and Brief Interventions (SBI).
•  All PCT areas should have effective specialist alcohol services which are accessible to local communities.
• Specialist alcohol treatment must meet the needs of all those affected by alcohol misuse.
• There needs to be clear protocols and pathways in place to tackle alcohol misusers with more complex needs.
• In order to tackle alcohol harms, PCTs must understand the scale of the problem they are facing and share data as required.
• The Department of Health should update and reissue existing guidance and support implementation with regional training.
• There needs to be an ongoing training programme for alcohol commissioners.
• Strategic Health Authorities must ensure that PCTs are assessing need in their area and commissioning alcohol treatment commensurate with that need.
• Clear guidelines are required about how different parts of the alcohol treatment sector are to work effectively together.
• The National Institute for Health and Clinical Excellence (NICE) should look at how the Quality and Outcome Framework (QOF) for GPs can be amended to help tackle alcohol misuse.
• Access to accurate alcohol misuse and dependency data must become a priority for the Department of Health.

• 80% of NW respondents said they thought low price and discounts increased people’s drinking;
• 75% of NW respondents believe large measures are key to increased drinking;
• 68% of NW respondents say allowing street drinking increases alcohol use;
• Over half of NW respondents believe advertising (56%) and extended drinking hours (54%) are factors that increase drinking;
• Nearly half the NW respondents avoid town centres because of the drunken behaviour of others

Big Drink Debates are being rolled out as Social Marketing projects that are recommended as one of the Department of Health High Impact Changes for reducing alcohol-related harm. See the National Social Marketing Centre for guidance.

A new Home Office binge drinking campaign is also running this summer as part of the national Know Your Limits social marketing campaign.

The key findings of the report include:

• Young people in the capital are less likely to drink, and less likely to get drunk than young people elsewhere in the country.
• More than a third (35 per cent) of Londoners aged 11-21 drank regularly in 2005-06.
• Londoners aged 11-15 now drink around 307,391 units of alcohol a week
• 11-15 year old women now have similar drinking habits to young men of the same age.
• Around 80 to 90 per cent of 17-21 year olds have ever had an alcoholic drink, compared to 15 per cent of 11 year olds and 60 per cent of 15 year olds.
• In 2005-07, ten per cent of Pakistani and 12 per cent of Bangladeshi young people drank at least once a year (up from 4% and 2% respectively in 2001-04).
• Alcohol-specific hospital admissions for 11-21 year old Londoners have almost doubled in recent years. In 2006, there were 1315 hospital admissions for 11-21 year olds, compared to 690 in 2002 – an increase of 91 per cent.
• The alcohol-specific hospital admission rate for young women (at 14.0 admissions per 10,000) was almost twice as high as the rate for young men of the same age (at 7.4 admissions per 10,000).
• In 2003, there were 1,272 incidents where 11-21 year olds were accused of alcohol–related offences, compared to 2,370 in 2007; nearly double.
• Underage drinking was the least frequently reported issue in a survey on alcohol-related disorder conducted with community safety staff in London boroughs.

Recommendations (summary):

1. The Greater London Alcohol and Drugs Alliance (GLADA) should monitor the alcohol consumption of young Londoners between 2009 and 2012 to assess whether recent increases in drinking among young women and among young Pakistani and Bangladeshi Londoners are part of ongoing trends.
2. The Mayor should commission an immediate review of GLADA’s membership, resourcing and remit to ensure it can effectively implement the Regional Statement of Priorities for Alcohol and provide strong regional leadership on alcohol misuse.
3. The Mayor should outline initiatives to tackle the disproportionate impact of alcohol on the health of people from deprived communities in his upcoming Health Inequalities Strategy.
4. By March 2010, London boroughs where alcohol-specific hospital admissions for under-18s are higher than the national average (currently Kingston and Sutton) should appoint an alcohol harm reduction champion.
5. A London borough and local police service working with the Retail of Alcohol Standards Group should pilot the St Neots community alcohol partnership model to reduce alcohol misuse by under 18s during 2009/10. Representatives of both the on- and off-licence trade should be engaged in this partnership.
6. The Department for Children, Schools and Families and the Qualifications and Curriculum Authority should ensure that alcohol education is effectively covered in the mandatory PSHE curriculum, currently under development. Alcohol should be given the same prominence in this curriculum as drugs, and the focus should be on how to reduce alcohol harm. The curriculum should cover how and why alcohol tolerance varies between men and women. It should also include first aid techniques, so that young people know how to help in emergencies such as a friend collapsing because of alcohol.
7. By June 2010, The Department for Children, Schools and Families and the Home Office should run a national FRANK campaign around alcohol that focuses on the consequences of drinking, and also promotes the information FRANK can provide about alcohol and local services.
8. By December 2010, GLADA should co-ordinate a London wide social marketing campaign that aims to reduce alcohol harm, in association with external partners. The campaign should target groups including parents and carers, young women aged 11-15 and young Pakistani and Bangladeshi Londoners.
9. By March 2012, NHS London should ensure that Screening and Brief Intervention Initiatives are in place at every London Accident and Emergency Department, and available to adults and to young people. A detailed evaluation of the impact of Screening and Brief Interventions on young Londoners’ drinking behaviour should be conducted by March 2014.

Interestingly the report does not extensively refer to the draft guidance from the Chief Medical Officer (CMO) issued earlier this year, though it does claim to support it: "The Committee welcomes [the CMO] guidance, but believes that once the guidance has been finalised, it should be disseminated together with information about alcohol treatment and support services for young people and for their parents and carers."

The Youth Alcohol Action Plan was released as the government's national strategy for young people in 2008.

The main tool is the Ready Reckoner v1 which generates data to identify the potential impact of increasing alcohol interventions and treatment for local PCTs. By selecting your PCT and entering possible increased provision (in the yellow boxes), the tool will calculate the costs, potential cost savings and predicted impact on hospital admissions. The ready reckoner calculates the possible impact of increasing High Impact Change interventions of A&E nurse specialists, hospital ward Alcohol Health Workers, Primary Care brief interventions and psychosocial interventions for dependent drinkers. A guidance document for using the tool is available.

The ALC have also highlighted the Rush report as a resource to assist commissioners in assessing the need for treatment capacity.

Information on the Purple Report is also available, whereby commissioners can access alcohol data collected from local treatment services via NDTMS.

Advertising launched last year included TV, radio, online and print advertising. According to Forster campaign awareness is very high at 96% of 18-24 year olds; of those, 67% agreed the TV advertising made them think more carefully about their drinking behaviour and 65% agreed the campaign is making them think about how much they drink on a night out.

TV, radio, print and online advertising will be running as follows:

• TV advertising – male and female versions of the TV ad will be aired from 8th June - 27th July
• Press advertising – 15th June - 27th July
• Radio advertising – 13th July - 3rd August
• Online advertising – 8th June - 27th July

The Home Office has produced two new print adverts and one new radio advert aimed primarily at 18-24 year old women. There is also a new online viral targeting 18-24 year olds which will be available on YouTube from Saturday 6th June and officially launched on Monday 8th June.

The Home Office are also partnering with Hollyoaks this summer on twelve spin off online episodes which will be shown online in July. These episodes bring to life some of the consequences of binge drinking such as aggression and violence and vulnerability. They follow on from an independently planned storyline on binge drinking in the TV soap. The spin off episodes will be shown here.

The stakeholder website  will be updated on Saturday 6th June to include the new print adverts and the viral. The new radio advert will be added at the end of June, prior to its launch in July.

• A systematic review of emergency care brief alcohol interventions for injury patients.

• A preliminary study of the population-adjusted effectiveness of substance abuse prevention programming: towards making IOM program types comparable.

One of the biggest strategic decisions facing prevention planners is whether to target high-risk groups or to prioritise universal programmes. This analysis won't decide the issue, but it does create an important new tool for comparing these strategies.


The report examines the efficacy of universal or targeted interventions against different substances