Staff at trauma clinics asked people with injuries a series of questions while taking out their stitches as part of the Cardiff University project.

Researchers found patients were more likely to address their issues as they were “feeling sorry for themselves”.

The Welsh government is now extending the scheme across Wales.

Nurses who work in trauma and facial injury clinics will be given training to talk to all patients with an injury as they treat their wound or remove stitches.

They will take them through a series of questions about the patient’s drinking habits – called the fast alcohol screening test (Fast) – and if it flags up a problem, nurses will talk to them about their issues.

They will also offer advice and support about tackling their misuse of alcohol, such as setting targets to cut down drinking or referring them to a specialist if they have an addiction.

Prof Jonathan Shepherd, director of Cardiff University’s Violence and Society Research Group, said they had carried out two clinical trials and found the approach had been successful.

“It’s informal and empathetic – and that’s on purpose,” he said.

“We found that having your stitches out the week after the injury can represent a “teachable moment”.

“Having the stitches out from your leg or your face, whilst that’s being done you’re feeling sorry for yourself.

‘Small cost’

“[The questions] can help you link up getting drunk with the predicament you got into.

“The research shows that if anyone’s going to be receptive to the message about drinking it’s then.”

He said the “small cost” of training nurses would mean a saving for the NHS in the long run if it reduces the amount of people abusing alcohol.

“This approach basically cuts about a quarter of hazardous drinking to safe drinking in a year. That’s from our research,” he said.

“The amount of drinking out there is epidemic at night in town and city centres in Wales.”

The Welsh government said the University of Wales Institute, Cardiff (Uwic) had trained 131 nurses as part of the pilot project.

“Public Health Wales will be reviewing this training activity to date and developing a programme of support for the on-going implementation of alcohol brief interventions at a local health board level,” a spokesman said.

Dr Sara Hayes, deputy chief medical officer for Wales, added: “Evaluations of brief interventions have consistently shown them to be the most effective approach to reducing problem drinking.”

via BBC News – Nurse advice cuts binge drinking in Cardiff University project.

Comments included criticism of the government’s Responsibility Deal, comparing it unfavourably with the Scottish approach of a minimum pricing policy.

However, Henry Ashworth, chief executive of the Portman Group, a social responsibility body for the UK drinks trade, argued: “It is really important that we put this report in context.”

Insisting that “The vast majority of people drink responsibly,” Ashworth warned: “Painting doomsday scenarios won’t help reduce alcohol misuse and calling for Soviet Union style population controls cannot do anything but alienate the vast majority of people who already drink within government guidelines.

“We agree with the Prime Minister that strong partnerships are essential to tackle the minority who use alcohol recklessly and drinks producers are committed to supporting this approach.”

Only last week, UK Prime Minister David Cameron condemned the country’s drinking culture as the “scandal of our society”.

In response, Gavin Partington, spokesman for the Wine & Spirit Trade Association, emphasised: “The drinks industry is committed to helping the government tackle alcohol misuse, alongside other stakeholders.

“This is why we are working hard through the Public Health Responsibility Deal on a range of initiatives to promote responsible drinking.”

via Portman Group rejects “doomsday” alcohol outlook.

Now state legislatures around the country are taking tough steps to make life even more difficult for those who would drink and drive. Key among the new measures are laws requiring the installation of in-car breathalyzers for all motorists convicted of drunken driving. The devices, known as ignition interlocks, prevent engines from starting if a driver’s blood-alcohol level registers above a preset level.

Read more Virginia’s chance to improve safety by locking out drunk drivers – The Washington Post.

But the junior health minister said one of the key goals was to

“remove significant number of units of alcohol from the UK market through changes in how alcohol is produced and sold”.

“Quality above quantity is something we’re aiming to do,” she said. “We can’t turn this problem around overnight but we’re deadly serious about a deadly problem.”

In the strategy, ministers are expected to unveil measures to increase the price of alcoholic drinks according to how strong they are. This could be done through higher taxation per unit, minimum pricing per unit or simply higher levels of duty for strong drinks. Ministers will also encourage companies to produce weaker alcoholic drinks.

Prime Minister David Cameron is known to have sympathy with the idea of minimum pricing, which medics say could save nearly 10,000 lives per year if set at 50p per unit.

However, legal complications may mean ministers opt for the simpler concepts of either higher taxation per unit or more duty for strong drinks.

The strategy was meant to be published earlier this year, but it has been delayed for some weeks while the issue of taxation is debated within Downing Street, the Treasury, the Home Office and the Department of Health.

Yesterday, Ms Milton said: “I know the issue of price setting will carry on. There are some misconceptions about the use of the term minimum unit pricing… The fact is that shops sell alcohol at a loss to get customers through the door. That can encourage binge drinking.

“That is why we are committed to banning the sale of alcohol below cost. It is an important first step. There are many different ways to achieve this aim and we will continue to review all the evidence and the alcohol strategy will outline our steps to tackle this issue.”

Doctors groups, including the Royal College of Physicians and the British Medical Association, strongly support the toughest option of minimum pricing per unit

A coalition of churches is now adding to these calls, after a study showing six in ten people feel excessive drinking is blighting their communities.

The Church of England, the Methodist Church and the Baptist Union of Great Britain, have all written to the Prime Minister urging him to consider strong measures to tackle “current levels of ill health and public disorder”.

They say “a ban on below-cost sales, a special tax on strong beers or a voluntary code for advertising are likely to be inadequate”.

Ms Milton said current ways of tackling binge-drinking would be strengthened in the new strategy by a “life course approach” to educating people about the dangers of alcohol.

She said children will be taught how much alcohol is safe to drink, working age adults warned about the serious consequences of drinking more than their weekly limits and older people told about reduced quality of life due to alcohol dependence.

“Excessive drinking affects our communities, ruins lives and all too often ends them,” Ms Milton said.

The minister was speaking in a Westminster debate called by Dr Sarah Wollaston, an MP and former family doctor campaigning for alcohol to be sold at higher prices.

Dr Wollaston said the Government had a “blind-spot” when it came to the scale of Britain’s problems with alcohol.

“If a jumbo jet laden with passengers crashed over Britain every fortnight we would see some pretty drastic action. This is what we’re talking about with alcohol,” she said.

via Alcoholic drinks to get weaker, says minister – Telegraph.

The group pointed to official figures showing 14m working days are lost each year, at a cost of £6.4bn annually, due to lost productivity and absenteeism because of excessive drinking.

Around 10m men and women in England drink above the recommended guidelines and every day, about 200,000 people go to work in the UK with a hangover, the charity warned.

But apart from an “obvious” rule prohibiting employees from being drunk at work, many companies are doing little about the effects of alcoholism, the charity said.

Under the corporate governance code, listed companies must outline how risk is assessed and managed, and make sure the human resources is in place to meet business objectives and obligations to shareholders.

But Alcohol Concern is calling for boards to have a formal responsibility to address financial losses incurred through workers’ reduced performance caused by alcohol.

By failing to do this, and in many cases failing to even recognise the impact of alcohol misuse, “boards are neither complying with the spirit or the letter of the Code”, the charity warned.

Alcohol Concern chief executive Eric Appleby said: “Companies simply have to address attitudes to alcohol and drinking behaviours – it is costing the economy billions every year.

“The evidence is that boards are not taking the issue seriously and that’s why we are calling on the Government to include alcohol policy as a specific requirement under the corporate governance code. This will help improve the wellbeing of employees, and at the same time, improve efficiency and productivity.”

via Drink problems in workplace ‘ignored’ – Telegraph.

Professionals working with homeless and dependent street drinkers have expressed concern for many years that cheap white cider at 7.5% abv (Alcohol by Volume) seems to have a particularly damaging effect on the health and behaviour of the people they work with.

There is additionally a widespread belief among drinkers, workers and the public at large that this drink has ‘never seen an apple’, and is only made from chemicals.  This research project seeks to examine the evidence for this claim, and studies the impact of white cider on homeless dependent drinkers.  It examines the history, production and taxation of white cider, and considers the implications for future taxation, health and homelessness policies.

Methods Used

Evidence for this report was largely gathered from questionnaires from drinkers and hostels’ workers. The sample consisted of 41 questionnaire responses from drinkers and 23 from workers from services in London, Leeds and Sussex.  A total of 31 interviews with drinkers and workers were also conducted in three of the ‘wet’ hostels (where residents are allowed to drink on the premises).  Several liver specialists and treatment service providers also gave their views, as well as cider producers Heineken UK and Aston Manor.

What is white cider?

White cider was first produced in the 1980s, to make a distinctive cider that was easy to drink.  Around the year 2000 the cider industry had financial difficulties, which resulted in price reduction and white cider became the cheapest way to buy alcohol.  A commonly held myth is that white cider had never seen an apple during production, and was just produced from chemicals.  There is very little difference between this and the commercial production of any cider.  Cider production has been governed since the 1970s by Notice 162 of Customs and Excise.  This included a very restrictive list of permitted cider ingredients, together with; ‘water no limit; sugars and sugar syrups no limit.’ This means that until recently cider could be made with minimum apple content. Yeast is added for fermentation, and corn syrup is just one form of sugar used in general food manufacture, and is used in similar proportions in other ciders.

One brewer said “What you can’t do is ferment sugar and add a bit of apple flavouring. It wouldn’t work and you couldn’t class it as the drink that pays cider duty”  However white cider is no longer made from cider apples, but from juice concentrate which is normally imported from wherever it is the cheapest.

In 2003 Heineken bought out Bulmers, makers of white cider market leader White Lightning.  They felt responsible brewers should no longer be producing white ciders, but failed to convince the rest of the industry.  They eventually stopped making White Lightning in 2009 due to “its negative ‘park bench’ image” and to “reinforce our stance on responsible drinking and drive more value into the cider market. White cider is the cheapest way to buy alcohol in the UK. This is pocket money these days. There is no other alcohol category that has the same challenge as white cider.”

Those who still produced white cider disagreed with Heineken’s approach and an Aston Manor senior manager stated, “White cider is no different in actual cost – we charge a fair price, or what the market price is for our product. The biggest so-called white cider is our brand Frosty Jack’s”. He went on to say, “We have the same attitude as the National Association of Cider Makers, choosing to focus on problem drinkers rather than drinks. We think problem drinks are a myth.  If you take all the white ciders in the UK, it accounts for 0.1% of alcohol consumption, and is being abused by a small percentage of people.  Problem drinkers are a social issue not an economic issue.”

Cider taxation

Cider contributes more than £1m a day in excise duty and VAT, but it is taxed at a lower rate than other alcoholic drinks in order to protect the traditional cider industry, primarily to allow for investment in the slow process of orchard development.  Cider at 1.2 to 7.5% abv attracts a lower rate of duty at £35.87 per 100 litres. Ciders at 7.5 to 8.4% abv attract the higher rate of £53.84.  White cider is therefore diluted to sit in the lower band.

A minimum juice level of 35%, with a specific gravity of at least 1033 degrees was introduced in 2010, and products below that would be subject to the much higher wine rate of £241.23 per 100 litres.  This made little difference as few were below 35%.

The question has to be addressed; why should producers that use imported concentrate benefit from cider tax breaks, particularly if this might be one of the factors that keep white ciders so cheap?

White cider and street drinkers

Street drinking ‘alcoholics’ are very often marginalised by society and are largely hidden from view, out of work, struggle to find a roof and are often parted from their families.  They live an existence that would be intolerable to most people, and one of the most available escape routes is through a bottle of white cider.
Of white cider drinkers and hostel workers completing the questionnaire, 75% of drinkers and 80% of the workers rated price as the most important reason to choose it.  This was followed by effect, then availability, with taste coming last.  Only three of the drinkers rated taste as their most important attraction.  It is often argued that raising prices would not change the drinking habits of this group.  It was very clear during interviews that most of them have a detailed knowledge of price variations, and will often travel distances for the best bargain.  They reported that some small shops give them credit if they were sure of payment when their welfare payments were received.  Other shopkeepers sell below the prices on the shelves to these very regular customers.

Their cheapest way to buy white cider is in two and three litre plastic bottles (often promoted as 3 litres for the price of 2).  Three litres of white cider contain 22.5 units of alcohol which is more than the maximum number of weekly units recommended for a man.

Roughly 25% of rough sleepers in London at the moment may be from central and Eastern Europe. They don’t have the same welfare benefits safety net, unless they have worked and paid National Insurance contributions for a year.  This leaves them living on the streets, and they are typically drinking vast quantities of white cider with devastating consequences.

One worker reported ‘There is one of these rough sleepers in North London at the moment who is being paid in white cider to unload deliveries at an off-licence.’

It is not surprising that this study found 100% of those who work with these drinkers believe that, because it is killing their clients – white cider should either be banned or that it should be priced out of their reach. What was perhaps more surprising was that around 50% of the drinkers themselves agreed with this.  There were others who thought it should be made cheaper, be free or provided on prescription. It is interesting that they should consider the latter an option as they are clearly viewing white cider in the same way as they would an illegal drug such as heroin where withdrawal is often assisted through methadone on prescription.

Does white cider have a different health impact?

The research tried to find out if white cider has different health or behavioural impacts to the other drink of choice for this group; super-strength lager at 9% abv.  For many drinkers there appears to be little difference, but for others, and in the view of many of the workers, white cider seemed to produce far more severe stomach problems.

Those workers by and large believe that they do see a difference in health and behaviour compared to those who drink lower strength ciders.  However few claim any discernable difference between super-strength drinks, apart from the increase in stomach damage from cider.  Two of the hostels have harm minimisation programmes to try and move clients onto weaker drinks.  However for some drinkers this does not work.

They talk of weaker drinks “not touching the sides” for them.  A typical reaction is, “If I had to drink 5% I’d be well fed up because I’d have to drink so much that I’d be sick before I can stop the shakes.” It was interesting to note that even the Aston Manor manager was clearly aware of the health impact when he says ‘If you got a consumer of 7.5% abv cider and got them onto 5% you might see an improvement in their health.’

Recommendations

All three main political parties have expressed strong concern about super-strength drinks, but their combined actions have brought about little change so far.  Here are eight recommendations developed from the evidence of this research.

1. The simplest solution would be to introduce a minimum unit price per unit of alcohol of 50p.  At a stroke a three-litre bottle of Frosty Jack’s would jump from around £2 to at least £11.50.
2. At the moment the lower tax band for cider is much lower compared to beer and extremely wide, stretching from 1.2 to 7.5% abv.  Those who work with heavily dependent drinkers and even some in the cider industry see a difference in health outcomes from those drinking below 5% abv. This suggests a clear need to link cider duty rates to beer duty rates and to introduce a new tax band for any ciders above 5.0% abv, which needs to be at a considerably higher rate if it is to impact on the price of white ciders. The intention would be to deter production of ciders above 5% abv and provide a strong duty ‘penalty’ for producing ciders above this level. Alternatively consideration could be given to the adoption of a system similar to that used for beer since 1993, which includes a charge for each percentage point of alcohol by volume. This would create duty parity for these two products.
3. Cider gets significant tax breaks in order to protect the traditional cider industry, due to higher production costs and to allow for investment in lengthy cider apple orchard development.  We are in favour of continuing this policy. However, there seems to be no reason why producers that use imported apple concentrate should benefit from these tax breaks.  This is a complicated matter as concentrates are also used in some other industrial cider production, but the technical sub-committee might investigate whether the use of imported concentrate can be taxed differently.
4. The move to a 35% minimum juice standard has been a useful first step, but consideration should be given as to whether this is sufficiently high.
5. The large size of white cider bottles is clearly part of the problem.  We would recommend a ban on cider at a greater strength than 5.0% abv being sold in any container larger than 1 litre.
6. The Licensing Act 2003 should be amended to include an objective to protect public health, which would allow local authorities to take the level of alcohol-related health harm into consideration when making licensing decisions, with an option to ban the sale of super-strength drinks across their locality.
7. The Portman Group should set an example by publicly supporting an end to the production of white ciders and encourage their members to cease making it.
   Finally, government must protect alcohol services funding to ensure support and provision for street drinkers

Conclusion

Is there a place in society for the continued presence of strong cheap ciders which are solely used for the purpose of instant intoxication.  If they were removed, the current crop of drinkers who are dependent on them would struggle to find a ready replacement.  Their bodies have been conditioned to need at least 7.5% abv.  Street drinking ‘alcoholics’ existed long before these drinks were designed, however they did not need such high strength, non-spirit drinks because they did not exist.  If these drinks are allowed to remain on the shelves, then new generations of drinkers will be led down the same pathway.

Acknowledgements

Alcohol Concern would like to acknowledge and thank the staff and service users of St Mungo’s, St George’s Crypt Leeds, St Anne’s Alcohol Services Leeds, West Sussex DAAT and Thames Reach who gave up their time for this research. We would also like to extend our thanks and appreciation to Heineken UK and Aston Manor for agreeing to be interviewed and to Alcohol Research UK for their funding.  This report was written and researched by Tony Goodall.

Researcher

Tony Goodall

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A study by researchers at Sheffield University found that fixing the minimum price at 45p a unit – the price most frequently quoted by deputy first minister Nicola Sturgeon – would have a lesser effect on alcohol-related illnesses, crime and the economy now than in 2009.

Its impact has fallen because alcohol prices have risen slightly and abuse rates have fallen. A 45p basic price would cut consumption by 3.5%, saving 36 lives in the first year and about 196 a year over a decade, with 2,160 fewer crimes, the researchers said.

A similar study in 2010 estimated that 50 lives would be saved in the first year, and 225 lives annually within 10 years.

The findings suggest Sturgeon would have to fix the minimum price at 50p a unit when she publishes her plans in the spring in order to ensure a significant effect on ill-health, offending behaviour and wider costs to society.

The researchers found that a 50p basic price would cut consumption by 5.7%, most heavily affecting alcoholics, saving 60 lives in the first year, and 318 a year within a decade. At 70p a unit consumption would fall 16.9%.

Sturgeon said the findings supported her push to raise prices, which in some cases would triple the cost of the cheapest ciders.

“We all know that Scotland has a serious problem with alcohol misuse, with Scots drinking more than any other part of the UK, and these findings further confirm my belief that minimum pricing can be a key weapon in the battle against this,” she said.

“The findings also confirm that the measure will have more of an effect on heavy drinkers as they tend to favour cheaper alcohol.”

The plans, which would affect the price of cheap ciders, lagers and supermarket own-brand vodka and whisky, carry political and legal risks for Alex Salmond’s government.

English chief constables and health officials are urging Sturgeon to introduce minimum pricing, but critics of the measure believe it will damage the Scottish government’s popularity in the run-up to its independence referendum.

Richard Simpson, Scottish Labour’s health spokesman, said the revised data again “watered down” the impact of a minimum price.

The report suggested the measures would have less impact on young men, the perpetrators of much alcohol-related crime, as they mostly drank to excess in pubs rather than at home.

It said a 45p price and a total ban on discounting would give supermarkets a “whopping windfall” of more than £100m in increased revenues; 50p would increase their takings by £124m.

“It is becoming increasingly clear that minimum unit pricing will do more to boost the profits of big supermarkets than tackle alcohol misuse, especially among young people who binge drink,” Simpson said.

A higher price is likely to increase the chances of a legal challenge to the plan, which the drinks industry and UK ministers have warned is likely to breach European and global free trade and competition rules. Sturgeon has already conceded that legal action is likely.

The report said the most effective minimum pricing policy would include a total ban on all drinks price-cutting, which would most dramatically affect death rates, crime and social impacts. But this policy is not in force in Scotland. Sturgeon has only been able to ban three-for-two-style promotions and bulk discounting rather than every type of price cut; the supermarkets have since cut prices per bottle instead.

With a complete ban on price cuts or promotions, a 50p minimum price would lead to a 13.3% cut in hospital admissions and cut premature deaths by 427 a year, said the study. The Sheffield researchers said they were unable to test the impact of current Scottish policy because they did not have the data.

via Scottish government warned over impact of alcohol pricing plan | Society | The Guardian.

In one corner will be health professionals, charities dealing with the consequences of Ireland’s problematic relationship with drink, and Government Ministers, particularly Minister of State with responsibility for Primary Care, Róisín Shortall. In the other will be the retail giants who use cheap booze to help coax shoppers through their doors and a multibillion-euro drinks industry that advocates responsible drinking while profiting handsomely from the more irresponsible kind.

Shortall believes Irish drinkers “lost the run of themselves” during the boom. Drinking of alcohol is costing more than €3.5 billion a year once chronic diseases, injury and other societal ills are taken into account, she says.

A briefing note prepared for Minister for Health Dr James Reilly last year said adults drink “in a more dangerous way than nearly any other country”, while Irish children “drink from a younger age and are drinking more than ever before”. It described alcohol as “a contributory factor in half of all suicides and accounts for up to 10 per cent of bed days in hospitals, while alcohol-related road accidents cost an estimated €530 million in 2007”.

In an interview with The Irish Times , Shortall says the details of the overhaul of public health legislation will emerge at the end of this month when the National Substance Misuse Strategy steering group publishes its report. She also indicates that controls on pricing and advertising and more strict enforcement of existing laws are inevitable.

The steering group was set up at the end of 2009 to establish a new approach for dealing with substance misuse. Almost immediately, a row broke out. The group included representatives from the drinks industry, who objected to their addictive but legal drug being ranked alongside addictive but illegal drugs. Other members of the group objected to vested interests being part of their cohort and playing a role in developing policy.

This week, several committee members privately accused the industry of delaying the report’s publication by refusing to sign off on key elements. “To say they spent the two years raising objections and dragging their heels would be putting it mildly,” one source says.

ACCORDING TO ITS website, the Alcohol Beverage Federation of Ireland has “excellent access to Government Ministers and senior public officials”. It stoutly rejects allegations it has slowed the process and says it had been “professional and constructive” throughout.

“We were asked to participate, and we have a right to a voice,” its spokeswoman Kathryn D’Arcy says. She accepts there were some recommendations in the report the group opposed – most notably concerning pricing and advertising – “but to say we obstructed the group is terribly unfair”.

The Government is also preparing a more ambitious range of measures in a Public Health Act to be drawn up this summer, but so far pricing has dominated the headlines. Among the proposals will be rules governing the lowest price at which alcohol can be sold. This minimum cost will depend on the number of units of alcohol a container holds – and if the level is set at 50 cent per unit, then the lowest price for a bottle of wine containing eight units will be €4.

Read more Price a key issue in abuse of alcohol – but culture must also change, insists Minister – The Irish Times – Wed, Jan 18, 2012.

Thirty-seven percent of men and twenty-nine percent of women in England drank more than the government recommended amount (2-3 units a day for women and 3-4 units a day for men) at least one day per week in 2009 (ONS, 2011). Given the known health risks associated with higher levels of alcohol consumption the UK Government recommends that alcohol products include information labels that warn of the risks. However, there is little evidence that such labels influence drinking behaviour (Stockwell, 2006; Wilkinson & Room, 2009).

Health warning labels present potentially threatening information that arouse unpleasant emotional states. Threatening messages can be detrimental to people’s sense of self (Steele, 1988) and lead individuals to process the information in a way that is consistent with their existing beliefs and thus unlikely to result in behaviour change. However, when participants are given a self-affirming manipulation, they process warning labels as more threatening and personally relevant, perceive higher levels of self-efficacy and have higher levels of intention for behaviour change (Harris, Mayle, Mabbott & Napper, 2007).

One of the difficulties of self-affirmation manipulations is that they are often time-consuming and impractical in the field.  However, drawing on the work of Harris, Napper, Griffin, Schuez, and Stride (2011), Armitage, Harris & Arden (2011) presented participants with the stem, “If I feel threatened or anxious, then I will…” (see Harris et al., 2011) and combined it with a self-affirming statement (e.g. “I will think about things that are important to me”, see Harris et al., 2011) to create a brief (one sentence long) but effective self-affirmation intervention that reduced alcohol intake by more than 1 unit per day. This kind of brief self-affirmation intervention could be used within an ecologically valid on-product health warning label. Thus this pilot study aimed to investigate the efficacy of an on-product self-affirmation intervention to promote alcohol consumption within recommended guidelines.  It was predicted that the intervention would result in more accurate judgements of the message and safe alcohol volume and result in changes in alcohol consumption in the following month.

Methods and Findings

The study took the form of a small-scale experiment in which participants were randomly allocated to one of two conditions. All participants completed baseline questionnaires (Alcohol Use Disorders Identification Test; Babor et al., 2001, Alcohol diary for the previous week; Sobell & Sobell, 1992;  and Protection Motivation Theory (PMT) measures; Rogers, 1983), and were exposed to one of two types of alcohol information labels positioned on a wine bottle: UK Government recommended information or UK Government recommended information + the self-affirmation statement: If I feel threatened or anxious, then I will think about things that are important to me.

They then undertook a wine pouring task in which they were asked to pour an amount of wine ‘that you think would be safe to drink on a single occasion’.  The number of units poured was then calculated. They also completed post-task questionnaires (Thought-listing procedure; Cacioppo & Petty, 1981, Perceived message strength; Zhao et al., 2011, Message derogation; Witte, 1994 and PMT measures).  113 participants (70 females and 41 males) completed this part of the study.

All participants were contacted 1 month later by letter or email (according to their stated preference) and completed time 2 questionnaires (Alcohol diary for the previous week; PMT measures). 107 participants completed this part of the study.

The results showed:

• There were no differences in the amounts of wine poured between those exposed to the self-affirmation message and those not exposed.
• Both males and females poured significantly more wine than the higher recommended limits.
• There were no differences in the message perception measures by condition.
• The information labels lead to a range of different thoughts including surprise, disagreement and reflecting on drinking behaviour
• For participants classified as hazardous and harmful drinkers (AUDIT categories), exposure to the self-affirmation message resulted in significantly lower levels of alcohol consumption at time 2.
• There were some effects of time but not condition on PMT variables.

Implications

The findings of this study indicated that a short self-affirmation message on an alcohol information label could reduce alcohol consumption for harmful and hazardous drinkers.  Further research should investigate the robustness of this effect, through which variables it acts, and test whether it is effective in the field.

The findings also indicated that the current recommended alcohol information is insufficient to enable people to make accurate judgements of ‘safe’ alcohol volumes. Further research should be conducted to establish what information should be provided to enable individuals to accurately make this judgement.

Research Team

Dr Madelynne Arden, Department of Psychology, Sociology & Politics, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP

Tel: 0114 2255623

Dr Christopher Armitage, Department of Psychology, University of Sheffield.

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The Final Report

References

Armitage, C. J., Harris, P. R., & Arden, M. A. (2011). Evidence that self-affirmation reduces alcohol consumption: Randomized exploratory trial with a new, brief means of self-affirming. Health Psychology, 30, 633-641.

Babor, T.F., Higgins-Biddle, J.C., Saunders, J.B., and Monteiro, M.G. (2001). The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. 2nd ed. World Health Organization, Department of Mental Health and Substance Dependence: Geneva, Switzerland.

Cacioppo, J.T., & Petty, R.E. (1981). Social Psychological Procedures for Cognitive Response Assessment: The Thought -Listing Technique. In T.V. Merluzzi, CR.Glass & M. Genest (Eds.) Cognitive Assessment pp. 309-392. New York: Guilford Press.

Harris, P.R., Mayle, K., Mabbott, L., & Napper, L., (2007). Self-affirmation reduces smokers’ defensiveness to graphic on-pack cigarette warning labels. Health Psychology, 26, 437-446.

Harris, P. R., Napper, L., Griffin, D. W., Schuez, B., & Stride, C. (2011). Developing a measure of spontaneous self-affirmation. Manuscript in preparation.

Rogers, R.W. (1983). Cognitive and physiological processes in fear appeals and attitude change: A revised theory of protection motivation. In J. Cacioppo & R. Petty (Eds.) Social psychophysiology. New York: Guilford, pp. 153-176.

Sobell, L.C., & Sobell, M.B. (1992). Timeline follow-back: a technique for assessing self-reported alcohol consumption. In J.P. Allen & R.Z. Litten (Eds.), Measuring Alcohol Consumption: Psychosocial and Biochemical Methods, pp. 41-72. Totowa, NJ : Human Press.

Steele, C.M. (1988). The psychology of self-affirmation: Sustaining the integrity of the self. In L. Berkowitz (Ed.) Advances in experimental social psychology, Vol. 21, pp. 261-302. New York: Academic Press.

Stockwell, T. (2006) A Review of Research Into The Impacts of Alcohol Warning Labels On Attitudes and Behaviour. Centre for Addiction Research of British Columbia, Canada.

Wilkinson, C. & Room, R. (2009) Warnings on alcohol containers and advertisements: International experience and evidence on effects. Drug & Alcohol Review, 28, 426-435.

Witte, K. (1994). Fear control and danger control: A test of the extended parallel process model (EPPM). Communication Monographs, 61, 113–134.

Zhao, X., Strasser, A., Cappella, J.N., Lerman, C., & Fishbein, M. (2011). A Measure of Perceived Argument Strength: Reliability & Validity. Communication Methods and Measures, 5, 1-28