When it comes to alcohol, how to make healthier choices easier choices

Peter AndersonArmagh 26 January 2012

1. Three reasons why we need to do this

2. Five ways to do it

1. Three reasons why we need to do this

2. Five ways to do it

1. High consumption

2. High harm

3. High cost

1. High consumption

2. High harm

3. High cost

1. High consumption

2. High harm

3. High cost

Regional variation of proportion of alcohol-attributable deaths to all deaths for people 15 to 64 years of age, 2004 , European Union

1. High consumption

2. High harm

3. High cost

Economic costs per head (2007 $US PPP) due to alcohol by cost category

Economic costs per head (2007 $US PPP) due to alcohol by cost category

1. Three reasons why we need to do this

2. Five ways to do it

1. As with tobacco, improve health literacy with consumer information and warnings

2. As with tobacco, ban advertising

3. As with tobacco, deal with the workplace

4. As with tobacco, provide help and support

5. As with tobacco, put up the price

1. As with tobacco, improve health literacy with consumer information and warnings

2. As with tobacco, ban advertising

3. As with tobacco, deal with the workplace

4. As with tobacco, provide help and support

5. As with tobacco, put up the price

Overall evaluation

Alcoholic beverages are carcinogenic to humans

Ethanol in alcoholic beverages is carcinogenic to humans

Risk of breast cancer by daily alcohol consumption

0.02.04.06.08.0

10.012.014.016.0

10 20 30 40 50 60 70 80

Life

time

risk

of a

n al

coho

l-re

late

d de

ath

(1/1

00)

Grams alcohol per day or per week

Men daily

Women daily

Men weekly

Women weekly

Lifetime risk of dying from alcohol-related death by gram alcohol/day or /week for Australian men and women.

1. As with tobacco, improve health literacy with consumer information and warnings

2. As with tobacco, ban advertising

3. As with tobacco, deal with the workplace

4. As with tobacco, provide help and support

5. As with tobacco, put up the price

Report of the European Commission Science Group on alcohol:

“It can be concluded from the studies reviewed that alcohol marketing increases the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol”

Characters consumed alcohol 3 times and alcoholic beverages were portrayed an additional 15 times

Characters consumed alcohol 18 times and alcoholic beverages were portrayed an additional 23 times

In both movies, there were two commercial breaks, either non-alcohol or alcohol advertisements

non-alcohol commercials

non-alcohol commercials

alcohol commercials

alcohol commercials

2.38

1.73

0

0.5

1

1.5

2

2.5

3

Alcoholic movie Non-alcoholic movie

Num

ber o

f dri

nks c

onsu

med F=4.44; p<0.05

2.42

1.69

0

0.5

1

1.5

2

2.5

3

Alcoholic commercial Non-alcoholic commercialNum

ber o

f dri

nks c

onsu

med F=4.93; p<0.05

2.98

1.51

0

0.5

1

1.5

2

2.5

3

3.5

Alcohol movie and commercial

Non-alcohol movie and commercial

Num

ber o

f drin

ks co

nsum

ed

1. As with tobacco, improve health literacy with consumer information and warnings

2. As with tobacco, ban advertising

3. As with tobacco, deal with the workplace

4. As with tobacco, provide help and support

5. As with tobacco, put up the price

Report of the European Commission Science Group on alcohol:

“alcohol workplace activities should be embedded within well-being at work initiatives, including structural factors and management and leadership styles”.

“Increasing the extent of alcohol free workplaces will result in reductions of alcohol-related work place accidents and injuries, as well as creating a culture for a more healthy relationship with alcohol that impact on families and friends through social networks.”

Male alcohol-related deaths by age group, England

English civil servants: Risk of alcohol dependence in 1991-93 by work environment in 1985-88

1. As with tobacco, improve health literacy with consumer information and warnings

2. As with tobacco, ban advertising

3. As with tobacco, deal with the workplace

4. As with tobacco, provide help and support

5. As with tobacco, put up the price

Impact of AUDIT-C 3 screening and 5 minute intervention, England over 10 years

Next GP consultation

1. As with tobacco, improve health literacy with consumer information and warnings

2. As with tobacco, ban advertising

3. As with tobacco, deal with the workplace

4. As with tobacco, provide help and support

5. As with tobacco, put up the price

Affordability of alcohol in UK

Average world price elasticities (112 studies) (% reduction with 10% increase in price)

Average world harm impact (50 studies) (% reduction in US with doubling of alcohol tax)

Impact of 10% increase in price on health and crime costs saved, 1st year, England

Impact of minimum price (€0.07/g alcohol, average off trade price)on health and crime costs saved, 1st year, Scotland

1. Should we be increasing price in times of economic downturn?

Associations of a more than 3% rise in unemployment with death rates, EU, 1970-2007

1. Should we be increasing price in times of economic downturn?

2. Don’t price increases lead to more illegal production and cross border trade?

Alcohol tax cuts and alcohol-positive sudden deaths, Finland

Source: Koski et al 2007

On 1/3/04, tax reduced by 33% retail price decreased by 22%

7.7 additional deaths/week, 17% increaseGovernment alcohol tax revenue went down by 17%

Number of alcohol-positive sudden deaths/week

Changes in deaths/100,000 person years adjusted for age and economic activity men and women aged 30-59 years

Herttua et al 2008

Age-standardized mortality from alcohol-related diseases and accidental poisoning by alcohol in 1969 to 2010 per 100,000 persons

1. Should we be increasing price in times of economic downturn?

2. Don’t price increases lead to more illegal production and cross border trade?

3. But, price increases don't affect heavy drinkers and penalize moderate drinkers don’t they?

Impact of 10% price increase on consumption and cost of harmful and moderate drinkers, England

Impact of minimum price (€0.07/g alcohol, average off trade price)on consumption and cost of harmful and moderate drinkers, Scotland

1. Should we be increasing price in times of economic downturn?

2. Don’t price increases lead to more illegal production and cross border trade?

3. But, price increases don't affect heavy drinkers and penalize moderate drinkers don’t they?

4. Prices increases will damage the alcohol business, won’t they?

Impact of 10% increase in price on employment-related benefits 1st year, England

Impact of minimum price (€0.07/g alcohol, average off trade price)on employment-related benefits 1st year, Scotland

Impact of minimum price (€0.07/g alcohol, average off trade price)on extra industry revenues, annually, Scotland

1. In north-west Europe, 1 in 8 of all male deaths and 1 in 14 of all female deaths in the age group 15-64 years are caused by alcohol.

2. There is a strong case for placing consumer information and warning labels on alcohol beverage containers; as a rough guide, adult drinkers should be advised never to drink more than 20g alcohol (2 drinks) on any one day or occasion.

3. There is a strong case for banning all forms of alcohol advertising, including those in social media outlets.

4. Workplaces are strongly advised to implement well-being at work initiatives; they will not only improve productivity, but also reduce the risk of alcohol problems.

5. There is a pressing need to increase the reach of brief advice and treatment programmes; these save people’s lives, and, in the case of brief advice programmes, save health systems much needed money.

6. But, increasing taxes and setting a minimum price is the key. Without these, you cannot hope to reduce the burden and promote the health and well-being of individuals and communities.