When it comes to alcohol, how to
make healthier choices easier choices
Peter Anderson
Armagh
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
1970
1972
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
Litres per capita
Pure alcohol consumption, litres per capita, age 15+
16
14
12
Ireland
10
8
United
Kingdom
EU
6
4
2
0
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
Lifetime risk of an alcoholrelated death (1/100)
16.0
14.0
Men daily
12.0
Women daily
10.0
Men weekly
8.0
Women weekly
6.0
4.0
2.0
0.0
10
20 30 40 50 60 70 80
Grams alcohol per day or per week
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 nonalcohol or alcohol
advertisements
non-alcohol
commercials
alcohol
commercials
non-alcohol
commercials
alcohol
commercials
Number of drinks consumed
3
2.5
2.38
2
F=4.44; p<0.05
1.73
1.5
1
0.5
0
Alcoholic movie
Non-alcoholic movie
Number of drinks consumed
3
2.5
2.42
2
F=4.93; p<0.05
1.69
1.5
1
0.5
0
Alcoholic commercial
Non-alcoholic commercial
Number of drinks consumed
3.5
3
2.98
2.5
2
1.51
1.5
1
0.5
0
Alcohol movie and
commercial
Non-alcohol movie and
commercial
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
On 1/3/04,
tax reduced by 33%
retail price decreased by
22%
Number of alcohol-positive sudden deaths/week
7.7 additional
deaths/week, 17%
increase
Government alcohol tax
revenue went down by
17%
Source: Koski et al 2007
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.