SHAAP Director gives evidence on alcohol harms
SHAAP Director Elinor Jayne gave evidence to the Health, Social Care and Sport Committee on alcohol harms in Scotland.
On 1 March 2022, the Health, Social Care and Sport Committee took evidence at the Scottish Parliament on tackling alcohol harms in Scotland, from the following stakeholders representing the sector:
- Elinor Jayne, Director, Scottish Health Action on Alcohol Problems (SHAAP)
- Alison Douglas, Chief Executive, Alcohol Focus Scotland (AFS)
- Professor Niamh Fitzgerald, Professor, Institute for Social Marketing, University of Stirling
- Lucie Giles, Public Health Intelligence Principal, Public Health Scotland
Prior to the evidence stakeholder session, key documents were provided to establish the background of the health emergency of alcohol harms in Scotland:
Watch the recording of the session here.
Read the official report here.
Here are some of the key arguments and evidence brought forward during the session by SHAAP and fellow witnesses:
COVID-19 Alcohol Consumption:
- Despite the fact that overall alcohol consumption may have decreased on a population level, average units consumed were still above the maximum recommendation of 14 units per week.
- In 2020/21, there were 35,124 alcohol-related hospital stays in Scotland (at a rate of 641 per 100,000 in the population) - this was around a 10% decrease in admission when compared to the previous year.
- Men were 2.3 times more likely to be admitted to hospital for alcohol-related conditions than women.
- Those individuals living in the most deprived areas of Scotland were around 7 times more likely to be admitted to hospital for alcohol-related conditions than those living in the least deprived areas and four times more likely to die from alcohol.
- Alcohol-related deaths were also 4.3 times higher in the most deprived areas of Scotland when compared to the least.
- The Impact of lockdown on drinking practices in Scotland and England in 2020 report showed that the March 2020 lockdown was associated with a 2.23 increase in off-trade units per week in Scotland – corresponding to a 21.3% increase in off-trade consumption.
- Analysis of off-trade data suggests a statistically significant increase in heavy drinking occasions per week and drinking days per week following the initial March 2020 lockdown.
- Evidence suggests that a polarisation exists, whereby lockdown affected groups of society differentially: individuals who already did not drink heavily drank less during lockdown, but heavy drinkers drank more.
Rural alcohol harms:
- The importance of alcohol is disproportionate in rural communities, given the lack of alternative recreational activities, particularly in winter. The significance of alcohol is entrenched in cultural and social norms due to traditions, hospitality and economic dependence on tourism and alcohol production. Non-drinkers often feel ostracised from social gatherings and few alcohol-free spaces, if any, exist in their communities.
- Alcohol harms cannot be treated the same way in urban settings and in rural settings, as the underlying problems are not always the same.
Minimum Unit Pricing (MUP):
- MUP is a preventative measure targeting affordability. Affordability is directly linked to consumption which is directly linked to harm. This is why the WHO includes price as one of the most important measures that can be taken to reduce harm caused by alcohol. In Scotland alcohol was 73% more affordable in 2020 than 1987. In the first full year of MUP, we saw a 3.5% reduction in off-trade sales per adult and a 10% reduction in alcohol-specific deaths.
Source: Impact of minimum unit pricing on alcohol purchases in Scotland and Wales: controlled interrupted time series analyses. | Lancet Public Health;6(8): e557-e565, 2021 08. | MEDLINE (bvsalud.org)
- The Sheffield modelling for MUP from 2016 found that a minimum unit price of 60p would save twice the number of lives and reduce hospital admissions by twice the level of 50p per unit, while 70p per unit would have three times the effect. MUP to be uprated to 65p per unit to make good on inflation and optimise the policy.
- The original MUP modelling looked only at deaths. Wider effects like a reduction in cancers, alcoholic liver disease, and harm to others are expected to show over the next 20 years.
Affordability, availability, labelling:
- Alcohol labelling is a simple and effective way to communicate health information to the public and address their limited awareness of alcohol harms.
- There is currently no requirement for alcoholic drinks to display important health information such as the drinking guidelines, health warnings or calorie content.
- The alcohol industry has shown it cannot be trusted to provide this information voluntarily. It is time for alcohol labelling to be mandated.
- During the 2020 Six Nations broadcast of Scotland vs England there was a reference to alcohol every 12 seconds.
- The promotion of a hazardous health product such as alcohol has no place in the sponsorship of sports.
Treatment and recovery:
- While the intentions behind the Right to Recovery Bill were welcomed by SHAAP, on balance we do not support the Bill. Introducing a legal right to some or all aspects of treatment services won’t necessarily help address the problem of improving access but could instead serve as a distraction, as well as potentially pitting service user against healthcare professional when what is needed is a collaborative approach to treatment.
- The forthcoming UK-wide Alcohol Treatment Guidance will provide an opportunity for the Scottish Government to set out what services should be available with a range of models for their provision, and at the same time the Scottish Government should make available the investment needed to provide such services.
- It may also be necessary to establish a set of standards and associated indicators – similar to the Medication Assisted Treatment standards which have successfully focused resource on services for people who use drugs – to meet that guidance.