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Scottish National Alcohol Strategy calls time on binge drinking

Concerted action to tackle Scotland's 'lad' and 'ladette' culture is at the heart of a new Scottish Executive plan for action on alcohol problems launched in January.

The plan was drawn up in partnership with health groups, the police, the drinks industry and other stakeholders, mainly through the Scottish Advisory Committee on Alcohol Misuse (SACAM). Advice was sought from experts and wide-ranging public consultations were carried out and their results fed into the development of the plan.

Its immediate aim is "to kick start the cultural shift needed if Scotland is to turn away from the unsavoury drinking practices that cost the country £1 billion a year."

Launching the plan, Scottish Assembly Deputy Health Minister Mary Mulligan said:

"It used to be said that Scotland had a 'hard man' drinking culture. Those days are gone. Now women are involved in the 'lad' and 'ladette' binge-drinking culture too. And it is not just young people. Scots of every generation have drinking problems. That much is clear.

"Chronic heavy drinking and binge drinking is not only a problem for the individual concerned. It affects friends, families, neighbours, and colleagues. It impacts on all our health and social services. It contributes to public safety worries and crime problems. And it leads to problems for industry through loss of productivity.

"This plan is not 'anti-alcohol'. Alcohol is part of Western culture. Demonising alcohol would be pointless and potentially counterproductive. But we have to recognise the damage that too much drink can do. In Scotland alone, problem drinking is costing at least £1 billion in health costs, sick days and lost productivity – enough to build 10 new hospitals every year.

"Shifting to a culture of more sensible drinking cannot be achieved overnight, nor can central government be expected to achieve it in isolation. We do not intend to dictate how people live their lives. But we can and will work to encourage and support a change in behaviour.

"That means raising awareness of the effects and dangers of alcohol, for all ages. At home, in schools, in the workplace, in the community, and in the pub.

Encouraging people to use that information and take greater responsibility for their own actions. And more widespread training for managers and staff of licensed premises on their responsibilities to promote sensible drinking.

"The key to the success of this plan will be partnership working, involving all the education, industry, service provider and enforcement bodies. Working together, we can begin to take the first steps towards reversing Scotland's drinking problems."

Action over the next 12 months includes:

  • a new £1.5 million national campaign, involving TV advertising, to change attitudes to binge drinking
  • better and more widespread training for bar staff and licensees on their responsibility to encourage sensible drinking
  • specific action targeted at children and young people, including new resources for parents to discuss alcohol issues with their children, better education in schools, promotion of healthy alternatives to drinking, and better early support when problems arise
  • better support for local alcohol action teams – doubling funding to £1 million, publishing a framework for alcohol support and treatment services, and appointing a National Alcohol Liaison Officer to support their work
  • better information on patterns of problem drinking to help develop future policy – including more consistent recording of problems by GPs, consultants and other health professionals to get a better picture of the extent of the problem
  • raising with the UK Government concerns over the advertising and marketing of drinks

Investment through the NHS and social work services to tackle the problems and effects of drinking is estimated at around £182 million for 2001-02. GP consultations, A&E attendances, community psychiatric visits and other health services come to £96 million, while social work services, including work with children and families and community based rehab and treatment services, comes to £86 million.

Scottish Assembly Deputy Minister for Justice Richard Simpson said:

"Scotland has a serious problem with drunken and disorderly behaviour. This much is obvious to anyone walking down one of the main streets in Scotland's towns and cities late at night.

"Public safety demands that we take action to address this problem. That is why we have backed police campaigns to crack-down on drink-related violence and set up a committee to review licensing laws in relation to public health and public order. But it is also important that we tackle the problem at root and that is where this action plan comes in."

The director of The Portman Group, Jean Coussins, a SACAM member, also welcomed the plan:

"The Executive are to be congratulated for delivering a strategy that provides both direction and resources for the efforts to educate people in Scotland about the effects of alcohol misuse.

"We must encourage the three key factors of personal responsibility, consistent law enforcement and responsible marketing practices by the industry to achieve a culture where sensible drinking is the norm amongst those who choose to drink."

Paul Waterson, Scottish Licensed Trade Association spokesman and another member of SACAM commented:

"Although most Scots drink alcohol sensibly, there can be no doubt that excess drinking is on the increase, especially amongst young people and women.

"The consequences of alcohol misuse to the health services, in terms of stretching resources; to the police, in terms of controlling violence and so on; and to society generally, in terms of anti-social behaviour, should not be under-estimated. The implications for health and public order are clear.

"This report, which we welcome and fully support, commits us and all other interested parties to work together in the promotion of sensible, responsible drinking. This heralds the beginning of Scotland's determination to rid itself of it's binge drinking culture and the Scottish Licensed Trade Association is ready to play it's part."

The Action Plan will develop in stages up to 2005 and beyond.

Targets and Strategies

While it is emphasised repeatedly that the purpose of the Plan is to reduce alcohol-related harm and that it is not a crusade against alcohol per se, it is clear that, however discretely it is written, and however many references it contains to promoting responsible drinking, it is a Plan for reducing the total amount of alcohol consumed in Scotland.

The principal targets are to reduce the proportion of men exceeding the weekly `sensible limits' from 33 per cent to 29 per cent, and the proportion of women exceeding the limits from 13 per cent to 11 per cent in both cases by 2010. Because the minority of the population who exceed the weekly sensible limits account for such a high proportion of the total amount of alcohol consumed, a reduction in their numbers will necessarily result in significantly less alcohol being sold and consumed in Scotland. This has led some commentators to wonder how long alcohol industry organisations such as the Portman Group will be able to continue to support the Plan.

There is also the issue of the means proposed to achieve the Plan's aims and objectives. These are principally to do with various programmes of education and training, but the questions of alcohol availability, advertising and promotion are also raised.

Critics have commented on the Plan's lack of a clear commitment in regard to alcohol taxation. On this the Plan states that there is a lack of evidence that tax and price increases would assist in reducing harmful patterns of alcohol consumption. This is a view likely to be challenged by virtually all alcohol policy advocates, who no doubt will be happy to explain to the Scottish Executive that there is in fact very good evidence that tax and price increases reduce alcohol-related harm – rather superior evidence, indeed, than there is for the efficacy of the educational measures the Plan proposes to employ.

The more plausible reason given by the Executive for not using tax policy is simply that it is unable to do so because it is outside its jurisdiction, being reserved to Westminster.

Alcohol advertising is another matter on which the powers of the Scottish Executive are limited and which need to be addressed at UK level. The Plan also states that here too evidence about the effects of advertising on alcohol consumption and harm is equivocal. It was however a subject which was raised frequently in the public consultation, and the Plan commits the Scottish Executive to raising issues surrounding alcohol advertising with the UK Government and the alcohol industry.

On liquor licensing, the Scottish Executive had already announced a review of the licensing law and its implications for health and public order, and the review is complementary to the Action Plan.

The Plan details a list of specific aims for both the short term and the longer term

The short term aims are:

  • to raise awareness of alcohol problems in Scotland
  • to promote a social environment, policy context, and legislative framework which will support the overall purpose of the plan
  • to recognise the links to other areas of work and encourage initiatives which will tackle the causes and effects of alcohol problems
  • to start to change unhelpful perceptions of and attitudes to alcohol, offering realistic options and alternatives
  • to promote clear and consistent messages relating to alcohol problems
  • to improve awareness of sources of help and support with alcohol problems
  • to provide equitable, accessible and inclusive services to address the needs of those who experience alcohol problems and those affected by others use of alcohol
  • to develop an appropriate structure to deliver the plan locally
  • to foster accountability for achieving results
  • to develop training and support for those involved in implementing the plan.
  • Longer term aims include:
  • reducing the consumption of alcohol by some groups in the population whose drinking gives cause for concern
  • reducing harmful patterns of alcohol consumption
  • reducing specific risks relating to alcohol consumption such as hazards through work or sports
  • reducing crime, nuisance and fear of crime relating to alcohol.

The priorities are to reduce binge drinking, because of its harmful social and individual consequences, and to reduce harmful drinking by children and young people because of the particular health and social risks.

The Alcohol Problem in Scotland

Binge drinking is even more common in Scotland than it is south of the border, and alcohol places a huge burden on health and other public services. In 2000, there were almost 33,000 admissions to acute hospitals in Scotland with an alcohol-related diagnosis, representing more than 3 per cent of all acute admissions. The number of alcohol-related deaths has risen steeply in the last decade, from one in a 100 deaths in 1990 to one in 40 in 1999.

To aid development of the plan, the Scottish Executive commissioned a special study of the trends and costs of alcohol misuse. It estimated that alcohol misuse costs Scotland at least £1 billion each year, equivalent to over 1.5 per cent of Scotland's GDP. The costs of alcohol problems to the health, social service, and criminal justice systems exceed those caused by drug misuse, Alzheimer's Disease, schizophrenia and stroke.

Whether or not the appearance of the Scottish alcohol strategy will prompt the Government finally to launch the strategy for England and Wales remains to be seen. This has been promised for years but has not materialised.

When she was Minister for Public Health, Tessa Jowell formally announced that the strategy would be published in the summer of 1999. However, in a debate in the autumn of 2001, Hazel Blears M.P., the Parliamentary Under-Secretary of State for Health, assured Mrs Marion Roe M.P., the vice-chairman of the all party parliamentary group on alcohol misuse, that the Government was on course to implement the English and Welsh strategy by 2004. Ms Blears explained that the original timescale for launching the strategy had been ambitious and that priority had been given to early action relating to coronary heart disease, mental health and cancer.