Alcohol harm

Last week (2 December 2016) Public Health England (PHE)  published a comprehensive review of the evidence on alcohol harm and its impact in England. It examines alcohol’s health, social and economic impact, and the effectiveness of actions in reducing its harms.

The review, whose formal title is: The public health burden of alcohol and the effectiveness and cost-effectiveness of alcohol control policies: an evidence review concludes that alcohol is now more affordable and people are drinking more than they did in the past. Between 1980 and 2008, there was a 42% increase in the sale of alcohol. Despite recent declines in sales, as a nation we are still drinking too much, with over 1 million hospital admissions relating to alcohol annually.

The economic burden of health, social and economic alcohol-related harm is substantial, with estimates placing the annual cost to be between 1.3% and 2.7% of annual GDP. Alcohol related deaths affect predominantly young and middle aged people; as a result alcohol is a leading cause of years of working life lost in England.

The review provides national and local policy makers with the latest evidence to identify those policies which will best prevent and reduce alcohol-related harm. It details policies that impact directly on the environment in which alcohol is sold and marketed, including its price, availability and advertising along with policies directed at people most at risk.

Professor Kevin Fenton, National Director of Health and Wellbeing at PHE, said:

The harm alcohol causes is much wider than just on the individual drinker. Excessive alcohol consumption can harm children, wreck families, impact on workplace colleagues and can be a burden and drain on the NHS and economy. It hits poor communities the hardest.

As a nation we are drinking more alcohol than we did in the past and there are more than one million alcohol-related hospital admissions a year, half of which occur among the most deprived groups.

This evidence review will help local and national government and public services like the police and NHS to develop policies designed to reduce the harmful effects of alcohol.

Since 2008, there has been a drop in total alcohol consumption but there has not been a corresponding drop in the level of related harms. The evidence review makes clear that alcohol-harm disproportionately affects the poorest communities, even though on average they drink no more than more affluent groups.

Other findings from the review include:

• most adults in England drink alcohol – more than 10 million people are drinking at levels that increase the risk of harming their health
• 5% of the heaviest drinkers account for one third of all alcohol consumed
• alcohol is the leading cause of death among 15 to 49 year olds and heavy alcohol use has been identified as a cause of more than 200 health conditions
• alcohol caused more years of life lost to the workforce than from the 10 most common cancers combined – in 2015 there were 167,000 years of working life lost
• the evidence strongly supports a range of policies that are effective at reducing harm to public health while at the same time reducing health inequalities – reducing the affordability of alcohol is the cost effective way of reducing alcohol harm

Recommendations

The PHE report comes out strongly in favour of a minimum unit price for alcohol:

Taxation and price regulation policies affect consumer demand by increasing the cost of alcohol relative to alternative spending choices. Policies that reduce the affordability of alcohol are the most effective, and cost-effective, approaches to prevention and health improvement. For example, an increase in taxation leads to an increase in government revenue and substantial health and social returns. According to Treasury forecasts, cuts in alcohol duty since 2013 are projected to have reduced income to the Exchequer by £5 billion over five years, reducing to £3.45 billion when consumption increases are considered. This does not include increases in societal and NHS costs.

Implementing a minimum unit price (MUP) is a highly targeted measure which ensures tax increases are passed on to the consumer and improves the health of the heaviest drinkers. These people are experiencing the greatest amount of harm. The MUP measure has a negligible impact on moderate drinkers and the on-trade.