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NCD Alliance sets out 10 year vision as stark death toll from alcohol, tobacco and unhealthy foods revealed

·       Four in five deaths in Scotland are caused by Non-communicable Diseases (NCDs), causing over 52,000 deaths in 2023

·       Estimates show that more than one fifth of these deaths are caused by alcohol, tobacco and unhealthy food and drinks

·       Health campaigners set out a long-term vision to improve health by limiting influence of companies promoting health-harming products

Leading health organisations have joined forces to set out a strategy to tackle the key risk factors causing death and ill-health in Scotland.

Non-Communicable Disease (NCD) Alliance Scotland, a coalition of 24 health organisations, working alongside leading global experts, has outlined a vision to fundamentally change Scotland’s poor health.

Alcohol, tobacco and unhealthy food and drink consumption are some of the leading factors causing non-communicable diseases (NCDs), which are diseases that cannot be directly transmitted between people.

These diseases, including heart disease, cancer, diabetes, Alzheimer’s, and lung disease, significantly impact the health and well-being of the population, causing chronic ill-health, disability, and premature death.

They are estimated to be responsible for 4 in 5 deaths in Scotland and in 2023, these conditions caused more than 52,000 deaths. But much of this is preventable with, alcohol, tobacco and unhealthy food and drink estimated by the British Heart Foundation to be linked to as many as 1 in 5 of these deaths,

In a report ‘Creating a Healthier Scotland’, published today, NCD Alliance Scotland is calling for action to reduce the impact of these health harming products.

It warns Scotland is in the grip of an alcohol emergency; a new generation is threatened by addictive nicotine products; and an unhealthy food and drink culture is further fuelled by exploitative marketing tactics.

Consequently, Scotland’s health is in a state of decline, with the country experiencing the lowest life expectancy in Western Europe. The disparity in health outcomes is stark, with life expectancy in the most deprived areas being 25-26 years lower than in the least deprived areas.

Yet the burden of NCDs is projected to increase by 21% by 2043.

The NCD Alliance Scotland report sets out a 10-year vision for a healthier Scotland, outlining key principles to protect public health.

These include:

• Adopting a ‘Commercial Determinant of Health’ approach, which means encouraging businesses whose activities contribute to good health, whilst holding larger health-harming industries to account and reducing their influence.
• Restricting the marketing of health-harming products, including advertising, sponsorship and packaging, in particular to children and young people.
• Action on the price of health-harming products, exploring levies and taxations, and restricting promotions like multibuy deals and other exploitative tactics.
• Reducing the availability of health-harming products and increasing availability of heathy alternatives.

The strategy has been developed following an 18-month process that has included consultation with an advisory panel of Scottish public health experts and the input of over 60 public health experts from Scotland, the UK and internationally.

NCD Alliance Scotland believes that adopting these steps could result in a significant transformation of health outcomes within a decade, re-establishing Scotland as a world leader in public health.

It also reflects public engagement with adults and young people, who have expressed that they want to see Government action on these drivers of ill health.

But action by the Scottish Government to tackle the impact of alcohol, tobacco and unhealthy food and drinks has slowed and while Minimum Unit Pricing (MUP) was increased to 65p in May 2024, other commitments to restrict alcohol marketing and unhealthy food promotions have been repeatedly delayed.

David McColgan, Chair, NCD Alliance Scotland, said: “As the Scottish Parliament marks 25 years since devolution, we have many great moments to point to where Scotland has led the way including the smoking ban in public places in 2006 and minimum unit pricing of alcohol in 2012.

“However, it is apparent that the Scottish Government has lost its way and its bravery in taking principled stances to protect the health of the people of Scotland.

“Government inaction only serves to prolong the suffering of those most in need of support in Scotland. And the disparity in health outcomes is only growing, with tactics such as price promotion, marketing and availability, strangling individuals’ choices.

“This work is a call to Government and parliamentarians to look at the actions of health harming industries, who profit from the ill-health of Scots. It is a call to regulate their activities and reduce their influence and availability of health harming products like alcohol, tobacco and high fat salt and sugar food and drink in our communities.

“Government action doesn’t reduce choice for consumers it protects that choice and helps make the healthy choice the easy choice for all people in Scotland.” 

Alison Douglas, CEO of Alcohol Focus Scotland said: “This strategy is published at a pivotal moment when Scotland is in the grip of an alcohol emergency, with alcohol specific deaths having just reached a 15-year high of 1,277. These deaths were all entirely preventable.

“With changes to drinking patterns during the Covid-19 pandemic having become embedded, Scotland faces a ticking time bomb of alcohol related illness in the coming years unless we take bold action now.

“Commercial actors including the alcohol industry play a major role in shaping the environments and cultural and social norms which give rise to Scotland’s worsening health outcomes. Bold action to tackle the commercial determinants of health such as restricting alcohol marketing, introducing an automatic uprating mechanism for minimum unit pricing and introducing an alcohol harm prevention levy on retailers selling alcohol products would help Scotland re-establish its global leadership position on reducing alcohol harm.”

Sheila Duffy, Chief Executive of ASH Scotland, said: “Tobacco remains Scotland’s primary cause of preventable early death, shortening the lives of almost 9,000 people a year. The achievement of public health measures in driving down Scotland’s smoking prevalence is increasingly under threat due to new addictive, health-harming recreational nicotine products being taken up by children.

“Studies consistently show that young people who use e-cigarettes are up to three times at greater risk of starting to smoke tobacco, and the lack of regulations restricting the visibility and availability of vapes is playing into the hands of Big Tobacco. Government must use all available powers to eradicate the damage that profit-centred multi-national tobacco corporations are inflicting on people’s lives, especially in our poorest communities.”

Dr Andrew Fraser, Chair, Obesity Action Scotland, said: “We need to quicken progress towards the diet and health plans that have been in place for some time. Changing the commercial environment in which we decide to buy and consume food, drink, alcohol and tobacco is essential to change our prospects for health. Frameworks of Government-backed regulation are essential to drive a change in mind-set that transforms our retail and eating-out environment. This is the main way to create the level playing field that drives improvement for everyone, and in a way that offers the most benefit for those who face the greatest challenges. That means action on marketing, advertising, promotions and incentives for producers, retailers and consumers to create a new future for prevention and health in Scotland.”

Dr Peter Rice, Chair of Scottish Health Action on Alcohol Problems (SHAAP), a partnership of the medical royal colleges, said:

“If the Scottish Government is serious about tackling alcohol related harm it needs to act now. This strategy sets out a range of steps the government can take, from tackling alcohol marketing to mandating labelling for alcohol products, to introducing a levy on alcohol retailers. Together these would make a huge difference to creating a positive, healthier environments for future generations to live in.”  

“Exposure to alcohol marketing directly influences how much and how often people consume alcohol. It is associated with people starting to drink, an increase in consumption including binge drinking, and is also thought to lead to an increased risk of relapse for those in recovery. Alcohol companies invest billions of pounds every year in marketing, aiming to increase the consumption of their products, often through the targeting of heavy drinkers and recruitment of new drinkers.  

“The alcohol industry should not have a role in shaping government policy. We need to listen to the experts who say that restricting the availability of alcohol is an important tool in reducing harm. Comprehensive restrictions on alcohol marketing and promotion are upheld as one of the World Health Organization’s ‘best buys’ to reduce alcohol harms.”