Reducing harm caused by alcohol


What next for reducing alcohol harm in Scotland?

The Scottish Government is expected to publish its alcohol strategy ‘refresh’ in the summer, eight years since the last strategy – Changing Scotland’s Relationship with Alcohol: A Framework for Action.

Some good progress has been made since 2009. Scotland has banned irresponsible off-sales promotions which encouraged people to ‘bulk buy’ alcohol; lowered the drink drive limit to make our roads safer; and health professionals have delivered over 500,000 brief interventions to at-risk drinkers.

These are all positive steps and they have had some impact, but Scotland still has the highest level of consumption and harm in the UK. Alcohol-related deaths have risen again in each of the last two years, with 1,150 Scots dying because of alcohol in 2015, and the downward trend in sales has now stalled.

One million Scots are putting themselves at risk of cancer, stroke, liver disease and mental health problems by drinking above the recommended guidelines of 14 units per week.

One of the main reasons for the lack of progress is the delay to minimum unit pricing being introduced. Increasing the price of the cheapest alcohol is recognised as the most effective way to reduce consumption and harm and we hope that this will finally be introduced early next year.

It’s clear that addressing cheap alcohol is essential, but what else should we be doing?

The current alcohol strategy recognised that a multi-faceted approach is required to address alcohol problems. The evidence is very clear that approaches to reducing drinking across the population are much more effective (and cost-effective) in reducing problems than measures to change individual behaviour like education. Policies to restrict the supply and availability of alcohol are particularly effective.

Healthy places

Where we spend our time living, working and socialising affects the lifestyle choices we make. Our high streets have an abundance of off licences, pubs, fast food joints and betting shops. Asking people to make healthy choices won’t work unless we actively make our neighbourhoods, towns and cities healthier places to live.

A healthy environment isn’t just about more green spaces, it’s about ensuring that retail and leisure opportunities support positive lifestyles and contribute to wellbeing.

Alcohol is available pretty much everywhere we spend our leisure time – from shopping centres to sports events, cinemas and coffee shops. This creates the impression that alcohol is a normal part of everyday life when actually it’s a product that causes significant health and social harm. It is time we challenged how readily available alcohol is in Scotland. 

Where once off-licences were specialist shops, now every corner shop and supermarket seems to be licensed. We know that the more alcohol that is available in an area, the more likely it is that the people living there will experience the negative consequences, from noise and litter to ill health and injury.

Every year, around 96% of all licensing applications are approved and over each of the last five years there have been increases in both on and off-sales licences. There are 40% more licensed premises in our most deprived communities than in our most affluent. A system that is intended, amongst other things, to protect and improve public health is failing to do so.

Licensing decisions

Scottish Government urgently needs to provide clear direction on controlling the availability of alcohol, with policy solutions that respond to changes in how and where we drink. Local licensing boards would then have a clearer framework for making decisions that contribute to national outcomes whilst also responding to local needs.

Licensing boards must also take better account of the experiences of the people affected by their decisions, whether that’s members of the public or front line workers like police, paramedics and doctors who deal with the effects of too much alcohol day in, day out.

There is currently a distinct lack of transparency about how this evidence is listened to and acted upon. Alcohol harm is costing local authorities millions of pounds a year. In Edinburgh alone, the annual cost is £221 million; money that could surely be better spent on social care, schools or many other competing needs. Decisions on licensed premises shouldn’t be made in isolation.

The implications of widely available alcohol go right across local authorities, putting extra pressure on resources and budgets for social work, health care, community safety and criminal justice, not to mention our emergency services.

Action to reduce the widespread availability of alcohol is one of the key recommendations in a new report produced by Alcohol Focus Scotland, BMA Scotland, SHAAP and Scottish Families Affected by Alcohol & Drugs.

The report contains a comprehensive set of policies aimed at curbing Scotland’s alcohol problem and addressing the associated health inequalities. It provides a blueprint for action which would improve the lives of millions of Scots, make our communities better and safer places to live, and reduce demand on our over-burdened public services.  

Alison Douglas Chief Executive, Alcohol Focus Scotland