alcohol and public health

Question 1

alcohol attributable mortality through life - causes

Answer 1

16-34 yrs	
Accidents/ trauma			
Self Harm and Suicide			
Alcohol intoxication (poisoning) 
7-10% female deaths in age group
15-20% male deaths

34-64yrs
Alcohol related liver disease
6-12% female deaths
10-12% male deaths

64+
Alcohol related cancers. .
Breast, oesophagus, colon, mouth and upper aerodigestive tract.
2-3% of deaths

Question 2

impact of alcohol on health

Answer 2

Question 3

alcohol related deaths and age

Answer 3

Alcohol-related deaths typically occur at younger ages than smoking-related deaths and deaths from all causes.

More working years under 65 are lost to alcohol than the 10 most frequent cancer types combined.

Question 4

rate of alcohol harm change

Answer 4

• adjusted for age and gender mix in the population
• narrow definition of alcohol specific deaths, 65% liver disease
• Number of alcohol attributable deaths is much higher. Includes cancers, accidents, suicide, cardiac, stroke.

Question 5

liver disease mortality rates - changing trends

Answer 5

Alcohol related liver disease rates were increasing in Scotland

Falling elsewhere in Europe

Not historical or inevitable

Question 6

changing trends in drinking

Answer 6

change in location - pubs vs at home
where alcohol was bought
price of alcohol
who is drinking - 65% of consumption by <45y/o in 1980s to 45% in 2010s

Question 7

most worrying trends in harm re. alcohol use

Answer 7

men
older people
home drinking
long term health conditions

Question 8

WHO global alcohol strategy and actions in Scotland

Answer 8

red = most important

Question 9

alcohol prevention, harm and inequalities - mortality trends

Answer 9

since introduction of actions to reduce harm

fall in mortality has been mainly among lower income groups (lowest 20%)

Question 10

impact of minimum unit pricing in Scotland

Answer 10

Scottish consumption falling, notably in the off trade, and the long established Scotland / England & Wales gap is narrowing.

fall in alcohol purchase is almost exclusively in the 20% highest purchasing households, across all income groups.

Admission data for 2019-20 shows downward trend in Alcohol Related Liver Disease admissions, down 8% from 17-18 .

Downward ARLD admission trends are predominately in lower income groups. Liver admissions in lowest income decile are at lowest level since 2004.

Alcohol mortality fell by 10% in 2019 but full effect is expected after 3 years

Industry Impact :
Industry co-operation in evaluation has been limited
Benefit to smaller retailers
No evidence of substantial cross border sales
No evidence of move to other drugs
No evidence of home production.

Question 11

Russia - tackling alcohol harm

Answer 11

40% mortality fall

increase of 9 years of male life expectancy

Complex set of sustained measures including marketing restrictions, minimum price for vodka, limiting kiosk sales, no internet sales.

Question 12

impact of pandemic on alcohol consumption and harm

Answer 12

Accelerated long established trend to home drinking.

Cemented key role of major supermarkets in alcohol retail.

UK Alcohol Duty Returns April – October 2020

	        Tax returns up 4.5% - indicator of alcohol sales

		Wine     +13%
		Spirits   + 10%
		Beer      - 9.7%
		Cider     -11.3%

Fall in alcohol related trauma - different type of trauma, less young people

Consumer surveys show a polarisation with light drinkers drinking less and heavy drinkers drinking more.

Likely to lead to an increase in chronic health harm.