1. Alcohol Guidelines 2016 Gail Hughes Public Health Lead Surrey County Council February 2016

2. New Alcohol Guidelines: Context Chief Medical Officer has published new alcohol guidelines. Detailed review of scientific evidence since the previous guidelines were set in 1995. New guidelines have been set at a level to keep the risk of mortality from cancers or other diseases low.

3. The Latest Evidence ‘Red wine is good for your heart’ myth: Protective effects of drinking regularly at low levels is only evident in women over the age of 55* Drinking risk and cancer: Drinking any amount of alcohol regularly, does increase the risks of a range of cancers. Drinking risk and gender: The overall health risks are broadly similar for men and women.

4. What’s Changed? Recommended limit of alcohol units for regular drinking is weekly not daily Recommended weekly limit is the same for men as it is for women There is currently no numerical recommended limit for single drinking episodes (drinking on any single occasion) Recommendation for pregnant women and those planning to get pregnant is to abstain completely from drinking alcohol

5. RecommendationOld GuidanceNew Guidance Alcohol units - guidelines DailyWeekly Alcohol units for men and women <3-4 units per day for men <2-3 units per day for women <14 units per week spread evenly over three or more days for men and women Single Drinking Episodes Consuming more than twice the lower risk levels in one day: Men > 8 units / Women > 6 units No numerical unit* General recommendations on ways to reduce risk** Drinking in Pregnancy Months 1-3: Avoid alcohol Months 4+: No more than 1-2 units once or twice a week and should not get drunk or binge drink while they are pregnant. Abstain completely from alcohol whilst pregnant or planning to become pregnant

6. Advice on Regular Drinking Safest not to drink regularly more than 14 units per week. Best to spread this evenly over 3 days or more. One or two heavy drinking sessions in a week increases risk of death from long term illnesses, accidents and injuries. The risk of developing a range of illnesses including cancer, increases with any amount you drink on a regular basis.

7. 14 Units of Alcohol

8. Advice on Single Drinking Episodes No numerical unit limit set for single drinking episodes (drinking on any single occasion)* Reduce risk by: Limiting the total amount of alcohol you drink on any one occasion. Drinking more slowly, drinking with food, and alternating with water Avoiding risky places and activities, making sure you have people you know around, and ensuring you can get home safely.

9. DoH Drinking Categories MENWOMEN Lower Risk Less than 14 units a week spread evenly across 3 or more days. Increasing Risk 15-49 units per week.15-34 units per week. Higher Risk More than 50 units per week (or more than 8 units per day) on a regular basis More than 35 units per week (or more than 6 units per day) on a regular basis Alcohol Dependence Drinking behaviour characterised by an inner drive to consume alcohol, continued drinking despite harm and commonly withdrawal symptoms on stopping drinking

10. Advice on Drinking in Pregnancy For women who are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all. Drinking in pregnancy can lead to long-term harm to the baby; the more that is drunk the greater the risk. The risk of harm to the baby is likely to be low if a woman has drunk only small amounts of alcohol before she knew she was pregnant or during pregnancy.

11. Our Approach in Surrey Communicate the new guidelines widely, including what they mean and advice on how they can be achieved/maintained. Encourage and support people to either: i) continue drinking within the recommended limits or; ii) move towards drinking at lower risk levels. Commissioning evidence-based interventions which promote healthy drinking behaviour and support those who wish to cut down

12. Public Consultation PHE-led public consultation on whether the recommendations and the reasons behind them, are clear and easy to understand. Not seeking feedback on the scientific evidence or how the expert group has used it to decide on their recommendations. Purpose is to ensure the guidelines are practical and useful. Closes: 1 st April 2016

13. Weblinks Health Matters: Harmful drinking and alcohol dependence: https://www.gov.uk/government/publications/health- matters-harmful-drinking-and-alcohol-dependence/health- matters-harmful-drinking-and-alcohol-dependence CMO alcohol guidelines and consultation documents: https://www.gov.uk/government/consultations/health-risks- from-alcohol-new-guidelines

14. Don’t Bottle It Up What is Don’t Bottle It Up? An interactive web-based screening tool that enables people to assess whether their drinking is putting their health at risk, and provides personalised feedback, advice and signposting to local support and services.

15. Don’t Bottle It Up Website Visits & Alcohol Screens How do people find out about DBIU?* 32% - Social media 30% - Search engine 16% - Link on another website ActivityNov 2015 Jan 2016 YTD Monthly Average Website visits18452144515 AUDIT screens8761014244

16. Don’t Bottle It Up Data Drinking Risk Levels (YTD)

17. Don’t Bottle It Up – Audit Screens AreaOctNovDecJanTOTAL 1Epsom and Ewell89832233371 2Elmbridge1213821166337 3Guildford716826130331 4Reigate and Banstead57211101189 5Woking6701273161 6Surrey Heath474963150 7Waverley768451130 8Spelthorne148760116 9Runnymede250653111 10Mole Valley449742102 11Tandridge13784187

18. www.dontbottleitup.org.uk Please promote this link widely to the public and within your own organisation. For further information please contact Gail Hughes: gail.hughes@surreycc.gov.uk