1. THE NORTH EAST ALCOHOL OFFICE Tackling Alcohol Harm in Durham 12 May 2015 Colin Shevills Director THE NORTH EAST ALCOHOL OFFICE

2. Tackling alcohol harm The problem with alcohol Levels of harm Impact on the economy What the evidence says What the public thinks How we can work together

3. THE NORTH EAST ALCOHOL OFFICE The trouble with alcohol … World’s third leading cause of ill health and premature death Linked to 60 different medical conditions – same cancer causing group as tobacco Significant contributor to crime and disorder One-third of offenders in NE alcohol dependent Linked to domestic abuse, child protection and self-harm Liver disease could overtake stroke and coronary heart disease as cause of death within 20 years

4. THE NORTH EAST ALCOHOL OFFICE British Liver Trust / ONS 2009 UK Mortality Trends

5. THE NORTH EAST ALCOHOL OFFICE Biggest impact on vulnerable As many as 1 in 100 births affected by FASD 1 child admitted to hospital every day in NE Highest numbers under 18s in treatment Quarter male deaths 16-24 years due to alcohol Alcoholic liver admissions up 300% in under 35s Over 65 admissions doubled in 10 years Least affluent more likely to suffer harm 45% more likely to suffer alcohol related death Almost three times more likely to end up in hospital 36% domestic violence cases - likely to be under - estimate

6. THE NORTH EAST ALCOHOL OFFICE Industry vs Public Health INDUSTRY MODEL Problem – few bad people who can’t control themselves Solution – partnership, education, enforcement PUBLIC HEALTH MODEL Problem – addictive drug irresponsibly produced, priced, promoted, sold Solution - regulation

7. THE NORTH EAST ALCOHOL OFFICE Impact in Durham 2 in 5 drinking at risky levels Alcoholic liver disease admissions up 46% in 6 years Wholly attributable admissions up 54% in 6 years Related admissions up 64% in 6 years Some improvement in last year: Men’s specific admissions fell 8.7% Women’s specific admissions fell 6.4% Under 18 specific admissions fell 20.6% Effect of tax and duty cuts?

8. THE NORTH EAST ALCOHOL OFFICE NHS:£50.35m CRIME & LICENSING:£51.82m WORKPLACE:£94.97m SOCIAL SERVICES:£16.70m TOTAL COST + :£211.72m + Total cost excludes crime related healthcare costs. The crime cost minus healthcare figure used for the adjacent pie chart is £49.71m OVERALL COST PER HEAD COUNTY DURHAM:£413 NORTH EAST: £419 PUBLIC HEALTH ENGLAND (PHE) NORTH REGION:£413 ENGLAND: £402 DDES costs for alcohol specific admissions – Total - £3.5m Ave per practice - £82,114 Total admissions – 2,096 All alcohol related admissions – Total - £11.9m Ave per practice - £282,519 Total admissions – 7,068 Economic Impact

9. THE NORTH EAST ALCOHOL OFFICE What the Evidence Says AFFORDABILITY Alcohol 61% more affordable than 1980 NICE: “Making alcohol less affordable is the most effective way of reducing alcohol related harm” MUP (50p): Targets children and heavy drinker Doesn’t penalise moderate drinkers or poor – 80%+ lives saved from less affluent Would help community pubs Deaths down 960; crimes down 50,700; hospital admissions down 35,100 Deaths fell 32% in British Columbia after 10% increase in minimum price

10. THE NORTH EAST ALCOHOL OFFICE

11. BBPA handbook

12. THE NORTH EAST ALCOHOL OFFICE Affordability driving the problem

13. THE NORTH EAST ALCOHOL OFFICE 50p Heavy drinkers buy cheapest booze

14. THE NORTH EAST ALCOHOL OFFICE What the Evidence Says AVAILABILITY Places selling alcohol doubled since 1950s NICE: “…making it less easy to buy alcohol … is another effective way of reducing alcohol related harm” LICENSING ACT Presumption to approve Move to off sales, pubs closing More inappropriate locations – soft play, multiplex cinemas

15. THE NORTH EAST ALCOHOL OFFICE What the Evidence Says PROMOTION NICE: “…children and young people should be protected as much as is possible by strengthening the current [marketing] regulations” LATEST 1 in 4 cinema ads for alcohol Children see more TV alcohol ads than adults Football on TV – 111 visual references to alcohol an hour UK has some of laxest regulation in Europe

16. THE NORTH EAST ALCOHOL OFFICE What the Evidence Says SCREENING and BRIEF ADVICE NICE: “NHS professionals should routinely carry out alcohol screening as an integral part of service provision …non-NHS professionals should focus on groups that may be at an increased risk of harm” SPECIALIST TREATMENT Treatment effective and cost effective – 1:5 ROI NICE, DH, Alcohol Concern all recommend c15% dependent drinkers should be in treatment

17. THE NORTH EAST ALCOHOL OFFICE What does the public think? 50% support MUP – 31% oppose 7 in 10 support 9pm watershed TV ban and no ads in cinema unless showing 18 film 45% support restricting sports sponsorship – 32% oppose 99% say enough or too many places selling alcohol 80% support health warnings on product labels

18. THE NORTH EAST ALCOHOL OFFICE What is NHS view? Five Year Forward View: “The NHS will back hard-hitting national action on obesity, smoking, ALCOHOL and other major health risks” “NHS … can and should now become a more activist agent of health-related social change” “… we will actively support comprehensive, hard- hitting and broad-based national action to include information and labeling, targeted personal support and wider changes to distribution, marketing, pricing and product formulation.”

19. THE NORTH EAST ALCOHOL OFFICE What can we do? Support national action on pricing, marketing, licensing, drink driving and labeling: Sign up to Local Alcohol Declaration Write to ministers Contact/meet your MP Write to media Support our campaigns: alcohol and cancer Promote on websites and in surgery Act as spokesperson Find case studies Make alcohol screening integral to service provision

20. THE NORTH EAST ALCOHOL OFFICE Tackling Alcohol Harm in Durham 6 February 2015 Colin Shevills Director THE NORTH EAST ALCOHOL OFFICE