Working Together for Better Health & Wellbeing: Understanding What Works Alcohol

1. Working Together for Better Health &
Wellbeing: Understanding What Works
Alcohol
Prof Joe Barry
Chair of Population Health Medicine
Tuesday 9th October 2017

2. Trinity College Dublin, The University of Dublin
Over to you: How can we reduce the
harm from alcohol in Ireland
1. What are the three priorities for North South alcohol
policy in your group?
Draw upon your range of expertise
Draw upon North and South experience
2. What are the barriers?
3. What are the facilitators?

3. Trinity College Dublin, The University of Dublin

4. Trinity College Dublin, The University of Dublin
Alcohol consumption is set to increase in the Irish
population over the next number of years, given:- the
current and projected economic growth; an anticipated
increase in the number of people drinking more beer
which is less sensitive to price increases; possibly greater
access to alcohol through increased special exemptions
for longer opening hours, a greater number of young
people starting to drink at a younger age and a higher
percentage of regular drinkers by the age of 18 years
with a preference for beer; strong alcohol advertising
campaigns in all media in terms of volume, exposure
and extensive sponsorship promotions with highly
visible sports.
Summary - National Alcohol Policy

5. Trinity College Dublin, The University of Dublin
Alcohol consumption per capita, in litres of pure alcohol,
1989-2000 EU countries
1989 2000
Luxembourg 12.5 12.1
Ireland 7.6 11.1
Portugal 10.4 10.8
France 12.8 10.5
Germany 10.4 10.5
Spain 10.8 10.0
Denmark 9.6 9.5
Austria 10.3 9.4
Greece 8.4 8.0
Belgium 9.5 8.4
Netherlands 8.2 8.2
United Kingdom 7.6 8.4
Italy 9.9 7.5
Finland 7.6 7.1
Sweden 5.6 4.9

6. Trinity College Dublin, The University of Dublin

7. Trinity College Dublin, The University of Dublin
Regulate availability
Increase excise duty
Restrict increase in outlets/times
Streamline licensing laws
Promote public awareness of right to object
Prohibit sale of alcohol at children’s special events
Restrict distance sales

8. Trinity College Dublin, The University of Dublin
Number of licences issued in Ireland 1998-2013 by
licence type
1998 2001 2004 2007 2010 2013
Pubs 10,395 11,272 9,946 9,402 8,393 8,414
Spirit
retailers off-
licences
589 792 983 1,342 1,537 1,746
Wine only
off-licences
483 1,284 2,790 3,691 3,206 3,370
Source: Statistical reports 1998-2013, Revenue Commissioners

9. Trinity College Dublin, The University of Dublin

10. Trinity College Dublin, The University of Dublin
Government Alcohol Advisory Group
recommendations
•Recognise specific properties of alcohol (No Ordinary
Commodity)
•Extend ability to object to off-licences to include owners of local
residences
•Voluntary pilot projects with local Gardai to assess the value of
labelling (traceability)
•Gardai to target “Dial-a-can” and similar delivery services
•Prohibit discount promotions
•Bye-laws to prohibit consumption of alcohol in public places
•Garda Commissioner should appoint an officer in each Garda
area with responsibility for alcohol issues

11. Trinity College Dublin, The University of Dublin
Control promotion of alcohol
•Ensure legislation is enacted to reduce exposure of children to
advertising, sponsorships and promotions
•Recommend national sporting bodies to develop a proactive
strategy to find alternative sponsorship
•Ensure international agreements and EU
directives/regulations do not impinge on Government

12. Trinity College Dublin, The University of Dublin

13. Trinity College Dublin, The University of Dublin

14. Trinity College Dublin, The University of Dublin
Deaths on Irish Roads 1961-2011
Blood alcohol reduced to
80 mg/ml
RBT
Blood alcohol
reduced to 100
mg/ml
1st Road
safety
strategy
3rd Road
safety
Strategy
2nd Road
safety
strategy
F Howell, TCD 2016 14

15. Trinity College Dublin, The University of Dublin

16. Trinity College Dublin, The University of Dublin

17. Trinity College Dublin, The University of Dublin

18. Trinity College Dublin, The University of Dublin
Risk to children 1+ harms
child verbally abused
child le in unsafe situa on
child witness to serious violence in home
child physically abused
10.1
9.2
5.4
4.8
2.8
Alcohol's harm to children due to others drinking
One in ten children
were exposed to
1+ harms from
others drinking
%

19. Trinity College Dublin, The University of Dublin
HSE alcohol screening in four emergency
departments, 2010
M-SASQ – Modified Single Alcohol Screening Questionnaire
How often have you had 5 or more standard drinks if female, or 7
or more if male, on a single occasion in the last year?
Less than monthly 460/944 (49%) No intervention
Monthly to weekly 345/944 (36%) Brief advice
Daily or almost daily 83/944 (9%) Referral
Refused to participate 56/944 (6%)
Source: Armstrong & Barry (2014)

20. Trinity College Dublin, The University of Dublin

21. Trinity College Dublin, The University of Dublin
•Recommendations
• Foundation to Reduce Alcohol Misuse
•Enforcement of regulations
• Review existing measures (all stakeholders)
•Education
• Put education at the forefront of public health efforts
• Shape population’s attitudes to alcohol responsibility
•Parental, peer and community engagement
• Support parents
• Resource community networks
• Role models to set an example
Stop out of Control Drinking (Diageo funded)

22. Trinity College Dublin, The University of Dublin
Drugs and alcohol compared
Illicit Drugs Alcohol
Prevalence 1% - 5% Prevalence 80%
Marginal activity Easy to measure
Narrow spectrum of effects Wide spectrum of effects
Mostly among poorer people All classes
Users have little power Users mainstream
Suppliers pariahs Suppliers powerful