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The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): I congratulate my hon. and learned Friend the Member for Dudley, North (Ross Cranston) on his success in securing a debate on this important topic.
As we know, about 90 per cent. of adults in Britain drink alcohol and most of them drink sensibly for most of the time, but we are all aware of the harms associated with alcohol misuse. My hon. and learned Friend knows that the Government are committed to tackling those harms, which is why we are currently developing an alcohol harm reduction strategy for England. In the national health service plan, we said that we would implement the strategy during 2004 and I am pleased to say that we are on course to achieve that timetable. This will be the first time that there has been a co-ordinated and joined-up effort to tackle alcohol-related harm in England and I am pleased to be involved in the current work.
It is important to ensure that we develop a robust and effective strategy, so it is vital that we draw in the expertise of all the stakeholders, including the all-party group on alcohol misuse, which has contributed to the work to date. I thank the group for its contribution. Over the last seven months, since I took over the public health brief, I have been struck by the number of stakeholders, both inside and outside Government, involved in tackling alcohol-related harm. That demonstrates beyond doubt that a joined-up approach is needed, and that we will be able to build a successful strategy only if we recognise that the Government cannot tackle the problems of alcohol misuse alone. The contribution of the voluntary sector, the private sector and individuals themselves will be needed if the strategy is to make a real difference.
My hon. and learned Friend mentioned some of the harms associated with alcohol misuse. As he noted, the Prime Minister's strategy unit recently published its interim analytical report, which gives a comprehensive account of the types of alcohol-related harm that are most prevalent in modern-day England. My hon. and learned Friend has mentioned some, and I, too, shall refer to a few of them.
On the harm to health, we know that between 15,000 and 22,000 people die in England each year as a result of alcohol misuse, and that such misuse accounts for 150,000 hospital admissions each year. The strategy unit
also commissioned research that indicated that about one third of all attendances at accident and emergency departments are alcohol-related. It is certainly clear that addressing health harms will need to be a cornerstone of the strategy.My hon. and learned Friend mentioned alcohol-related crime and antisocial behaviour. He will be aware that the strategy unit's interim analytical report noted that the cost of alcohol-related crime in England has risen to £4.7 billion per year. Action to combat alcohol-related crime will also need to be at the forefront of the strategy.
Before moving on to other matters, I join my hon. and learned Friend in commending the Stella project. As he said, the project works with mainstream substance misuse services to ensure that they can offer non-judgmental help to both perpetrators and victims of domestic violence. The project provides a valuable resource for substance misuse services in the capital, and I add my praise to that of my hon. and learned Friend.
My hon. and learned Friend referred to the evening economy and the problems generated by alcohol-related crime and disorder in an evening economy that often seems to exist only to serve younger people. Supporting urban regeneration by developing a diverse evening economy that caters for a range of ages and leisure tastes will be quite a challenge for the Government, local authorities and leisure providers to meet.
I shall briefly mention some of the risk factors and the reasons why people misuse alcohol. Several factors were identified in the interim analytical report and without understanding what they are we shall not be able develop effective interventions. A number of individual risks were reportedpersonality, attitudes and beliefs, genetic make-up, age and gender, occupation and, indeed, even the region where people liveall of which have a role to play in whether someone develops a problem and misuses alcohol.
Of course, those individuals do not live in a vacuum, and the report also identifies a number of other factors in an individual's immediate environment that increase risk: family structure and parental divorce, parental drinking and parental attitudes to drinking, relationships with parents and pressure from and relationships with peers and friends.
Of course, risks are posed by the wider culture. The unit's analysis shows that culture and attitudes towards alcohol are driven by multiple influences. At various times, as we all know, many people will use alcohol to be sociable, to gain acceptance as part of a group, to relieve stress or to deal with trauma and to get drunk. The culture of getting drunk and going out to get drunk is particularly worrying, as my hon. and learned Friend and my hon. Friend the Member for Newcastle upon Tyne, Central (Mr. Cousins), who is also present, will agree. The strategy unit's analysis found that going out to get drunk was particularly associated with the 16 to 24 age group, and that, in turn, it could increase the risk of suffering certain alcohol-related harm, particularly alcohol-related violence.
The interim analysis also considered the extent to which the market for alcoholic drinks can pose additional risks for individuals. The unit found that
price and availability could influence alcohol consumption and, presumably, could therefore influence alcohol misuse as well, but an individual's relationship with the alcohol market and the extent to which the market shaped drinking preferences or was shaped by them was far less clear. That lack of clarity comes to the fore when we consider the marketing and advertising of alcoholic drinks.The relationship between marketing, advertising, attitudes and behaviour is, of course, complex. My hon. and learned Friend drew attention to the often conflicting evidence in that area, with one study noting that higher expenditure on alcohol advertising appears to be associated with higher alcohol consumption, while findings from other studies appear to suggest that an advertising ban would not lower alcohol consumption. Furthermore, the strategy unit found that seven in 10 people thought that advertising influenced the amount that others drank, but only one in 10 felt that advertising influenced the amount that they drank.
I think that it has been worth while spending this short time considering those risk factors, as they serve to show us that the reasons lying behind an individual's alcohol misuse can be very complex, and they demonstrate the scale of the challenge that the Government and our partners face in tackling alcohol misuse.
The unit is entering the final stage of its work on drafting the alcohol harm reduction strategy for England. I cannot yet discuss the detailed options that the strategy will contain, but I can say that it will be firmly based around effective interventions in the four main areas: education and communication, supply and pricing, health and treatment services and, finally, community safety and criminal justice. The final strategy will need to contain interventions in all four areas, and it will also need to ensure that the initiatives fit together into a coherent whole, as well as linking to other Government initiatives in the fields of health, crime, antisocial behaviour and so forth.
My hon. and learned Friend has made some valuable suggestions on ways to tackle alcohol misuse, and I should like to discuss them. He suggested the tightening of the current statutory and voluntary codes on advertising, with the option to regulate alcohol advertising in the future; cracking down on irresponsible retail promotions that encourage excessive drinking; displaying sensible drinking information in licensed premises; ensuring that reasonably priced non-alcoholic drinks are available; unit labelling of alcohol containers; an awareness campaign to raise the knowledge of alcohol misuse and its potential for harm; and a levy on alcohol advertising expenditure. As ever, my hon. and learned Friend has come up with some interesting and innovative suggestions, which will be considered by the strategy unit team.
We have seen that there is no evidence to suggest that there is a clear link between the advertising and the promotion of alcoholic drinks and alcohol consumption or misuse. However, as a society we believe that unrestricted advertising and promotion is not acceptable and, as my hon. and learned Friend has noted, we have a number of statutory and non-statutory
codes that seek to ensure that the advertising of alcoholic beverages is not aimed towards young people, does not promote excessive drinking and does not suggest that alcohol consumption can be linked with physical, mental, social or sexual success.My hon. and learned Friend mentioned some recent advertisements that do not appear to be in keeping with the spirit of the codes, and I certainly agree with him. He noted that some drinks manufacturers have begun to take their social responsibilities more seriously and have taken steps to ensure that their advertisements are in keeping with both the spirit and the letter of those codes. Like him, I commend those companies that have chosen to take that action. However, as he notes, there is a growing concern that the self-regulatory elements of our framework are not working as well as they could or should. Ensuring that we can have confidence in our arrangements for alcohol advertising is crucial, and proposals in this area will certainly form part of the strategy.
In relation to irresponsible retail promotions and my hon. and learned Friend's reference to the recent Nicholson committee review in Scotland, we too have read the report with interest and I am always keen to review the practices of and learn from others with an interest in tackling alcohol misuse. We will give careful consideration to the committee's proposals for dealing
with those irresponsible retail promotions of alcoholic drinks that result in excessive drinking, even if they do not set out actively to encourage such drinking.I assure my hon. and learned Friend that we will be looking very carefully at his other suggestions. An examination of the best ways of getting information about alcohol misuse to the public will be one of the fundamental parts of the strategy, and our work in this area will also cover issues such as the display of unit information and the sensible drinking message. I am looking forward to hearing what people have to say about the proposals for an advertising levy set out in the Labour party's big conversation.
In conclusion, I thank my hon. and learned Friend for the opportunity to discuss an interesting and useful topic and for the coverage that it has given to issues relating to the marketing of alcohol and to other issues that are crucial if we are successfully to tackle alcohol misuse. Again, I thank him and his colleagues in the all-party group for providing a valuable contribution to the ongoing development of our alcohol harm reduction strategy for England, and I promise him that it will not be too much longer before he will have the pleasure of seeing the finished piece of work.
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