Science and Technology Committee HC 1536 Alcohol GuidelinesWritten evidence submitted by The British Beer & Pub Association, The National Association of Cider Makers, The Scotch Whisky Association and The Wine and Spirit Trade Association (AG 08)

We welcome the opportunity to respond to the Science and Technology’s Committee’s inquiry into the evidence base for alcohol guidelines. This response is presented on behalf of trade associations representing nearly 500 companies in the UK alcoholic drinks sector, which range from global businesses to SMEs, producers to retailers. We are:

The British Beer & Pub Association (BBPA);

The National Association of Cider Makers (NACM);

The Scotch Whisky Association (SWA); and

The Wine and Spirit Trade Association (WSTA).

This response is limited to questions 3 and 4 within the remit of the Committee’s inquiry, namely:

3.How well does the Government communicate its guidelines and the risks of alcohol intake to the public?

4.How do the UK Government’s guidelines compare to those provided in other countries?

We do not consider ourselves best placed to comment on scientific advice and evidence underpinning the current guidelines.

Summary

Industry is committed to helping people drink within guidelines. We want a future for the alcohol industry in which our products are made, sold and enjoyed responsibly. The health and well-being of consumers is important to the industry, which is why we promote a range of activity to encourage people to drink within recommended guidelines.

More people are drinking responsibly. Evidence indicates that there is greater awareness of units and guidelines, alcohol consumption has declined and more people are drinking within recommended guidelines. This suggests that action to communicate guidelines and the risks of alcohol misuse is helping to change drinking behaviour.

No wish to see a change in the recommended drinking guidelines at the present time. The adoption of revised guidelines would undermine the progress which has been made in improving awareness of the current guidelines and the future work the industry has committed to deliver under the Public Health Responsibility Deal.

Question 3: How well does the Government communicate its guidelines and the risks of alcohol intake to the public?

Action to communicate drinking guidelines and risks of alcohol misuse

1. There has been concerted action by government, industry and NGOs to encourage people to drink more responsibly. Better education and information campaigns have been central planks of the Government’s alcohol strategy. However in considering how well the guidelines are communicated, it would be wrong to focuss on government initiatives in isolation. Industry can reach consumers in ways which government cannot and has worked to communicate units and sensible drinking guidelines in a range of ways.

Labelling

2. In 2007, the industry reached a voluntary agreement with the Government to communicate unit information and recommended drinking guidelines on product labels. Five elements for inclusion on labels were: unit content; the Chief Medical Officer’s recommended daily guidelines; a drinking when pregnant warning; a responsible drinking message and the Drinkaware website address. The industry’s commitment as part of the Department of Health’s Public Health Responsibility Deal builds on this agreement and takes it further (see paragraph 21 below).

Drinkaware

3. Through voluntary donations, the industry supports Drinkaware, an independent, UK-wide charity which tackles alcohol misuse. It carries out campaigning and educational work to equip people with the knowledge they need to drink responsibly. The Drinkaware website offers tools to help people drink within guidelines, such as a simple unit calculator. The Drinkaware web address now features on over five billion drinks containers and online, in print, poster cinema and television advertising.

4. The Drinkaware “Why let good times go bad?” campaign is targeted at encouraging 18 to 24 year olds to drink responsibly. The five-year, £100 million advertising campaign utilises behaviour change messaging and focuses on practical tips for sensible drinking, such as alternating alcoholic drinks with water. Now into its third year, the campaign is delivering results. Following the 2010 activity, 70% of the target audience said they would re-consider their drinking behaviour and 74% said they would drink more responsibly.

Alcohol Awareness Week in Scotland

5. Alcohol Awareness Week is an initiative from the Scottish Government Alcohol Industry Partnership supported by Government, the alcohol industry, health stakeholders and a broad range of other organisations. First launched in 2007, the responsible drinking campaign takes place over a one-week period in October, to make people aware of responsible drinking tips and help them understand the number of units in the drinks they consume.

6. For maximum impact, the campaign uses a range of resources, from bill boards, a website and local events. This ensures that consumers are exposed to messages in a variety of locations, whether they are visiting their local supermarket, going to the pub, travelling to work or watching TV. Over 600,000 unit measure cups and 350,000 unit calculators have been distributed in Scotland as part of Alcohol Awareness Week.

“Know Your Drinks” Campaign

7. In October 2006, the Home Office and Department of Health launched the first Know Your Limits campaign, aimed at 18–24 year old binge drinkers. The Government’s updated alcohol strategy launched in June 2007 outlined plans to build on this with a second phase of work with the drinks industry, to display unit information and sensible drinking information at points of sale.

8. As a result of this, the WSTA and Drinkaware launched the “Know your Drinks” point of sale campaign in 2008. The campaign was built around two core elements: clear guidance to people about the units of alcohol they are consuming, relating information to types of drink and complementary tips encouraging people to drink sensibly and responsibly. It included short, simple messages such as “Know your drinks…a standard 25ml measure of 40% ABV spirit is 1 unit.” Materials were designed in a variety of formats, from posters, shelf edge stickers, web banners and hanging installation displays. Materials were used in well over 10,000 retail outlets run by WSTA members.

Progress: More people are drinking responsibly

9. The factors influencing the level of a population’s alcohol consumption are complex. However recent trends in consumption suggest that the work by government, industry and NGOs to communicate sensible drinking messages is having an impact. Much of the public policy debate on alcohol is shaped by the assumption that alcohol consumption is increasing in the UK. In fact, the reverse is true, with more people drinking within the recommended guidelines.

Average consumption has fallen

An analysis of HMRC clearance data shows that total alcohol consumption fell by 11% between 2004 and 2010.

According to the latest available data, in 2009 average weekly consumption was below government guidelines at 11.9 units a week, down from 13.5 in 2006. Average male consumption was 16.3 units a week, down from 18.7 in 2006. Average female consumption was 8 units, down from 9 units in 2006.

More people are drinking within guidelines

The proportion of men in Great Britain drinking more than 21 units a week has fallen from 31% in 2006 to 26% in 2009. The share of women drinking more than 14 units a week has dropped from 20% to 18%. The downward trend has also occurred among 16-24 year olds, with a significant drop in young men drinking more than recommended weekly guidelines from 30% in 2006 to 21% in 2009.

The proportion of people exceeding the guidelines on their heaviest drinking day has decreased since 2004. The proportion of men exceeding four units on their heaviest drinking day was 41% in 2007 and 37% in 2009, with an even greater reduction in the 16-24 age group. The proportion of women drinking more than three units in a day was 34% in 2007 and 29% in 2009.

Binge drinking continues to decline

The number of people reporting binge drinking (over 8 units for men and 6 units for women) on at least one day in the previous week continues to fall. Men down from 23% in 2006 to 20% in 2009 and women down from 15% to 13%. Again, the drop amongst men in the 16-24 age group has been even greater—from 30 to 24%.

10. The Chief Medical Officer recommends that children should not drink any alcohol until they are at least 15. The most recent evidence suggests that more young people are choosing not to drink alcohol.

The proportion of 11-15 year olds in England who had never drunk alcohol increased from 39% in 2003 to 55% in 2010. The proportion of pupils who drank alcohol in the last week dropped from a peak of 26% in 2001 to 13% in 2010.

Underage drinking less acceptable

Young people are also becoming less tolerant of drinking amongst their peers. In 2010, just under a third—32%—agreed that it was acceptable for someone of their age to drink alcohol once a week, compared with 46% in 2003.

Knowledge of units and sensible drinking guidelines has increased

11. Knowledge of units and alcohol guidelines arms individuals with the information they need to be able to monitor how much they drink. Such knowledge does not necessarily mean that a person will drink less: they can choose to ignore sensible drinking advice. However the declines in consumption and adoption of more responsible drinking habits have occurred alongside greater awareness and understanding of units and guidelines. This again suggests that campaigns to communicate responsible drinking have helped to foster this change.

Understanding of units

12. According to the latest available ONS survey data, knowledge of alcohol units has increased considerably over the past decade:

90% of people have heard of units, up from 79% in 1997.

It is especially important that people understand what a unit of alcohol is of the drinks they regularly consume. It is welcome that there have been considerable increases in the proportions of people regularly drinking beer, wine and spirits who are able to identify a unit of that drink.

REGULAR DRINKERS OF BEER/WINE/SPIRITS WHO COULD CORRECTLY IDENTIFY A UNIT OF THAT DRINK

	1997	2009
Drinkers consuming beer at least once a week	54	69
Drinkers consuming wine at least once a week	67	83
Drinkers consuming spirits at least once a week	57	67

In 2009, just two years after the voluntary industry agreement with government on unit and health labelling, almost a half—49%—of drinkers who had heard of units had seen unit labelling on alcohol. This is up from just 23% in 2000.

Knowledge of drinking guidelines

13. There has also been an increase in the knowledge of daily drinking guidelines of three to four units a day for men and two to three units for women:

In 2009, 75% of people had heard of the daily drinking limits, up from 54% in 1997. Unsurprisingly, those who drink the least are less likely to have heard of these limits.

In 2009, 44% of people could correctly identify the recommended limit for men, up from 35% in 1997.

The proportion knowing the female daily limit is up from 39% to 52%.

Knowledge of health risks

14. A high proportion of people understand the risk of health problems linked to alcohol misuse. In 2009, 96% of people are aware of the risk of accidents and liver disease. The majority of people are aware that alcohol misuse increases the risk of depression (85%), hypertension (82%), coronary heart disease (77%), stroke (68%) and pancreatitis (64%).

Progress still to be made

15. Despite this welcome progress, there is still work to be done to promote sensible drinking and encourage people to use the advice they are being given. For a minority, alcohol misuse and drinking in excess of recommended guidelines remains a problem.

16. For example, still too few people monitor the number of units they are drinking. The proportion of people who keep a daily or weekly check on the number of units drunk has fluctuated between 11 and 16% since 1997.

17. Similarly, despite CMO advice that children should not drink any alcohol until they are at least 15, underage drinking persists. Significant progress has been made though action to tackle underage purchases of alcohol, including industry initiatives such as Challenge 21 (on trade) and Challenge 25 (off-trade). However young people access alcohol from a variety of sources. In 2010, 20% of 11 to 15 year olds who had obtained alcohol in the previous month said they had been given it by parents.

Going Further: Industry commitments under the Public Health Responsibility Deal

18. The Public Health Responsibility Deal, launched in March 2011, will go even further towards ensuring widespread understanding of the recommended drinking guidelines. As Trade Associations, we have been at the forefront of the work on the alcohol strand of the Deal. WSTA Chief Executive, Jeremy Beadles, is co-chairman of the Alcohol Network, the group charged with overseeing development of the voluntary alcohol pledges.

19. By August 2011, more than 200 organisations had signed up to the Deal as a whole, with half supporting seven collective alcohol pledges to help foster a culture of responsible drinking. The Deal represents a long-term programme of work, with new pledges being developed over the coming months.

20. Existing pledges range from ongoing support for Drinkaware to the development of community initiatives to tackle alcohol-related issues. Three pledges focussed specifically on communicating sensible drinking guidelines to consumers are around labelling and unit awareness campaigns.

Labelling commitment

21. Building on the 2007 voluntary labelling agreement, the industry has pledged to include clear unit labelling, NHS guidelines and a warning about drinking when pregnant on over 80% of alcohol products on shelves by 2013. The Portman Group has agreed to monitor the industry's implementation of the pledge. Criteria agreed with the Department of Health will ensure labels display information in a clear and consistent manner.

22. Businesses will also be encouraged to include two additional elements, which are the Drinkaware web address and a responsibility statement such as “drink sensibly” or “know your limits”. Left is an example of an acceptable label format.

Unit awareness campaigns

23. There will be two separate, but coordinated, campaigns in the on and off trades to increase consumer awareness of units, NHS drinking guidelines and health harms related to alcohol. The BBPA and WSTA will work in partnership with Drinkaware to develop the two respective campaigns. The off-trade campaign will draw on material produced for use in pubs and clubs in order to provide consistent messaging wherever alcohol is being consumed.

24. In the on-trade, campaign materials are in the process of being piloted in selected BBPA member pubs. These include newly designed posters, tent cards and beer mats featuring the slogan “how many units in your drink?” The materials adopt a “2-2-2-1” approach, to show the units in a typical pint of 4% abv beer, a typical 330ml bottle of 5% beer, a 175ml glass of 12% wine, and a 25ml single serve of a 40% spirit. The design follows extensive research conducted with consumers and retailers in partnership with Drinkaware.

Question 4: How do the UK Government’s guidelines compare to those provided in other countries?

25. Many countries have recommended drinking guidelines. However there is no international consensus on what constitutes a sensible daily limit or indeed how a unit of alcohol is measured— the average ranges between 8 and 14 grams of pure ethanol. Many countries have a maximum recommended gram intake per day without defining a unit. This makes international comparisons of recommended drinking advice difficult.

26. The International Centre for Alcohol Policies compiles information on recommended drinking guidelines from around the world. A simplified version of the ICAP table is reproduced below, with the countries approximately ranked according to the recommended daily consumption for men in terms of grams of alcohol. This demonstrates that there is considerable variance in sensible drinking guidance offered worldwide. With its guideline of 3-4 units of alcohol a day for men, equivalent to 24-32g of alcohol, the UK is roughly mid-table, with a higher limit than the USA and Australia but lower than European neighbours such as Italy.

27. It should be noted that there does not appear to be a correlation between recommended drinking guidelines and consumption patterns. For example, countries such as Germany and Ireland have higher overall alcohol consumption but similar recommended daily guidelines to the UK. Italy and Netherlands have lower overall alcohol consumption but higher recommended guidelines.

INTERNATIONAL COMPARISONS OF RECOMMENDED ALCOHOL CONSUMPTION GUIDELINES:COUNTRIES RANKED ACCORDING TO MALE DAILY GUIDELINES

Country(rankedlow to high)	Unit/standarddrink	Men	Women
Japan	19.75g	1-2 units/day (19.75-39.5g/day)
United States	14g	1-2 units/day (14-28g/day), not to exceed 14 units/week (196g/week)	1 unit/day (14g/day), not to exceed 7units/week (98g/week)
Australia	10g	no more than 2 standard drinks (20g) on any day reduces lifetime risk	no more than 2 standard drinks on any day
Poland	10g	2 units/day (20g/day) up to 5 times/week (not to exceed 100g/week)	1 unit/day (10g/day) up to 5 times/week (not to exceed 50g/week)
Slovenia	N/A	not to exceed 20g/day and 50g/ on a drinking occasion	not to exceed 10g/day and not to exceed 30g/drinking occasion
Sweden	N/A	not to exceed 20g/day	not to exceed 20g/day
Czech Republic	N/A	less than 24g per day	less than 16g per day
Austria	10g	24g pure ethanol per day	16g pure ethanol per day
Finland	11g	not to exceed 15 units/week (165g/week) [equivalent to 24g a day]	not to exceed 10 units/week (110g/week)
Germany		not to exceed 24g/day	not to exceed 12g/day
United Kingdom	8g	should not regularly drink more than 3-4 units/day (24-32g/day)	should not regularly drink more than 2-3 units/day (16-24g/day)
Canada	13.6g	not to exceed 2 units per day (27.2g/day); 14 units per week (190g/week)	not to exceed 2 units/day (27.2g/day); 9 units per week (121.5g/week)
Portugal	14g (unofficial)	2-3 units/day (28-42g/day)	1-2 units/day (14-28g/day)
Spain	10g	not to exceed 3 units/day (30g/day)	not to exceed 3 units/day (30g/day)
New Zealand	10g	not to exceed 3 units/day (30g/day), 21units/ week (210g/week)	not to exceed 2 units/day (20g/day), 14 units/week (140g/week)
France	10g	not to exceed 30g/day	not to exceed 30g/day
Ireland	10g	21 units/week (210g/week) [equivalent to 30g a day]	14 units/week (140g/week)
Romania	N/A	not to exceed 32.5g beer/day or 20.7g wine/day	not to exceed 32.5g beer/day or 20.7g wine/day
Denmark	12g	not to exceed 21 alcohol units (252g) a week [equivalent to 36g a day]	not to exceed 14 (168g) units a week
South Africa	N/A	not to exceed 21 units/week (252g/week) [equivalent to 36g a day]	not to exceed 14 units/week (168g/week)
Nether-lands	9.9g	not to exceed 4 units/day (39.6g/day)	not to exceed 2 units/day (19.8g/day)
Italy	12g	less than 40g per day	less than 40g per day

September 2011