Health Committee - The Government's Alcohol StrategyWritten evidence from The Salvation Army (GAS 08)
The Salvation Army is an international Christian church working in 125 countries worldwide. As a registered charity, The Salvation Army demonstrates its Christian principles through social action and is one of the largest, most diverse providers of social welfare in the world.
The Salvation Army welcomes the publication of the Government’s Alcohol Strategy. This is a welcome declaration of intent to seriously address the detrimental impact of alcohol on individuals, families and society and we look forward to actively contributing to the consultation process.
We have worked closely on the issue of Alcohol Policy including being closely involved in the legislative process in Scotland. The Salvation Army has given evidence to the Scottish Parliament on these vital issues. The Salvation Army has a long history of working with those whose lives are damaged by addictions, most notably to alcohol and drugs. We provide an extensive range of treatment services for those who are recovering from alcohol abuse.
The Committee has invited written submissions and has requested views on the following issues:
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1. The Salvation Army’s Response to Selected Questions
Historically, The Salvation Army has unashamedly expressed the view that excessive alcohol consumption has only a negative impact upon society and we have consistently sought to ameliorate this effect through programmes of intervention, particularly among the most marginalised populations. Sadly, our task has become increasingly difficult over recent years due to the exponential increase in alcohol outlets and the proliferation of stronger and cheaper products.
This, along with the “normalisation of intoxication” reflects an increased tolerance within society of alcohol use, the consequences of which are now all too evident and well documented. Although there is current concern emanating from mortality, liver deaths and crime statistics there are wider issues relating to personal well-being and negative health behaviours, especially in the young, which will hopefully be addressed in the implementation of the alcohol strategy.
The Salvation Army warmly welcomes the Alcohol Strategy and the range of measures that it proposes in order to tackle harmful and hazardous drinking. Every day we see the consequences of excess alcohol consumption on the physical and mental health, careers, relationships and family lives of those we help. Many with alcohol problems have often exhausted the kindness of family and friends and have lost contact with their own children.
There is a huge alcohol related problem in this country. In 2010 we saw over a million alcohol related admissions to hospital. It is costing the NHS an estimated £2.7 billion every year. The number of alcohol related deaths has increased by 101% in the last 20 years.
2. Coordination of Policy Across the UK with the Devolved Administrations, and the Impact of Pursuing Different Approaches to Alcohol
We welcomed the recent move to introduce minimum pricing in Scotland and have given evidence to the Scottish Parliament.
The Health Secretary has introduced a Bill within the Scottish Parliament that looks to implement minimum pricing of alcohol. The price will be set through a formula related to the alcoholic strength. This will be announced during the bill. Whilst we strongly welcome this move we also urge them to set the price no lower than 50p per unit.
Scotland already has introduced a ban on quantity discounts and promotions in retail sales have been restricted, we welcome these moves.
We have also welcomed the Northern Ireland Executive’s moves towards introducing a minimum unit price in Northern Ireland.
We feel that Westminster has been behind the curve on this vital issue and we hope that there will be effective co-ordination, for example in setting a broadly similar minimum price so that “alcohol tourism” does not result from these welcome UK wide measures.
3. The Role of the Alcohol Industry in Addressing Alcohol-Related Health Problems, including the Responsibility Deal, Drinkaware and the Role of the Portman Group
We believe that raising awareness of the negative impact of alcohol use is important and should be prioritised.
Such a belief stands contrary to the current freedoms enjoyed by the industry in the unrestricted promoting of alcohol. We therefore would support an intention to extend the existing regulations to target irresponsible promotions. Promotional activities increase sales and often outweigh the responsibility message. Curtailing promotional activity and increasing the responsibility agenda is a crucial first step in addressing the current imbalance.
We would support proposals to introduce labelling but would prefer to see this as a mandatory requirement rather than a voluntary agreement.
4. The Evidence Base for, and Economic Impact of, Introducing a Fixed Price per Unit of Alcohol of 40p, including the Impacts on Moderate and Harmful Drinkers; Evidence/Arguments for Setting a Different Unit Price; the Legal Complexities of Introducing Fixed Pricing
We acknowledge that the research by The School of Health and Related Research, University of Sheffield in 2008 and 2009 produced a convincing model measuring the potential impact of minimum alcohol pricing on a variety of population groups. We are encouraged by the intention of the Scottish Government to re-run the Sheffield Model to secure up-to date evidence in support of the minimum unit price.
There is a significant body of international research literature on the relationship between the price of alcohol and consumption levels.
“…price affects drinking of all types of beverages, and across the population of drinkers from light drinkers to heavy drinkers. We know of no other preventive intervention to reduce drinking that has the numbers of studies and consistency of effects seen in the literature on alcohol taxes and prices”.
Wagenaar, A C, Salios, M J, Komoro, K A, Effects of beverage alcohol price and tax levels on drinking: a meta-analysis of 1,003 estimates from 112 studies, Addiction, 104, 179–190, Society for the Study of Addiction, 2009.
The evidence suggests that consumers of alcohol increase their drinking when prices are low and decrease their consumption when prices rise. Therefore, public health can be further protected by increases in price.
The current research indicates that setting a level of 50p per unit would result in a significant reduction in alcohol related harms whilst ensuring that alcohol remains affordable for moderate drinkers.
There is a well documented link between this level of harm and the rising cost and availability of alcohol. Minimum pricing per unit is the most efficient, fair and effective way of tackling this problem.
Alcohol has become more affordable and more widely available. In 2010, alcohol was 44% more affordable than in 1980.
This rising availability can be partially explained through the growing price gap between on and off trade sales. In recent years the supermarkets have driven down the price of alcohol selling well below the cost of production.
As such The Salvation Army advocates the introduction of minimum pricing of alcohol at a minimum of 50p per unit.
Setting a basic 50p per unit price for alcohol would mean a can of lager could not cost less than £1, a pint could not be less than £1.50, a bottle of wine could not cost less than £4.50 and a 70cl bottle of spirits could not be less than £14.
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5. The Effects of Marketing on Alcohol Consumption, in Particular in Relation to Children and Young People
We would support interventions aimed to minimise the harm caused to children and young people by alcohol misuse. Accurate information about the physical, emotional and social impact of alcohol misuse should be embedded within our learning structures and young people should be encouraged to build up “personal resilience” to challenge the “cultural norm” of under-age drinking.
We would also suggest that “at risk” groups should be given particular attention and would encourage a more assertive approach to children who suffer through parental alcohol misuse. Early intervention in such groups can minimise the risk that such behaviour is replicated through the family system. Interventions should include easier and quicker access to specialist treatment for parents linked into structured therapeutic programmes that address family issues caused by the alcohol misuse.
We would also be encouraged by the development of “diversionary schemes” which promote alcohol-free alternatives for young people. Meaningful activity should be prioritised with strong role-model leadership in such schemes.
6. The Impact that Current Levels of Alcohol Consumption will have on the Public’s Health in the Longer Term
A number of clients who use Salvation Army services have on-going alcohol related problems. As such The Salvation Army works closely with addiction referral services as well as providing six specialist detox centres in the UK. This is complimented by rehabilitation and support programmes to facilitate recovery and social integration.
The delivery of these services comes at a large monetary cost to the taxpayer and to charities such as The Salvation Army. However it is the cost of ruined lives that is incalculable.
9.International evidence of the most effective interventions for reducing consumption of alcohol and evidence of any successful programmes to reduce harmful drinking, such as:
Public health interventions such as education and information;
Reducing the strength of alcoholic beverages;
Raising the legal drinking age; and
Plain packaging and marketing bans.
The harmful use of alcohol is a global problem and the eyes of the world are on the UK as first the Scottish Government, then the Northern Ireland Executive, and now the UK Government in Westminster all look at radical measures to tackle alcohol misuse.
In Geneva on the 20 May last year the 193 Member States of the World Health Organization adopted in a consensus vote their eagerly awaited Global Strategy to Reduce the Harmful Use of Alcohol.
Addressing price and availability through legislation are consistently recognised as effective, public health interventions and we would strongly encourage Parliament to pursue these options.
Conclusion
The inclusion of a minimum unit price, as a whole population approach, is welcomed. Setting this at a level which has the effect required is, of course, vital to the success of this initiative. The proposed level of 40p, while laudable, is, in our opinion, too low. An entry level of 50p, supported by many who contribute to this debate, should be carefully considered. This opportunity to protect vulnerable lives and tackle the inter-generational misery caused by over consumption of alcohol should not be lost.
Minimum alcohol pricing is one measure to tackle harmful and hazardous drinking and we have offered the Government our support and expertise in seeks to address this problem. The Salvation Army will do all we can to provide, through our community and residential centres, support and help to those whose drinking detrimentally affects their daily lives and helps to minimise the damage that over indulgence of alcohol produces in our society.
The Salvation Army warmly thanks the Committee for the opportunity to respond to this inquiry.
May 2012