Health CommitteeWritten evidence from Drinkaware (GAS 16)

1. About Drinkaware

1.1 Drinkaware provides consumers with information to make informed decisions about the effects of alcohol on their lives and lifestyles. Our public education programmes, grants, expert information, and resources help create awareness and effect positive change. An independent charity established in 2007, Drinkaware works alongside the medical profession, the alcohol industry and government to achieve its goals.

1.2 Drinkaware is entirely funded by voluntary donations from across the drinks industry, but operates completely independently from it. Our board is made up of five members of the health community, five members of the drinks industry and three independents. This structure enables the organisation to act independently whilst being fully funded through voluntary donations from industry.

1.3 Our behaviour change campaigns are designed using an evidence-based approach. Drinkaware provides consumers with best evidenced information and facts about alcohol. Our independent medical advisory panel checks all information, web, and printed materials to ensure their accuracy and that it reflects the most current evidence.

1.4 We promote responsible drinking and find innovative ways to challenge the national drinking culture to help reduce alcohol misuse and minimise alcohol-related harm. One example is our five-year £100 million “Why let good times go bad?” campaign which is already delivering measurable results.1

1.5 Drinkaware was established following a Memorandum of Understanding between the Portman Group, the Department of Health, the Home Office, Scottish Executive, Welsh Assembly Government and Northern Ireland Office. This enabled the Portman Group’s former campaigning arm—called the Drinkaware Trust—to be transformed into an independent charity in 2007.

1.6 We provide accessible, free-of-charge, evidence-based information about alcohol and its effects on employers, young people, teachers, parents and community workers. Using a range of media, such as interactive educational resources, film, social media, multimedia and outdoor advertising, we help dispel myths and present the best evidenced facts about alcohol.

1.7 Our campaigns focus on specific demographics as our evidence suggests that this targeted approach yields results.

2. Declaration of Interest

2.1 Drinkaware welcomes the opportunity to submit evidence to this inquiry. As the leading source of alcohol information for consumers in the UK, with more than 320,000 unique visitors coming to its website every month, Drinkaware is one of the primary resources consumers turn to for evidence-based advice.

2.2 Our brand is displayed on at least 5 billion drinks containers every year and independent research shows that 44% of consumers questioned believe that the Drinkaware logo is a prompt to consume alcoholic drinks responsibly.2

2.3 This submission, following the publication of the Government’s Alcohol Strategy, responds to a number of the Committee’s key terms of reference. It provides a detailed response to subject areas where Drinkaware is able to supply clear evidence and where it does not conflict with our Memorandum of Understanding which precludes us from commenting directly on policy matters.

3. Summary of our Views

3.1 Our views can be summarised as follows:

Evidence suggests that the Alcohol Strategy’s emphasis on a “long-term and sustained action by local agencies, industry, communities and Government” is appropriate.

The strategy makes positive reference to two of our current programmes. The first is a campaign to make information more easily available to 18–24 year olds, entitled “Why let good times go bad?” and the second is the research project we are facilitating in Wales on the use of “social norms”.

Whilst irresponsible and harmful drinking amongst young people remains problematic, levels of this activity have declined and it is important that young people know that the majority (55%) of 11–15 year olds have never drunk alcohol; a percentage that has increased in recent years.3

Alcohol misuse among young adults remains an issue which needs to be tackled, but evidence suggests that we should not overlook other at-risk drinkers.

Tackling alcohol misuse among under-18s is a key area for Drinkaware. Parents are the biggest influence on their child’s attitudes to drinking. Drinkaware research4 highlights that 72% of the 10–17 year olds questioned say their parents are the first people they would approach with questions about alcohol, yet half (50%) of those who have had a drink report it was their parents who supplied them with the alcohol the last time they drank.5

Drinkaware’s Parents’ campaign6 seeks to give parents support and age appropriate advice on how to talk to their children about alcohol in the pre-teen years. It encourages parents to delay the age of their first drink to the UK Chief Medical Officers’ guidance of 15 years old.7

Educational public health interventions based on acquiring “life-skills” have a strong evidence base for reducing alcohol misuse among under-18s. Drinkaware has begun to roll out a life-skills based programme called In:tuition in UK schools.

Another of Drinkaware’s target groups is middle class working professionals (aged 25–44) who drink regularly (at least once a week). The proportion of this group who drink regularly is considerably higher than for the 18–24s age group (67% vs 47%).8 evidence which was confirmed by recent ONS statistics.9

In response to this problem, Drinkaware launched a drinks tracker in May 2011 called MyDrinkaware. The new tool is an easy-to-use multi-faceted tool, which supports people in their efforts to moderate their drinking and engages with wider lifestyle issues. It combines a drink diary, budget manager and diet programme into one online and mobile tool and delivers personalised feedback on the risk levels associated with a person’s alcohol consumption.

Evidence suggests that changing attitudes towards drinking is critical to reducing alcohol misuse in the UK. Drinkaware believes that, while it is highly valuable to provide information to consumers on the consequences of excessive drinking, this action should be balanced by simultaneously taking action to address the underlying foundations of popular attitudes towards alcohol.

4. Question 1: Who is responsible within Government for alcohol policy in general, policy coordination across Whitehall and to what extent should the Department of Health take a leading role?

4.1 Drinkaware’s Memorandum does not permit the organisation to comment on policy, this includes the extent to which individual Government departments take a leading role on alcohol policy. However, as a charity with a national perspective, we have evidence to suggest that the Alcohol Strategy is correct to highlight the importance of effective partnership working at both the local and national level.

4.2 Drinkaware has worked with the UK Government in communicating unit guidelines. This work has included coordinating campaigns and messages to reflect Government advice as well as practical partnerships including mail drops of a “unit and calorie calculator” to more than 2.3 million households in support of the Change4Life January 2011 campaign activity.

4.3 Drinkaware engages with all major departments involved in alcohol policy implementation to ensure that we are communicating the best evidenced information once it has been established by Government and to share our research findings. This includes the Department of Health, the Home Office, the Department for Education and the Department for Transport.

5. Question 2: How well does the coordination of policy across the UK with the devolved administrations work, and what is the impact of pursuing different approaches to alcohol?

5.1 Drinkaware’s Memorandum does not permit the organisation to comment on policy, this includes the coordination of policy. However we do know that the success of alcohol education, both through Drinkaware and other bodies, is predicated on credibility amongst consumers.

5.2 Drinkaware is one of the primary resources consumers turn to for evidence-based advice on low-risk drinking. It is essential that its advice is trusted and seen as credible by consumers, including the 320,000 unique users who come to our website every month looking for information about alcohol and the 175,000 who have accessed MyDrinkaware to understand more about their drinking and its impact on their body. Whilst Drinkaware has extensive experience of working with the UK and devolved Governments on specific initiatives, maintaining a reasonable level of convergence on any unit guidelines is necessary to achieve acceptance by consumers and ultimately shape their behaviour.

5.3 However, Drinkaware also acknowledges that consumers are not a homogenous group and that targeted communication based on nationally accepted guidelines can be highly effective. For this reason, Drinkaware runs campaigns aimed at young people (18–14), adults (30–45) and parents, and has launched a life-skills education programme, In:tuition, for use in schools.

5.4 As the Government’s Alcohol Strategy highlights, the factors contributing to harmful alcohol use are complicated and any effective response should also be adapted for local circumstances. As an example, in 2010 Drinkaware joined forces with the Newquay Safe Partnership providing strategic guidance, a national perspective and an alcohol-free café offering advice and support for 16 and 17 year olds visiting the area.

5.5 Cornwall PCT were active members of the Newquay Safe Partnership and multi-agency specialists offered support and assistance for people with minor injuries or other issues. This lead to a much reduced demand on front line services—in particular the ambulance service.

5.6 In its first year (2009–10), the Newquay Safe Partnership’s headline achievements were:

No deaths or serious alcohol-related injuries in the area.

Anti-social behaviour down 19%.

Rowdy/nuisance behaviour down 22%.

Violence against the person down 7%.

Alcohol-related violence down 9%.

Sexual offences down 7%.

Drug offences down 14%.

Theft down 15%.

5.7 Drinkaware has also successfully worked with each of the devolved Governments of the UK to assist the delivery of alcohol related messaging and the execution of research.

5.8 Drinkaware has worked with the Scottish Government, supporting its Alcohol Awareness Week activities in 2008, 2009 and 2010. Drinkaware provided almost 400,000 unit measure cups to help consumers in Scotland easily identify the number of units of alcohol in wine, beer and spirits and assist them in moderating their drinking behaviour.

5.9 We also fund Scottish Sports Future’s Jump2it programme, an activity-based schools programme that addresses healthy lifestyles, which is delivered to primary school aged children through a mixture of information provision and physical activity via Glasgow Rocks basketball players and qualified coaches.

5.10 Over a seven month period, researchers utilised a range of evaluation methods primarily across 10 selected case study schools with the aim of gaining an indication of the impact on pupils of the Jump2it programme.

5.11 The resulting survey of 666 pupils shows that, following a six to eight week period, pupils demonstrated a significant increase in knowledge of diet, alcohol, smoking and exercise. This was the case for both those pupils who received the standard programme and those who participated in the extended version.

5.12 In 2009–10 the Welsh Government funded Drinkaware to research social norming in relation to drinking practices amongst the student population across universities in Wales.

5.13 The project takes a multi-component approach, including a toolkit and a social norming intervention. The toolkit and social norming intervention materials were provided to universities during the summer of 2011 and the intervention took place in the first two terms of the 2011–12 academic year.

5.14 Measures of success will include observed changes in student consumption rates, observed student drinking patterns and the use and engagement of the toolkit by university staff. The results of the evaluation will be published in August 2012.

5.15 In Northern Ireland Drinkaware is supporting “My Name is Katie” an early intervention project funded by the Department of Justice Community Safety Unit Project and set to educate parents on how to talk to children about alcohol. The project will be operating initially in the Coleraine Borough Council area before being run out in Limavady, Ballymoney and Moyle.

5.16 The programme is based on the evidence that although parents might be tempted to delay speaking to their children about alcohol until they are older and more mature, opening a dialogue in their pre-teen years is crucial to delaying the age of first drink.10

6. Question 3: What is the role of the alcohol industry in addressing alcohol-related health problems, including the Responsibility Deal, Drinkaware and the role of the Portman Group?

6.1 Drinkaware is currently undergoing an audit and review, the result of which will determine the effectiveness of activity to date and priorities for the organisation from 2013 onwards, including its campaigns, funding and structure.

6.2 As part of a process established between Government, industry and the public health community this follows from the 2009 review which led to a higher level of funding for Drinkaware and the involvement of more industry partners.

6.3 One of the key pledges of the Responsibility Deal is the continuation of industry support for Drinkaware. This currently takes the form of around £5.2 million in financial support and a target has been set for £50 million of in-kind support across all three campaigns in 2012.

6.4 A major example of the impact of this support is our “Why let good times go bad?” campaign which was launched in 2009. “Why let good times go bad?” is a five-year £100 million project to challenge the social acceptability of drunkenness among young UK adults, and operates in partnership with more than 40 drinks industry companies and the UK Government.

6.5 The “Why let good times go bad?” target is to achieve £20 million in support, of which £5 million is from media buy (rate-card valued advertising) and £15 million from in-kind support from partners. In 2011, industry support achieved a significantly higher value of £27 million, thus exceeding the target for this campaign.

6.6 Targeted at 18–24 year olds, the campaign warns of the risks of binge drinking and encourages drinkers to adopt smarter drinking tips. These include eating before drinking, alternating alcoholic drinks with water or soft drinks, and looking after friends when consuming alcohol.

6.7 An independent evaluation among a representative sample of 18–24 year olds, conducted by Millward Brown, following the 2011 “Why let good times go bad?” campaign activity found that:

27% recalled seeing the campaign—double that of industry norms.

8 out of 10 claimed to be adopting at least one of the campaign tips.

56% claimed it made them consider drinking differently.

82% agreed “They could personally relate to it”.

72% agreed “It was the sort of advertising they would talk about with friends”.

66% agreed “The advertising clearly communicated that ‘drinking too much alcohol can ruin a good night out’”.

6.8 In 2011 Drinkaware and the British Beer and Pub Association (BBPA) developed a new “2–2-2–1” unit campaign providing a simple and quick way to gauge the number of units in the four most popular drinks—a pint of beer, a 175ml glass of wine, a 330ml bottle of 5% beer, and a 25ml pour of spirits.

6.9 Through a partnership with the Wine and Spirits Trade Association (WSTA), Drinkaware has helped develop a similar “2–2-2–1” campaign for use in the off-trade sector, which replaces a pint of beer with a 440ml can of 4% beer and a 330 ml bottle of 5% lager with a 330ml bottle of ready to drink (RTD) lager. When approved, it is anticipated that the campaign will be rolled out in the majority of retail outlets across the UK.

7. Question 4: Do you think the proposed reforms of the NHS and public health systems will support an integrated approach to future planning of services for people who experience alcohol-related harm?

7.1 As a national charity our resources are completely free and will be available for all new bodies established through the Health and Social Care Act reforms. We have successfully worked with a wide range of bodies and will continue to help administrations deliver well-evidenced and targeted campaigns.

8. Question 5: What evidence exists of the most effective international 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

8.1 Drinkaware has considerable insight into public health interventions and has recently built on European evidence of success in reducing harmful behaviour choices to develop a UK-specific initiative called In:tuition.

8.2 In:tuition is a life-skills resource aimed at providing teachers with the tools required to equip learners with the knowledge and skills to make lifelong healthy decisions, develop greater self-esteem and self-confidence and enhance cognitive and behavioural competency to reduce and prevent a variety of health risk behaviours. Across the UK, 38 schools are taking part in the In:tuition pilot and 459 schools have registered to use the programme.

8.3 In:tuition was informed by international examples of rigorously evaluated, best-evidenced life-skills based education programmes, which have been shown to be effective in preventing alcohol and other substance misuse—reducing alcohol misuse by 28–31%.11

8.4 Evidence such as the EU-Dap trial, UNPLUGGED, a multi-centre study implemented by nine partners from seven different European countries with funding from the European Commission formed a key basis in the development of the In:tuition programme.

8.5 UNPLUGGED aimed “both to develop a theory-based school programme for the prevention of use of tobacco, drugs and alcohol, and to assess its effectiveness by mean of a rigorous experimental design.”

8.6 The UNPLUGGED programme was developed by the EU-Dap Intervention Planning Group and evaluated roughly 7,000 12–14 year old students during the 2004–05 school year. The contents of the programme were dedicated to decreasing drug initiation and/or delaying the switch from experimental to repeated drug consumption.

8.7 UNPLUGGED focused on a “life-skills” programme where intra- and interpersonal skills, enhancing young people’s self-discipline, were used to increase learners’ understanding of self-respect, respect for others and their trustfulness, feelings, individuality and privacy.

8.8 According to the EU-Dap trial, “results have shown that comprehensive social influence programmes do help prevent the use of alcohol, tobacco and other drugs.” The UNPLUGGED programme was found to be effective in preventing the onset of alcohol, tobacco and other drug use. Results from an 18 month follow-up study found that “persisting beneficial program effects were found for episodes of drunkenness ... in the past 30 days.”12

8.9 After one year the evaluation showed that pupils who participated in the UNPLUGGED school curriculum had a 30% lower probability to have smoked cigarettes (daily), to have experienced drinking to intoxication, and a 23% lower probability to have used cannabis in the past month, compared to students who followed the usual educational curricula.13

8.10 Adapted for the UK context, Drinkaware’s cross-curricular programme builds the esteem, confidence and decision-making skills of learners aged 9 to 14, so they can make more informed decisions about a range of issues—including alcohol, sex and relationships, personal finance, health and civic responsibility. Research, such as the 2011 Foxcroft and Tsertsvadze Cochrane collaboration14, suggests that a “life-skills” based approach to teaching, encompassing current guidance, is one of the best ways to achieve these outcomes.

May 2012

1 For information on research and campaigns visit http://www.drinkaware.co.uk

2 Base: All those who have definitely/probably seen the logo in the last nine months (417 Jul 11) among 1,000 adults 16+, Britain. Source: Charity Awareness Monitor, Jul 11, nfpSynergy.

3 NHS Information Centre, Smoking, drinking and drug use among young people in England in 2009, 2010. P 10.

4 Drinkaware KPI and Insight Research—Young People aged 10–17 and their Parents, Ipsos Mori, 2012.

5 Ibid When asked about the last time they were drinking, 50% of 10-17 year olds who have had a drink say their parents gave them the alcohol.

6 Drinkaware.co.uk/parents.

7 The UK Chief Medical Officers recommend an alcohol-free childhood is the healthiest and best option.
England and Northern Ireland
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_110258
Scotland
http://www.scotland.gov.uk/Topics/Health/health/Alcohol
Wales
http://wales.gov.uk/topics/health/ocmo/publications/position/alcohol/?lang=en

8 Base: 25–44 year old ABC1 (723). Source: Ipsos MORI Social Research Institute. November 2011.

9 General Lifestyle Survey: A report on the 2010 General Lifestyle Survey.

10 Spoth R L., Lopez Reyes M., Redmond C, Shin L, 1999. Assessing a public health approach to delay onset and progression of adolescent substance use: latent transition and log-linear analyses of longitudinal family preventative intervention outcomes. Journal of Consulting and Clinical Psychology, 67: 619–630.

11 Base: 25–44 year old ABC1 (723). Source: Ipsos MORI Social Research Institute. November 2011.

12 Faggiano et al (2010). The effectiveness of a school-based substance abuse prevention program: 18-Month follow-up of the EU-Dap cluster randomized controlled trial.

13 Faggiano et al (2008). The effectiveness of a school-based substance abuse prevention program: EU-Dap cluster randomised controlled trial.

14 Foxcroft and Tsertsvadze (2011), Universal school-based prevention programs for alcohol misuse in young people: The Cochrane Library.

Prepared 19th July 2012