Hello and welcome to the Alcohol Alert, brought to you by The Institute of Alcohol Studies.
In this edition:
IAS blogs
The power of community in recovery: exploring Alcoholics Anonymous 🎵 podcast feature 🎵
Alcohol-specific deaths in England rise by 4.6% in 2023
Welsh government plans to continue minimum pricing of alcohol, as final evaluation report published
Alcohol Health Alliance position on alcohol-free and low-alcohol drinks
Calls increase for a reduction in the drink drive limit
The U.S. Surgeon General sounds the alarm on alcohol and cancer risk
New U.S. drinking guidelines could reduce recommended limits
Alcohol Toolkit Study: update
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IAS blogs
To read blogs click here.
The power of community in recovery: exploring Alcoholics Anonymous 🎵 podcast feature 🎵
In this episode, we dive into the history, structure, and impact of Alcoholics Anonymous (AA). Our guests, Tim, a long-standing member and trustee on the General Service Board, and Dr Kieran Moriarty, founder of Alcohol Care Teams and AA trustee, share their insights into the organisation’s role in supporting individuals struggling with alcohol dependence.
Tim outlines AA’s origins in 1935, its foundational principles, and how it operates as a fellowship rather than a governing body. Kieran discusses the success of AA as outlined in a Cochrane review and NICE Quality Standard on alcohol-use disorders.
A key takeaway is the power of community in recovery. As Tim puts it:
“AA isn’t about rules or restrictions; it’s about one alcoholic helping another. That’s where the real change happens.”
To find information on AA, including meetings, visit: https://www.alcoholics-anonymous.org.uk/
Alcohol-specific deaths in England rise by 4.6% in 2023
Deaths from conditions wholly attributable to alcohol have increased by 4.6% from 2022 to 2023, reaching the highest number for the fourth year in a row.
The Department for Health and Social Care’s Alcohol Profile shows that 8,274 people died from alcohol-specific causes in England in 2023 (up from 7,912 the year before).
This is a 42% increase compared to 2019, before the pandemic. And compared to 2006, this is an increase of 64%.
The majority of these deaths are from alcohol-related liver disease. 5,984 people died prematurely (under 75) from the disease in 2023, a rise of 3.6% from 2022, and a shocking 93% rise compared to 2001.
In a blog for IAS, health economist Professor Colin Angus wrote that:
“Perhaps the most puzzling aspect of the rising numbers of deaths is that there is some evidence that alcohol consumption among heavier drinkers has fallen since the early phases of the pandemic, although remaining above 2019 levels.
“Perhaps part of the story lies in generational differences. Data suggest that the prevalence of risky drinking never rose in 16-24 year olds, that it rose and then fell back in ages 25-54, but in the over 55s it rose and remained high, or even rose further. This aligns with a longer-term trend of rising drinking among older adults – 55-74 year olds are now the heaviest drinking age group.”
For the first time in recent history, the death rate in the North East of England has overtaken the rate in Scotland:
The North East alcohol office Balance told the BBC that despite two thirds of people in the North East taking steps to cut down, health issues due to alcohol remained "historically high", and called for action on marketing, price and labelling.
Following the news, the Alcohol Health Alliance (AHA) wrote a public letter to Health Secretary Wes Streeting urging him to “stop the needless suffering”. The letter stated that:
“After decades of inaction, we urge you to make it your New Year’s resolution to redress this alarming trend and stop needless suffering of countless individuals, their children, families and communities across the country.
“Stronger, comprehensive government intervention is required. The Health Mission board is ideally placed to mobilise cross-government action to implement effective, live-saving policies.”
The AHA has not yet received a response from Wes Streeting. However, Public Health Minister Andrew Gwynne responded to a number of written parliamentary questions on the topic, including from Labour MP Tanmanjeet Singh Dhesi, stating that:
“Through our mission-driven Government, we will prioritise actions targeted at reversing this trend.
“The Office for Health Improvement and Disparities (OHID) has an action plan to reduce drug and alcohol-related deaths. In light of the recent data, this plan will be reviewed to ensure that it is grounded in the latest understanding of the drivers of drug and alcohol related deaths, and is responding to these.”
In related news, a BMJ editorial and a BMJ opinion piece were published, with both calling for the development of a comprehensive alcohol strategy to turn the tide on rising deaths.
In the editorial and off the back of a recent Medical Council on Alcohol report, the report authors argued that “as the progress made in Scotland shows, much can be done when there is the government will to do it”.
In the opinion piece, public health specialty registrar Una Geary and professor of European public health Martin McKee wrote:
“Successive Westminster governments have shown little enthusiasm to do much, if anything, in terms of alcohol control policy, thereby supporting those who manufacture and promote it.
“A focus on such population-level policies is particularly important. There is a need to move away from the stigmatising rhetoric of “individual responsibility” favoured by the alcohol industry and the organisations it funds.”
Welsh government plans to continue minimum pricing of alcohol, as final evaluation report published
The final evaluation of Wales’s minimum unit pricing (MUP) policy has been published, which shows that the policy has: been broadly welcome, implemented effectively, reduced the availability of very cheap, high-strength products, and reduced the amount of alcohol purchased compared to England.
In a statement, the Welsh Cabinet acknowledged the difficulty assessing the policy:
“assessing impact of the legislation against the backdrop of the pandemic, persistently high levels of inflation and the cost-of-living crisis has been challenging.”
The report concludes that the government should “renew rather than lose the option of the legislation as an alcohol policy measure in Wales” and recommends increasing the minimum price to at least 65p to sustain the policy’s value and the positive impacts observed so far.
The evaluation also found minimal evidence that people who were primary drinkers (and not already using drugs) were likely to start using drugs and that evidence of cross-border shopping was small scale and most evident among communities living close to the border. These are two issues that were consistently brought up as opposition to the policy before implementation.
Media coverage of the news was quite confused, with the BBC focusing almost solely on the impact of the policy on dependent drinkers, stating that some people had swapped to “buying litres of vodka,” and “some problem drinkers are going without food or heating, begging, turning to sex work, or stealing to pay for drink.” This is clearly an issue that needs to be addressed and which the report noted, but is also only one of many other findings of the report.
One of the main studies was an evaluation by the National Centre for Social Research which found that:
“Initially, there was a marked increase in alcohol purchases in Wales following its introduction, coinciding with the COVID-19 mitigation measures. However, this surge was smaller in Wales than in England, and subsequently alcohol purchasing declined more rapidly in Wales after the pandemic.”
The report makes it clear that the policy should sit “within a clear and comprehensive set of alcohol policy approaches”, for instance on availability and marketing.
In a blog for IAS, Alcohol Change UK Wales wrote that:
“The most obvious impact of MUP in Wales has been on the availability of the cheapest, strongest drinks – such as the “white ciders” often favoured by chronically alcohol-dependent drinkers. MUP has also removed many of the cheapest spirits from the market, while making it more difficult for supermarkets to offer multiple purchase discounts, such as three bottles of wine for the price of two.
“The overall conclusion of the evaluation is that MUP has been a positive development in Wales, and that it should stay in place, alongside bolstering the support for low-income alcohol-dependent drinkers.”
Alcohol Health Alliance position on alcohol-free and low-alcohol drinks
With a rise in popularity of alcohol-free and low-alcohol drinks, and a number of concerns among the public health community about these products, the AHA has published a position paper. The paper covers eight key areas where the Alliance is calling for changes and/or new national policies:
Calls increase for a reduction in the drink drive limit
In mid-January, the National Police Chiefs' Council (NPCC) and the Association of Police and Crime Commissioners (APCC) got behind the BMA in calling for a reduction in the drink drive limit, after deaths from drink driving hit a 13-year high.
They also backed a change in procedure to allow the police to issue a driving ban at the roadside when someone tests over the limit, rather than letting them continue driving pending a court case.
Police and Crime Commissioner Joy Allen, APCC addictions and substance misuse lead, said:
“I support a total drink and drive ban, both because drink driving is the cause of hundreds of unnecessary deaths on the UK’s roads every year and because the impact of alcohol differs for every person, dependant on gender, weight and the type of drink.
“People can’t guess at what is safe and what isn’t and so the safest thing to do, and the easiest thing for everyone to understand, is just not to drink and drive.”
RAC road safety spokesman Rod Dennis said:
“We hope the issue of drink-driving will be addressed in the Government’s soon-to-be-published road safety strategy, as clamping down on it in the right way could save hundreds of lives every year.”
The RAC also released new data that show 38% of motorists think harsher sentences are the answer to reducing drink driving, with the second most popular option being a reduction in the limit.
Rod Dennis said:
“It’s clear motorists want to see something done differently to tackle the scourge of drink-driving which is still responsible for the loss of far too many lives every year.”
On 28 January, there were reports that the government is considering reducing the alcohol limit to zero for young drivers, to boost road safety. And in mid-December, Transport minister Lord Hendy of Richmond Hill said that:
“This Government takes road safety seriously, and we are committed to reducing the numbers of those killed and injured on our roads. Since the general election, the Department has begun work on a new Road Safety Strategy, the first in over a decade. The Department will share more details in due course.”
Nowhere else in Europe has a limit as high as England, Wales, and Northern Ireland at 80mg of alcohol per 100ml of blood. Although Northern Ireland has planned to reduce the limit for over a decade, with delays “due to the lack of roadside breath testing equipment”. All other countries in Europe have a limit of 50mg or 20mg.
The U.S. Surgeon General sounds the alarm on alcohol and cancer risk
The U.S. Surgeon General has issued a landmark advisory on the link between alcohol consumption and cancer, calling for urgent action to raise public awareness and implement stronger policies to mitigate harm. The advisory, Alcohol and Cancer Risk 2025, highlights alcohol as a leading preventable cause of cancer in the United States, attributing it to nearly 100,000 cancer cases and approximately 20,000 cancer-related deaths annually.
The advisory underscores the well-established causal link between alcohol consumption and increased cancer risk. Despite this, public awareness remains low. To address this gap, the Surgeon General has put forward several recommendations, including updating the existing health warning labels on alcoholic beverages to explicitly state the cancer risks associated with alcohol consumption and making these warnings more visible.
The advisory has not only sparked public health discussions but has also caught the attention of investors. A recent Financial Times article suggests that increased regulatory scrutiny and shifting societal attitudes towards alcohol could reshape the industry, potentially affecting long-term investor confidence.
A Sunday Times article also looked into the topic in depth, writing that the Alcohol Health Alliance is pushing for clearer labelling that would include health warnings. Jem Roberts of IAS told the paper that:
“It’s kind of ridiculous that you buy a bottle of orange juice with all this nutritional information and ingredients on it, but a bottle of wine is exempt from that.”
In the UK, Labour MP Dan Carden pressed the government to reassess alcohol labelling policies in light of the U.S. Surgeon General’s recommendations, to which Andrew Gwynne responded:
“We have noted the United States Surgeon General’s recommendations, and will continue to consider how alcohol labelling can be improved to support consumers in making informed decisions about the products they are purchasing, whilst also promoting low risk consumption.”
Watch our film Alcohol and Cancer: Explained:
New U.S. drinking guidelines could reduce recommended limits
Also across the pond, the U.S. is preparing to update its Dietary Guidelines by the end of 2025, with potential significant changes to alcohol consumption recommendations. A scientific review panel, including experts like Dr Tim Naimi and Dr Kevin Shields – who contributed to Canada's recent guidelines – is analysing current evidence to inform these updates.
Currently, the guidelines advise that men limit themselves to two drinks per day and women to one. However, emerging research – particularly on alcohol and cancer – has prompted a re-evaluation of these recommendations.
A report from the National Academies of Sciences, Engineering, and Medicine suggests that moderate drinking may lower cardiovascular mortality but slightly increase breast cancer risk. This perspective contrasts with findings from the National Cancer Institute, which links even low alcohol consumption to at least seven types of cancer. Critics argue that some reports may selectively review studies, potentially favouring industry interests.
Public opinion is also shifting. A recent survey indicates that the percentage of Americans who believe moderate drinking is unhealthy has risen from 17% in 2018 to 45% today.
The alcohol industry is lobbying to maintain current guidelines, fearing stricter recommendations and increased public health warnings. Senator Ted Cruz expressed political opposition to potential new limits, stating, "If they want us to drink two beers a week, frankly they can kiss my ass."
As the debate continues, the forthcoming guidelines are expected to reflect the latest scientific evidence and public health considerations, potentially leading to more stringent alcohol consumption recommendations.
Alcohol Toolkit Study: update
The monthly data collected is from English households and began in March 2014. Each month involves a new representative sample of approximately 1,700 adults aged 16 and over.
See more data on the project website here.
Prevalence of increasing and higher risk drinking (AUDIT-C)
Increasing and higher risk drinking defined as those scoring >4 AUDIT-C. A-C1: Professional to clerical occupation C2-E: Manual occupation
Currently trying to restrict consumption
A-C1: Professional to clerical occupation C2-E: Manual occupation; Question: Are you currently trying to restrict your alcohol consumption e.g. by drinking less, choosing lower strength alcohol or using smaller glasses? Are you currently trying to restrict your alcohol consumption e.g. by drinking less, choosing lower strength alcohol or using smaller glasses?
Serious past-year attempts to cut down or stop
Question 1: How many attempts to restrict your alcohol consumption have you made in the last 12 months (e.g. by drinking less, choosing lower strength alcohol or using smaller glasses)? Please include all attempts you have made in the last 12 months, whether or not they were successful, AND any attempt that you are currently making. Q2: During your most recent attempt to restrict your alcohol consumption, was it a serious attempt to cut down on your drinking permanently? A-C1: Professional to clerical occupation C2-E: Manual occupation
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