Wednesday 13 May 2020

Alcohol consumption in the lockdown

Cards on the table, folks. I don't know what's happened to per capita alcohol consumption during lockdown. Aside from the drinks industry and possibly HMRC, I doubt anyone has much of an idea.

The media keeps repeating the line that alcohol sales in the off-trade rose by 31 per cent at the start of lockdown, with the implication that alcohol consumption has soared. This is wrong, of course. Not only were people stockpiling it to consume over several weeks, but sales in the on-trade have fallen by 100 per cent.

If I had to guess, I'd say that overall alcohol consumption has fallen. People who only drink when they go out can no longer do so and whilst there will be plenty of people who drink more out of boredom, there may be more who don't want to or cannot afford to.

If you work in 'public health' you must think that alcohol consumption - and therefore alcohol-related harm - has definitely gone down. In neo-temperance ideology, consumption is driven by advertising, affordability and availability - and harm is driven by per capita consumption (or so they believe). I don't know what's happened with affordability, but advertising has all but disappeared (as it has in most industries) and availability has shrunk enormously as a result of 100,000 licensed premises closing.

Good news for the health of the nation, then? Not really, because neo-temperance ideology is bunkum. Per capita alcohol consumption is a distraction. We are bound to see a fall in the harms associated with the night-time economy, albeit at huge economic and human cost, but I'd be surprised to see a fall in self-inflicted health harms.

Figures published last month by Alcohol Change UK (formerly Alcohol Concern and Alcohol Research UK) seem to bear this out.

While much media coverage has focused on people’s drinking increasing, more than one in three of the 1,555 drinkers surveyed told us that they have either stopped drinking or reduced how often they drink, since the lockdown. Six per cent have stopped drinking entirely.

However, some people are drinking more often. Around one in five drinkers (21%) told us that they have been drinking more frequently since the lockdown. This suggests that around 8.6 million UK adults are drinking more frequently under lockdown. 

So more people are drinking less than are drinking more. However...

It is the people who were already drinking the least often who have cut down in the greatest number. Nearly half (47%) of people who drank once a week or less have cut down or stopped drinking, compared to just over a quarter (27%) of people who drank two to six times a week, and just one in five (17%) daily drinkers. Worryingly, nearly one in five (18%) daily drinkers have further increased the amount they drink since lockdown.

There is also anecdotal evidence from people who work with problem drinkers that the situation is getting worse. So much for the whole population approach.

In the BMJ, Harry Rutter and Adam Briggs, a pair of one club golfers from the 'public health' industry who called for lower speed limits, minimum pricing and more tobacco control as a response to the lockdown, are calling for exactly the same policies as a response to easing the lockdown. Fancy that!

They seem to accept that any decline in alcohol consumption in the last two months has not been accompanied by health improvements, and may have been accompanied by a worsening, but they have a predictable solution for that...

Drinking habits have also changed. A survey from the charity, Alcohol Change UK, suggests that up to a third of UK adults have reduced how much they drink compared to a fifth that have increased consumption. Whilst welcome, closer reading of the data tell us that those who drink most often are the least likely to have cut back—those dependent drinkers who are most likely to respond to policies such as minimum unit pricing

It was unfortunate timing for them that their blog post was published on the same day as the latest nugget from the official minimum pricing evaluation was published. Based on focus groups with social workers and health practitioners, it found that these professionals quite liked the idea in theory but didn't see any evidence of it working on dependent drinkers in practice.

Within this context, participants were, however, broadly supportive of MUP as a policy to address hazardous and harmful drinking at a population level. Participants felt that the increase in price may encourage people to reflect on, and possibly reduce their consumption, with positive implications for children and young people.

Participants, however, also suggested that MUP may have little positive impact on those who they described as having a possible dependency; for this group the view was that MUP would not be sufficient to address the perceived dependency. Contingent on whether and how someone’s preferred alcohol was affected by MUP, participants suggested this could mean increasing financial strain on families who may already be experiencing financial hardship. It could also mean people changing what they consume to get a better ‘return on the price’, for example, switching from strong white cider to vodka.

Anyone could have told the government this before it went ahead with the stupid, regressive policy. Indeed, many of us did.

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