Daily Archives: 06/08/2014

Public Health England and alcohol (2)

Alcohol Policy UK recently sent out their email discussing Public Health England’s just released 2014-2017 marketing strategy outlining plans for campaign related activity around alcohol and other lifestyle behaviours.

However PHE says its plans for alcohol-related communications are limited for a number of reasons. Namely, budget limitations and recognition of the limited evidence base for alcohol campaigns in changing behaviour, alongside the awaited revisions to the Chief Medical Officer (CMO) drinking guidelines. The strategy says the CMO’s review will “involve appropriate consultation and so is unlikely to report before the end of the year” and this has been awaiting revision since first being announced in March 2012 (so over 2 years and counting).

Under the alcohol chapter, 7.4 Making it easier for adults to drink at lower-risk levels, PHE says it has developed an evidence-based model for which:

‘alcohol is reported as low priority in the model, due principally to the paucity of evidence (nationally and internationally) of success in marketing-based interventions around alcohol. Given the low prioritisation we could not support a recommendation to develop a significant national campaign in 2014. This is further argument for taking a test-learn-refine approach.’

If there is paucity of evidence then surely new research needs to be funded to look at marketing-based interventions around alcohol rather than using that logic as a reason to side-step it as a strategy?

The strategy identifies a number of possible areas for ‘social marketing’ based activity including binge drinking and preventing early age drinking. However it states since industry-derived funding (via Drinkaware) will continue around young people and resume shortly around young adults, we recommend focusing PHE’s funds on increasing and higher risk drinking in middle-aged and/or older adults.’

So we’ll let the industry lead the way shall we?  No conflict of interest there then!!

The strategy says most increasing and high-risk drinkers underestimate their level of risk and are happy with their consumption levels. This is in contrast to other areas such as diet where target populations ‘readily accept that they need to change and are keen to eat more healthily and be more active.’ The strategy also says that PHE and a small number of other organisations have made attempts to change at-risk drinkers’ beliefs and behaviours regarding alcohol.

So although they state that high-risk drinkers underestimate their risk because they are happy with their consumption level there is no current role for public health!!!

However it says:

‘while the evidence is patchy, the emerging picture is that attempts to change attitudes generally fail (although possibly because no one has ever spent enough to impact on the counterweight of industry spend); however, providing people with tools to assess and record their drinking has had some success in reducing consumption. While people repeatedly tell us that they have no intention to change how they drink, it seems they do change in response to price, availability and strength, but also to identification and brief advice.’

So because we can’t compete on funding we just won’t try then is that it?

They outline 2 regional pilots to be implemented:

1. A participative abstinence event – so building on the success of Dry January and Dryathalon (and indeed to repeat or enlarge temporary abstinence outside of January).
2. Promoting irregular drinking – This project will start with research into people who already drink within guidelines, to understand the strategies they currently deploy to drink at lower risk levels. From this phase, we will develop articulations of strategies for maintaining low consumption and, via an experimental methodology, assess the ability of increasing and higher risk drinkers to adopt and follow the strategies. For example, daily drinking is a key contributor to increased risk, so it is possible that promoting a simple approach such as never drinking two days in a row would have a positive impact.

I’m not saying that these are not good pilot strategies but they are regional and I feel are tinkering around the edges of the problem we have in this country with alcohol.   They are not targeting the right people with the right questions.

I feel like a school teacher going through a piece of work with a red pen here but my frustration is almost uncontainable.  I didn’t know how to post this and respond eloquently without losing myself (and you) hence my bold thoughts after each statement which feels a bit clunky.

So to summarise: the industry gets to keep doing what they are doing for the next 3 years completely unchecked and with no national PHE initiatives to counter the problem?  Genius PHE genius …….

46 days to go