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Welcome to SHAAP’s (Scottish Health Action on Alcohol Problems) weekly media monitoring service.

05 May 2016

#MUPsaveslives

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This briefing aims to provide a ‘snap shot’ of latest news on alcohol and health policy. The inclusion of an article in the briefing should not imply that SHAAP approves or condones the content.

SHAAP provides a coordinated, coherent and authoritative medical and clinical voice on the need to reduce the impact of alcohol related harm on the health and wellbeing of the people in Scotland. SHAAP was set up by the Scottish Medical Royal Colleges, through their Scottish Intercollegiate Group (SIGA) and is governed by an Executive Committee made up of members of the Royal Colleges.

Irish Scots twice as likely to be hospitalised or die from alcohol, study reveals

IRISH people in Scotland are twice as likely to be hospitalised or die from alcohol-related diseases than white Scottish people, new research suggests.

And the risk for women from a mixed ethnic background is almost 100 times that of white Scots, said scientists from the University of Edinburgh.

The study also shows that people from a Chinese or Pakistani background had the lowest risks of alcohol-related illness or death.

Researchers say that ethnic variations were a "cause for concern" and lessons should be learned from the communities with low rates of death and illness from alcohol use.

The large-scale study is believed to be the first to use a reliable measure of ethnicity, taking data from the NHS and the 2001 Census.

It looks into ethnic variations in the rates of hospital admission and deaths resulting from alcohol use, and uses the rate of disease in the white Scottish population, Scotland's largest ethnic group, as its benchmark.

Findings showed that compared with rates for white Scottish people, the risks of alcohol-related disease hospitalisations or deaths for Irish people living in Scotland increased by 82 per cent for men and 55 per cent for women.

The corresponding risks of alcohol-related disease hospitalisations or deaths for women of mixed ethnicity in Scotland increased by 99 per cent compared with white Scottish women.

For Chinese men or women, the risks of alcohol-related disease hospitalisations each decreased by around 45 per cent, while the decrease was 33 per cent for Pakistani men and 52 per cent for Pakistani women compared to white Scottish people. The report, however, did also say that they were at greatest risk of other liver diseases such as viral hepatitis.

The researchers said that they hope the findings will inform public health policy on alcohol use, pricing and taxation for the whole population of Scotland.

Dr Neeraj Bhala, who conducted the study at University of Edinburgh’s Centre for Population Health Sciences, said: "The ethnic variation in the alcohol and liver-related hospitalisations and deaths in Scotland found in this large-scale study is a cause for concern.

"We have important lessons to learn about preventing these alcohol- and liver-related deaths, and we should look to communities with typically low levels of alcohol consumption to help develop policies that benefit the whole population of Scotland."

According to data from the National Records of Scotland, there were 1,152 alcohol-related deaths in the country in 2014, of which 784 were men, and 368 women.

Over the years since 1979, there have been roughly twice as many male deaths as female deaths.

In 2014/15, there were 35,059 alcohol-related hospital stays, 91 per cent resulting from an emergency admission.

Although alcohol-related deaths have declined in recent years, rates remain higher than they were in the early 1980s and higher than those in England and Wales

The findings from the University of Edinburgh study have been published in the journal Alcohol and Alcoholism.

 
Source: Herald Scotland, 10th May

 

University students more likely to be heavy drinkers when they grow older according to  Glasgow University academics

STUDENTS are more likely to become heavy drinkers once they leave university, Scottish research has found.

The UK-wide study also showed the longer term impact of a drinking culture in higher education was particularly prevalent amongst female students.

Researchers called on institutions to examine the findings to assess whether they were doing enough to combat exposure to excess alcohol at university because of the long-term implications for health.

The study, by Glasgow University academics, comes after previous research showed students are more likely to drink, smoke and take drugs than the general population with peer pressure, cheap student bars and the freedom of living away from home all seen as contributing factors.

Dr Michael Green, a research associate with the Glasgow University's public health sciences unit, said: "Students are often moving away from home and they have more freedom and fewer responsibilities and they are associating with a lot of other people who are in a similar situation.

"That environment contributes to heavy drinking as well as the fact the drinks industry is promoting drinking to students because they think it can be profitable."

Mr Green said the association between heavier drinking and former students was stronger for females than males.

He added: "Previously women would have tended to drink less than their male counterparts, but those that went to university would have been that much more likely to drink.

"Student drinking has been recognised as a problem for a while and there are various interventions that people have been doing to try and ameliorate that.

"Whether this is taken seriously varies from institution to institution, but what we are trying to do is provide information to those that have responsibility for students so they know what the problem is and raise awareness about it."

Jonny Ross-Tatam, president of the Edinburgh University Students' Association, said it "wasn't helpful" to reinforce stereotypes of a student drinking culture.

He said: "Levels of alcohol consumption vary hugely among students, just as they do in all sections of society and we offer a wide range of events and activities, some with alcohol and some without.

"In the venues we run we promote quality over quantity, and our staff are trained in promoting responsible drinking to all our customers.

"We make sure we provide students with information on responsible drinking when they join us, and there's always advice available on our website."

A spokeswoman for Universities Scotland said: "Scotland’s universities bring together students from all backgrounds, nationalities, cultures, religions and ages and this contributes to a rich and very varied range of social events on offer, the majority of which will have nothing to do with alcohol.

"Universities have been pleased to support student associations build Freshers’ week activities, societies and programmes of events for students that add to their educational experience and don’t centre around alcohol.

"Universities have a duty of care towards their students and that includes support for anyone suffering from problems linked to alcohol."

She said all universities offer a student counselling service and can refer students to specialist medical and counselling services if required.

The study was funded by the Medical Research Council (MRC) and the Scottish Government Chief Scientist Office.

Source: Herald Scotland, 10th May

 

A third of Scots workers admit to hangovers at work

WORKERS say a rampant drinking culture in Scotland's workplaces has led to one in five developing problems with their health.

Encouragement from employers to take part in after-hours drinking session and a lack of advice on the dangers of alcohol abuse have contributed to the situation, while many say they have gone to work with a hangover, damaging productivity.

The troubling picture of Scottish employees' battles with booze has been laid bare in a survey of workers attitudes to alcohol consumption.

WORKERS say a rampant drinking culture in Scotland's workplaces has led to one in five developing problems with their health.

Encouragement from employers to take part in after-hours drinking session and a lack of advice on the dangers of alcohol abuse have contributed to the situation, while many say they have gone to work with a hangover, damaging productivity.

The troubling picture of Scottish employees' battles with booze has been laid bare in a survey of workers attitudes to alcohol consumption.

''Employers would be wise to address the issue by reviewing their workplace culture and conditions to ensure they’re not inadvertently stoking the flames of alcohol misuse.

“If businesses take steps to identify whether or not alcohol is causing a problem to their employees’ health and to business productivity they can then train managers, where necessary, to recognise problems and pinpoint trends."

He added: “Tackling the drinking habits of employees can be challenging, but advice and guidance on attitudes towards alcohol and sensible drinking can be included in a company’s health and wellbeing strategy."

More than a quarter of workers across Britain as a whole admitted to having gone to work with a hangover, with male workers (35 per cent) more culpable than their female counterparts (18 per cent).

Eleven per cent of male workers said they did so regularly, compared with just four per cent of females.

The study follows research which found that Irish people in Scotland were twice as likely to be hospitalised or die from alcohol-related diseases than white Scottish people.

The risk for women from a mixed ethnic background was almost 100 times that of white Scots, while people from a Chinese or Pakistani background had the lowest risks of alcohol-related illness or death, according scientists from the University of Edinburgh.

Jennifer Curran, Acting Deputy Chief Executive, Alcohol Focus Scotland, said that workplaces are often reflective of what is happening in wider society.

She said: "In Scotland nearly one in four men and around one in six women drink at harmful or hazardous levels and those in employment are more likely to drink than those who don’t work.

"In 2015 a review by the Organisation for Economic Co-operation and Development (OECD) suggested that the UK should consider tougher action, such as implementing minimum unit pricing, banning sports sponsorship and introducing clear labelling to reduce the impact of alcohol in terms of lost productivity, health spending and accidents."

She added: "To help reduce the impact of alcohol, workplaces can introduce a number of interventions, including having a workplace alcohol policy and training for staff and managers.

"However, to increase the effectiveness of any workplace interventions, it is critical that action is taken on the price, availability and marketing of alcohol."


Source: Herald Scotland, 11th May

 

Bartenders cannot refuse pregnant women alcohol, New York City says

It can be an awkward order for a pregnant woman: A glass of merlot, please.

But she is legally entitled to it, according to New York City.

For the first time, the city is explicitly prohibiting restaurants and bars from refusing alcoholic drink orders to mothers-to-be, with new guidelines that say doing so would represent discrimination under the city’s Human Rights Law.

“While covered entities may attempt to justify certain categorical exclusions based on maternal or fetal safety, using safety as a pretext for discrimination or as a way to reinforce traditional gender norms or stereotypes is unlawful,” the guidance released by the Commission on Human Rights on Friday says.

That would also apply to foods deemed risky during pregnancy, such as raw fish or soft cheese. But it’s alcohol consumption by pregnant women that has long driven the touchiest debates over private etiquette and public policy.

At least 18 states have laws that regard the use of intoxicants by pregnant women as child abuse, according to a survey by ProPublica. It was not clear how many jurisdictions have rules that specifically ban restaurants and bars from refusing alcohol service.

Several medical organizations, including the American Academy of Pediatrics and the Surgeon General’s Office, discourage any alcohol consumption. The Centers for Disease Control and Prevention has gone even further, recommending that sexually active women who are not using birth control abstain from alcohol.

Nonetheless, many expectant mothers allow themselves an occasional glass of wine, encouraged in part by research showing that small amounts of alcohol may not be harmful. According to the C.D.C., about 10 percent of pregnant women drink alcohol.

“I looked forward to my Friday night margarita during each of my pregnancies, and I think they contributed to a happier, healthier pregnancy for both mom and baby,” wrote one New York Times commenter. Another reacted to abstinence advice this way: “Stop infantilizing women.”

New York City’s new guidelines would not undermine a state law that requires bartenders not to serve guests who are “visibly intoxicated.” But some bar owners worry that the rules could muddy the question of when it is appropriate to cut off a pregnant patron.

“To a certain extent it’s government run amok,” said Robert Bookman, a lawyer with the New York City Hospitality Alliance, a trade group. Under state law, he noted, bars are required to post signs warning about the dangers of alcohol to fetuses.

“Here you now have a city agency saying that if we take that seriously and try to discourage a pregnant woman from drinking, we’re in violation of the law,” he said, adding, “We’re stuck in the middle on this one.”

Released before Mother’s Day, the guidelines from the Human Rights Commission were intended to clarify the anti-discrimination protections afforded pregnant women in the workplace, in housing and in public settings.

The commission said it was investigating at least one case of a pregnant woman who was denied entry to a bar over the moral judgments of its employees. In another case, a woman was refused entry to a concert in the Bronx after she was told that it was an unsafe environment for pregnant women, the commission said.

The city cited research showing that pregnant employees continue to be denied accommodations they are entitled to, such as schedule changes, arrangements for “light duty” or bathroom breaks. Many expectant mothers are also sidelined in their careers, officials said.

The commission said it was investigating more than 40 cases of pregnancy-related discrimination, most involving the workplace. In one case, a pregnant employee who asked if she could arrive late to work so she could attend a medical appointment was subjected to a series of inappropriate questions, the commission said, including “Who is the father?”

“Accommodation of pregnant women cannot be a favor,” Azadeh Khalili, the executive director of the Commission on Gender Equity, said in a statement supporting the new guidelines.It is a human right and the law in New York City.”

Source: New York Times, 9th May
 

Prayer can reduce alcohol cravings, study finds

A craving for alcohol could be tempered by the power of prayer.

Researchers from New York University worked with longstanding members of Alcoholics Anonymous (AA) to assess their cravings after reading various texts.

They found that prayer can minimise alcohol cravings by stimulating the parts of the brain which are responsible for attention and emotion.

The participants, who were first shown a series of images considered to induce alcohol cravings, reported less desire to drink after then reciting a prayer.

Marc Galanter, senior author of the study and Professor of Psychiatry and Director of the Division of Alcoholism and Drug Abuse at the university, said the experience of going to AA had left some people with an "innate ability" to use prayer to minimise the effect of alcohol triggers.

“Craving is diminished in long-term AA members compared to patients who have stopped drinking for some period of time but are more vulnerable to relapse,” he added.

Of the 20 AA members who took part in the study, none reported a craving for alcohol in the week prior to the testing, but all reported some degree of craving after viewing the images.

Yet all of the participants said these cravings had reduced after reciting an AA prayer.

Dr Galanter said they wanted to find out what was happening in the brain when an AA member experienced a 'trigger', such as a bar, or going through something upsetting. 

MRI scans showed those who prayed had increased activity in the regions of the brain which control attention and emotion.

“This finding suggests that there appears to be an emotional response to alcohol triggers, but that it’s experienced and understood differently when someone has the protection of the AA experience.

“Our current findings open up a new field of inquiry into physiologic changes that may accompany spiritual awakening and perspective changes in AA members and others,” said Dr Galanter.

Source: The Independent, 5th May
 

Drinking alcohol can increase the risk of illness and death from the hepatitis C virus. A new national household study of U.S. adults published in the American Journal of Preventive Medicine shows that many people living with hepatitis C report either former or current excessive alcohol use. In addition, hepatitis C-infected adults were three times more likely to drink five or more drinks per day every day at some point in their lives than those without hepatitis C.

Across the United States, alcohol abuse causes almost 88,000 deaths per year, and among those who die, drinking shortens their lives by an average of almost 30 years. Alcohol misuse also places an enormous burden on the economy, costing $223.5 billion per year in the U.S. alone. Alcohol use is especially detrimental to patients with hepatitis C.

"Alcohol promotes faster development of fibrosis and progression to cirrhosis in people living with hepatitis C, making drinking a dangerous and often deadly activity," said lead investigator Amber L. Taylor, MPH, from the Centers for Disease Control and Prevention's Division of Viral Hepatitis. "In 2010, alcohol-related liver disease ranked third as a cause of death among people with hepatitis C."

In order to better understand the link between alcohol use and hepatitis C, investigators examined self-reported alcohol use in relation to hepatitis C status. Using information from the National Health and Nutrition Examination Survey (NHANES), researchers looked at hepatitis C infection rates for four groups: lifetime abstainers, former drinkers, non-excessive current drinkers, and excessive current drinkers. They found that two groups - former drinkers and excessive current drinkers - had a higher prevalence of hepatitis C (2.2 percent and 1.5 percent, respectively) than lifetime abstainers or current non-excessive drinkers (0.4 percent and 0.9 percent, respectively).

A follow-up survey of people who participated in NHANES 2001-2008 and who tested positive for hepatitis C antibodies (indicating they had been infected at some point in their lives) found that 50 percent were unaware of their hepatitis C status before being notified of their positive test by NHANES, mirroring the national trend.

"Half of all people living with hepatitis C are not aware of their infection nor the serious medical risks they face when consuming alcohol," said Taylor. "This highlights the need for increased diagnosis as well as comprehensive and effective interventions to link hepatitis C-infected individuals to curative treatments now available and provide education and support needed to reduce alcohol use."

CDC recommends a one-time hepatitis C test for everyone born during 1945-1965, and explicitly recommends screening for alcohol use among individuals who test positive.

The new information provided by this study helps shed more light on the level of alcohol consumption among those living with hepatitis C. It can help guide best practices for both treating patients and steering possible interventions. "The implementation of behavioral screenings to identify at-risk drinking among both hepatitis C-infected and uninfected individuals could prevent alcohol abuse and serve as a platform to educate patients on the associated risks," concluded Taylor. "Targeted strategies should emphasize testing to increase hepatitis C awareness among undiagnosed people, prevent disease progression, and ultimately link those infected to curative lifesaving treatments."

Source: News Medical, 11th May
 

Global alcohol consumption has declined for the first time this century amid the slump in oil and commodity prices, currency volatility and economic headwinds in China.

The volume of alcoholic beverages drunk in 2015 fell by 0.7pc to 248bn litres as the worldwide population imbibed 1.7bn litres less than the year before, according to Euromonitor International.

This follows an increase of 0.2pc between 2013 and 2014 and is the first decline since Euromonitor started tracking this data in 2001.

China recorded a 3.5pc decline amid economic difficulties and a clampdown in extravagant lifestyles.

The Asian powerhouse is the world's biggest alcohol market, at almost twice the size of the US, and accounts for around a quarter of global consumption.

China's growth slowed last month to its weakest pace since the financial crisis and Shanghai stocks continue to languish far below pre-summer sell-off levels. 

Alcohol consumption in Russia and Ukraine fell by 8pc and 17pc respectively as political tensions, economic sanctions and tumbling oil prices took their toll on the countries' economies. 

“While terms such as authenticity and craftsmanship are losing traction, the trajectories of sophistication, moderation, perceived exotic credentials, accessibility and aspirational attributes remain the key driving forces fuelling pockets of buoyancy,” said Spiros Malandrakis, senior alcoholic drinks analyst at Euromonitor. 

“Premium English gin, Irish and Japanese whiskey and dark and non-alcoholic beer are the flag bearers of growth and it is no coincidence that those also happen to be the segments gaining further momentum with the ever-important millennial demographic in mature western markets.”

Euromonitor expects alcohol consumption to recover this year, rising by 1.3pc to 251.3bn litres. 

Russia's shrinking alcohol market spelt bad news for vodka, which relies on Russia for around a third of its global sales. 

Globally, vodka and rum were among the worst performers, while tequila and bourbon remained at healthy levels and a resurgence in cognac helped boost the spirits sector by 0.8pc. 

Cider consumption jumped by 4.5pc although beer lost 1.3pc as young consumers turned to "aspirational" and "exotic" alternatives


Source: The Telegarph, 12th May
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