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

26th March 2015


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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.


Consuming three alcoholic drinks a day may cause liver cancer – study

The Guardian - 24th March

Consuming three alcoholic drinks a day can be enough to cause liver cancer, experts have said.

The World Cancer Research Fund (WCRF) has pinpointed the level of drinking implicated in liver cancer after undertaking what it says was the biggest review so far of the evidence on the relationship between diet, weight, physical activity and the disease.

Its assessment of 34 previous studies covering 8.2 million people, more than 24,500 of whom had liver cancer, revealed “strong evidence” linking intake of three drinks a day to the disease.

“Around three or more drinks per day can be enough to cause liver cancer,” said Amanda Mclean, director of the charity’s UK branch. “Until now we were uncertain about the amount of alcohol likely to lead to liver cancer. But the research reviewed in this report is strong enough, for the first time, to be more specific about this.”

The WCRF’s findings prompted the Alcohol Health Alliance, a coalition of health organisations, to claim that alcohol is so toxic that cans and bottles should carry health warnings.

“Alcohol, like tobacco and asbestos, is a class 1 carcinogen and it is totally unacceptable that the public is not provided with such basic information”, said Prof Sir Ian Gilmore, the alliance’s chair.

“This report shows that there is no safe level of drinking when it comes to cancer prevention. It’s time for the government to take action to minimise the risk of harm, including ensuring that labels carry mandatory health warnings and lists of ingredients to standards that are developed independently from groups with vested interests.”

About one in 100 men and one in 200 women in Britain develop liver cancer at some point in their lifetime, and 4,703 people were diagnosed with it in 2012. It has one of the lowest survival rates among the 200 different types of cancer.

Women should try to limit themselves to no more than one drink a day and men to two in order to minimise their risk of the disease, the WCRF said.

 The Telegraph - 25th March

You might think that the stronger a wine, the more intense it tastes, but according to Spanish researchers, it's actually weaker wines that have the best flavour.

Neuroscientist Ram Frost and his colleagues from the Basque Centre of Cognition, Brain and Language in Donostia-San Sebastian, wrote in the journal Plos One: "Over the last few decades, wine makers have been producing wines with a higher alcohol content, assuming that they are more appreciated by consumers.

"To test this hypothesis, we used functional magnetic imaging to compare reactions of human subjects to different types of wine, focusing on brain regions critical for flavor processing and food reward."

 Frost and his team used fMRI - a brain imaging technique - to measure the brain activity in 21 "inexperienced wine consumers" who drank wine on a regular basis but not more than once per week.

Participants were asked to taste samples of different red wines, one strong and one weak. The scan showed there was stronger brain activity when participants drank the weaker wines, compared to the stronger ones.

Frost said: "This suggests that contrary to the common intuition regarding high-alcohol content wines - and thus contrary to the expected prediction - at least in our study, these wines induce weaker activation relative to the low-alcohol content ones."

The study didn't reveal any part of the brain where stronger wines cause more activity.

Despite causing more brain activity, Frost doesn't believe the weaker wines contain more flavour, but that instead people pay more attention to the flavour when the alcohol content is lower. "The low-alcohol content wines induced a greater attentional orienting and exploration of the sensory attributes of wines relatively to high-alcohol content wines," he said.

Frost argues that his study proves that high alcohol wines "often lack finesse...and overshadow the subtle flavours and aromas that the wine could exude."

"Lower alcohol content wines have a better chance to induce greater sensitivity to the overall flavour expressed by the wine," he said.

Department of Health-commissioned alcohol report attacks Responsibility Deal, demands more action

The Grocer - 26th March

An independent evaluation of the Responsibility Deal (RD) commissioned by the Department of Health has found it is unlikely to have any significant impact on reducing alcohol consumption, and as a result urges the government to make alcohol more expensive and devise sanctions against suppliers.

The Policy Innovation Research Unit at The London School of Hygiene & Tropical Medicine was appointed by then-health secretary Andrew Lansley in 2012 to conduct a sweeping review of the voluntary measures to tackle obesity and alcohol abuse.

Its two reports have subsequently found that the measures on alcohol had been, at best, “ineffective” with actions “poorly reported” by suppliers.

Researchers claimed that just 11% of alcohol pledge-related activities were a direct result of the RD in action, with 65% being activities that drinks companies and retailers were already undertaking, such as reducing the strength of products and bringing in better labelling.

The report went on to suggest that the wave of lower ABV products could potentially increase, rather than decrease, the number of alcohol products on the market and make the nation’s alcohol problems worse.

“The evidence is clear that an alcohol control strategy should support effective interventions to make alcohol less available and more expensive,” concluded lead author Cécile Knai.

The researchers said they had analysed all publicly available data about organisations’ plans and progress towards achieving key alcohol pledges of the deal as well as conducting a systematic review of international evidence about the different types of interventions proposed by the organisations, to see how effective the pledges would be in reducing harm from alcohol.

They found 75% of the pledges aimed to provide consumer information and choice, interventions which the study said were known to have limited effectiveness. The other 25% included measures such as reducing alcohol content in products.

“If implemented fully, the pledges may potentially be effective in improving consumers’ knowledge and awareness, but they are unlikely to affect consumption,” one of the reports reads. “This suggests that, in their present form, they are unlikely to have any significant positive impact on population health in England. “

The second report attacked suppliers over the quality of their reporting changes to products and said that although the evidence suggested the unit reduction achieved ranged from between 1.6m to 1.1bn units being removed, it was unclear if this was a result of the RD.

It said that more than one in ten of the company progress reports in 2014 under the Deal were “identical” to those made in 2013 and said the vast majority of action in the deal surrounded the launch of new, lower strength products, whilst concluding that “most alcohol pledge signatories appear to have committed to actions that they would have undertaken anyway, regardless of the RD.”

The damning report follows an early scoping review carried out by the unit in 2013 which found there was “little evidence” the Responsibility Deal would work better than regulation and recommended bring in a system of sanctions for companies who missed targets.

Knai said: “We know that effective voluntary agreements are based on clearly-defined, evidence-based and quantifiable targets, which require partners to go beyond ‘business as usual’, and penalties for not delivering the pledges.

“However, the alcohol pledges of the Public Health Responsibility haven’t met these criteria.

“Excessive alcohol consumption continues to be a major public health problem in England and needs to be addressed by effective interventions, notably those which change the market environment to make alcohol less available and more expensive. We hope our evaluation will contribute to decision-making about how to effectively tackle this problem.”

NICE redoubles efforts to reduce harm from alcohol, smoking and physical inactivity

NICE - 25th March

Smoking, excessive drinking and being physically inactive are some of the biggest causes of disease and early death in England. They cause a mounting burden for the NHS.

  • In 2013, smoking killed almost 80,000 adults aged over 35. The number of hospital admissions for smoking related diseases has risen by 30% since 1996 – from 3,044 admissions per day to around 4,400 last year.
  • Similarly, in 2012/13 there were estimated to be more than 1 million admissions related to alcohol.
  • If people were more physically active, it is estimated that 37,000 deaths could be prevented each year.

The National Institute for Health and Care Excellence (NICE) has issued three new quality standards to encourage healthy living and reduce harm from smoking, alcohol and physical inactivity in local areas.

Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said: “In England smoking, excessive drinking and physical inactivity cause too many deaths and too much disease. They cost taxpayers, through the NHS, over £7 billion every year.

“There are areas where we can make improvements. We can help the NHS and local authorities to take action in their local area and educate younger people so that healthy choices become a life-long habit. These new quality standards include interventions to help people of all ages so we can continue to improve the health of the nation.”

The quality standards include specific actions which can be used at a local level to help prevent harmful alcohol use, reduce tobacco use and encourage people to be more physically active:

  • Healthcare services using contracts that do not allow employees to smoke during working hours to set an example to the wider community and ensure that ‘no smoking’ is the norm.
  • Local authorities using local crime and related trauma data to inform policy by mapping the extent of alcohol-related problems to help meet licensing objectives.
  • NHS organisations setting out organisation-wide programmes which employ a range of measures to encourage and support employees to be more physically active.

Promoting healthy behaviour from an early age can have a huge impact on life-long choices. The standards include statements aimed at changing attitudes in children and young people.

All statements are available in the full standards on the NICE website.


How alcohol is making you fat

Closer - 26th March

Sugar content

Alcoholic drinks are infamously high in sugar. Cider, wine and alco-pops are amongst the worst offenders when it comes to high-levels of sugar. Some drinks contain as many as 5 teaspoons of sugar in a single serving. Putting this into perspective, experts recommend a daily allowance of 6 teaspoons.

High sugar intake has been linked to weight gain, diabetes and heart disease amongst other problems.

Drinks with lower levels of sugar include a small glass or red wine, with the highest being Baileys Irish Cream.

Post-booze snacking

We’ve all been there. Stumbling out the pub at 2am and heading to the nearest chip or kebab shop. Hangovers can also lead you to crave greasy, calorific foods (not to mention destroy any ambitions of heading to the gym).

For many women the temptation is to skip dinner in an attempt to make up the calories, but the best thing to do before drinking is to eat a healthy meal, this will stop you craving saturated fats on the way home and will also stop you from becoming ill. Drinking on an empty stomach is a massive no!

If you feel the need to snack after drinks with friends, try and hold off til you get home and snack on some granary toast with low-fat cream cheese.

Boozing can slow your metabolism

According to American Women’s Health, research has proven that alcoholic drinks can actually slow down fat burning, causing you to hinder weight loss and even gain weight. Think about this next time you crack open the white wine.

Alcohol boosts cortisol levels

Scientists reckon that drinking can actually boost levels of the hormone cortisol. This hormone is famous for causing weight gain, in particular belly fat.

Not only this but it also affects muscle gain, which can have a massive impact on your fitness and weight loss goals.

Little nutritional value and high calorie content

There is almost zero nutritional value along with a high calorie content. Basically, this means empty calories. Bad news for dieters!

The best thing to do is to cut back on alcohol consumption in order to follow a healthy, calorie controlled diet.

If you want to enjoy a drink with dinner or friends, simply stick with a small glass of red wine (which also contains anti-oxidants) or a less-calorific gin and tonic- and don’t over do it!

Alcohol Ads Increased 400% Over 40 Years, but Americans Aren't Drinking More

AdWeek - 15th March

Advertising drives choice, not consumption, new study says. Alcohol marketers have two reasons to feel good about the findings of a new academic study on advertising impact.

For one, their money seems to be well spent on generating new or loyal customers. But at the same time, their ads don't seem to be turning America into a nation of drunks.

A new study from the University of Texas at Austin, led by advertising professor Gary Wilcox, suggests ads have little impact on how much wine, beer or liquor people consume.

The study looked at alcohol sales between 1971 and 2011 and found that during the 40-year time frame, per capita consumption remained relatively unchanged. In that time period, the study reports, alcohol advertising in the U.S. increased more than 400 percent.

Relating these findings to previous research reveals a consistency in that there is either no relationship or a weak one between advertising and aggregate sales," the report states. "Over this time period, beer sales have exhibited a downward trend since the early 1990s, while wine and liquor have increased their share of total alcohol sales. This is despite large increases in advertising expenditures across all three categories of alcohol."

While advertising might have little impact on how much we drink, the study says it's still safe to assume that ads are effective at guiding brand preference.

One might be swayed to stock up on Budweiser or Heineken after watching a particularly strong ad, for example, but that's not to say the customer will go out and drink more than he should or would anyway.

The academics behind the study didn't delve into this issue of brand affinity themselves, but they do cite several studies that support the market power viewpoint that advertising is most effective at informing consumers of competitive information such as pricing and availability.

The researchers say their findings on overall consumption being flat as ad sales skyrocket bring into question the idea of restricting alcohol advertising to curb problem drinking.

"This study has provided evidence of consumption changes across categories of alcohol beverages over the past 40-plus years, with the preponderance of those changes significantly correlated to fluctuations in demography, taxation and income levels—not advertising."

Los Angeles recently banned alcohol advertising from public transit, including bus shelters, as several other U.S. cities have done in the past. The reason is usually to avoid underage exposure to alcohol ads. For example, a 2008 study of alcohol ads on Boston's public transit found that the ads were seen 1.2 million times per day and that 54 percent of public school students saw the ads.

The new study from the University of Texas at Austin argues that such well-intentioned bans likely aren't actually effective at limiting how much people drink.

"Although criticisms of alcohol advertising and promotional methods abound, remedies that would restrict or overly regulate such communication activities usually do not have the desired effect of reducing consumption," wrote Wilcox, the study's lead professor. "Instead, a more logical alternative would be to communicate as much information as possible to the public about the subject and encourage all viewpoints so our society makes an autonomous, rational choice regarding alcohol consumption."

In America, at least, most restrictions on alcohol advertising are self-imposed by the beverage industry and focus on encouraging responsible drinking. That's why most beer ads, for example, focus on taste rather than hard partying.

Palcohol: Risky for Teens and People in Recovery?

WebMD - 13th March

The powdered alcohol product known as Palcohol may be available on store shelves this summer. Some health officials are concerned it will only worsen underage drinking.

Federal regulators with the Alcohol and Tobacco Tax and Trade Bureau approved the new product this week. Five states have banned sales of powdered alcohol, and 28 states have proposed laws this year to ban or regulate it.

In the U.S., about 5,000 people under age 21 die each year due to alcohol-related accidents, homicides, suicides, and injuries, according to the National Institutes of Health.

Mark Phillips, the creator of Palcohol, doesn't see what the fuss over his product is about. He calls efforts to outlaw it the work of those who want a ''nanny state."

What Is Palcohol?

It's a powdered, freeze-dried version of common drinks. It includes rum, vodka, a Cosmopolitan, and a “powderita,” Phillips' version of a margarita.

Each pouch-like package weighs about an ounce. Along with the powdered alcohol, it also includes natural flavorings and the sweetener sucralose. You add water or a mixer to the package and shake it to create an average-sized mixed drink. By itself, the powder has about 80 calories a package. One packet equals one shot of alcohol, according to Palcohol’s web site.

The Alcohol and Tobacco Tax and Trade Bureau, a division of the U.S. Treasury Department, worked with the FDA to approve the product, says Tom Hogue, a spokesman for the bureau. The bureau reviews the formulation and labeling of distilled spirits products. The FDA reviews the non-alcoholic ingredients.

The FDA doesn't have concerns about those ingredients at this time, says Theresa Eisenman, a spokeswoman for the agency.

Hogue says that states ''have very broad authority to regulate the sale of alcohol within their borders.”


Powdered alcohol will trigger abuse by young people, says Scott Krakower, DO, assistant unit chief of psychiatry at Zucker Hillside Hospital, Glen Oaks, N.Y. "I think it's going to appeal to adolescents and will potentially be harmful," he says.

The easy-to-carry product may also tempt people in recovery from alcoholism, he says, since the package seems simple to conceal. He fears some people will try to snort it, which he views as especially dangerous due to choking hazards. Some may combine powdered alcohol with other drugs, such as heroin, he says.

Diageo steps down from Stop Out-of-Control drinking board

The Irish Times - 25th March

Diageo would “have to listen” if a report the drinks giant was funding recommended a ban on alcohol sponsorship of sports and other live events, its chief executive has said.

However, David Smith, who has stepped down from the board of Stop Out-Of-Control drinking campaign amid controversy about the campaign’s independence if he remained on it, noted such bans had not been effective elsewhere.

Mr Smith said he had decided to step down from the board as there had “undoubtedly been a lot of pressure on other board members” because of his presence.

“Each one of the members has given their time and energy to something they really believe in. For them to be called out and for there to be the suggestion that they were naive or had been hoodwinked on some way, it was unfair. So I decided it was the right thing to remove myself to remove any question about the independence of the campaign.”

Stop Out-of-Control Drinking, which was established last month to develop a strategy to reduce alcohol abuse, has been criticised as it is funded by Diageo, one of the biggest alcohol producers in the world.

Questions were raised about the board’s independence given the inclusion of Mr Smith. The campaign is inviting submissions from the public and is also holding work-shops to develop ideas. It will write a report with recommendations before the summer.

'Healthy Welfare Card' trials to tackle violence and alcohol abuse

Sydney Morning Herald - 22nd March

Welfare recipients will be given cashless cards to stop them from spending money on alcohol and drugs in a bid to combat violence against women and children.

Parliamentary Secretary to the Prime Minister Alan Tudge said the government was planning trials of the cards "in a small number" of places that are yet to be decided later this year.

He said the government was talking to communities where there were problems with "welfare-fuelled alcohol and drug abuse" and community leaders were prepared to back a trial.

"The potential upside could be absolutely life changing in terms of community safety for women and children," Mr Tudge said.

The card, which was suggested by mining magnate Andrew Forrest in a report to the government last year, would be redeemable at any Australian shop that accepts Visa with electronic and EFTPOS payment facilities. But it could not be used to buy alcohol or drugs or gamble.

The trial would not make people's welfare payments completely cashless, to allow for situations that are cash only – such as catching a bus or buying lunch at school.

Mr Tudge said people who were not heavy drinkers or problem gamblers would not notice a huge difference in their lives.

"Instead of reaching for cash for something, you'll have to reach for your card and tap," he said.

But in terms of dealing with alcohol-fuelled violence, Mr Tudge said the card could quickly have "an enormous impact".

In his report to government last year, Mr Forrest recommended the so-called "Healthy Welfare Card" be made available to all Australians who were on benefits.

Social Services Minister Scott Morrison praised the cashless card as an "excellent idea" on Sunday but said there were no plans "at this stage" to roll it out to all those on benefits.

"We are proceeding carefully and patiently and incrementally," he said in Sydney.

The federal government has been in talks with banks during the past six months about what would be technically feasible with the debit cards and when the technology might be introduced.

More than 20,000 Australians have their welfare incomes managed voluntarily or compulsorily in places such as Perth, the Kimberley region, Cape York, Bankstown and Shepparton.

The existing schemes, which were introduced by Coalition and Labor governments, quarantine at least half of a person's payment for necessary items and prevent spending on things such as alcohol, cigarettes, home- brew kits and pornography. At this stage, the various schemes are due to end in mid-2015 and mid-2016, and the government has been considering its next move in the area.

National Welfare Rights Network president Maree O'Halloran said she had serious concerns about compulsory income management and did not think it would solve problems such as alcohol abuse.

"It's like making people children," she said, adding that the evidence on the effectiveness of income management was "mixed".

Ms O'Halloran said it would be sad to see the card used to control people and take away their choices.




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