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Executive summary

Alcohol is a legal substance which is enjoyed in moderation by many people. We know, however, that when consumed excessively or inappropriately, it takes its toll on our health, our families, our relationships, and our communities. In Scotland we face a substantial challenge in readjusting our attitudes and behaviours in relation to alcohol, and in particular, educating our young people to adopt a sensible approach to alcohol consumption. This plan outlines a number of ways in which the Executive can support this readjustment, not forgetting that personal responsibility is at the heart of sensible alcohol consumption.

This updated plan builds on progress made since the original Plan for Action on Alcohol Problems was published in 2002. It sets out a programme for the next three years to change drinking cultures and reduce alcohol-related harm through government action, partnership working, and encouraging individuals to take personal responsibility. It will be supported by a detailed delivery plan which will enable Scottish Ministers and the Scottish Ministerial Advisory Committee on Alcohol Problems ( SMACAP) to monitor progress and ensure delivery of each of the high level actions.

The update retains the broad structure of the original plan but does not include specific actions under the heading of culture change. This reflects the belief that real culture change requires integrated and sustained action across all pillars of the plan; protection and controls, prevention and education and the provision of services.

It is recognised that a wide variety of partners and networks have a role to play in supporting the implementation of the Plan for Action. The Scottish Executive will support partners in their delivery role, facilitating effective partnership working and maintaining strong and effective working relationships between the Executive and all stakeholders in the delivery of this plan.

This is a plan that will achieve greater results through cumulative action than through actions in isolation. Key actions include:

• extending the alcohol test purchasing pilot to all Scotland in 2007;
• using the Executive commissioned evaluation of effectiveness of drugs education in Scottish schools to develop an alcohol education programme as part of a wider, robust substance misuse education programme for schools;
• giving Licensing Boards more power to control the spread of licensed premises, and tackling excessive drinking, through the implementation of the Licensing (Scotland) Act 2005;
• piloting, during 2007/2008, a telephone based brief interventions service, aimed at identifying harmful and hazardous drinkers at an early stage and providing appropriate support;
• completing, by mid 2007, a set of national publications about the short and long term effects of drinking alcohol;
• supporting further development of Youth CAFEs (Community Alcohol Free Environments) and working with partners to provide other diversionary activities for young people, for the duration of this Plan;
• undertaking, by May 2007, a stock-take of Alcohol and Drug Action Teams ( ADATs) to assess performance to date and capability to deliver Ministerial priorities on drugs and alcohol. This should establish a firm evidence base to determine the future mechanism for effective local action to deliver national priorities;
• researching how best to improve recording and reporting information on drug and alcohol use during pregnancy - report anticipated in July 2007;
• extending successful measures from the Alcohol Education Research Council ( AERC) funded culture change pilot to all areas of Scotland, by December 2007;
• developing a quality standards framework for drug and alcohol services;
• developing a national drugs and alcohol workforce development strategy by summer 2008 and plans for its implementation by spring 2009.

Progress towards achieving the aims set out in this plan, and in the accompanying industry partnership agreement, will be monitored and managed rigorously: this will include the ongoing review of the individual actions. A formal report on the progress towards delivering these actions, and on their impact on addressing alcohol misuse, will be included in the Executive's annual report on health improvement: Delivering a Healthy Scotland - Meeting the Challenge. In addition, the Chief Medical Officer's annual report will report on thelong-term benefits of the plan.

Impact of alcohol

Alcohol consumption and excessive drinking are increasing in Scotland. Alcohol-related hospital admissions and deaths continue to rise for both men and women and there has been a 54% increase in reported drinking by 15 year olds and a 100% rise in drinking by 13 year olds since 1990. There is justifiable concern about alcohol-fuelled violence and other forms of alcohol-related antisocial behaviour. We also know that young people who drink are more likely to smoke, take drugs or have unsafe sex.

Alcohol industries are estimated to employ around 155,000 people in Scotland whilst at UK level alcohol taxes account for 7% of total Customs and Excise revenue. Alcohol is estimated to cost Scotland £418 million pa from a reduction in output and productivity and a further £484 million pa in public services.

Changing alcohol cultures

The plan provides a framework of action to accentuate the positive and tackle the negative aspects of drinking cultures in Scotland. Our long-term aim is to create a society in which the safe and sensible consumption of alcohol is recognised as being compatible with a healthy lifestyle. Priorities for action are to:

• promote healthy lifestyle choices and the role of moderate and appropriate alcohol consumption within such choices;
• further restrict the availability of alcohol to under age groups, strengthen responsible marketing and sales strategies and ensure an appropriate balance between supply and demand;
• challenge social norms surrounding the excessive use of alcohol and work with the media against the overt glamorisation of alcohol;
• reinforce social norms where these are positive in relation to responsible drinking patterns and behaviour;
• help individuals to take personal responsibility for the consequences of their drinking;
• make it clear that drinking behaviour that misuses alcohol carries enormous risks for the health, reputation and enjoyment of the individual concerned and that it can adversely affect others; and
• ensure that families, friends and communities are protected from the unacceptable consequences of the irresponsible promotion, sale and consumption of alcohol.

Protection and controls

Action to control the supply of alcohol is designed to complement communication and other preventative activity aimed at changing cultures of excessive drinking and underage drinking. This includes work with:

• Licensing Boards to tackle the overprovision of licensed premises and restrict unacceptable commercial activities which encourage excessive drinking;
• the alcohol industry to further promote the responsible serving of alcohol and consider whether marketing strategies, including packaging, labelling and branding, are contributing to the drinking culture;
• local authorities to ensure that public byelaws are effective in dealing with nuisance drinking in public; and
• the UK Government on issues such as alcohol advertising, labelling, pricing and drink driving which have UK wide implications.

Prevention and education

The plan retains a focus on promoting the cultural shift away from excessive drinking and helping more people living in Scotland to adopt a responsible approach to alcohol.These aims will be achieved by:

• implementing a communications strategy which promotes positive lifestyles, the responsible use of alcohol as part of a healthy lifestyle and highlights choices in a relevant, appealing and creative way;
• challenging the cultural acceptability of excessive drinking, by focusing attention on the short and long term consequences of drinking in excess of recommended limits and focusing on activities which are incompatible with drinking alcohol, such as driving, building on our 'Alcohol. Don't Push It' campaign;
• working with partners such as Alcohol Focus Scotland ( AFS) and the Scottish media to challenge stereotypes, promote responsible drinking and provide a more balanced portrayal of alcohol and alcohol problems;
• fostering social and working environments which support healthy choices;
• working with the alcohol industry and licensed trade both to tackle the irresponsible promotions which can encourage excessive drinking and to also proactively promote responsible drinking;
• developing a better understanding of the links between the use of alcohol and other substances; and
• ensuring that people have access to information, support and advice to help them make and sustain healthy choices.

Provision of services

The plan aims to deliver equitable, accessible, appropriate and inclusive services throughout Scotland by:

• supporting the delivery of person centred services which meet the needs of individuals and their families and children;
• supporting the implementation of existing guidelines for the treatment and support of people needing alcohol services;
• working with partners to assess local capacity, need and service gaps and tracking growth of capacity as a result of increased investment;
• linking additional resources to service level agreements with local partners which accept responsibility for expanding high quality services in line with national priorities;
• supporting the further development of well trained staff at all levels in alcohol and drug services throughout Scotland;
• ensuring that we are able to respond to the ways in which an increasingly ageing population might affect the demand for alcohol services in Scotland; and
• linking with partners to ensure an appropriate response to alcohol problems and aco-morbid physical and/or mental illness.

Getting the framework right

Whilst progress has been made since the publication of the original plan, more can be done to strengthen our capacity to deliver measurable outcomes. Our ability to deliver the actions and benefits in this updated plan will be enhanced by ensuring that:

• strategic and planning partnerships at all levels have the active support of all key stakeholders and are able to assess and reflect the specific needs of their communities;
• local and national agencies and partnerships accept responsibility for the delivery of agreed outcomes and the contribution that these make to national priorities;
• we maintain strong and effective working relationships between the Executive and all stakeholders in the delivery of this plan; and work with government agencies within the framework set out in the Vision for the Voluntary Sector;
• relevant staff in generic and specialist agencies have appropriate training in identifying, assessing and managing alcohol problems;
• measurement systems are robust, fit for purpose and used to support the ongoing delivery of this plan; and
• knowledge of the impact of alcohol harm reduction is developed and the impact of the actions outlined in the plan is evaluated.

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