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CHAPTER 3 ALCOHOL AND THE COMMUNITY
Key Point Summary
- Alcohol use is an accepted and important part of our culture throughout Scotland and is used as part of many positive aspects of our lives.
- The selling of alcohol within a community has to be placed within this context, with off-sales being a part of this culture.
- It is also recognised that when misused, alcohol causes considerable damage to society.
- Any changes to behaviour need to driven by social acceptance/ unacceptance.
- How young people consume alcohol has changed; alcohol is now consumed to 'get smashed', rather than 'get merry'.
- Across many of the participants, alcohol is viewed an 'ordinary' commodity similar to general groceries by focus group participants.
- Health Strategic Stakeholders thought responsibility for change must come from government with a consistent and concerted approach.
The Importance of Alcohol within the Community
3.1 The act of drinking is key to what we do; a person will die of thirst long before they will succumb to starvation and this need for liquids has been a major influence on our human evolution. Today the legacy of this dependence takes many forms in rites and rituals, customs and ceremonies all focused on the simple yet vital act of taking a drink.
3.2 Alcohol provides fundamental links with key aspects of our lives from birth to death, so much so, that alcohol use is now an accepted part of social interaction in our culture, and the majority of adults in Scotland drink alcohol regularly. However, it is commonly recognised that when alcohol is misused there are serious consequences for individuals, their families and friends, and for society as a whole. From illness, to family problems, accidents and crime, alcohol has the potential, and in many cases does, damage lives. The 2004 Scottish Social Attitudes Survey found that 64% agreed that "drinking is a major part of the Scottish way of life" and that 46% thought alcohol caused the greatest problems for Scotland as a whole (Bromley and Ormston, 2005).
Alcohol and Health
3.3 As alcohol is such an important aspect of our culture within Scotland it also represents clear dangers to our society when it is misused. Since 1980, alcohol-related deaths have risen from less than 1 in 100 deaths to 1 in 30 of all deaths in Scotland ( NHS National Services Scotland, 2005).
3.4 Recent media and political interest has focused particularly on the social problems associated with binge drinking and with underage drinking. Current Department of Health Guidance defines a 'binge' as drinking double the daily recommended maximum units (2-3 units for women and 3-4 for men).
3.5 The Scottish Health Survey (2003) states that in 2003, 28% of Scottish men and 18% of Scottish women reported exceeding double the daily benchmark on at least one day in the previous week. In addition to rising concern about the health impacts of alcohol misuse, there are high levels of concern about the social effects of problem drinking in terms of crime and disorder impact on families; and especially the level of drinking involving young people within the UK and Scotland.
3.6 The Scottish Schools Adolescent Lifestyle and Substance Use Survey found that 40% of 15 year old boys and 46% of 15 year old girls had drunk alcohol in the week before the survey; 53% of 13 year-olds and 74% of 15 year-olds had been drunk at least once in the last 30 days prior to the survey; and 31% of 13 year-olds and 56% of 15-year-olds reported drinking five or more drinks on that same occasion (Corbett et al, 2005).
Current Scottish Policies on Alcohol Misuse
3.7 The Scottish Executive's strategy for tackling the problems of alcohol misuse is set out in its Plan for Action on Alcohol Problems (2002). This identifies the reduction of binge drinking, and reducing harmful drinking by children and young people as key priorities. It also sets out various strategies for tackling alcohol problems including: working to achieve cultural change in attitudes towards alcohol in Scotland; improving prevention and education strategies; closing gaps in service provision for those with alcohol problems; and introducing new protections and controls to limit the sale and purchase of alcohol.
3.8 Legislative proposals to control the sale and purchase of alcohol are contained in the current Licensing (Scotland) Act 2005, which is expected to come into force in 2009.
How our Communities use Alcohol - the Culture of Drinking
3.9 It is well established that alcohol is a key part of Scottish Culture (Bromley and Ormston, 2005), therefore it follows that focus must then, at least partially, be on our cultural attitudes towards how and why we use alcohol.
3.10 This was seen as key across all groups and individuals involved in the present study. A number of Area Key Stakeholders ( AKS) focused on the wider 'societal' issue of alcohol, specifically with respect to the fact that alcohol is cheaper, more accessible, stronger, and more palatable than ever before; that areas of high unemployment are perceived to have heavier drinking cultures, and that educational messages are not always internalised by target populations. It is noted that AKS and focus group participants think that young people consume alcohol in a different way than previously; drinking to 'get smashed' rather than 'get merry'.
3.11 Participants in rural areas spoke more frequently about drinking at home than those in the urban areas. However, there was a general perception that across both rural and urban locations that the average age of 'first drink' is thought to be lowering whilst the incidence of alcohol abuse is increasing. Corbett et al (2004) showed 88% of 15 year olds compared with 68% of 13 year olds reported having had a 'proper alcoholic drink - not just a sip'. Among 15 year olds, girls were more likely than boys to have ever drunk alcohol: 90% of girls compared with 86% of boys. There was no significant gender difference among 13 year olds.
3.12 Focus group participants of the study were well aware of the health implications that excessive alcohol consumption brings however this worry tended to be displaced onto younger generations rather than on personal health; for these people, the focus is always on somebody younger than themselves.
3.13 The major theme that health and community safety Strategic Key Stakeholders wanted to address was the culture of drinking in Scotland. The belief across the board was that alcohol was now seen as an ordinary commodity and its potential consequences were not fully appreciated.
3.14 Those same Strategic Key Stakeholders perceived the culture of getting a drink from off-sales shops is seen as an everyday part of life. Selling alcohol like any other product is now seen as the norm; however, what is lacking is any connection to the associated problems.
3.15 There was a strong request to address the culture where intoxication is accepted or even celebrated. It was felt there was considerable hypocrisy connected to alcohol use. There was a realisation from health Strategic Stakeholders that responsibility for change must come from government with consistent and concerted action.
3.16 Community safety Stakeholders felt that there was a need for a clear split between national action on price and availability, whereas locally, it was the responsibility of everyone to address selling and education. Again, like the health arena there was a wish for problem drinking to be socially unacceptable.
3.17 A member of the retail community felt that the biggest issue was to address the deprivation within certain communities within Scotland; it was acknowledged that alcohol played its part but that people were essentially drinking to escape.
Negative Consequences of Alcohol in the Community
3.18 Specific issues to do with antisocial behaviour and drinking are discussed later in the report (see Chapter 7), however, a number of points gathered across the data discuss overarching issues faced by the community due to alcohol sales.
3.19 A wide range of Strategic Key Stakeholders thought that the selling of alcohol in the community from off-sales often meant associated problems remain hidden as the problem is taken away from the premises, and little is known about the relationship between specific alcohol sold and problematic behaviour both in the short and especially the long term.
3.20 An interesting research study by Matthews (2006) looking at alcohol price sensitivity and violence, collected data over a 5 year period from 58 NHS Emergency Departments ( ED) in England and Wales to develop an economic model of the determination of violence-related injuries in relation to the price of beer. The findings estimated that a 1% rise in the real price of alcohol would equate to an economy wide reduction in ED assault cases of 5000 per year.
3.21 It was also shown that there was a clear seasonal pattern to the data, in that violence related injuries were highest in Summer. Major sporting events, which engage the national population, also produce a significant increase in violent injuries. 12 Whilst it is unclear what element of the economic model developed here relates to the cost of off-sales, the authors indicate the real price of beer within the model acts as a proxy for alcohol prices. It would be necessary to explore the model further before implications for off-sales can be drawn.
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