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CHAPTER 4: ANALYSIS OF RESPONSES FROM ORGANISATIONS

Summary

• There was strong support from a large majority of organisations for the overall approach and Framework for Action outlined in the discussion paper. However, a significant minority of organisations, mainly from the alcohol trade and business sector, were critical of both the overall approach and specific proposals contained in the discussion paper.
• A large majority of organisational respondents were in favour of the proposals to end irresponsible promotions and below-cost selling (73% fully or partly in favour); minimum retail pricing (65%); and, increasing the age of checkout staff (72%).
• Smaller majorities supported the principle of introducing a social responsibility fee (54%) and further restrictions on promotional material in licensed premises (56%).
• Views were evenly on the proposal for separate checkouts for alcohol sales (47% in favour; 50% against).
• A large majority of organisations were opposed to the proposal to increase the minimum legal age for off-sales purchases to 21 (63% against; 27% in favour).
• There were very clear differences in the views of organisations in the health and local government sectors compared to those from the trade and business sector. Health and local government bodies overwhelmingly supported all the proposals put forward in the discussion paper; with the exception of increasing the minimum age for purchase of off-sales alcohol (only a small majority of health bodies supported this proposal while a majority of local government bodies opposed it).
• On the other hand, trade and business sector respondents were strongly opposed to almost all the proposals on which the discussion paper sought views. The only proposal which was not opposed by a clear majority of trade and business sector respondents was increasing the minimum age of checkout staff.
• In addition, many respondents provided detailed comments on other actions included in the discussion paper and, in the main, were supportive of measure already being pursued by the Scottish Government, or provided suggestions for how they could be taken forward.

Introduction

4.1 This chapter provides an analysis of the responses submitted by 207 organisations. A qualitative analysis of views on the discussion paper's set questions is supported by a qualitative analysis and illustrative quotes of different views expressed in responses.

4.2 Many organisations submitted detailed written responses rather than complete the online questionnaire. Most of these respondents did answer the set questions and provided additional comments. However, a significant proportion of organisations did not answer the set questions and/ or only commented on a specific aspect of the discussion paper that was not dealt with in the set questions.

4.3 As was the case with individual responses, there were several questions where organisations generally indicated their support or opposition to the principle of the proposal outlined in the discussion paper rather than commenting in detail on the specifics contained in the question. The report highlights where the analysis of responses is based on views on the principle of a proposal rather than the detail.

4.4 The proportion of respondents not answering questions varied from 15% (Question 4) to almost 70% (Question 7). Therefore in order to provide a more meaningful and consistent comparison, all the percentages quoted in the analysis below refers to the 'valid responses'; i.e. the percentages based on the total number of responses to each question and not the total of all responses.

4.5 In order to provide a comparison between the views of key sectors as well as the views of all organisations we have analysed the answers to the consultation questions from the three key sectors - health, trade and business, and local government - that responded to the consultation. Between them these three groupings included 161 (78%) of the 207 organisations that responded to the consultation (see paragraphs 2.9 - 2.11 above). Charts have been used to compare the views of all organisations and the three key sectors. Tables outlining the full quantitative analysis are provided in Appendix 2.

4.6 The quantitative and qualitative analysis of responses highlights differences in views between these three key sectors and differences of opinion within each sector. In addition, the analysis highlights significant variations in the views of other respondents, particularly youth organisations, children's charities and 'other' organisations.

Overview of Organisational Responses

4.7 There was strong support from a large majority of organisations for the overall approach and Framework for Action outlined in the discussion paper. There was a consensus amongst respondents, including some organisations that were critical of certain proposals, that the proposed approach is bold and puts Scotland at the leading edge of tackling alcohol misuse.

4.8 Many respondents acknowledged the scale of the alcohol misuse problem in Scotland and the need for government to take decisive action. For example, BMA Scotland commented that the discussion paper " outlines a number of bold strategies that will, if developed in partnership and appropriately resourced, help to turn around Scotland's relationship with alcohol." Scottish Health Action on Alcohol Problems ( SHAAP) considered the new strategic approach to be " a landmark in the development of alcohol policy in Scotland".

4.9 Many organisations welcomed the evidence-based approach taken by the Scottish Government both in relation to highlighting alcohol-related harm ( e.g. in relation to health) and the cost of alcohol misuse and to developing measures to tackle alcohol misuse. In particular, organisations such as SHAAP welcomed the use of evidence that "controls on the price and availability of alcohol are one of the most effective policy measures government can take to reduce alcohol-related harm."

4.10 However, a minority of organisations were critical of the overall approach and most of the proposals outlined in the discussion paper. Many alcohol trade and business organisations, while acknowledging the need for action, felt that the proposals outlined in the discussion paper would not achieve the desired outcomes. Five main areas of concern or disagreement raised particularly, though not exclusively, by trade and business sector respondents have been identified by the analysis:

• the possibility of unintended consequences stemming from the implementation of the proposals;
• concern that some proposals may not be evidence based and some may require further detailed consideration as to how they might be implemented;
• legal questions and issues around definitions;
• a perceived dichotomy between a whole population approach and targeting young people and 'irresponsible drinkers'; and,
• whether the emphasis should be on enforcing current legislation rather than introducing new measures.

Further Measures to End Irresponsible Promotions and Below-cost Selling

Q.1 We invite views on whether regulations should be made, under the Licensing (Scotland) Act 2005, to:

• put an end to off-sales premises supplying alcohol free of charge on the purchase of one or more of the product, or of any other product, whether alcohol or not.
• put an end to off-sales premises supplying alcohol at a reduced price on the purchase of one or more of the product, or of any other product, whether alcohol or not.
• prevent the sale of alcohol as a loss-leader.

4.11 Most organisational respondents expressed their views on the principle of ending promotions and below cost-selling rather than on the three measures outlined in the discussion paper. Therefore, it is not possible to provide a detailed breakdown of views on each of the three measures.

4.12 Two thirds of organisations (66%) that responded to this question supported the principle of ending promotions and the sale of alcohol as a loss-leader or supported all three of the options presented in the question. A further 7% expressed support for at least one of the options. Just under one in five respondents (19%) were opposed to these proposals and a further 8% were uncertain, wanted further information or provided an inconclusive reply. (see Chart 1)

4.13 Respondents from the health and local government sectors were overwhelmingly in favour of ending promotions and below-cost selling (93% and 82% respectively supported the proposals in principle or all three. measures). However, a majority of trade and business organisations (56%) were opposed in principle. Only 16% were in favour in principle of further restrictions, while 20% supported at least one of the proposed measures. Eight out of the nine youth organisations that submitted a response to the discussion paper supported the principle and / or all three measures (one did not answer this question).

Chart 1: Views of organisations on the proposals to end 'irresponsible promotions and below-cost selling' (Q.1)*

* The 'Yes' in this chart reflects those respondents in favour of the principle of ending irresponsible promotions and below-cost selling, all three or at least one of the measures presented in Question 1.

Note: 'trade' in charts includes trade and business sector organisations

4.14 Almost all of the organisations that commented on the three detailed proposals outlined in Question 1 supported all three proposals. However, 12 organisations only supported one or two of the three measures, including seven alcohol trade and business sector bodies that supported the principle of ending the sale of alcohol as a loss leader but did not support ending off-sales promotions.

4.15 Most of the organisations that supported the proposals agreed with the view expressed in the discussion paper that there is a direct link between availability of cheap alcohol and excessive and irresponsible drinking and consequent harm. Several organisations also highlighted the anomaly that the Licensing (Scotland) Act 2005 includes regulations banning irresponsible promotions in the on-sales environment but a more limited range of irresponsible promotions in respect of off-sales.

4.16 Many health sector respondents including Alcohol and Drug Action Teams ( ADATs) and Royal Colleges supported the views expressed by SHAAP on this issue:

"As the discussion paper highlights, there is a clear link between alcohol consumption and harm and evidence suggests that the increasing affordability of alcohol in the UK over the past 20 years has fuelled a rise in consumption. The most recent independent review of the relationship between alcohol price and consumption conducted by Sheffield University (June 2008, prepared for Department of Health in England) has confirmed findings of previous studies that price increases and taxation have a significant effect in reducing demand for alcohol.

In light of the accumulated evidence, it appears increasingly anomalous that most of the provisions designed to control irresponsible drinks promotions in the new Scottish Licensing Act only apply to the on-trade sector. Sales data reveal that the most aggressive cut-price alcohol promotions occur in the retail sector and that more and more people are choosing to purchase alcohol from off-licensed premises for home consumption."

4.17 The Royal College of Physicians, Edinburgh ( RCPE) also highlighted both issues in its response:

"The Licensing (Scotland) Act 2005 already includes regulations to curtail irresponsible drinks promotions in the on-trade sector and we believe it was anomalous and a weakness of the original legislation that such regulations were not applied equitably to the off-trade sector. It is essential to close this loophole.

There is strong evidence to demonstrate a correlation between the price of alcohol and the level of alcohol consumed. In recent years competition between retailers (principally the four largest supermarket chains) has driven down the price of alcohol in the off-trade sector. Given the extent of alcohol-related harm in Scotland, we believe it would be irresponsible and highly damaging to allow the continued sale of alcohol by retailers as a loss-leader."

4.18 The Scottish Association of Alcohol and Drug Action Teams ( SAADAT) welcomed the proposals as a contribution to raising the price of alcohol as this is "one of the most effective policy tools for tackling alcohol misuse."

4.19 Eighteen respondents from the trade and business sector supported all or some aspect of the proposals to end promotions and below-cost selling. These included:

• nine organisations that supported all three of the proposals outlined in Question 1, including three producers, four small retail stores and two 'other' trade and business sector organisations;
• seven organisations (including the Federation of Small Businesses, the Scottish Grocers' Federation, a major producer and four small retail stores) that supported the ending of the sale of alcohol as a loss-leader but not the proposals to end promotions in off-sales; and
• two organisations that supported a different combination of two of the three proposals.

4.20 The Scottish Grocers' Federation opposes below-cost selling in principle. However, it queried how the proposal to ban below-cost selling could be accomplished:

"Scottish Grocers' Federation ( SGF) is not aware of any convenience stores that sell alcohol products below cost and believe this practice is irresponsible. Legislation to prevent loss leader promotions is difficult to devise, because, the components of cost price differ between retailers, with the large supermarkets enjoying a much lower price than a typical convenience store. In addition, separate discounts and contributions from suppliers could constitute an even lower cost price structure. Therefore below-cost activity could mean something different in each store group resulting in the control of this type of activity being virtually impossible. In principle SGF opposes below-cost selling."

4.21 A majority of alcohol trade and business sector organisations, including on-sale and off-sale retailers and producers, opposed the proposals to restrict promotions and end below-cost selling. Most of these respondents stated that they were unconvinced by the evidence presented in the discussion paper that drinks promotions per se lead to the misuse of alcohol. Alcohol trade and business organisations, the Law Society of Scotland and some local government bodies, including Licensing Boards raised concerns in a number of areas including:

• how terms such as 'promotion of alcoholic drinks' would be defined in legislation; and,
• what is meant by 'loss-leading' and how will local authorities and / or Licensing Boards determine this.

4.22 Several retailers expressed the view that restricting their ability to offer special promotions and cut price deals would have an adverse impact on consumers, in particular, people on low incomes. For example:

" ASDA does not accept that an outright ban on promotions is in the interests of Scottish consumers - especially low-income shoppers and pensioners. ASDA has already taken voluntary steps to cut back on promotions of alcohol in Scotland. So, we now offer good-value deals on single packs, rather than multi-pack promotions.

The cost structure of alcohol is very complex because of the way in which promotions are supported both by ASDA and by the supplier. Assessing what constitutes below-cost selling would be far from straightforward. Furthermore, the Government would need access to our trading accounts in order to check that alcohol was not being sold below cost."

4.23 Several distilleries and whisky producers and associations (including the Scotch Whisky Association) queried how the proposals would affect whisky tasting and other promotions undertaken by distilleries.

4.24 No organisations from the health sector, only one local government body and three 'other organisations' opposed these proposals. One of the few non-trade organisations that opposed these proposals in principle was Age Concern Scotland. It stated:

"Age Concern Scotland believes that this approach to reducing alcohol sales is unfair on older people with fixed incomes. As inflation is driving up the costs of food, fuel and other consumer items older people should not be prevented from benefiting from deals that will help them reduce their weekly shopping. Binge drinking in Scottish society is a cultural problem, not a free-market one and will not be solved by increasing the cost of alcohol. Creating a market place with clear differentials in price will result in increased cross-border traffic akin to day-trips taken to the continent to purchase cheaper alcohol."

Minimum Retail Pricing

Q.2 We invite views on the proposed principles on which a minimum pricing scheme for alcohol products should be established.

4.25 Although the discussion paper asked for views on the principles on which a minimum retail pricing scheme should be based, most organisations commented on whether a scheme should be introduced rather than on the details and basis of such a scheme. Around two thirds (65%) of all organisations that answered this question supported the proposal to introduce a minimum pricing scheme for alcohol products or specifically supported various options for how such a scheme could be implemented. Just under a quarter (23%) of organisations that responded to this question expressed their opposition in principle to the proposal.

4.26 Chart 2 (see below) clearly shows that whilst a very large majority of respondents from the health and local government sectors (90% and 84% respectively) supported the introduction of a minimum pricing scheme, almost two thirds (61%) of respondents from the trade and business sector were opposed. It should be noted that five of the nine youth organisations that submitted responses to the consultation, including, the CARDAS, the National Union of Students and the Scottish Youth Parliament supported minimum pricing, whilst four did not answer this question.

4.27 Most organisations that supported minimum pricing did so from a public health perspective. Several respondents referred to the SHAAP report on ' Alcohol: Price Policy and Public Health'¹³ which provided a comprehensive review of the evidence on the relationship between price and the level of alcohol consumption.

Chart 2: Views of organisations on minimum retail pricing (Q.2)

Note: 'trade' in charts includes trade and business sector organisations

4.28 Almost all health organisations and local government bodies supported minimum retail pricing in principle and agreed with the view expressed by SAADAT and others that a minimum pricing scheme should be based on the principles outlined in the SHAAP report:

• "That alcohol strength determines the price;
• That price should be applied equally to all premises selling alcohol products; and,
• That price should be set independently of those involved in the production, distribution, retail or any other activity connected with the sale of alcohol products."

4.29 The Royal College of Psychiatrists stated that it strongly supports action to reverse the falling relative cost of alcohol and the idea of a minimum price for a unit of alcohol. It argued that some retailers publicised their decision to absorb the costs of the increase in excise duties following the budget in April 2008, thereby negating any potential public health benefit. Therefore, it suggested that minimum pricing would ensure that Government could have the necessary influence on the cost to the consumer.

4.30 Ten trade and business organisations supported the minimum retail pricing proposal in principle (for example, the Scottish Licensed Trade Association) or expressed a view in favour of one of the criteria suggested in the discussion paper for determining the minimum price. For example, Punch Taverns supported minimum pricing being set for off-sales only.

4.31 The Portman Group expressed doubts about whether minimum pricing will reduce alcohol consumption but stated:

"We do acknowledge that if one nonetheless seeks to address misuse through raising price, a policy of minimum pricing is likely to be more effective than a policy of raising taxation levels. First, it is guaranteed to impact on price; tax rises may be absorbed by the retailer. Secondly, it is more targeted in that it is acting only against the lower price-end of the market which is the end at which those who misuse alcohol are more likely to make their purchases (though in so doing one might argue that it is also targeted against the poorer members of society).

If minimum pricing were to be introduced on social responsibility grounds, we agree it should be based on minimum price per alcohol unit irrespective of drink type (beer, wine, spirit, etc). Otherwise, the harmful drinker (whom the measure is seeking to target) would simply switch to whichever drink-type was the cheapest price per unit."

4.32 Thirty of the 36 organisations that expressed their opposition to minimum pricing were trade and business organisations. The main reasons given for opposing the principle of a minimum pricing scheme were that it would impact disproportionately on people on low incomes and that it might have ' unintended consequences', such as people buying cheap alcohol over the internet or from shops and warehouses in England. For example, Sainsbury's stated:

"A policy of minimum retail pricing is likely to result in unintended consequences, which will undermine the Government's overall objective of reducing alcohol-related harm. As an initial statement, it is worth stating that the Government's conclusion that linking the product strength to the retail price would help reduce alcohol consumption and thereby reduce alcohol-related harm is unsound. Minimum pricing will only affect - disproportionately - those households with a lower disposable income and may simply lead to a shift in product choice rather than a reduction in consumption."

4.33 Sainsbury's further suggested that " There is the very real possibility of increasing cross-border 'white van'-type sales." and provided an example of cross-border shopping in practice from its Newry store in Northern Ireland, which " regularly sees shoppers 'commute' from Dublin to Newry to do their weekly or monthly shops."

4.34 A number of respondents, including some that supported the principle of a minimum pricing scheme questioned the practicality of introducing such a scheme. Several trade and business respondents also questioned the reasoning behind the minimum pricing proposal, suggesting that it is another tax raising measure, and/ or queried the legality of the proposal. For example, CPL Training stated:

"Minimum pricing, however confected, is simply a way of putting a moral spin on a tax increase… We doubt that such a scheme would be consistent with either European law or competition law."

4.35 However, it should be noted that in its response SHAAP referred to legal opinions it had commissioned for its 'Alcohol: Price Policy and Public Health' report, which " confirmed that minimum pricing was possible under both UK and EU competition law" if minimum prices are set independently "of those who profit from the production or sale of alcohol".

4.36 Nine trade and business sector respondents did not answer this question, and a further nine were unsure, sought additional information or suggested that further research is required. For example, Tesco stated:

"We need to better understand the impact of price and be mindful of the fact that the vast majority of people consume alcohol responsibly and shouldn't be penalised for the actions of less responsible drinkers. In taking action on price, we would hope that the Scottish Government will be mindful of potential unintended consequences; for example, people purchasing from retailers who do not have stores located in Scotland or even from unregulated illegal sources. All of these would have knock-on effects on jobs in Scotland and a subsequent wider negative economic impact."

Information for Parents

Q.3 What particular information do you think parents and carers would find helpful?

4.37 Organisations provided a wide range of comments on the information that parents and carers would find helpful. The most common suggestions were:

• information about the potential harmful effects of alcohol;
• information about the strength of alcohol and recommended or guideline maximum units of alcohol;
• parents providing good example in responsible alcohol consumption and introducing children to sensible drinking;
• support for parents and relatives who misuse alcohol;
• alcohol awareness education in schools as part of the curriculum and peer led education; and
• more investment in, and information about, youth diversionary activities.

4.38 Learning and Teaching Scotland's response provided a comprehensive response on this subject which was reflected by other respondents:

"Consultation is essential to identify how best to engage with parents and carers in communicating information relevant to their potential role in the prevention of alcohol misuse. Also important would be identifying gaps in knowledge and understanding in relation to alcohol use, and to recognise that people at different ages and stages can become involved in alcohol misuse for a variety of reasons, consequently a lifelong learning dimension is essential to any strategy aimed at preventing alcohol misuse. Key elements include:

• Clear information about how alcohol misuse impacts on mental and emotional health, social health and behaviour, and physical health.
• The human costs for all ages and what this means for society in
  terms of the cost of services (Police, Health, Social etc.) and the impact on the economy.
• What it means for children and young people - specific risks etc.
• Clarity about the law in relation to alcohol generally, and children and young people specifically.
• How behaviour and attitudes of different family members to alcohol, and availability of alcohol in the home (or not) might impact on children and young people in positive and negative ways.
• Strategies for discussing issues around alcohol with children and young people.
• Making the most of opportunities for home, school and community links e.g. through Curriculum for Excellence generally, and experiences and outcomes for Health and Wellbeing which includes substance misuse and has a focus on school and community partnerships.
• Importance of involvement in supervised out of school activities and local youth work activities as an alternative to alcohol.
• Sign posting sources of advice, support and further information especially at local level e.g. youth work as a major source of substance misuse education.

4.39 The response from the RCPE noted the recent increase in the number of young people presenting with early signs of alcoholic liver disease and attending hospital with the acute effects of excessive alcohol consumption. It suggested that young people are not receiving adequate information or responding to existing information about the chronic effects of excessive alcohol consumption. RCPE argued that evidence shows health education messages have had little impact on reducing alcohol consumption and require wider cultural and societal change to be successful. Therefore, it suggested that health educational messages must be additional to regulatory measures rather than an alternative. The areas in which the Royal College suggested existing information is insufficient for parents and carers include:

• the unit strength of different types of alcohol;
• the effects of alcohol on brain and physical development in those under 18; and,
• the chronic effects of alcohol on those under 18.

4.40 The British Psychological Society also suggested that while the discussion paper cites evidence of good practice in alcohol education in schools, there is, at present, little available evidence that alcohol education is effective. It noted that there was no mention in the discussion paper of whether current educational efforts are evidence-based or if they are currently, or will be in the future, subject to evaluation. Noting that peers are a primary influence on shaping attitudes to, and use of, alcohol in adolescence and that alcohol education delivered by adults may fail to engage the target population, the Society recommended the use of peer education.

4.41 Alcohol Focus Scotland ( AFS) highlighted that it is currently piloting approaches and resources in accordance with its strategy plan for Early Years, Primary Years and Teenage Years - the Continuum. It stated:

"Young people must have access to reliable information about alcohol and its harmful effects. Whilst we welcome the government's undertaking to work with partners at national and local level to improve the delivery of substance misuse education in schools, AFS has been concerned for many years that the provision of such education in schools has been uneven and frequently unbalanced with little attention given to alcohol issues. We are aware that in overall strategies for affecting alcohol misuse, alcohol education is often cited as ineffective, but we believe that well structured, well delivered programmes made widely available, have a vital part to play alongside other measures. We believe the curriculum for excellence provides an opportunity to create alcohol education that engages children, and equips them to deal better with alcohol issues."

4.42 Several children's organisations, such as Childline Scotland, and other respondents that commented on this question from the perspective of children and young people highlighted the issue of children and young people being affected by misuse of alcohol by their parents. For example, Scotland's Commissioner for Children and Young People suggested that:

"Much more could be done to ensure that parents are aware of the impact of alcohol misuse on parenting. Preventative support is also essential to prevent parents' alcohol misuse from escalating and having a damaging effect on their children."

4.43 The Commissioner's response also highlighted the findings of a report on 'Consultation with Children and Young People on the Scottish Executive's Plan for Action on Alcohol Misuse'¹⁴, which although now six years old "is likely still to have some relevance." It added:

"They identified peer pressure and the bad example of adults as significant contributory factors to underage drinking. 61% agreed that alcohol advertising encouraged young people to drink. Young people believed there should be more encouragement to become involved in healthier alternatives to drinking, e.g. sport and leisure activities."

4.44 Many respondents highlighted the importance of listening to young people and welcomed the Scottish Government's plans to consult and engage with young people in developing the overall alcohol misuse strategy and particularly in relation to information and education. For example, Childline Scotland pointed to recommendations that have come from its Young People's Conferences and its Young People's Advisory Group including:

• "Pupil involvement is crucial to alcohol education;
• alcohol education must start earlier and use peer education approaches;
• alternative learning methods are essential such as discussion, exploring options and outcomes, workshops, role-play etc.; and
• alcohol education should be realistic about both negative and positive effects of alcohol."

4.45 The comments from NHS Ayrshire & Arran Health Promotion Team are illustrative of the comments made by other health organisations that highlighted the need to educate parents and children and young people about the potential health risks of alcohol consumption:

"There is also a growing concern over the number of children and young people who drink alcohol inappropriately that has been given to them by their parents/ carers. Clear information to support parents and carers making positive choices about alcohol is viewed as less of a concern than that of drugs. Parents and carers need information regarding the health risks that can occur from alcohol consumption in children and young people both in the short and long term."

4.46 Several local government bodies made detailed suggestions along similar lines to those highlighted above. For example, the Association of Directors of Social Work suggested:

• the ' Alcohol Guide for Parents' should be distributed throughout the country;
• Local Parenting Strategies and Action Plans should consider the range of resources which may be available to parents to assist them to engage with their children;
• non-stigmatising, opt-in, face-to-face support sessions should be offered to parents seeking advice on alcohol and under-age drinking as part of early intervention at community level;
• more work is required on the subject and content of substance misuse education in schools; and,
• support for a variety of activities based alternatives to alcohol should be developed based on existing knowledge of what young people want and what works.

4.47 Trade and business sector organisations also supported the broad thrust of the discussion paper's approach to providing information for parents and made a range of suggestions, including giving consideration to developing local projects such as the St Neot's Community Alcohol Project established by a partnership of public agencies and private sector organisations in Cambridgeshire.

Raising the Minimum Legal Age for Off-sales Purchases to 21

Q.4 We invite views on whether we should raise the minimum age for off-sales purchases to 21 in Scotland.

4.48 Almost two thirds (63%) of organisations that answered this question were opposed to the suggestion that the minimum legal age for off-sales purchases should be increased from 18 to 21, whilst only just over a quarter (27%) supported it.

4.49 As can be seen from Chart 3, a small majority (52%) of health sector organisations were in favour of the proposal, whilst around one third (37%) did not support it. A clear majority of respondents from all other sectors were opposed, including 62% of local government bodies and 87% of trade and business sector organisations. In addition, all nine youth organisations opposed the proposal as did a large majority of 'other' organisations.

Chart 3: Views of organisations on raising minimum age for off-sales purchases to 21 (Q.4)

Note: 'trade' in charts includes trade and business sector organisations

4.50 Most organisations that supported the proposal to increase the minimum age for off-sales purchases expressed support for the reasons outlined in the discussion paper and saw this measure as one part of the overall strategy. For example, SHAAP stated:

"For the reasons outlined in the discussion paper, and in light of evidence on the practice of 'pre-loading' amongst young people (where alcohol is bought from an off-licence and consumed in a domestic setting prior to going out for the evening), SHAAP believes that there could be significant health benefits for young people in raising the minimum age of off-sale purchases to 21.

SHAAP believes that this proposal, if implemented as part of a comprehensive alcohol policy that seeks a reduction in overall alcohol consumption, has merit. We know that young people are more vulnerable to the harmful effects of alcohol and therefore to protect young people from both immediate and longer-term harm, interventions targeted specifically at young people, in addition to population-based strategies, are indicated."

4.51 NHS Greater Glasgow and Clyde was one of the minority of NHS bodies that fully supported this proposal. Although it stated that more should be done to enforce current laws it acknowledged that: " the proposal may help to protect communities from these actions and we support the government in introducing this change".

4.52 SAADAT supported the principle behind the proposal although it: " accepts that it may be difficult to implement and requires considerable investment in enforcement." It went on to refer to:

"Evidence produced by Greater Glasgow and Clyde Alcohol Action Team that age restrictions are linked to decreased use but only as part of a wider package of measures. Evidence from New Zealand regarding lowering of purchase age indicates decreases in vandalism, traffic accidents and assaults as a result. A co-ordinated package of measures would send a clear message that would help unify drugs and alcohol policy for young people by acknowledging that drug use can be dangerous and that alcohol is another potentially dangerous drug."

4.53 However, several health sector bodies questioned the evidence cited in the favour of raising the minimum age of off-sale purchase but still supported the proposal. For example, NHS Grampian Public Health Directorate stated:

"The evidence-base on which this initiative relies appears still to be tentative. The US experience will not necessarily be generalisable to the Scottish context as regards other lifestyles issues between the two countries too. Given the cited evidence on the high risk of alcohol-related road traffic accident in this age group and other risk scenarios associated with youth drinking in non-regulated areas, it appears sensible to support this proposal."

4.54 The Association of Directors of Social Work welcomed the 'Test Purchasing Pilots' and initiatives now being pursued as they felt these will help change culture in respect of the sale of alcohol to under-18 year olds. Therefore, it " broadly" supported the proposal to increase the off-sale purchase age to 21.

4.55 Many organisations that supported the proposal pointed out that young people aged 18 to 20 would still be able to consume alcohol within the safer environment of pubs and clubs but that the measure would reduce unsupervised, outdoor drinking that places young people at greater risk of a range of harms. Several organisations also agreed that the measure would contribute towards reducing street drinking, anti-social behaviour and associated crime.

4.56 A number of health organisations and Alcohol and Drug Action Teams reported that there were a range of views amongst their members about whether the minimum age for off-sales purchases should be raised. Several organisations suggested that the increase in the minimum age of purchase should be a component of a comprehensive alcohol strategy encompassing on-sales as well as off-sales purchases. For example, Greater Glasgow and Clyde Alcohol Action Team ( GGCAAT) stated:

"The evidence base on this issue would suggest that an across the board increase in the legal drinking age from 18 to 21 would have substantial effects on youth drinking and alcohol related harm. There is not such evidence for an age increase for off-sales only.

The rigorous enforcement of the current law seems to us to be the top priority with further consideration to be given to an overall increase in age limits."

4.57 The Scottish Drugs Forum reported that whilst it was recognised that the proposal could help to reduce the problems associated with under-age drinking it had doubts that this was the way forward. It raised a concern about the "potential for an increase in the use of volatile substances and other relatively cheap substances among young people."

4.58 Only three trade and business organisations (6%) were in favour of the proposal to increase the minimum age for off-sales purchase - two small stores and the Scottish Licensed Traders Association, which stated:

"The Association cautiously supports this proposal based on our concerns with underage drinking and purchases of alcohol by minors from off-sales premises... We do agree that such a proposal would not only help with the issue of alcohol related harm amongst the 18-21 age group but would also help substantially the reduce the access to alcohol for those under 18."

4.59 Forty seven trade and business organisations (87%) expressed opposition to the proposal. This included on-sales as well as off-sales retailers and producers. For example, Punch Taverns stated:

"Measures which have been introduced under the Licensing (Scotland) Act 2005 and others which may be introduced such as minimum pricing should be allowed to take effect before further measures are implemented. Indeed, before raising the minimum age for off-sales purchases to 21 it is submitted that greater attention should be paid to those premises which it is believed are selling alcohol to persons under 18 years. As with drink driving, perhaps the greatest deterrent (not to sell alcohol to under-18s) is the risk of being prosecuted. Further efforts and energy should be directed to ensure that those who sell and indeed persist in selling alcohol to under-18s are prosecuted."

4.60 The Punch Taverns response went on to make a point also made by other respondents that the proposal to have different minimum ages for off-sales and on-sales purchases creates anomalies. For example:

"For on-sales premises, one could be faced with a situation where a person under-21 years is permitted to consume alcohol on a licensed premises but has to be refused a request to purchase alcohol for consumption off the premises."

4.61 Many off-sales retailers pointed out that they already operate a Challenge 21 system to request identification from young people. Most alcohol trade and business respondents suggested more stringent application of existing legislation to stop sales of alcohol to under-age (under 18) drinkers and more emphasis on Challenge 21 or even a Challenge 25 scheme would be preferable. Several retailers ( e.g.ALDI) suggested they might support the proposal but felt that it was inconsistent as it would apply only to off-sales.

4.62 Several trade respondents questioned the evidence from the Armadale pilot ¹⁵. They pointed out that the reduction in vandalism and the number of assaults reported during the pilot coincided with the introduction of other measures, such as additional policing, and may not be directly attributable to the increase in the minimum age of purchase.

4.63 Local government organisations were against the proposal to increase the minimum purchase age to 21 by a large majority of more than two to one - 63% compared to 28% (9% were 'not sure'). Local authorities were almost evenly split with five in favour and six against. However, only one Licensing Board and one Licensing Forum were in favour compared to nine Boards and four Forums that were against. The three Community Councils that responded to the consultation were in favour.

4.64 The Association of Directors of Social Work was the only professional association within the local government grouping that expressed support whilst three were opposed, including the Association of Chief Police Officers in Scotland ( ACPOS). ACPOS stated that it was sceptical about the proposal to increase the age of purchase of off-sales to 21:

"Whilst we recognise the positive aspects of what was a fairly short initiative (the Armadale pilot) we are not persuaded that raising the age of purchasing alcohol from off sales from 18 to 21 will have the desired, long term effects."

4.65 Several organisations, including NHS Health Scotland and COSLA, suggested that more evidence is required from further pilots as to the impact of increasing minimum age of off-sales purchase from 18 to 21. For example, COSLA stated:

"The proposal that off licence sales be restricted to those over 21 has generated considerable debate, with no over-riding consensus emerging from the responses available to COSLA. Further research and/or additional pilot projects might be helpful to demonstrate whether a two tier structure would be helpful. If the over 21 requirement is introduced, strong policing will be required to ensure its efficacy and there will inevitably be additional resource demands on local authorities which would require to be addressed. The routine production of proof of age when purchasing age restricted products should perhaps be an aim."

4.66 Only one children's organisation supported this proposal whilst four expressed opposition. For example, the Aberlour Trust stated:

"Whilst the objective of increasing the minimum age for off sales purchase is to curb underage drinking by making it far more difficult for young people to pass themselves off as being of age, we believe that it will instead unfairly restrict the rights of young adults without adequately addressing the underage problem."

4.67 The Young Scot consultation with young people showed opinions amongst those who responded to be evenly split on this issue (see Chapter 5). However, all nine youth organisations that responded to the consultation expressed strong opposition to this proposal even though they supported most of the other measures proposed in the discussion paper.

4.68 The response submitted by CARDAS focussed on the case against increasing the minimum age for off-sales purchases to 21, highlighting the following key points that were echoed by other youth organisations:

• the case has not been made for raising the minimum purchase age;
• raising the minimum purchase age is likely to prove counterproductive and actually worsen alcohol misuse and alcohol-related problems in Scotland;
• age is not the issue - we need to change the drinking culture;
• raising the minimum purchase age contributes to the demonisation of young people, and infringes on the rights and responsibilities of young adults, in contradiction with the age of majority; and,
• public opinion is against raising the minimum purchase age.

4.69 The CARDAS response made detailed proposals as alternative to raising the minimum purchase are. This was based on improving enforcement of the current minimum purchase age for alcohol, including a mandatory Challenge 21 scheme, a national proof of age card and increased use of test purchasing.

Social Responsibility Fee

Q.5 What criteria should be used to determine the types of premises (or specific premises) that should be subject to the fee? ( e.g. late opening premises, or premises in a particular area) or conversely what criteria should be used to consider exemptions from the fee. How should the fee be determined? ( e.g. based on rateable values, alcohol sales turnover)

Q.6 Should a fee be applied to Occasional Licences as well as Premises Licences?

Q.7 Should a similar fee be applied to other premises licensed under separate legislation? If so, what types of premises should be subject to a fee?

4.70 The discussion paper did not ask respondents to comment on whether a social responsibility fee should be introduced but rather the criteria that the fee should be based on. However, most organisations commented on the principle of introducing a fee rather than the details or options presented in the discussion paper. Table 8 and Chart 4 therefore show the number and percentages of organisations that expressed support or opposition in principle to the introduction of a social responsibility fee.

4.71 It should be noted that over a quarter (26%) of organisations did not answer Question 5 and a further 8% provided an inconclusive answer. Just over half (54%) of the organisations that did respond to this question supported the principle of a social responsibility fee, whilst just over a third (36%) opposed the introduction of the fee.

4.72 As can be seen from Table 8, less than a third of organisations answered Questions 6 and 7 (66 and 64 respectively) on whether a social responsibility fee should be applied to Occasional Licences and / or 'other' licensed premises. However, a majority of organisations that did answer these questions were in favour of extending the social responsibility fee to Occasional Licenses and 'other licensed premises.

Table 8: Views of all organisations on introducing a 'Social Responsibility Fee' (Q.5, Q.6 & Q.7) (base 207)

* The figures shown for Q.5 relate to views for or against the principle of a 'Social Responsibility Fee' rather than views on the details contained in the question

4.73 Chart 4 provides a comparison of the views expressed in response to Question 5 by organisations in the three key sectors. This shows that whilst health sector organisations and local government bodies were overwhelmingly in favour of the introduction of a social responsibility fee (84% and 71% respectively) the trade and business sector was overwhelmingly opposed (82% against).

4.74 As noted above, most respondents that stated they were in favour of the introduction of a social responsibility fee did not comment on the possible criteria that could be used as the basis for introducing the fee. However, a majority of those that did comment on the detail supported all premises being subject to paying the fee and it being based on alcohol sales or turnover.

Chart 4: Views of organisations on introducing a 'Social Responsibility Fee' (Q.5)*

* The figures shown relate to views for or against the principle of a 'Social Responsibility Fee' rather than views on the details contained in the question

Note: 'trade' in charts includes trade and business sector organisations

4.75 Health organisations were particularly supportive of the principle of introducing a social responsibility fee and several suggested it should be levied on producers as well as all retailers. For example, SHAAP stated:

"We support the principle that there should be a relationship between the financial cost of responding to the impact of alcohol and the profits made by the industry. We believe this can be achieved in a number of ways which go beyond the immediate local costs. For instance, a proportion of turnover could go to an independently administered research fund. For this to be fairly applied, any fee would have to be levied on producers and all retailers, not just pubs in a locality."

4.76 Alcohol Focus Scotland's response commented on the details of administering a social responsibility fee covering all licensed premises as well as producers:

"We would like to see consideration of establishments which provide positive benefits to the community, who could receive a 'credit'. This would have a dual benefit of exempting premises from paying an additional tax/fee and also a community could benefit from having a free hall/function room to host events e.g. alternative activities for young people, health promotion with parents etc. AFS believes that

1. A social responsibility fee must apply to all premises and not just problematic ones - under the new Licensing Act, problematic premises need to be penalised by the licensing board.
2. Irresponsible practices are found across both the on and off-trade, therefore all licensed premises need to contribute here.
3. Manufacturers of alcohol should also play their part by paying a % fee levied on what they would spend on advertising and sponsorship, to be used for awareness campaigns to counter-balance the positive images portrayed by the industry."

4.77 Several health organisations supported the principle of a social responsibility fee but with certain conditions. For example, SAADAT stated:

"We recognise, however, that licensed premises also provide necessary community benefits, including economic benefits, and under new legislation pay a fee to cover the costs of licensing boards. We believe that problematic premises should be penalised by licensing boards under the terms of the new legislation, with a social responsibility fee being applied to all premise (on-trade and off-trade) as a contribution to the costs of policing, nite-zone management, accident and emergency, vandalism, cleaning and pest control."

4.78 A number of organisations that were more sceptical about the principle of introducing a fee ( e.g. Highland Drug and Alcohol Action Team) suggested that it should be introduced as a targeted levy rather than a blanket fee. It could be aimed at those premises whose practices " result in increased activity for enforcement services." They suggested that the criteria for levying the fee should be based on the record of the premises concerned, together with the impact of the sale and supply of alcohol on community safety.

4.79 There was no real consensus amongst local authorities and Licensing Boards / Forums on the criteria on which a social responsibility fee should be based. For example, East Dunbartonshire Licensing Board suggested that the fee "should apply to nightclubs and be determined on the basis of alcohol sales turnover." On the other hand, Dundee City Council suggested that:

" The fee should be levied on all premises, irrespective of hours of operation or location, since it would be almost impossible to identify which premises are responsible for late night problems and which are not; rateable value would be consistent with the way licensing fees are determined."

4.80 Aberdeenshire Council expressed doubts about the introduction of a fee as licensees are already paying increased fees as well as other costs relating to the implementation of the Licensing (Scotland) Act 2005. It suggested that introducing further fees "may well be the final "nail in the coffin" for some premises, particularly ones where alcohol is an ancillary item." However, it suggested that if a fee is to be introduced it should be levied on premises (or events such as musical festivals) with a high turnover in the sale of alcohol and it should apply to:

• "Premises benefiting from the late night economy;
• premises within areas identified by Police (or any relevant statutory consultee) as hot spots for anti-social behaviour - based on charges brought, incidents recorded, callouts, public complaints;
• nightclubs;
• premises with a wet sales turnover above a defined limit.

4.81 COSLA also suggested that further discussion is required on the detail of how a social responsibility fee should be introduced. ACPOS expressed support for the " ethos of a social responsibility fee" but pointed out that: "we do not underestimate the difficulties of introducing such a levy". It suggested that the Scottish Government should establish a Working Group " to identify a means of introducing a fee that will be acceptable to all."

4.82 Only seven trade and business organisations (representing different parts of the sector) supported the proposal to introduce a fee and expressed a view on how it should be introduced; but there was no real consensus amongst this small number.

4.83 Forty two trade and business organisations expressed opposition to the principle of a social responsibility fee. Very few trade and business organisations responded specifically to Questions 6 and 7 as they expressed their opposition to the introduction of a fee in principle and would therefore not wish to see it extended to 'occasional licenses' or 'other premises' Opposition to introducing a fee centred around views that:

• it will be 'just another tax';
• it taxes the supplier of alcohol rather than those who are misusing it; and,
• it could penalise all traders to compensate for the small number who allow misuse of alcohol to take place.

4.84 The Federation of Small Businesses highlighted some of the issues raised by retailers and small stores:

"We oppose the idea of a social responsibility fee as it would hit the overwhelming majority of retailers who operate within the law. Legislation exists to punish retailers who break the law. This should be rigorously enforced before imposing additional costs on small businesses.

We also feel that it would set a precedent if those retailers who sell alcohol paid for the social costs of its effects. Without stretching the point too far, one might reasonably say should the retailers who sell tobacco pay towards the running costs of the NHS for the effects of smoking related conditions? Should fast food companies pay for the effects of obesity?"

4.85 Several organisations suggested that Business Improvement Districts ( BIDs) could be used as a means of involving the trade in supporting and funding measures to reduce anti-social behaviour. From their perspective a voluntary based scheme such as BIDs would be preferable to a fee which might be levied on all licensed premises.

Promotional Material in Licensed Premises

Q.8 Do you agree that regulations should be made, under the Licensing (Scotland) Act 2005, to extend the existing regulations to:

• Prevent the display on licensed premises of promotional material relating to alcohol in a way visible to persons outside the premises?
• Prevent the use on licensed premises of any special display designed to promote sales of alcohol for consumption off the premises?
• Prevent on licensed premises any other promotional activity to induce the sale of alcohol for consumption off the premises?

4.86 Most respondents answered this question in general terms, either expressing support or opposition in principle to the extension of the regulations on displaying promotional material, rather than commenting in detail on the three proposals. Therefore, Chart 5 shows the level of support or opposition to the extension of regulations as a whole rather than a breakdown of views on the measures presented in Question 8.

Chart 5: Views of organisations on restricting promotional material in licensed premises (Q. 8)

Note: 'trade' in charts includes trade and business sector organisations

4.87 Forty five of the 48 health sector organisations that responded to this question supported the proposal compared to only two that were opposed (one was 'not sure'). The organisations that were in favour of the proposal supported the reasoning outlined in the discussion paper. For example, SHAAP stated:

"New measures already agreed to restrict alcohol displays in off-sales to a single area will be substantially undermined if product displays are simply replaced with promotional materials. Although alcohol is a legal substance, due consideration must be given to the fact that it is also a potentially addictive, psychoactive drug. It is therefore only reasonable that its availability is regulated and controlled to the extent necessary to limit the harm caused by its use."

4.88 Many of these organisations also agreed that alcohol should be treated differently from other products and material promoting alcohol products should be restricted in order to discourage impulse buying. For example, Forth Valley Substance Action Team stated:

"We consider that alcohol should not be presented in such a way as to encourage impulse buying. Treating the display of alcohol in a way similar to cigarettes and non-prescription medicines, will support a change in purchasing patterns."

4.89 Several organisations, including some that supported extending regulations, suggested that further clarification is required if it is to be introduced successfully. For example, City of Glasgow Licensing Board stated:

"With regard to the proposals, it is also not clear whether regulations to introduce such restrictions would involve mandatory or discretionary conditions. In the view of the Licensing Board any such conditions should be mandatory given that by the time regulations are introduced almost all existing licensed premises will have been granted their new premises licence - mandatory conditions would be applied automatically without the need to have a review of the licence.

In the event that regulations are introduced, the restrictions would require to be carefully worded so that they are precise, reasonable and enforceable in order to survive a legal challenge."

4.90 Only four out of 50 trade and business organisations that responded to this question supported the proposal compared to 43 who were opposed and three 'not sure'. The comments from Wm Morrison Supermarkets are illustrative of those made by retailers that questioned the evidence base for the proposal:

"The discussion paper offers no evidence to suggest that promotional material leads to either increased consumption or harm. Most promotional material is bout brands, explaining to the customer the quality and value of a particular product in order to gain market share. Promotional material therefore drives customer choice, often leading to brand switching. It does not necessarily lead to increases in the total volume of sales.

Removing promotional material is therefore likely to drive retailers to compete only on price; and if minimum pricing is introduced to head to the lowest common denominator."

4.91 The small retail stores that responded to the consultation were particularly strongly opposed to further restrictions on promotional material. Several producers and retailers, including whisky distilleries with visitor centres and the Scotch Whisky Association, also noted that tight restrictions on promotional material could affect their ability to promote specialist products, including Scottish products.

Separate Alcohol Checkouts and Minimum Age of Checkout Staff

Q.9 Do you think that there should be separate checkouts for alcohol sales?

Q.10 Should there be a requirement for alcohol checkout staff to be at least 18 years old?

4.92 The issue of separate checkouts for sale of alcohol divided opinion almost equally between those in favour of the proposal (47%) and those opposed (50%); although it should be noted that a relatively high proportion of organisational respondents did not answer this question (21%).

4.93 Large majorities in both the health and local government sectors supported the proposal to introduce separate alcohol checkouts - 76% and 64% respectively. However, there was a higher level of opposition to this proposal in these sectors than for any of the other proposals in the discussion paper, with the exception of raising the minimum age of off-sales purchases - 22% and 36% respectively. A large majority of trade and business sector organisations (92%) opposed this proposal (see Chart 6).

4.94 Organisations overwhelmingly suggested that it would only be practical to introduce separate alcohol checkouts in supermarkets and agreed that small stores should be exempt, as was suggested in the discussion paper.

4.95 Most organisations that were in favour of this proposal expressed their support for separate alcohol checkouts as an important indicator that alcohol can no longer be treated as an ordinary commodity by retailers or consumers. Once again the response from SHAAP is illustrative of the responses made by many health organisations:

"This measure will, as the proposal states, underline the point that alcohol is not an ordinary commodity and discourage impulse buying. In addition, the reduced convenience to the consumer has the potential to reduce consumer demand for alcohol and therefore the measure may contribute to a reduction in alcohol consumption and consequently harm. Those most inconvenienced by separate checkouts will be those who buy alcohol most frequently."

Chart 6: Views of organisations on separate alcohol checkouts for alcohol sales (Q.9)

Note: 'trade' in charts includes trade and business sector organisations

4.96 However, several health organisations (for example, the RCPE) expressed some doubt as to whether there is sufficient evidence to suggest that separate checkouts will have a positive impact on reducing alcohol misuse. The College further suggested that the proposal may prove controversial to implement and proposed that a locally based pilot to assess the impact is required.

4.97 Forty seven trade and business sector respondents opposed this proposal compared to only two that supported it. Most of the 17 small retail stores that responded to the consultation only commented on the impracticality of separate checkouts in small stores and did not comment on whether supermarkets should have them.

4.98 The larger retailers opposed separate checkouts in supermarkets as did many producers on the basis that it would inconvenience 'responsible' drinkers and there is no evidence that it would reduce alcohol misuse. For example, Tesco stated:

"Alcohol-only checkouts would inconvenience customers and may have unintended consequences. Our customer evidence shows that the vast majority of alcohol sales are part of a mixed basket of goods. A system of separate alcohol checkouts would maximise inconvenience for the customer, while presenting no evidence of changing buying habits for customers. Indeed, it may convince customers to buy only alcohol or to buy alcohol less frequently but in greater quantity so that they do not run out."

4.99 The proposal to increase the minimum age of checkout staff selling alcohol from 16 to 18 was supported by just over seven out of ten (72%) organisations, compared to just over two out of ten (23%) who opposed it. Large majorities of health and local government sector organisations were in favour of this proposal (93% and 73% respectively) whilst the trade and business sector was almost evenly split with 50% of respondents in favour and 44% against.

Chart 7: Views of organisations on raising the minimum age of checkout staff to 18 (Q.10)

Note: 'trade' in charts includes trade and business sector organisations

4.100 Most of the organisations that supported the proposal agreed with the reasoning outlined on the discussion paper. ASDA was one of the retailers that supported this proposal:

"The proposal for a minimum age of 18 for staff on the alcohol checkout would cause some disruption for other retailers, especially convenience stores, but we would be prepared to agree to it if it would make a positive difference. We already ensure that colleagues aged between 16 and 18 are trained and always have their alcohol sales approved by an older colleague, so this would be a logical extension of our existing approach."

4.101 The Scottish Licensed Trade Association also supported the proposal and went further in suggesting that " in light of the proposal that no one under the age of 21 may make an off-sales purchase of alcohol, it would seem logical that the individual serving from an off-sales checkout should also be at least 21 years of age."

4.102 Many of those organisations that opposed the proposal pointed out that staff under the age of 18 can only sell alcohol if supervised by an older staff member. For example, the Co-operative (Food Operations) stated:

"We do not think it is necessary to introduce a requirement that checkout staff should be at least 18. The only justification given to this is on the basis of difficulties staff face in challenging underage customers, when these difficulties do not just relate to younger staff. Staff under 18 will have the same training to ensure underage sales do not take place. There are also means for these sales to be supervised which we consider is sufficient to ensure that there are no difficulties when it comes to ensuring underage sales are not made."

4.103 Several small retail stores stated that they have difficulty recruiting staff who are aged 18 or over for part-time sales jobs. Four youth organisations also opposed the increase in the minimum age of checkout staff (as opposed to two that supported the proposal). For example, the Scottish Youth Parliament ( SYP) stated:

" SYP does not believe it is necessary for alcohol checkout staff to be at least 18 years old, and would strongly object to a requirement of staff being at least 21 years old were the minimum purchase age to be increased."

Additional Actions

4.104 In addition to the new proposals on which it specifically sought views the discussion paper outlined additional actions the Scottish Government is already committed to. Most respondents who commented on these actions supported the policies and actions already being pursued by the Scottish Government and provided suggestions for how they could be taken forward; for example in relation to:

• developing the alcohol workforce;
• identifying and evaluating models for designated places of safety;
• encouraging the development of integrated pathways for offenders; and,
• supporting the provision of youth work and / or diversionary opportunities.

4.105 Since the discussion paper did not specifically seek respondents' views on the additional actions this report has not sought to provide a detailed analysis of responses on these issues (it is for the Scottish Government to consider these views more fully). The following is a brief overview of the views and comments on additional actions that potentially might be more controversial or drew significant levels of comment.

We support the introduction of legislation to require licensed premises to offer measures of 125 ml of wine and 25ml measures of spirits

4.106 Organisations from a range of sectors strongly supported the introduction of legislation to require licensed premises to offer measures of 125ml of wine and 25ml measures of spirits. For example, the Tayside Council on Alcohol, amongst other health and voluntary organisations, expressed support for the standardisation of offering 125ml and 25ml measures in licensed premises, with clarity over where 250ml measures of wines are provided as a choice:

"We consider that this will contribute to the reduction of confusion for the public in consuming and purchasing alcohol, and contribute to the message that alcohol is a controlled substance, not an ordinary commodity."

4.107 The British Psychological Society supported the recommendation that 125ml and 25ml measures should be available. For wine, however, they suggested the legislation should be amended so that only measures of 125ml or multiples thereof can be sold, removing the 175ml measure from circulation in premises. They suggested this since there is low unit awareness:

"Such a move would mean that consumers could more clearly see the difference between a small (125ml) and a large (250ml) glass of wine. This should increase awareness of the difference in alcoholic content and may promote more informed choice."

4.108 Some trade and business sector respondents were more cautious and suggested that they would support the proposal as long as choices are still being offered to the customer. However, the SLTA pointed out that:

"As over 80% of wine and over 75% of all spirits ( UK figures) are sold through the off-trade for consumption at home, where it is impossible to control quantities, we are of the opinion such a proposal would have extremely little effect and view such a proposal as a "let's target the pub again" measure.

However, if such measures were to be introduced, on the basis that it was only a requirement to offer measures of 125ml or 25ml, but other measures could also be offered, then we do not see this as being a major issue for the On-trade, with the exception of premises which serve 35ml spirit measures."

A Scottish survey of the incidence of Fetal Alcohol Syndrome ( FAS)

4.109 Several organisations suggested that the commitment to investigate and then develop support around FAS should be extended to include Fetal Alcohol Spectrum Disorder ( FASD). For example, SADAAT expressed concern at the rising number of women of childbearing age who drink heavily and the limited research in the UK on FAS and FASD. Therefore it welcomed the survey on the incidence of FAS but also suggested that the Scottish Government should strengthen its prevention efforts in this area, including screening of pregnant women and mandatory labelling providing clear information about the dangers of drinking when pregnant. Alcohol Focus Scotland also argued that more work needs to be done to ensure that the whole spectrum of disorders ( FASD) caused by fetal alcohol absorption are diagnosed and recorded.

4.110 Children in Scotland welcomed the heightened emphasis on FAS and it suggested several additional actions should be considered by the Scottish Government, including:

• once the prevalence of FAS has been established, there should be a similar effort to identify children and young people burdened with Fetal Alcohol Spectrum Disorder ( FASD);
• providing meaningful assistance, support and treatment for children identified as having FAS or FASD;
• awareness, identification and management of FAS/ FASD should become a routine feature of core initial education and professional development for all child-related professionals; and,
• a major, unified, unambiguous public health campaign to promote abstinence from alcohol among women who are pregnant, trying to conceive, or at high risk of becoming pregnant unintentionally.

Calling for a reduction in the drink drive limit from 80mg to 50mg per 100ml of blood and the introduction of random breath testing

4.111 Respondents that commented on this issue, including ACPOS, generally welcomed the Scottish Government's stance on supporting a tightening of the laws on drink driving, especially to reduce the legally acceptable blood alcohol level. Several health organisations went further in calling for a zero tolerance approach to drink driving in particular for young people under 25. For example:

• Alcohol Focus Scotland suggested that the limit for young drivers should be 10mg per 100ml of blood;
• the Royal College of General Practitioners Scotland called for a zero level for young drivers and those within two years of passing their test; and,
• the British Psychiatric Society argued for a complete ban on drink driving.

4.112 However, several respondents, including the British Institute of Inn-keeping ( BII), while supporting the proposals to introduce random breath testing was sceptical about whether reducing the drink drive limit from 80mg to 50mg per 100 ml of blood " will do anything to reduce numbers of persons, especially persistent offenders, drink driving."

Supporting measures to deliver improved alcohol product labelling

4.113 Several respondents including trade and business sector respondents, such as the Wine and Spirit Trade Association, welcomed the actions being taken to deliver improved alcohol product labelling. They commented on the need for improved information about the strength of drinks, recommended or guideline alcohol units, and the potential health risks of alcohol in response to various questions in the discussion paper.

4.114 A number of organisations supported mandatory product labelling across the UK. For example, Greater Glasgow and Clyde Alcohol Action Team ( GGCAAT) suggested that:

"This should include the requirement to prominently display alcohol content in units, recommended daily UK guidelines for alcohol consumption, a warning message advising that exceeding these guidelines may cause individuals and others harm and include government advice on alcohol in pregnancy. Furthermore this information should also be prominently displayed in all printed and electronic alcohol advertisements and at all display points where alcohol products are sold."

4.115 However, the Royal College of Psychiatrists suggested that the recommendations for action in relation to labelling were noticeably weaker than other parts of the paper. It argued for the impact of UK labelling proposals to be monitored and called for an examination of the assumption that giving information to the public about the alcohol content of drinks will lead to less alcohol consumption. For example, it noted that the average strength of beers and wines sold in the UK has increased since strength labelling was introduced.

Exploring how best to tighten restrictions on alcohol advertising in relation to young people

4.116 The Scottish Government's proposal to explore how best to tighten restrictions on alcohol advertising in relation to young people were welcomed by a wide range of organisations. For example, the Association of Directors of Social Work welcomed the Scottish Government's intentions and stated:

"In particular, we believe that cinema based advertising and any alcohol advertising before the 9.00 watershed warrants close inspection and, that all alcohol advertising in all media should be accompanied by appropriate health information and warnings. Restrictions should extend to the use of the internet and advertising on computer games."

4.117 Several health and addictions organisations suggested that the proposals could go further and include banning the sponsorship of events and sports by the alcohol industry. For example SHAAP stated

"The UK is unusual in having no restrictions on alcohol sponsorship in sport. It is disappointing that there is no action planned on this. We don't believe that alcohol brands should be associated with sporting achievements and that Scotland should follow the lead of other European countries and break this link which sponsorship provides."

4.118 SAADAT accepted banning sponsorship "is a complex issue and would take some time to implement." Therefore, it suggested that:

"An advertising promotions tax would be a reasonable compromise. A % tax on the £600 - £800 million that is spent by the drinks industry on promotional activities normalising drinking should be made and invested in diversionary activities for young people and to fund public attitude campaigns."

4.119 Several media and advertising bodies ¹⁶ responded to the consultation and in particular this section. Their responses drew out the nature of UK wide regulation and changes to drinking patterns and responses to drinks advertising. Ofcom provided information and research evidence on the market, impact and trends relating to alcohol advertising. ISBA (The Voice of British Advertisers) pointed out that advertisers are committed to the UK self-regulation system through various mechanisms including the Committee of Advertising Practice ( CAP) and the Advertising Standards Authority ( ASA). They stressed that they would encourage the Scottish Government to engage with industry bodies such as the ASA to ensure the UK rules are relevant and interpreted correctly.

4.120 Scottish Media Group stated that it did not believe that region-specific restrictions on advertising would be feasible or desirable for UK commercial broadcasters. Channel 4 urged caution in taking further action to restrict advertising as wider societal and cultural changes are likely to have a far greater impact on alcohol consumption than changes in the content rules in advertising.

4.121 ISBA argued that further restrictions are unnecessary as rules on alcohol advertising were tightened in 2005 and other changes were introduced in order to ensure that: "Advertisements for alcoholic drinks must not be likely to appeal strongly to people under 18, in particular by reflecting or being associated with youth culture."ISBA further noted that there is an absolute ban on alcohol advertising during or around dedicated children's programming. It also pointed out that cinema advertising is already strictly regulated by guidance and rules that advise on films that are deemed unsuitable for alcohol advertising and controls which packages of films can carry alcohol advertising.

Measures to improve support and treatment, including enhancing and capacity building in screening, brief intervention and treatment services

4.122 Health bodies and several charities provided detailed comments on the actions the Scottish Government is taking or proposes to take to improve support and treatment. SHAAP welcomed the significant resources that the government has made available to local health boards to build capacity for screening and alcohol brief interventions and the commitment to ensuring that these are routinely available through the NHS. However, it also suggested that the related training and technical support needs to be strengthened in order to support implementation.

4.123 Several of the Royal Colleges outlined how their particular profession could contribute to developing support and treatment. For example, the Royal College of Nurses suggested that the proposals for supporting families and communities and improving support and treatment will offer real opportunities for Scotland's nurses to challenge and develop their engagement with individuals, families and communities affected by problematic alcohol use. It argued for community-based Health Visiting to provide an important route in to early intervention.

4.124 The Scottish Pharmacy Board ( SPB) observed that effective local arrangements for delivering services are critical to the success of a national alcohol strategy. It suggested that the structure and function of ADATs varies and all should include a pharmacist with expertise in substance misuse and mental health to increase multi-disciplinary working within local delivery networks. Also it argued that there is an opportunity to build on the role pharmacists have played in the supervised methadone programme, including the success of drug treatment orders through the judiciary system, into the related areas of alcohol. It suggested that treatment orders for supervised abstinence therapy could allow suitable offenders to be treated in the community rather than in mental health units or correctional facilities.

4.125 Scottish Women's Aid's response to the discussion paper concentrated on drawing the links between alcohol consumption and the perpetration of domestic violence / domestic abuse. It welcomed the discussion paper's recognition of the connections between alcohol and domestic abuse and that alcohol problems cannot be treated in isolation (for example, there are connections between mental health, homelessness and the use of drugs). However, it suggested that the discussion paper did "not address the issue of women using alcohol and experiencing domestic abuse." Scottish Women's Aid identified the Tayside Multiple and Complex Needs Pathfinder as an initiative that could provide learning and good practice in developing an integrated approach to treatment and care, linking up and improving services for women experiencing domestic abuse who are also using drugs or alcohol.

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