Patterns of Alcohol Consumption Debating Paper

Transcription

1 HEALTH SCRUTINY PANEL 8 TH FEBRUARY 2011 Patterns of Alcohol Consumption Debating Paper The Health Scrutiny Panel agreed the following terms of reference for the review into patterns of alcohol consumption: Terms of Reference Investigate how alcohol consumption affects health. Examine whether patterns of alcohol consumption can be identified among different genders, age groups and social groups. Investigate public attitudes towards the consumption of alcohol and drinking behaviours. Identify what information and advice is available concerning alcohol consumption. Investigate how the Council can provide support in addressing the dangers to health associated with drinking alcohol, particularly among at risk groups. What is Excessive Alcohol Consumption? In the UK alcohol is measured in units; a unit is 7.9 grams, or 10 millilitres of ethanol. One unit is not necessarily the same as one serving of alcohol, for example there is one unit in half a pint of beer, lager or cider at 3-4% alcohol by volume (ABV); one and a half units in a small (125ml) glass of wine at 12% ABV; and one and a half units in a standard (35ml) pub measure of spirits at 38-40% ABV. In addition, alcohol also varies in strength, for example wine can range in strength from 10% to 14% ABV which affects the number of units in a serving. There is also a difference between the measures served in bars and restaurants which are standardised, and those poured at home which are usually estimated. 1 The Government issues recommended drinking guidelines for the consumption of alcohol; for men the recommended limit is 3-4 units per day or 21 units per week, and for women 2-3 units per day or 14 units per week. 2 Providing both a daily and weekly drinking limit makes it clear to the public that consuming the weekly allowance of units over just one or two days is inadvisable. Drinking plays an important role in the lives of many people, for example as an accompaniment to a meal or as part of a social event or special occasion 3 and it is estimated that around 90% of the UK population consume alcohol to some degree. 4 However, the level at which some people drink indicates that they are either not aware of the harm to health that can be caused by alcohol consumption, or they fail to appreciate how serious this harm can be. In recent years both government policy and the media have focused their attention on addressing the issue of young people drinking to excess, particularly

2 in public places, and the anti-social behaviour problems that this creates. However, this focus has detracted attention away from the health problems caused by the regular and excessive drinking that the wider population engage in, particularly in their own homes. As a result, people who drink regularly or excessively without the social problems associated with binge drinking may believe that their own drinking habits are normal and not a cause for concern. 5 However, binge drinking is not just a social phenomenon affecting young people; the term means heavy episodic alcohol consumption and can therefore be used to describe the behaviour of any individual drinking twice the recommended alcohol limit on at least one day a week (this equates to two thirds of a bottle of wine for women or four pints of normal strength beer for men). Binge drinking is not the only method of alcohol consumption which can affect a person s health; drinking every day or several times a week at high levels can also be harmful, for example consuming the maximum recommended daily amount of alcohol every day still exceeds the recommended weekly limit set by the Government (this equates to a third of a bottle of wine for women or two pints of normal strength beer for men). The Institute of Alcohol Studies suggest that alcohol prevention policies should aim to reduce overall consumption in the population rather than focus on reducing consumption in heavy drinkers. This is because the greater cost to the NHS and wider economy is not caused by those people who drink very heavily but by the far larger number of people who drink more than is recommended. 6 The NHS estimates that more than 9 million people in England exceed recommended drinking guidelines 7 and a YouGov poll conducted in 2010 suggests that as many as 7.5 million people could be putting their health at risk because they are unaware of the damage that can be caused by excessive drinking. Fiftyfive per cent of those surveyed believed that alcohol is only damaging to health if a person gets drunk regularly or binge drinks. Eighty-three per cent thought that regularly exceeding the recommended limits would not put their long-term health at risk. 8 Question for Discussion What role should South Staffordshire Council play in promoting a sensible drinking message to residents? Health Implications Regular drinking above the recommended levels significantly increases the risk of ill-health and can lead to serious illness and disease including high blood pressure, stroke, heart attack, liver disease, various cancers, and mental health problems. 9 Alcohol is the third highest risk factor for ill-health in Europe, behind only tobacco and high blood pressure, and ahead of obesity. 10 Annual healthcare costs relating to alcohol consumption in the UK amount to approximately 2.7 billion. 11 The Department of Health estimate that

3 approximately 180,000 hospital admissions a year are directly attributable to the effects of alcohol consumption. This figure is based on the number of people admitted to hospital with alcoholic liver disease, the toxic effects of alcohol or mental and behavioural disorders relating to alcohol consumption. 12 It is further estimated that in total alcohol consumption accounts for around 6% of all hospital admissions every year (this equated to 811,443 admissions in 2006/07). This figure takes into account the wider effects of alcohol consumption such as various cancers, heart disease and victims of violence. 13 According to the Office for National Statistics excess alcohol consumption resulted in over 9,000 premature deaths in the UK in 2008, 14 6,769 in England alone. 15 When also including deaths from diseases where alcohol has been shown to have a causal link, the Department of Health estimate that alcohol consumption may be responsible for between 15,000 and 22,000 premature deaths every year in the UK. 16 The NHS highlights the following conditions as being of particular concern for people who consume alcohol above the recommended limits. High Blood Pressure (Hypertension) High blood pressure can be particularly damaging as it causes no immediate symptoms or problems. Alcohol can cause damage to the heart and blood vessels leading to hypertension which may ultimately lead to other conditions including enlargement of the heart, heart rhythm problems, heart attacks and strokes. 17 Men regularly consuming alcohol at just above the lower risk limit (3-4 units a day) are almost twice as likely to experience high blood pressure as those who do not drink at all, whilst those drinking in the higher risk range (8 or more units a day) could be four times more likely to experience high blood pressure. 18 An estimated 42% of men and 10% of women who suffer from hypertension and an estimated 34% of men and 6% of women who suffer form coronary heart disease regularly drink alcohol in excess of the recommended daily limits. 19 Cancer Alcohol can contribute to a variety of cancers including those of the mouth, oesophagus and larynx (throat). Drinking alcohol can lead to tissue damage inside the mouth and throat, this damage results in cell changes that may in turn lead to cancer. 20 Men drinking just above the lower risk limit are up to 2½ times more likely to develop cancers of the mouth, oesophagus and larynx; women could be almost twice as likely to develop some of these cancers. People drinking at higher risk levels could be 3 to 5 times more likely to develop cancer

4 Drinking more than one unit of alcohol a day also increases the risk of developing breast cancer; the more alcohol consumed, the greater the risk. Women drinking at higher risk levels could be 1½ times more likely to develop breast cancer. 22 Stroke A stroke is caused by a blockage or bleed in blood vessels in the brain. Bleeding in the brain leads to haemorrhagic stroke; and a lack of blood from a blocked artery results in ischaemic stroke. Alcohol can also affect blood pressure, blood vessels and the heart which can contribute to a stroke. The risk of experiencing either type of stroke is 2 to 4 times greater for high risk drinkers than for those who do not drink at all. 23 An estimated 33% of men and 7% of women who have suffered a stroke regularly drink alcohol in excess of the recommended daily limits. 24 Liver Damage The liver can be damaged by alcohol in a number of ways: when alcohol is processed it releases substances that can damage or kill the liver cells; drinking can also cause bacteria in the gut to release toxins which can result in damage to liver cells; and alcohol can cause the immune system to attack liver cells when it becomes unable to recognise them. 25 Severe liver cirrhosis does not only affect alcoholics; it can be triggered by several years of drinking above the recommended alcohol limits in what many people may consider normal drinking behaviour. 26 People drinking in the higher risk range could be between 3 and 10 times more likely to develop cirrhosis or liver cancer than people who do not drink at all. 27 Mental Health Problems Alcohol works as a depressant on the nervous system causing people to be sleepy, lower their inhibitions and reveal their underlying feelings. Anxiety and depression are more common in people who drink above the recommended daily limit, and drinking is more common among people who suffer from anxiety or depression. 28 Reducing alcohol consumption may improve a person s mood and sleep patterns leaving them more rested and less prone to emotional swings. An estimated 42% of men and 16% of women who suffer from depression regularly drink alcohol in excess of the recommended daily limits. 29 Studies show that 70% of attempted suicides by men and 40% by women followed heavy drinking sessions

5 Other Health Issues Pregnant women are advised not to drink more than 1-2 units once or twice a week. It is also recommended that they avoid alcohol during the first 3 months of pregnancy as there is an increased risk of miscarriage during this time. Heavy drinking during pregnancy can result in Foetal Alcohol Syndrome (FAS) which can cause growth problems, facial abnormalities, and learning and behavioural difficulties. Alcohol can also affect fertility in both men and women. 31 Doctors advise diabetics to restrict their alcohol intake due to the high number of calories contained in alcoholic drinks. 32 An estimated 35% of men and 8% of women with diabetes regularly drink alcohol in excess of the recommended daily limits. 33 Drinking can also have an effect on the immune system which causes heavy drinkers to suffer from general ill-health, be more susceptible to infectious diseases and are more likely to experience complications following accidents. 34 Alcohol can cause memory loss, with heavy drinkers experiencing memory blackouts and possible long term memory damage. 35 Long term heavy drinking may also lead to changes in emotions, personality, perception and learning. This is as a result of damage to the brain, liver or general poor health. 36 In older people a lifetime of heavy drinking may have already resulted in ill health through liver damage, high blood pressure or various cancers. Episodes of heavy drinking by elderly people may also result in falls, incontinence, cognitive impairment, hypothermia and self-neglect which may be mistaken as signs of ageing. The Royal College of Physicians estimate that up to 60% of elderly people who are admitted to hospital due to falls at home, confusion, recurrent chest infections or heart failure may actually have alcohol problems that have gone undiagnosed. 37 Social Effects Consuming excess amounts of alcohol can impact on a person socially, having a negative effect on relationships with friends and family, and affecting employment. The Health Benefits of Alcohol Consumption Messages about the health risks caused by alcohol consumption may have become diluted or misunderstood in recent years due to increased awareness about the positive health benefits that can be linked to moderate drinking, particularly of red wine. The benefits of moderate drinking may be related not only to the consumption of alcohol itself but also to psychological benefits that come from the social

6 interaction associated with drinking, for example visiting a pub, attending a social occasion with friends or enjoying a glass of wine during a meal with family. 38 Question for Discussion What role should South Staffordshire Council play in raising awareness about the health problems associated with excessive alcohol consumption? Patterns of Drinking Among Different Age Groups The prevalence of alcohol consumption, reasons for drinking and the effects of ill health vary between different age groups. Regular alcohol consumption increases with age among both men and women: People who drink almost every day: by sex and age, Percentage and over 5 0 Men Women Source: Opinions Survey, Office for National Statistics The following paragraphs address the frequency of alcohol consumption and most common health problems experienced by different age groups. It should be noted that in some instances the statistics referred to may apply to more than one age group due to the way in which data has been collated and reported. Age 0-15 Alcohol related hospital admissions are lowest among the 0-17 age group accounting for just 4% of admissions for accidents and injury, 6% of acute admissions (including for the toxic effects of alcohol and alcohol poisoning), 8% of admissions resulting from violence and 3% of mental health admissions % xls 6

7 Age The Opinions Survey 2009 found that just 1% of young people aged between 16 and 24 drank alcohol almost every day. 40 However, on days that they did drink, a high proportion of this age group reported drinking in excess of recommended daily limits. It is worth noting that in 2009 the number of women drinking in excess of recommended limits in the age range was not significantly different to that of women in the and age ranges at around 35%. 41 Hospital admissions resulting from alcohol related violence were at their highest amongst people aged at 42%. 42 However nationally, for both men and women, the number of alcohol related deaths were very low for people aged between 15 and 34, with 230 men (2.9 per 100,000 population) and 98 women (1.4 per 100,000 population) dying in the UK during In general, younger people surveyed by the Joseph Rowntree Foundation, although aware of units and sensible drinking limits, considered their binge drinking behaviour to be a phase, believing they would drink less as they got older. People in this age range were therefore not worried about the damage they may be causing to their health through excess alcohol consumption. 44 Age Data suggests that both men and women in the age range have begun to reduce their excessive (or binge) drinking practices. 45 However, despite a fall in excessive drinking, the number of people in this age range who consume alcohol regularly (on at least five days a week) increases to 8% of men and 6% of women; among the age group this figure was just 1% for both men and women. 46 A survey conducted by the Joseph Rowntree Foundation found that people over the age of 25 believed that they drank a sensible amount and were not concerned about the risks associated with consuming alcohol. However, the amount of alcohol that some of these people reported drinking was at times quite heavy. The popularity of drinking at home may be one reason for the increase in regular drinking practices among this age group. When drinking at home it is also common to underestimate the amount of alcohol consumed because drinks are not poured to a standard measure as they would be in a pub. This results in people drinking both more frequently and in greater quantities than they thought. People in the age range made up 49% of alcohol specific acute hospital admissions which include admissions for the toxic effects of alcohol and alcohol % xls

8 poisoning. Hospital admissions for alcohol specific mental health problems were also most common in this age range at 43%. 47 Age Among the age range 11% men and 9% women report drinking almost every day. 48 The highest percentage of all alcohol specific admissions (including the toxic effects of alcohol and alcohol poisoning) is in the age range at 55%. This age range also has the highest occurrence for admissions for cancer (57%) and admissions for digestive conditions (45%) where alcohol may have been a contributory factor. Admissions for alcohol specific mental disorders in the age range were the second highest of all age ranges making up 27% of admissions. 49 Alcohol related mortality rates are at their highest among the 55 to 74 age range. For men in this age group the number of directly attributable deaths reached 2739 in 2008 (45.6 per 100,000 population). The mortality rate for women is also highest in this age range reaching 1362 in 2008 (21.5 per 100,000 population). 50 Age 65 and over A report by the Joseph Rowntree Foundation found that older people have far less awareness than younger people of the recommended limits for alcohol consumption or the fact that their domestic consumption may be defined as binge drinking. They also showed less awareness of the dangers that consuming alcohol may pose to their health. 51 The highest percentage of frequent drinkers is in the 65 and over age range; 20% of men and 14% of women reported drinking almost every day. 52 Eighty percent of hospital admissions for alcohol related instances of cardiac arrhythmias and 57% of admissions for hypertension occur in the 65 and over age range. People in this age range also have a high percentage of hospital admissions for cancer and digestive complaints at 32% and 34% respectively. 53 Alcohol related deaths among the 75 and over age range peaked in 2005 for both men and women when there were 449 male deaths (25.3 per 100,000 population) and 365 female deaths (13.1 per 100,000 population) % xls % xls % xls

9 Question for Discussion Should South Staffordshire Council help to ensure that residents receive information about alcohol consumption and its related health implications which is targeted to their age group? Alcohol Consumption in the UK The UK has one of the highest alcohol consumption rates in Europe 55 with the rate of drinking rising steadily since the 1950s. There are a number of reasons for this rise including the decline of religious and cultural expectations; an increase in new consumption patterns such as drinking wine with meals; the convenience of purchasing alcohol from off-licenses and supermarkets; and the fact that in relation to disposable income alcohol is far cheaper than it was during the 1950s. 56 England is seen by many to have a drinking culture where drunkenness is tolerated and considered normal. 57 Yet the majority of people do not drink to the point of drunkenness. 58 It is important to note that levels and patterns of drinking are usually identified using the data given in surveys. However when people are asked about the amount of alcohol they consume they often underestimate, a common reason for this is because many people drink at home where alcohol is not measured as it would be in a licensed premises. 59 Ninety per cent of people surveyed in 2009 by the Office for National Statistics were aware that alcohol consumption was measured in units and around half knew what the recommended limits were, yet 39% of men and 31% of women reported drinking in excess of those limits during the previous week. 60 Alcohol Consumption in South Staffordshire Figures for Staffordshire indicate that in general men consume more alcohol than women. Young people tend to drink more heavily whilst older people drink more regularly. Married or co-habiting people are most likely to drink whilst single people drink less frequently but more heavily. The study showed that there was very little difference between the amount of alcohol consumed by people in fulltime employment and those who were unemployed. Those in professional and managerial occupations were also more likely to be frequent drinkers than those in manual occupations. 61 It is estimated that approximately 80% of adults in Staffordshire are low-risk drinkers or non-drinkers. Of the remaining 20% around 131,000 Staffordshire residents are estimated to be hazardous drinkers, 32,000 harmful drinkers and AmongAdults2008.pdf SubstanceMisuseinStaffordshireKeyFindingsNov20071.pdf 9

10 21,000 dependant drinkers. 62 (Hazardous drinking is the consumption of between 22 and 50 units of alcohol per week for men and between 15 and 35 units of alcohol per week for women; harmful drinking is the consumption of more than 50 units of alcohol per week for men and more than 35 units of alcohol per week for women). Whilst dependant and harmful drinkers will probably have some idea of the damage that the consumption of alcohol is doing to their physical and mental health, hazardous drinkers may be completely unaware that the amount of alcohol they are drinking may contribute to ill-health in the long term. The following graph indicates the number of alcohol related hospital admissions in South Staffordshire during 2008/09. The highest number of admissions for both men and women was due to hypertension (high blood pressure), with admissions for women being slightly higher. The second most common reason for alcohol related hospital admissions among South Staffordshire residents was due to cancer, with the figure for female admissions being significantly higher than male admissions: Male Number of Alcohol Related Hospital Admissions in South Staffordshire 2008/09 Female Accidents & Injury (Acute) Alcohol specific (Acute) Alcohol specific (Chronic) Alcohol specific (Mental) Cancer Cardiac Digestive arrythmia (Chronic) s Hyperten sive (Chronic) Other diseases Violence (Acute) Male Female Source: Local Alcohol Profiles for England During 2008/09 there were 8,501 actual admissions relating to alcohol consumption. 64 However, official admission figures were calculated using the indicator NI39 which attributes a value to each actual admission depending on the patient s age, gender and diagnosis. 65 This calculation resulted in an NI SubstanceMisuseinStaffordshireKeyFindingsNov20071.pdf xls 64 % xls 65 NI39 is calculated based on the proportion of each admission that can be attributed to alcohol consumption. Each illness or injury has a diagnosis code to which fractions are assigned allowing a calculation to be made which results in an admissions total. As each admission only counts as a fraction this means that NI39 admissions are much lower than actual admissions. 10

11 admission figure of 1,910 for South Staffordshire residents in 2008/09 (which is equivalent to 1,323 per 100,000 population). NI39 admission figures for South Staffordshire show an increase every year since 2002/03 66 : Number of NI39 hospital admissions per 100,000 South Staffordshire residents 2002/03 to 2008/ /03 03/04 04/05 05/06 06/07 07/08 08/09 Source: Local Alcohol Profiles for England This graph shows that hospital admissions resulting from alcohol consumption rose by 127% between 2002/03 (584 admissions) and 2008/09 (1326 admissions) in South Staffordshire. 67 The increase across Staffordshire as a whole during this time period was 130%. 68 The numbers of deaths per 100,000 population in each of the Staffordshire districts between 2005 and 2007 were as follows: 69 Alcohol Specific Deaths Alcohol Attributable Deaths Cannock Chase East Staffordshire Lichfield Newcastle-under-Lyme South Staffordshire Stafford Staffordshire Moorlands Tamworth Source: Local Alcohol Profiles for England, DA4CC23F7E1/127904/SouthStaffordshire2010DistrictProfile.pdf

12 Locality profiles for South Staffordshire show that levels of binge drinking are similar to those seen throughout England. In South Staffordshire Locality 3 has the highest estimated number of binge drinkers. The following table shows the estimated number of binge drinkers in each of South Staffordshire s localities: Estimated number of binge drinkers 2010 Locality Locality Locality Locality Locality Source: Locality Data Profiles 2010, South Staffordshire Local Strategic Partnership The local adult lifestyle survey found that across the South Staffordshire the number of adults drinking twice the recommended levels of alcohol was three times higher in men than in women. 70 The North West Public Health Observatory (NWPHO) has published estimates of hazardous and harmful drinkers at a local authority level. Locality 3 has the highest estimated number of drinkers in all categories: Estimated number for 2008 Hazardous Drinkers Harmful Drinkers Dependant Drinkers Locality Locality Locality Locality Locality Source: Locality Data Profiles 2010, South Staffordshire Local Strategic Partnership Measures to Decrease Alcohol Consumption In order to make informed choices about their drinking habits people need to be able to estimate the amount that they are drinking and need to understand the effect that alcohol can have on their health. Advice and support aimed at helping people to reduce their alcohol consumption is available from Government departments and various other organisations. Evidence suggests that identifying alcohol misuse at an early stage and offering advice can be very effective in reducing alcohol consumption with as many as one in eight people reducing their drinking to within low risk levels. 71 Many drinkers, even those that consume alcohol at harmful or dependant levels, are able to successfully reduce the amount that they drink without professional help as long as they have the appropriate information along with support from family and friends. 72 The Government offers a variety of support measures including helping people to assess their alcohol consumption levels; offering brief advice and interventions; providing telephone helplines; offering advice and questionnaires via the internet; promoting self-help groups; and providing support through NHS Health Trainers

13 Analysis of brief interventions has shown that if the service is offered consistently across the country it could result in 250,000 men and 67,500 women reducing their drinking from hazardous and harmful levels to low risk levels every year. 74 The NHS suggests a number of ways to cut down on alcohol consumption. These include setting a limit on how much you will drink; taking a fixed amount of money to spend on alcohol; reducing the drink size, (for example, opting for a bottled beer or small glass of wine); consuming more water and soft drinks during an evening out; and having some alcohol free days during the week. 75 Guidance and support are not the only methods used to combat excessive drinking practices. Alcohol sales are taxed in order to discourage excessive consumption and regulated in order to ensure that alcohol is not sold to anyone under the age of 18. Many retailers now take part in the Challenge 25 scheme whereby customers who look younger than 25 are asked to provide photo ID to prove they are over 18 and legally entitled to purchase alcohol. The alcohol industry has been encouraged to include clear labelling on products showing the number of units that it contains, this helps to reinforce the sensible drinking message and allows drinkers to keep track of the number of units that they are consuming. A survey conducted during 2009 found that 49% of drinkers had seen unit labelling on alcohol. 76 The report Drinking places: where people drink and why concludes that alcohol awareness strategies need to be specifically targeted to different social groups because those groups have different needs and different experiences of drinking. Younger people for example, whilst aware of units, recommended limits and the dangers of binge drinking choose to ignore health warnings justifying their drinking behaviour as a phase that they will grow out of before ill-health develops. Older people on the other hand have far less awareness of the recommended limits for alcohol consumption, the associated dangers posed to their health or the fact that their domestic consumption may be defined as binge drinking. There are also differences in the consumption patterns of men and women which need to be acknowledged and addressed with targeted information. 77 In the West Midlands alcohol support services offer increasing levels of advice and assistance depending on the severity of a person s alcohol misuse problem. South Staffordshire and Shropshire NHS Foundation Trust provide various substance misuse services, from community based to specialist detoxification in a hospital setting. The Community Alcohol Team provides assessment and treatment to people who are experiencing alcohol dependency; a GP referral is needed in order to access these services. 78 Staffordshire County Council s Health and Wellbeing Strategy sets out a number of priorities in tackling alcohol misuse: To promote a responsible attitude to drinking To reduce the numbers of chronic, binge, hazardous, harmful and dependant drinkers

14 To ensure good quality information is easily accessible that enables a responsible attitude to drinking whilst reducing the stigma of asking for health with alcohol addiction, dependency and misuse. In order to meet these priorities the County Council has set out a number of actions, including to improve access to information; create appropriate support services including prevention and education programmes; support Practice Based Commissioning colleagues in developing effective primary care services with an emphasis on early recognition of alcohol related issues; and develop an alcohol education programme focused on the links between physical health and sensible drinking levels. South Staffs PCT works closely with other partners to provide alcohol advisory and treatment services. People may initially seek help or advice from their GP or practice nurse and GP surgeries are therefore able to offer help, advice and referral services to patients with concerns about alcohol. GP surgeries may detect potential problems related to excessive alcohol consumption through regular appointments or through specialist appointments such as the over 40s health check. Surgery staff can access training on how to manage patients with alcohol problems via Community Alcohol Teams and can also refer patients to specialist services if necessary. The PCT also commission services from ADSIS (Alcohol and Dependency Specialists) who offer advice and counselling to individuals who are concerned about their drinking behaviour. South Staffordshire Council works in partnership with the police, fire service and other organisations through the Community Safety Partnership to raise awareness around alcohol issues. Examples of alcohol awareness undertaken in the District by various partners include: A day during Rodbaston Fresher s Week is given over to multi-agency delivery of various information including drink-driving, safe drinking levels and awareness of health and wellbeing issues relating to alcohol consumption. Fun days and activities organised by PCSOs always include promotion of safe drinking. National drink-driving campaigns are held every Christmas in order to reduce injuries and deaths and are supported locally through the Joint Operations Group (JOG). Recent initiatives have included the I ll be Des campaign where a designated driver receives free or discounted soft drinks at pubs or bars. Peer Educators working with Staffordshire Young People s Service have developed their own alcohol presentation and DVD which they are delivering in high schools throughout the District. The Schools Improvement Division has delivered alcohol awareness presentations in high schools to young people and their parents. South Staffordshire Council s Health and Wellbeing Team encourage people to lead a healthy lifestyle which includes promoting the dangers of drinking excessive amounts at health awareness events. At these events, the Health and Wellbeing Team also display the literature of ADSIS, a Stafford based organisation who offer free and confidential advice, support and information to anyone affected by their own or someone else s drinking, misuse of other substances or dependencies. 14

15 Question for Discussion How can South Staffordshire Council work with other partners in order to deliver sensible drinking information and alcohol support services to residents? Opportunities for the Future Under Government proposals upper tier local authorities (the County Council in Staffordshire) will become responsible for delivering public health messages and will be granted a budget to support this work. Upper tier authorities will have the flexibility to work with district and borough councils on public health matters as they feel appropriate. This may provide opportunities to deliver public health messages specific to local communities, and to promote sensible drinking alongside other healthy lifestyle messages such as smoking cessation and healthy eating. There may be opportunities to work in partnership with both the County Council and with other local authorities in Staffordshire. It may also be possible to play a role in the public health messages delivered by local authorities in neighbouring regions such as Walsall, Dudley, Wolverhampton and Shropshire where South Staffordshire residents may be accessing some services. It may be possible to work with other partners for example GP consortia, pharmacies and other health care providers. 15