DriNkiNg To. influences on young adult drinking behaviours. SAVE Pre-load at home. THAT S THE SPiriT! An Alcohol Concern & Balance North East Report

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1 An Alcohol Concern & Balance North East Report Binge! November 2012 SAVE Pre-load at home LETHAL WEAPoN? Three litres of cider cheaper than movie ticket THAT S THE SPiriT! What women want DriNkiNg To get DruNk influences on young adult drinking behaviours

2 DriNkiNg To get DruNk Influences on young adult drinking behaviours Drunkenness is widely perceived as a defining feature of the UK s relationship with alcohol. On the one hand, consumption behaviours in late 20th and early 21st century Britain can be viewed as the historical continuation of an established tradition. On the other, developments in media and mass marketing, the changing environment of licensed premises, price mechanisms and innovation in the range and type of drinks on the market present greater opportunities than ever to influence consumer behaviours. Young people and adults aged years are more likely to drink to get drunk than any other age group, but identifying and understanding the competing forces that shape alcohol behaviours is complex. Alcohol Concern and Balance, the North East Alcohol Office, collaborated to consult 1,000 young people aged years across the UK about what defines and influences their age group s relationship to alcohol. The North East of England is a region with high levels of alcohol consumption, established cultures of excess and high levels of harm. This report builds on previous works published by Balance that explore levers of consumption in the North East, putting the views of young adults at the heart of the debate. Participants identify drinking to get drunk as the defining feature of how their age group relates to alcohol. Those surveyed agree strongly that the price of alcohol, as well as how alcohol is promoted, encourages this excessive consumption. Certainly, the alcohol industry did not single-handedly create the British drinking style that is often characterised, not always accurately, by the determination to drink large amounts in a short space of time. But producers and retailers do have the capacity to influence consumer behaviours, particularly in young people 1 : a clear majority of those consulted believe that both price and promotion strongly influence attitudes and behaviours towards alcohol. The reputation of the UK as a beer-soaked binge-drinking nation is not entirely deserved. In recent years what has emerged is a polarisation of drinking trends. After years of increase, overall consumption levels have begun to slightly decrease, most sharply amongst the years age group that we have chosen to consult. At the same time, however, one in five young men in England regularly binge-drinks 2 (defined as consuming double the daily recommended safe limit of alcohol units in one session: eight units for men and six units for women) and there has been a notable increase in women who feel that the point of drinking is to get drunk 3. Children growing up in England and Wales the next generation of consumers are more likely to have experienced drunkenness and at an earlier age than in almost any other European country 4. And there have been other important changes in drinking trends: spirit consumption, most notably amongst women and children, has risen significantly. The frequency of consumption of the strongest alcohol has doubled amongst year olds in the last 20 years 5. Society s relationship with alcohol is never static: underlying trends as well fads are shaped by a range of invisible market forces that, at a population level, affect consumption. Creating a healthier relationship with alcohol requires more than individual personal responsibility; it needs a change in the environment, created by effective and coordinated legislative intervention. An Alcohol Concern & Balance North East report 2

3 The North East In the North East, children aged years drink more frequently and in greater quantity than in any other region in England, and young adults there are more likely to have drunk twice the recommended daily limit on any one day in the last week. Levels of alcohol-related harm in the North East reflect the rates of consumption. In there were 80,761 alcohol-related hospital admissions, an increase of 9% on the previous year, and the highest per head of population in England 6. The North East also has the highest rate of young people under 18 being admitted to hospital for alcohol-specific conditions, more than twice the national average in England 7. Children and young people under 18 growing up in the North East are more likely to seek specialist alcohol treatment than anywhere else in England. During more than 600 under-18s were in treatment for alcohol misuse in the North East twice the national rate per 100,000, although this may also reflect effective identification and referral pathways 8. Changing drinking patterns: The rise of the spirit Amongst children and young people aged years, the frequency of spirit consumption has almost doubled since 1990 up by a staggering 95% amongst girls 9. In contrast the frequency of consumption of every other type of drink has decreased significantly except for the category of beer, lager, cider, which rose only modestly. Greater consumption of stronger alcohol is likely to increase the frequency of excessive consumption and raise the risk of harm. Today spirits are the type of drink most frequently consumed by young women aged years averaging 37% of total weekly consumption 10 with vodka, which is odourless and tasteless, the most popular amongst them. In 2008 one-third of female drinkers consumed vodka compared with one-quarter ten years earlier. Crucially, regular consumers of vodka are over three times as likely as regular wine drinkers to agree that they really enjoy going out to get drunk. This may in part be linked to age, as regular vodka drinkers are also more than three times as likely to be aged between 18 and The cost of a bottle of vodka has barely increased in the last ten years, with consumers still often expecting to pay around 11 for a 70cl bottle 12. Alcohol Concern and Balance commissioned YouthSight the UK s largest research agency to specialise in gathering the views of young people, students and young professionals to investigate influences on drinking cultures. The Youth Omnibus survey carried out in March 2012 interviewed a UK representative sample of 1,000 young adults aged 16-24, with quotas set to reflect the UK population in terms of age, gender, and educational status. A focus group of 19 young people in the North East was coordinated by the Matrix to gather greater qualitative and detailed evidence about key influences. This focus group of 16 and 17 year olds took place in South Shields, Tyne and Wear in April In light of common misunderstanding about the definition of binge-drinking, in both research strands the term drinking to get drunk was used because it reflects an intention rather than a volume of alcohol consumed. Methodology Younger drinkers are more likely to drink to get drunk than other age groups, although the greatest overall consumers of alcohol tend to be older. Drinking to GET Drunk Young people aged 15 and 16 years in the UK are more likely than those in almost any other European country to have been drunk at least once in the last month; are more likely to have experienced being drunk by the age of 13; and have by far the most positive expectations of drinking 13. Half of 15 year olds in Wales report having been drunk at least twice (behind only Denmark and Lithuania in comparative studies) and over 40% of 15 year olds in England 14. Boys tend to drink more overall, but girls in the UK increasingly experience being drunk as or more often 15,16 only girls in Denmark and the Isle of Man claim to have been drunk more frequently. Around one in five young adults drink to get drunk most times or every time they drink one in five young adults drink to get drunk An Alcohol Concern & Balance North East report 3

4 PriCE & EXCESSiVE CoNSuMPTioN Younger people are particularly price sensitive, and the findings of our research suggest that the cost of alcohol may be shaping attitudes and behaviours around excessive consumption. Seven in ten (69%) year olds consulted agreed or strongly agreed that the difference in the price of alcohol bought from pubs and bars compared with off-licences influences how people drink. Alcohol is 44% more affordable today in relative terms than it was in 1980, and the growth of off-licensed premises up 25% in the last 30 years 18 has increased the availability of cheap alcohol. The price differential between the on- and off-trade results in the consumption of greater quantities before going out, commonly known as preloading, in order to cut costs. Pre-loading is shown to considerably increase the likelihood of getting drunk, often inadvertently leading to drinking more than intended; it is also linked to increased involvement in nightlife violence 19. Econometric studies consistently show that as price relative to income goes down, consumption goes up. The North East focus group of 16 and 17 year olds agreed that for young people, price often dictated what and how much they would drink. Purchasing alcohol from an off-licence, rather than from a pub or club, was viewed as an accessible way for young people to get drunk due to their lower purchasing power. For some members it was common to get drunk at home to save money and, despite being under the legal age, they would go on to bars and clubs only when they wanted to socialise. Almost two-thirds (63%) of year olds further agreed or strongly agreed that cheap alcohol promotions encourage drinking to get drunk. Those living in the North East were more likely than all but those surveyed in the North West and London to agree or strongly agree that alcohol price promotions encourage drinking to get drunk. The youngest participants surveyed (16-17 years) were more likely than older participants to point to the influence of alcohol promotions, underlining the greater price sensitivity of younger consumers. The North East focus group of 16 and 17 year olds felt that particular promotions, such as Buy One Get One Free offers, attracted young people to drink more than they would have, and to drink to get drunk. The general affordability of alcohol, and attractive price promotions in particular, mean that it is often cheaper to drink than to do other activities with friends: young people can buy a 3ltr bottle of cider for less than admission to the cinema! 69% 63% 14% 12% 17% 25% Strongly agree / agree Disagree/ strongly disagree Undecided Strongly agree / agree Disagree/ strongly disagree Undecided Figure 1: To what extent do you agree or disagree that the difference in the price of alcohol bought from off-licences and alcohol bought from pubs/bars influences how people drink? Figure 2: To what extent do you agree or disagree that cheap alcohol promotions encourage drinking to get drunk? An Alcohol Concern & Balance North East report 4

5 MArkETiNg & EXPECTATioNS of EXCESSiVE CoNSuMPTioN Young people in the UK have far more positive expectations of being drunk than young people in any other country 20 and high levels of drunkenness at earlier ages. A clear majority more than six in ten (61%) of all year olds consulted agreed or strongly agreed that advertising which associates consuming alcohol with having fun influences expectations of drinking or being drunk. The youngest participants surveyed (16-17 years) were most likely to agree: over two-thirds (67%) felt this to be the case, suggesting that this age group viewed themselves as particularly susceptible to the messages contained in advertising. Children and young people in the UK are regularly exposed to alcohol marketing, and, according to the Government s alcohol strategy, there is a known link between advertising and people s alcohol consumption, particularly those under the age of Advertising often portrays alcohol in a cool, fun and exciting manner that naturally appeals to youthful consumers, and products are widely promoted as lifestyle markers of success. The survey findings clearly suggest that young adults feel that sophisticated and well-funded alcohol advertising campaigns influence expectations of drinking. Survey participants were also asked whether they could recall a particular alcohol advert, and if so, why. Humour and themes of fun were by some distance the two most common reasons for alcohol advertising recall, suggesting that such portrayals may have particular resonance in the minds of younger audiences. This tallies with recent evidence from Wales which showed that 10 and 11 year olds were more familiar with funny duo Dan and Brad from the Fosters beer commercials than with characters from leading brands of crisps or chocolate 22. The North East focus group of 16 and 17 year olds observed that advertising tended to portray drinking as a social activity that is essential to having fun, and often sold drinking as the right choice to make when socialising. Adverts that were funny tended to stay in the mind and reflected positively on the product. It was noted that adverts routinely made drinking alcohol seem more fun than it actually is and never genuinely portrayed experiences of drinking. The regulations as they stand do not prohibit alcohol advertisers from associating their products with positive themes such as fun and humour. A recent complaint about Smirnoff advertising by the Youth Alcohol Advertising Council (YAAC) a group of young people coordinated by Alcohol Concern who meet quarterly to scrutinise alcohol marketing against the advertising codes was rejected by the Advertising Standards Authority (ASA). The complaint specifically objected to Smirnoff urging consumers not to wait for an extraordinary night but to make one. The ASA rejected the complaint in part on the grounds that characters were not seen consuming alcohol, an interpretation that leaves ample scope for advertisers to make strong positive associations about the outcomes of drinking. 15% 24% 61% Strongly agree / agree Disagree/ strongly disagree Undecided Figure 3: To what extent do you agree or disagree that alcohol advertising which associates drinking with having fun influences expectations of drinking or being drunk? An Alcohol Concern & Balance North East report 5

6 Drinking to get drunk is widely regarded as an inevitable feature of youthful relationships with alcohol in the UK. But drinking with the intention of getting drunk is not a static, timeless tradition; attitudes to and relationships with alcohol which form what we perceive to be our pre-dominant drinking culture are constantly being shaped and pulled by invisible forces, some of which are heavily influenced by the market. A majority of young adults surveyed believe that price and alcohol promotion encourage excessive consumption amongst their age groups. Cheap alcohol deals and the price differential between onand off-trade may inadvertently result in people drinking more than intended. Alcohol marketing that makes associations with appealing themes such as fun and humour is likely to strengthen pro-drinking social norms and may influence youthful expectations of being drunk. As we have seen in recent years with tobacco and drink-driving, established cultures can be successfully tackled if supported by effective legislation. The Government s CONCLUSION alcohol strategy contains certain measures designed to curb the most irresponsible practices that encourage excessive drinking. A minimum unit price if set at an appropriate level will reduce consumption amongst young drinkers who are more price sensitive than other age groups. Research by the University of Sheffield suggests that the introduction of a 50p minimum unit price would reduce consumption amongst year olds by 7.3% 23. The Strategy needs to go far further if it is serious about protecting young people from being exposed to and targeted by alcohol advertising. Changing cultural expectations around heavy drinking is possible, and will produce significant economic, health and social benefits, but it will only come about if framed by effective legislative and regulatory intervention....established cultures can be successfully tackled if supported by effective legislation. 1 The Government alcohol strategy, March NHS Statistics on Alcohol: England, Marketing Research World [9/5/12] accessed online, available from: www. marketresearchworld.net 4 The 2007 ESPAD report: substance use among students in 35 European Countries, Stockholm, Swedish Council for Information on Alcohol and Other Drugs (2009) 5 Smoking, drinking and drug use among young people in England 2010, London, NHS Information Centre 6 North West Public Health Observatory, Local Alcohol Profiles for England [accessed 8/5/12] online, available from: 7 North West Public Health Observatory, Local Alcohol Profiles for England [accessed 9/5/12] online, available from: 8 Balance North East Alcohol Office [accessed 9/5/12] online, available from: 9 Smoking, drinking and drug use among young people in England 2010, London, NHS Information Centre 10 NHS Statistics on Alcohol: England, Marketing Week [accessed 2/5/12] online, accessed from: marketingweek.co.uk/trends/wine-women-and-strong-spirits/ article 12 Nielson, Off licence news, Spirits Report The 2007 ESPAD report: substance use among students in 35 European Countries, Stockholm, Swedish Council for Information on Alcohol and Other Drugs (2009) 14 Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6) 15 The 2007 ESPAD report: substance use among students in 35 European Countries, Stockholm, Swedish Council for Information on Alcohol and Other Drugs (2009) 16 Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6) 17 Drinkaware [26/5/12] http*://c r53.cf0. rackcdn.com/drinkaware%20presentation.pdf 18 British Beer and Pub Association (2010) Statistical Handbook, Brewing Publications Limited 19 Drinkaware [accessed 11/9/12], Do you pre-load before a night out? The 2007 ESPAD report: substance use among students in 35 European Countries, Stockholm, Swedish Council for Information on Alcohol and Other Drugs (2009) 21 The Government alcohol strategy, March Making an impression: Recognition of alcohol brands by primary school children, Alcohol Concern Cymru (2012) 23 University of Sheffield, Independent review of the effects of alcohol pricing and promotion (2008) file/partb.pdf References An Alcohol Concern & Balance North East report 6

7 DriNkiNg To get DruNk influences on young adult drinking behaviours Alcohol Concern Alcohol Concern is the leading national charity working on alcohol issues. Our goal is to improve people s lives through reducing the harm caused by alcohol. We have an ambitious long-term aim to change the drinking culture in this country. We campaign to raise awareness about alcohol misuse in England and Wales, through engagement with politicians, professionals and the public. Alcohol Concern Registered Charity No Balance Balance is the North East of England s Alcohol Office and the first of its kind in the UK. Our aim is to inspire changes to the way people in the North East think about and drink alcohol. We want to encourage people to reduce their consumption and reduce the impact that alcohol is having on our region. We are doing this by three key areas of activity: educating and informing; sharing best practice; calling on government for change. Balance, The North East Alcohol Office Alcohol Concern and Balance North East would like to gratefully acknowledge the contribution of the Matrix and young people from South Tyneside for participation in the focus group