Balance Benchmarking th November 2011

Introduction

 In 2010, Bluegrass Research undertook a piece of work, on behalf of Balance, which benchmarked alcohol-related perceptions and levels of alcohol consumption amongst the North East population  The purpose of this work was to establish a method of tracking Balance’s performance in relation to its key targets of changing the region’s attitudes to alcohol and alcohol abuse, and reducing the amount of alcohol consumed  In 2011, a second wave of research was undertaken to measure progress against key performance indicators  This presentation outlines the findings from the 2011 Balance Benchmarking project, comparing them to the 2010 benchmark

Methodology  Methodology used same as 2010:  Face to face interviewing  Interviews conducted across North East England  91% of interviews conducted on-street; 9% door-to-door  Data weighted to socio-demographic profile of North East population  A total of 2,388 interviews were undertaken

Alcohol Consumption

Regional Profile of Drinkers 2011 Non drinkers 23 % Low risk drinkers 38 % Increasing / higher risk drinkers 39 % 11% of non drinkers have stopped drinking in the past 12 months No significant year on year change

Key consumption measures Frequency of consumption Number of standard drinks Incidence of binging No significant year on year changes Patterns similar to 2010: Youngermen Younger people and men drink in greater quantities in a day and binge more often

Regional Profile of Drinkers 2011 * * * * * * * * *

Drinking Behaviour

Drinking too much alcohol % perceive drinking too much rarely / never Significant Change? % perceive drinking too much regularly / occasionally Significant Change? 34 % No 66 % No 8%8% 92 % No 60 % No 40 % No Men years Gateshead Women 55+ All drinkers Low risk Increasing / higher risk Also higher than average amongst:

Concern about amount of alcohol consumed All drinkers % fairly / very concerned Significant Change? % not very / not at all concerned Significant Change? Low risk Increasing / higher risk 92 % No 8%8% 98 % +2 % 2%2% -2 % 86 % No 14 % No Also higher than average amongst: Women 65+ SEG C2 Men years SEG E Gateshead

Thinking about reducing amount of alcohol consumed In the past 12 months, have you ever thought about reducing the amount of alcohol that you drink % yes 2011Significant Change? 18 % -8 % Thinking about reducing HIGHER than average amongst: Men Gateshead Increasing / higher risk drinkers Those very or fairly concerned about their drinking Those who regularly or occasionally drink too much Thinking about reducing LOWER than average amongst: Women 65+ SEG D Stockton-on-Tees, South Tyneside Low risk drinkers Those not very or not at all concerned about their drinking Those who rarely or never drink too much

Thinking about reducing amount of alcohol consumed In the past 12 months, have you ever thought about reducing the amount of alcohol that you drink % yes 2011Significant Change? 18 % -8 % Decrease driven by shifts amongst: 25-54, 65+ Men & women SEG: AB, C1, D Tyne & Wear, Tees Valley Drinkers (low & increasing / higher risk)

Amount of alcohol consumed compared to 12 months ago All drinkers % consuming less Significant Change? % consuming more Significant Change? Low risk Increasing / higher risk 8%8% No 25 % -6 % 4%4% No 23 % -9 % 12 % No 26 % No Also higher than average amongst: years Gateshead Increasing / higher risk drinkers years 65+ Darlington North Tyneside

Amount of alcohol consumed compared to 12 months ago All drinkers % consuming less Significant Change? % consuming more Significant Change? Low risk Increasing / higher risk 8%8% No 25 % -6 % 4%4% No 23 % -9 % 12 % No 26 % No Also higher than average amongst: years Gateshead Increasing / higher risk drinkers 65+ Darlington North Tyneside In both categories, those who: Regularly / occasionally drink too much Are very/fairly concerned about their alcohol consumption Have thought about reducing

Pre-loading How often, if at all, do you drink alcohol at home / at a friend's house, before going out to a bar or a club % yes 2011Significant Change? 42 % +6 % Incidence of pre-loading HIGHER amongst Middlesbrough, Newcastle South Tyneside Increasing / higher risk drinkers Incidence of pre-loading LOWER amongst 45+ SEG E Darlington, North Tyneside Low risk drinkers

Pre-loading How often, if at all, do you drink alcohol at home / at a friend's house, before going out to a bar or a club % yes 2011Significant Change? 42 % +6 % Increase driven by shifts amongst: 18-24, Men SEG: C1, C2 Tyne & Wear Increasing / higher risk drinkers

Non Drinkers who have given up in past 12 months % had a conversation with a health professional The Influence of Health Professionals All Drinkers 34 % 6%6% Did advice influence thinking about / reducing? Influenced.... Strongly: [13] To some extent: [3] A little: [0] Not at all: [4] Influenced.... Strongly: 25% To some extent: 24% A little: 25% Not at all: 27% Base: Non drinkers who have given up in past 12 months (60) and have had a conversation (20) Caution, small base Base: All Drinkers (842) who have thought about reducing or who drink less and have had a conversation (81) % whose drinking has reduced because of advice from health professionals 27 % 3%3%

Profiling the NE Drinker Segment

Profiling the NE Drinker Segment 2011 Perception of personal behaviour x concern Don't drink too much / are concerned 1%1% Drink too much / are concerned 7%7% Drink too much / not concerned 27 % Don't drink too much / not concerned 65 % +3 % -1 % Significant year-on-year changes:

Profiling the NE Drinker Segment 2011 Perception of personal behaviour x thought of reducing Don't drink too much / have not thought about reducing 61 % Drink too much / have not thought about reducing 21 % Drink too much / have thought about reducing 13 % Don't drink too much / have thought about reducing 5%5% +10 % -7 % Significant year-on-year changes:

Profiling the NE Drinker Segment 2011 Perception of personal behaviour x change in past 12 months Don't drink too much / drink the same 48 % Drink too much / drink the same 19 % Drink too much / drink more 5%5% Don't drink too much / drink less 15 % Drink too much / drink less 10 % Don't drink too much / drink more 3%3% Y-O-Y -5 % Y-O-Y +7 %

Profiling the NE Drinker Segment 2011 Perception of personal behaviour x thought of reducing Concerned / have NOT thought of reducing 1%1% Concerned / have thought of reducing 7%7% Not concerned / have not thought about reducing 80 % +9 % -8 % Significant year-on-year changes: Not concerned / have thought of reducing 12 %

Profiling the NE Drinker Segment Concern x change in past 12 months Not concerned / drink the same 65 % Concerned / drink the same 3%3% Concerned / drink more 2%2% Not concerned / drink less 21 % Concerned / drink less 3%3% Not concerned / drink more 6%6% Y-O-Y -6 % Y-O-Y +5 %

Profiling the NE Drinker Segment Intention x change in past 12 months Have NOT thought about reducing / drink the same 61 % Have thought about reducing / drink the same 7%7% Have thought about reducing / drink more 3%3% Have NOT thought about reducing / drink less 16 % Have thought about reducing / drink less 9%9% Have NOT thought about reducing / drink more 5%5% Y-O-Y -7 % Y-O-Y +7 %

Understanding Units & Limits

Awareness of alcohol units Aware of measuring alcohol in units % yes 2011Significant Change? 91 % No Awareness HIGHER than average amongst: SEG: AB, C1 Hartlepool Drinkers (increasing / higher risk) Awareness LOWER than average amongst: 65+ SEG E Newcastle South Tyneside Non-drinkers All NE Respondents

Keeping a check of units Do you keep a check of how many units of alcohol you drink? % yes 2011Significant Change? 15 % -9 % Monitoring units HIGHER than average amongst: Women SEG AB Darlington North Tyneside Low risk drinkers Monitoring units LOWER than average amongst: Men SEG D Middlesbrough Gateshead Increasing / higher risk drinkers All NE Drinkers

Keeping a check of units Do you keep a check of how many units of alcohol you drink? % yes 2011Significant Change? 15 % -9 % Decrease driven by shifts amongst: 55+ Men & women SEG: C1, C2, D, E Tyne & Wear; Tees Valley Drinkers: low & increasing / higher risk All NE Drinkers

Awareness of recommended maximum number of units Aware that there is a recommended maximum number of units % aware 2011Significant Change? 76 % -7 % Awareness HIGHER than average amongst: SEG: AB, C1 Hartlepool Northumberland Drinkers (increasing / higher risk) Awareness LOWER than average amongst: 65+ SEG: D, E Redcar & Cleveland Newcastle Non-drinkers All NE Respondents

Awareness that there is a recommended maximum number of units Aware that there is a recommended maximum number of units % aware 2011Significant Change? 76 % -7 % Decrease driven by shifts amongst: 18-24, 55+ Men & women SEG: C2, D, E Tyne & Wear Drinkers (low risk) Non drinkers All NE Respondents

Understanding of recommended maximum number of units Proportion of MEN who understand recommended daily limits % understand 2011Significant Change? 43 % No Proportion of WOMEN who understand recommended daily limits 39 % -6 % OVERALL POPULATION Proportion of MEN DRINKERS who understand recommended daily limits 46 % No Proportion of WOMEN DRINKERS who understand recommended daily limits 42 % -7 % DRINKERS

Minimum Pricing

Attitudes to current prices for alcohol Base: All respondents (2,388) 65+ years SEG: AB Non-drinkers year olds SEG: E Drink 4+ days a week S Tyneside Northumberland No significant year on year changes

Awareness of minimum pricing Aware of Minimum Pricing % aware 2011Significant Change? 45 % No Awareness HIGHER than average amongst: Men 35 – 54 SEG: AB, C1 Darlington Northumberland Drinkers Awareness LOWER than average amongst: Women 18 – 34 SEG: D, E Newcastle South Tyneside Non-drinkers All NE Respondents

Support for minimum pricing % 2011Significant Change? Support Minimum Pricing 56 % +7 % Against Minimum Pricing 28 % No Support HIGHER than average amongst : Women SEG: AB South Tyneside Sunderland Northumberland Non-drinkers & low risk drinkers Objection HIGHER than average amongst : years SEG: C2s Stockton on Tees Gateshead Drinkers (increasing & higher risk)

Support for minimum pricing % 2011Significant Change? Support Minimum Pricing 56 % +7 % Against Minimum Pricing 28 % No Increase in support driven by shifts amongst: Women SEG: E Northumberland Tyne & Wear Drinkers All NE Respondents

Minimum Pricing % 2011Significant Change? Prepared to pay more for positive societal benefits 53 % +6 % NOT prepared to pay more for positive societal benefits 29 % +4 % Preparedness to pay more HIGHER than average amongst : Women 55 – 64 SEG: AB South Tyneside, Sunderland, Northumberland Low risk drinkers Supporters of minimum pricing Not prepared to pay more HIGHER than average amongst : Men SEG E Stockton on Tees, Darlington Increasing & higher risk drinkers Objectors to minimum pricing

All NE Respondents Minimum Pricing % 2011Significant Change? Prepared to pay more for positive societal benefits 53 % +6 % NOT prepared to pay more for positive societal benefits 29 % +4 % Increase in support driven by shifts amongst : Women SEG: C2,E Tyne & Wear Drinkers Increase in objection driven by shifts amongst : Men SEG: A,B County Durham Tees Valley

All NE Respondents Effects of minimum pricing: impact on support Reduce alcohol related crime and violence % 2011 Significant Change? 84 % +7 % Reduce drunk / rowdy behaviour 83 % +6 % Reduce amount under 18s drink 80 % +6 % Reduce cost of alcohol related burden to NHS 78 % +7 % Only penalised heavy drinkers who bought cheap alcohol 69 % +4 %

Effects of minimum pricing Increases typically driven by: Younger age groups (18-34) Women C2DEs (most notably C2 & E) Drinkers Non-drinkers Effects have greater influence amongst: Women Non drinkers Low risk drinkers Middlesbrough Redcar & Cleveland Supporters of minimum pricing Effects have lower influence amongst Men Stockton on Tees North Tyneside Drinkers (increasing / higher risk) Those neutral and objectors to minimum pricing

14 % would drink less 86 % would drink the same Effects of minimum pricing on behaviour If minimum pricing was introduced, do you think that you would drink more, less or the same as you drink now? year olds Es Increasing/higher risk drinkers Darlington ; Hartlepool Gateshead; Newcastle All NE Respondents

Children & Alcohol

Alcohol Advertising & Children Alcohol advertising currently targets the under 18s % agree 2011 Significant Change? 55 % +10 % HIGHER than average agreement amongst: Older age groups – 55+ Women Non drinkers South Tyneside LOWER than average agreement amongst: Younger age groups (18-34) Men SEG: C1 Increasing / higher risk drinkers Darlington; N Tyneside All NE Respondents

Alcohol Advertising & Children Alcohol advertising currently targets the under 18s % agree 2011 Significant Change? 55 % +10 % 25-44, Men & women SEG groups (except C1s) Tees Valley Low risk drinkers & non- drinkers Positive shifts in opinion evident amongst... All NE Respondents

Alcohol Advertising & Children There should be a ban on alcohol advertising before 9pm % agree 2011 Significant Change? 68 % +3 % HIGHER than average agreement amongst: Women Older age groups (55+) SEG: E County Durham Non-drinkers LOWER than average agreement amongst: Men Younger age groups (18-34) Hartlepool Stockton-on-Tees North Tyneside Drinkers (Increasing / higher risk)

Alcohol Advertising & Children There should be a ban on alcohol advertising before 9pm % agree 2011 Significant Change? 68 % +3 % Age groups: 18-34; Women SEG: C2, E Northumberland Tees Valley Non-drinkers Positive shifts in opinion evident amongst... All NE Respondents

Giving alcohol to children Proportion stating that children aged should NEVER drink alcohol % 2011 Significant Change? 72 % -5 % More likely to agree: 65+ SEG: E Darlington; Hartlepool; Gateshead; South Tyneside Non-drinkers Lower risk drinkers Less likely to agree: SEG: AB,C1 County Durham; Stockton Increasing / higher risk drinkers All NE Respondents

Giving alcohol to children Proportion stating that children aged should NEVER drink alcohol % 2011 Significant Change? 72 % -5 % Negative shifts in opinion evident amongst ; Men & women SEG: C1, D Tyne & Wear; Tees Valley Increasing / higher risk drinkers All NE Respondents

Giving alcohol to children % 2011 Significant Change? Proportion stating that children aged should NEVER drink alcohol 34 % -7 % More likely to agree: Women 65+ SEG: E Darlington; South Tyneside Non-drinkers Less likely to agree: Men 18-24; SEG: C1 Stockton Increasing / higher risk drinkers All NE Respondents

Giving alcohol to children % 2011 Significant Change? Proportion stating that children aged should NEVER drink alcohol 34 % -7 % Negative shifts in opinion evident amongst ; 55+ Men SEG: AB,C1,C2 Tyne & Wear; Tees Valley Lower & Increasing / higher risk drinkers All NE Respondents

Normalisation

Drinking attitudes Woman drinking bottle of wine when out with friends % acceptable 2011 Significant Change? 64 % -4 % 2 couples sharing 3 bottles of wine when out for dinner 57 % No Man drinking 8 pints of lager/beer when out with friends 43 % +5 % Woman regularly drinking 2 glasses of wine 5 nights a week 39 % +7 % Drinking to get drunk 12 % No Man driving after drinking two pints lager/beer 5%5% -3 % All NE Respondents

Drinking attitudes Woman drinking bottle of wine when out with friends % acceptable 2011 Significant Change? 64 % -4 % Man driving after drinking two pints lager/beer 5%5% -3 % Women SEG: C1, E County Durham Tees Valley Drinkers (Low & Increasing / higher risk) Shifts to lower levels of agreement seen amongst: 18-24, Women SEG: C2, E Tees Valley Drinkers (Low & Increasing / higher risk) Shifts to lower levels of agreement seen amongst:

Drinking attitudes Man drinking 8 pints of lager/beer when out with friends % acceptable 2011 Significant Change? Woman regularly drinking 2 glasses of wine 5 nights a week Men SEG: AB, C2 Tyne and Wear Shifts to higher levels of agreement seen amongst: 55+ Men SEG: AB, C2, D Tyne and Wear Increasing / higher risk & Non Drinkers Shifts to higher levels of agreement seen amongst: 43 % +5 % 39 % +7 %

Coronary heart disease Greatly increases the risk of % 2011 Significant Change? 63 % No Depression 61 % +8 % Cancer 36 % No Stroke 52 % +7 % Gaining weight 73 % +10 % Perceptions of health impacts of alcohol All NE Respondents

Who’s influencing the shifts? 18-44, Women SEG: C1, C2 Drinkers Tyne & Wear, Tees Valley 18-24, 35-44, Women SEG: C1, C2 Low risk drinkers Tyne & Wear, Tees Valley Men & women SEG: AB, C1, C2 Drinkers Tyne & Wear, Tees Valley, Northumberland Perception that alcohol greatly increases the risk of depression up 8% Perception that alcohol greatly increases the risk of stroke up 7% Perception that alcohol greatly increases the risk of gaining weight up 10%

Assaults and violence % associating 2011 Significant Change? 97 % +3 % Domestic abuse 95 % +4 % Teenage pregnancy 82 % -6 % Anti-social behaviour 97 % No Social Impacts of Alcohol

Who’s influencing the shifts? Women SEG: C2, E Tees Valley Drinkers (low & increasing / higher risk) 18-24, Men & women SEG: C2, D, E County Durham, Tees Valley Drinkers (low & increasing / higher risk) 18-24, Men & women SEG AB, C2 Tyne & Wear, Tees Valley Low risk and non-drinkers Proportion associating alcohol with assaults and violence up 3% Proportion associating alcohol with domestic abuse up 4% Proportion associating alcohol with teenage pregnancy down 6%

Summary

Drinking Behaviour There has been no change to the regional profile of drinkers between 2010 and 2011 The key consumption measures around how often alcohol is consumed and the amount consumed have also remained constant...and we continue to see that drinking behaviour is influenced by demographic variables, such as age and gender How North East residents feel about their drinking has also remained constant There has, however, been a decline in the proportion who have made or thought about making changes to their drinking behaviour in the last 12 months The size of the ‘cause for concern’ segments remain in line with 2010

Summary Alcohol Units Reflecting 2010, the vast majority of North East residents have heard of measuring alcohol in units Despite this, there has been a decline in the proportion of NE drinkers keeping a check on their units. This is evident amongst both men and women Women are, however, more likely than men to monitor their alcohol intake using units...although there has been a slight fall amongst female drinkers (and women generally) with regard to understanding how many units should be consumed in one day

Summary Minimum Pricing Awareness of minimum pricing has remained constant this year There has, however, been an increase in support for the policy, with over half of the North East population now in favour There has been a polarisation of attitudes this year with regard to willingness to pay more for personal consumption alcohol; the majority, however, would be prepared to pay more The vast majority of drinkers do not feel that the introduction of minimum pricing will change their drinking behaviour...although the findings indicate that the likelihood of drinking less may be higher amongst target groups

Summary Children & Alcohol Attitudes with regard to alcohol advertising have shifted positively, most notably on the issue of alcohol adverting targeting the under 18s These shifts have resulted in: –A ban on alcohol advertising before 9pm being supported by over 2 in 3 –Over 1 in 2 perceiving that alcohol advertising targets the under 18s There has, however, been a ‘liberalisation’ in terms of how often people perceive it is acceptable for young people to drink alcohol, with a lower proportion of NE residents feeling that and year olds should never drink alcohol There continues to be a marked difference between the acceptability of providing alcohol to year olds, compared to those aged (with twice as many feeling it’s acceptable for the latter group to drink alcohol)

Summary Normalisation Attitudes towards some of the example drinking behaviours have changed, both positively and negatively: –A lower proportion perceive that it’s acceptable for: A woman to drink a bottle of wine when out with friends a man to drive after drinking two pints lager/beer –A higher proportion perceive that it’s acceptable for: A man to drink 8 pints when out with friends A woman drinking 2 glasses of wine 5 nights a week

Summary Social and Health Impacts In 2011, gaining weight is the health harm most strongly associated with alcohol, the result of a 10% increase The strength of association with depression and stroke with alcohol has also increased Cancer continues to be the health harm associated least with alcohol... and at significantly lower levels than the other health harms tested The vast majority of the NE public associate negative social impacts with alcohol, with an increasing proportion linking alcohol with assaults and violence and domestic abuse Interestingly, there has been a fall in the proportion of the NE public associating teenage pregnancy with alcohol, although the large majority do make the link

The “Line of Sight” to Behaviour Change Input measures eg comms campaigns undertaken Output measures eg awareness of safe levels Outtake measures eg understanding and knowledge Intermediate measures eg attitudes, intentions, response Behavioural change measures Reduced consumption Outcome/impact measures Reduced ARHA Source: COI “Evaluation for Alcohol Social Marketing. Guidance for PCTs”

The “Line of Sight” to Behaviour Change : NE Drinkers Base: All NE drinkers BEHAVIOURAL CHANGE INTERMEDIATE MEASURES OUTTAKE MEASURES OUTPUT MEASURES

The “Line of Sight” to Behaviour Change : All NE Drinkers: 2011 BEHAVIOURAL CHANGE INTERMEDIATE MEASURES OUTTAKE MEASURES OUTPUT MEASURES Base: All NE drinkers (1799); Low risk (857), Increasing/high risk (942)