1. When it comes to alcohol, how to make healthier choices easier choices Peter Anderson Armagh 26 January 2012

2. 1.Three reasons why we need to do this 2.Five ways to do it

3. 1.Three reasons why we need to do this 2.Five ways to do it

4. 1.High consumption 2.High harm 3.High cost

5. 1.High consumption 2.High harm 3.High cost

7. 1.High consumption 2.High harm 3.High cost

8. Regional variation of proportion of alcohol-attributable deaths to all deaths for people 15 to 64 years of age, 2004, European Union

9. 1.High consumption 2.High harm 3.High cost

10. Economic costs per head (2007 $US PPP) due to alcohol by cost category

11. Economic costs per head (2007 $US PPP) due to alcohol by cost category

12. 1.Three reasons why we need to do this 2.Five ways to do it

13. 1.As with tobacco, improve health literacy with consumer information and warnings 2.As with tobacco, ban advertising 3.As with tobacco, deal with the workplace 4.As with tobacco, provide help and support 5.As with tobacco, put up the price

14. 1.As with tobacco, improve health literacy with consumer information and warnings 2.As with tobacco, ban advertising 3.As with tobacco, deal with the workplace 4.As with tobacco, provide help and support 5.As with tobacco, put up the price

17. Overall evaluation Alcoholic beverages are carcinogenic to humans Ethanol in alcoholic beverages is carcinogenic to humans

18. Risk of breast cancer by daily alcohol consumption

19. Lifetime risk of dying from alcohol-related death by gram alcohol/day or /week for Australian men and women.

21. 1.As with tobacco, improve health literacy with consumer information and warnings 2.As with tobacco, ban advertising 3.As with tobacco, deal with the workplace 4.As with tobacco, provide help and support 5.As with tobacco, put up the price

22. Report of the European Commission Science Group on alcohol: “It can be concluded from the studies reviewed that alcohol marketing increases the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol”

23. Characters consumed alcohol 3 times and alcoholic beverages were portrayed an additional 15 times

24. Characters consumed alcohol 18 times and alcoholic beverages were portrayed an additional 23 times

25. In both movies, there were two commercial breaks, either non- alcohol or alcohol advertisements

26. non-alcohol commercials alcohol commercials

27. F=4.44; p<0.05

28. F=4.93; p<0.05

30. 1.As with tobacco, improve health literacy with consumer information and warnings 2.As with tobacco, ban advertising 3.As with tobacco, deal with the workplace 4.As with tobacco, provide help and support 5.As with tobacco, put up the price

31. Report of the European Commission Science Group on alcohol: “alcohol workplace activities should be embedded within well-being at work initiatives, including structural factors and management and leadership styles”.

32. “Increasing the extent of alcohol free workplaces will result in reductions of alcohol-related work place accidents and injuries, as well as creating a culture for a more healthy relationship with alcohol that impact on families and friends through social networks.”

33. Male alcohol-related deaths by age group, England

34. English civil servants: Risk of alcohol dependence in 1991-93 by work environment in 1985-88

35. 1.As with tobacco, improve health literacy with consumer information and warnings 2.As with tobacco, ban advertising 3.As with tobacco, deal with the workplace 4.As with tobacco, provide help and support 5.As with tobacco, put up the price

36. Impact of AUDIT-C 3 screening and 5 minute intervention, England over 10 years Next GP consultation

37. 1.As with tobacco, improve health literacy with consumer information and warnings 2.As with tobacco, ban advertising 3.As with tobacco, deal with the workplace 4.As with tobacco, provide help and support 5.As with tobacco, put up the price

38. Affordability of alcohol in UK

39. Average world price elasticities (112 studies) (% reduction with 10% increase in price)

40. Average world harm impact (50 studies) (% reduction in US with doubling of alcohol tax)

41. Impact of 10% increase in price on health and crime costs saved, 1 st year, England

42. Impact of minimum price (€0.07/g alcohol, average off trade price) on health and crime costs saved, 1 st year, Scotland

43. 1.Should we be increasing price in times of economic downturn?

44. Associations of a more than 3% rise in unemployment with death rates, EU, 1970-2007

45. 1.Should we be increasing price in times of economic downturn? 2.Don’t price increases lead to more illegal production and cross border trade?

46. Alcohol tax cuts and alcohol-positive sudden deaths, Finland Source: Koski et al 2007 On 1/3/04, tax reduced by 33% retail price decreased by 22% 7.7 additional deaths/week, 17% increase Government alcohol tax revenue went down by 17% Number of alcohol-positive sudden deaths/week

47. Changes in deaths/100,000 person years adjusted for age and economic activity men and women aged 30-59 years Herttua et al 2008

48. Age-standardized mortality from alcohol-related diseases and accidental poisoning by alcohol in 1969 to 2010 per 100,000 persons

49. 1.Should we be increasing price in times of economic downturn? 2.Don’t price increases lead to more illegal production and cross border trade? 3.But, price increases don't affect heavy drinkers and penalize moderate drinkers don’t they?

50. Impact of 10% price increase on consumption and cost of harmful and moderate drinkers, England

51. Impact of minimum price (€0.07/g alcohol, average off trade price) on consumption and cost of harmful and moderate drinkers, Scotland

52. 1.Should we be increasing price in times of economic downturn? 2.Don’t price increases lead to more illegal production and cross border trade? 3.But, price increases don't affect heavy drinkers and penalize moderate drinkers don’t they? 4.Prices increases will damage the alcohol business, won’t they?

53. Impact of 10% increase in price on employment-related benefits 1 st year, England

54. Impact of minimum price (€0.07/g alcohol, average off trade price) on employment-related benefits 1 st year, Scotland

55. Impact of minimum price (€0.07/g alcohol, average off trade price) on extra industry revenues, annually, Scotland

56. 1.In north-west Europe, 1 in 8 of all male deaths and 1 in 14 of all female deaths in the age group 15-64 years are caused by alcohol.

57. 2.There is a strong case for placing consumer information and warning labels on alcohol beverage containers; as a rough guide, adult drinkers should be advised never to drink more than 20g alcohol (2 drinks) on any one day or occasion.

58. 3.There is a strong case for banning all forms of alcohol advertising, including those in social media outlets.

59. 4.Workplaces are strongly advised to implement well-being at work initiatives; they will not only improve productivity, but also reduce the risk of alcohol problems.

60. 5.There is a pressing need to increase the reach of brief advice and treatment programmes; these save people’s lives, and, in the case of brief advice programmes, save health systems much needed money.

61. 6.But, increasing taxes and setting a minimum price is the key. Without these, you cannot hope to reduce the burden and promote the health and well-being of individuals and communities.