Reaching our limits on alcohol consumption

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Last week, as I sat on the 3:30 train from London to Cardiff, I watched two 20-year-old men drink a case of beer in that short journey. As we progressed west, everyone in carriages A and B listened to their language and logic progressively deteriorate (we were also subject to their drinking games). This is not an uncommon experience – we all have our own stories – on trains, in pubs and bars, in towns and at home.

Alcohol is a problem in the UK and in the last 20 years as the price of alcohol has decreased, consumption has increased – among the young and old, the working and middle classes, and both men and women.

In an area where policy has frequently feared to go, NICE has provided practical solutions in its new guidance on 'Preventing the development of hazardous and harmful drinking'. The aim of NICE is to improve our health, and if this guidance is implemented, it could potentially have substantial effects on our health and wider society.

Media coverage may emphasise the introduction of a minimum price and restricting advertising, but other recommendations in the guidance could potentially have even greater effects. The guidance recommends alcohol is made less ubiquitous in our society. This involves restricting advertising but more importantly, restricting where, when and how we buy alcohol. NICE recommends planning and licensing departments in local authorities take a more robust role in:

  • stopping local shops from selling alcohol to minors
  • limiting the number of hours when we can purchase alcohol
  • limiting the number of places that sell alcohol.

As nearly half of the alcohol we drink is in the home, any robust guidance needs to address both those who drink at home and away from it. This guidance deals with both as it seeks to transform the way we drink and provides practical prevention advice.

It acknowledges the NHS will not solve this problem on its own and needs to work in partnership with others including local authorities, the police and social services. It suggests different ways that organisations can take action, at both local and national levels. The guidance also provides a much needed prompt for us to discuss the difficult issue of how we manage and reduce alcohol consumption.

The next steps are ensuring the guidance is implemented, and that the NHS works with other organisations and individuals to tackle this significant, and expensive, public health problem.


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