Recently PhD students Laura Baines, Graeme Knibb and Panos Spanakis attended the North West Alcohol Conference. Here we summarise the highlights.
Following a welcome address from Dr. Steve Hood, Councillor Roz Gladden (stepping in for Liverpool Mayor Joe Anderson) provided the keynote address. According to Cllr Gladden, the North-west performs the worst in the UK for the amount of years lost due to alcohol; we have the highest hospital admission rate for alcohol-related injuries and more alcohol-related crimes than anywhere outside of London. She went on to outline five areas which should be addressed to reduce the impact of alcohol in the North-West (prevention and early intervention, treatment and recovery, community safety, protecting children and control). However, while Cllr Gladden provided examples of charitable and community organisations addressing these issues, in an ‘age of austerity’ how would the council address alcohol-related problems? One audience member asked what impact government cuts would have on council-led alcohol services. Cllr Gladden responded by stating that there are going to be severe in-house cuts and she cannot say that “…this is not going to affect services...” but she did state that the council intends to do their best “... to ensure it doesn’t impact as much as possible...”
While at times the talk threatened to spill over into political rhetoric, Cllr Gladden did discuss the prospect and practicalities of a region specific minimum unit pricing (MUP) policy. Due to intense lobbying from the alcohol industry, plans for national MUP have fallen by the wayside. However, with the creation of the ‘Northern Powerhouse’, Cllr Gladden believes it would be possible to introduce MUP in the North-west. But is this likely to happen? Later that day an audience member asked if the threat of devolved MUP would lead to devolved lobbying. The answer from two North-West councillors was a unanimous ‘yes’ and an ominous “...we need to be ready for it”.
Although absent Professor Gerard Hastings (University of Stirling) delivered a pre-recorded presentation concerning alcohol marketing. Prof Hastings was particularly concerned with the way in which digital marketing has become less recognisable as advertising and how social networking sites now enable consumers to become marketers themselves (through ‘shares’ and ‘likes’). He used Facebook’s recent advertising partnership with Diageo, the owners of the Smirnoff and Guinness brands, to highlight that the balance of ‘power’ is massively tipped towards advertisers. Prof. Hastings believes that Public Health must ‘fight back’ and outlined three possible public health responses. These were; containment (by regulation), counteraction (by counter advertising) and critical capacity building in the population (e.g. by increasing media literacy). These responses together, Prof Hastings suggests, can restore the balance of power between citizens and advertisers. He acknowledged that this would take time and international measures are needed but, in his words, “...it can be done, because it has to be done.”
Professor Sir Munir Pirmohamed, Director of the MRC Centre for Drug Safety Sciences in Liverpool and Executive Director of Liverpool Health Partners (LHP) focused his talk on the development of an academic health science centre, The Liverpool Alcohol Research Alliance (LARA). LARA is a multi-disciplinary group established to connect alcohol research areas, focusing on improving alcohol interventions as well as prevention of alcohol addiction. Professor Pirmohamed stated that the overall ambition is to become an organisation recognised worldwide for cutting edge research in alcohol related issues and to develop a Liverpool alcohol research centre. This is to improve patient benefit and to develop effective drugs to treat alcohol dependency. Prof. Pirmohamed informed us that LARA already has access to primary care data for more than 13 million patients, meaning it is the first group in the world to have access to this type of data on this scale. With more than 10 publications in preparation, the growth of the organisation sounded very promising.
The next talk focused on young people’s perspectives of alcohol marketing and was given by Steve Morton, a health and wellbeing manager for the North West. Specifically, Mr Morton focused on the effect alcohol advertising may be having on adolescent drinking and their perceptions of alcohol use. Many studies have reported that exposure to alcohol marketing is associated with an increased likelihood that adolescents will begin to consume alcohol, emphasising Mr Morton’s point that it may be important to tackle the vast amount of advertising. After all, the advertising of Tobacco is illegal so why is this not the case for alcohol? The speaker then proceeded to emphasise the sheer amount of alcohol marketing that is visible to young people. We were shown a wide variety of advertisements including special offers in shops, bus stops, pub advertising signs and various sports sponsorships. These photographs were taken by adolescents themselves emphasising how visible alcohol advertisements are to young people. The speaker therefore believed it was obvious something needed to be done. With his ultimate aim being to get a ban on alcohol advertising introduced, he argued that warning labels could be added to bottles, or alcohol harm could be incorporated more profusely into education.
A very interesting talk was given by Dr. Angela Attwood, from Bristol University, regarding “The Psychology of drinking”. More specifically, Dr. Attwood’s talk was focused on the concept of “choice architecture interventions”. Choice architecture interventions aim at changing aspects of the microenvironment where a given behaviour occurs. That could entail changing some properties of the environment or changing the place where an item or a product is located or even both. For example, the loudness of the music in a club can affect how quickly customers will return at the bar to order another drink. A more practical example of how choice architecture could be implemented to tackle alcohol abuse problems derives from a current study in Bristol University about glass shape. Researchers in Bristol University found that straight glasses make people drink slower, compared to the usual carved glasses used in most pubs, bars and clubs. A possible explanation for this effect could lie on volume estimation. A simple visual heuristic to estimate volume is height, so that the higher the liquid appears to be in the glass, the larger the volume of the liquid. Although this can be a quite accurate estimation with straight glasses, curved glasses made participant overestimate the volume of drink still left in their glasses. Consequently, curved glasses may drive people to drink faster, as it appears like they have more drink in their glasses than they really do. Concluding, Dr Attwood summarized the different environmental properties that could be of relevance for alcohol choice architecture interventions. These properties might have to do with the ambience of a place (at that point she made a complimentary reference to the special bar laboratory in University of Liverpool that simulates a real pub environment), the labelling of alcoholic drinks, as well as their presentation and the sizing of the portions.
A very informative workshop was delivered by Dr. Adam Mackridge, from LJMU School of Pharmacy, and Deirdre Boyd, director of the DB Recovery Services. Both speakers talked about what constitutes effective support for substance abuse and how effective support should look like. Dr. Adam Mackridge made a case about how community pharmacies could be utilized to tackle alcohol related problems. Community pharmacies provide unique advantages, as the broad range of the population that visits them and the possibility for instant provision of advice. A recent project, that he described, included using community pharmacies to screen large amounts of people for alcohol risks. Overall, there were positive outcomes, as the pharmacists were quite effective at screening the population and the public really accepted the whole procedure. In a restricted number of follow ups that were made possible, people were actually found to have reduced consumption after the screening and the consultation that happened in the pharmacy. Deirdre Boyd gave a talk about the crucial importance of good practice and the challenges faced by people with addiction problems. She explained how abstinence is only part of the rehabilitation process. Another crucial aspect of this process is to learn to recognize and control emotions that drive alcohol related behaviours. She explained how addicts learn life skills, as adults, that healthy individuals normally learn as children. To emphasize this, she explained how in the 12 steps of recovery from alcohol abuse only the first has to do with alcohol consumption itself. All the rest are mainly focused in leaving your old life.