By Tom de Castella BBC News Magazine Pressure to address the UK's binge drinking grows ever stronger, with a number of radical solutions being put forward to try to help people cut down.
David Cameron last week called binge drinking a "scandal" that costs the NHS £2.7bn a year. He pledged to introduce drunk tanks and booze buses, and there are plans for a minimum price for alcohol.
So what are the most radical solutions to the problem?
Continue reading the main story Definition of binge drinking
- For men, more than eight units of alcohol - or about three pints of strong beer
- For women, more than six units of alcohol, equivalent to three small (175ml) glasses of wine
Food firms have recently moved to cut the amount of salt and saturated fat in their products, following government pressure. The British Medical Association wants to see the same thing happen in relation to beer. So, for example, a premium lager could gradually be reduced from 5.5% to 5%, while a bitter comes down from 4.5% to 4%.
But Roger Protz, editor of the Good Beer Guide, says beer in Britain is much weaker than in the rest of Europe. And to reduce it would affect its characteristic flavour. "London Pride [bitter] at 4.1% is a lovely malty, hoppy beer but if you reduce it to 3.5% it will be very different."
Another approach would be to use the tax system to target stronger drinks. The March 2011 budget saw a rise in the duty on strong beers (above 7.5% alcohol) of 25%, and the duty on weak beers (below 2.8%) cut by 50%. Alcohol Concern says this should be extended to wine, which is getting stronger.
The British Beer and Pub Association says the current focus on beer is wrong. "We should be encouraging people to drink more beer rather than stronger drinks, which have been gaining market share. Beer tax here is 12 times that of Germany."
Many find it cheaper to drink at home A review of international research published last year by Bangor University found that pricing was the "key determinant" for how much people drank.
Alcohol Concern wants to see a minimum rate of 50p per unit of alcohol brought in. It would make a pint of beer at least £1.25 and a bottle of wine £5.
It would hit the low-cost retailers rather than bars and restaurants, says Andrew Misell, a spokesman for Alcohol Concern. "It won't affect pub prices. Where you will be hit hard is in the supermarkets where cider is on sale for as little as 13p a unit."
The drinks industry says such moves only encourage counterfeit and smuggled alcohol. And Tim Martin, founder of JD Wetherspoon, says consumers will simply go abroad. "It's an international industry. People can go to Calais and load up their car with as much alcohol as they want."
Jamie Bartlett, author of Under the Influence, a 2011 report on binge drinking for think tank Demos, says it would cut total alcohol consumption but not necessarily binges. "The problem is people going on benders and it's not clear it would have an impact on that."
Pubs are dying out but are they a safer place to drink? One of the traditional roles of the pub landlord is to tell a drinker when they've had enough. No such authority figure exists in people's living rooms. And pubs are closing in great numbers across the country, as supermarket-bought booze now accounts for about half of what's being consumed.
So, one solution is to shift drinking back into the pub where it is typically more expensive, served in measurable quantities, and supervised by trained staff. Martin says this can be done by cutting VAT on food and alcohol in pubs to 5%, a proposal that has been successful in helping restaurants in France and Ireland. Supermarkets add no VAT on to the food they sell, whereas pubs have VAT of 20%. "Supermarkets are effectively cross subsidising alcohol sales with their food sales. It's a huge tax advantage that undermines pubs," Martin says.
The British Medical Association does not accept that pubs should be cheaper but agrees that shop-bought drink should be made more expensive - "thus encouraging alcohol to be consumed in pubs where there are more controls". Misell cautions against getting too nostalgic about a golden age of pub sobriety that never was. "Some people idolise the pub as this place where it's impossible to get drunk. And yet we all know it's perfectly possible to over-indulge there."
In the US, the legal drinking age is 21. And there's an argument that by raising the minimum age, it makes it easier for retailers to police under-age drinking - most 21-year-olds look like adults. While raising the minimum age is not official BMA policy, the doctors' body argues that it is something that could be explored. A spokeswoman suggests: "Evidence from America clearly demonstrates that raising the legal drinking age has a significant positive effect on alcohol-related problems." Alcohol Concern agrees but says it would be politically impossible to raise the drinking age.
Tim Martin says that teenagers are going to try to drink, regardless of the law. The key thing is that they start by drinking beer in pubs, under the "watchful eye" of the landlord rather than vodka somewhere else. It's time the government stopped trying to entrap landlords by hiring 15 and 16-year-olds to try to get served.
Off-licences are rarely prosecuted for selling to under 18s, as it is, says Bartlett. So to raise the age limit even higher would not make sense. "Last year I think only one off-licence was fined for selling alcohol to a minor," says Bartlett.
The drinks industry says the issue of under-age drinking is already taken seriously in shops. For instance, under the Challenge 25 scheme shoppers are warned that if they look under 25 they may have to show ID, says Richard Dodd, spokesman for the British Retail Consortium. It raises the question of why this is not rolled out everywhere, as happens in countries like Sweden.
In some places - most of Canada, certain US States and Sweden - only certain state-owned shops can sell alcohol. The most rigorous is Sweden.
To buy a bottle of wine in Sweden, it's necessary to visit one of the country's network of Systembolaget shops, which close on Saturday afternoons and do not open on Sundays. The approach prevents impulse buys in the supermarket and the products are displayed in an atmosphere more akin to a chemist's than an off-licence. The Swedish model is based on the idea that by keeping control of price and availability, alcohol consumption is reduced.
A study carried out by international alcohol researchers in 2010 concluded that scrapping Sweden's state shops would lead to a 14% rise if sales were limited to private liquor stores. And allowing any grocery store to sell alcohol would result in a 29% rise in alcohol consumption.
However, such a proposal is unlikely to go down well with voters. Even Alcohol Concern warns of the dangers of "stockpiling".
And Dodd says it is absurd to crack down on supermarkets which would be most influenced by the change. "Supermarkets are already the most responsible alcohol outlets that there are and I can't see that preventing them from selling alcohol would improve things."
Buying rounds can create a social pressure to keep buying drinks because it's your turn. Last year the Sun reported that Prof Richard Thaler, an adviser to David Cameron on "nudge" - a form of behavioural economics, said buying rounds makes people drink more. He recommended that large groups set up a tab to be split at the end of an evening's drinking.
However bizarre, the idea of forbidding rounds is not new. During World War I, buying rounds - "treating" as it was known - was banned after fears that the war effort was being damaged by drunkenness.
Misell says it would be impractical to institute such a ban. But he supports the idea of improving public awareness on the perils of rounds. "My experience of rounds on a night out is that you very easily drink more than intended. My one piece of advice is - don't drink in rounds."
Critics of the drinks industry say that cut price deals and cheeky advertising makes people drink more than they otherwise would.
Research in 2008 by the Royal College of Physicians found a link between sports sponsorship by alcohol firms and binge drinking. At the time half of all Premier League football teams and all 12 of the Guinness Premier League rugby clubs had alcohol firms as a sponsor. Today, Everton has a brewer - Chang - as its shirt sponsor and, until recently, Liverpool shirts carried the name of Carlsberg.
Alcohol Concern wants to see alcohol advertising banned from sport, television, and in cinemas for films aimed at those under 18. In theory, advertising is forbidden from associating alcohol with social or sexual success.
Continue reading the main story Official advice on drinking
- Introduced in 1987, updated in 1995
- Men: 21 units a week max, with no more than three or four units a day
- Women: 14 units a week max, with no more than two or three units a day
- After heavy drinking, no alcohol for 48 hours to allow body to recover
"But in practice few ads don't include those two things," says Misell. By way of example he points to the beer advert featuring Holly Valance flirting with two Australian comedians. He is also in favour of renaming the large glass of wine (250ml) extra large - it equals a third of a bottle of wine. The small (175ml) glass could then be renamed medium, with a new small size(125ml) available.
Alcohol promotions such as three bottles of wine for £10, or trays of beer tied into the World Cup, are still common in England. However they've been banned in Scotland. Financial Times wine critic Jancis Robinson says banning such deals makes sense. "Cut price wine deals are killing wine suppliers, too."
But Sarah Hanratty, a spokeswoman for the Portman Group, which represents the drinks industry, says banning sports sponsorship and other forms of marketing would punish the sensible majority. "It's a competitive market and the role of marketing is to help consumers choose between brands based on their lifestyle."
Much of the media attention to do with binge drinking is focused on public drunkenness. But it's arguable that the greater problem is the health impact of drinking too much.
Liver disease is the only major cause of death in Britain that is on the increase. Hospital admissions for alcoholic liver disease among people in their early 30s in north-east England have increased by more than 400% in the past eight years.
Continue reading the main story “Start Quote
I was at the outer limit - stiff whisky or G&T before dinner, couple of glasses of wine or even half a bottle with it”
Tony Blair on his drinking habits in office Alastair Campbell, Tony Blair's former spokesman, has recently pointed out that middle-class professionals are now the most frequent drinkers in the country. According to the Office for National Statistics 41% of professional men drink more than their daily limit at least once a week. But instead of targeting the Rioja-drinking classes, the focus of much rhetoric was on the damage done by public drunkenness. For many commentators, the government is pointing at the wrong group.
Nicholas Lezard wrote in the Guardian that Cameron is "trying to make us think of the proletariat getting smashed on cut-price lager". Rod Liddle in the Sunday Times agrees. "He [Cameron] doesn't mean someone who has spent the evening with a really nice Sancerre". He means the poor but "the poor, do not, on the whole, binge drink".
But is it really feasible to target the middle-class professional with their trusty gin and tonic or bottle of pinot noir? Jancis Robinson says it's all unworkable. "I really can't see how the government can effectively control what we drink in our own homes."
When - and how - to introduce a child to alcohol? Parents who drink a lot in front of their children may normalise the idea of heavy drinking. The Demos report, Under the Influence, argued that the government should consider issuing advice to parents about drinking in front of their children.
"This evidence, although limited, fits with what we know about behaviour - that steady exposure to norms and habits tacitly builds attitudes. Therefore more consideration needs to be given to advice that is given to parents about drinking in front of children."
Carrie Longton, co-founder of Mumsnet, says parents need to be aware how they're seen by the children. "You need to teach by example. What you drink is important." So careful about drinking that second glass of wine in front of the children.
Frank Furedi, author of Paranoid Parenting, agrees that parents have an important role to play. But far from avoiding alcohol in front of the kids, parents should allow teenagers to drink a little with a meal.
It removes the mystique of "an illegal drug" and makes it part of food culture, he argues. His view goes against official advice. In 2009, Sir Liam Donaldson, England's chief medical officer at the time, said that children aged under 15 should never drink alcohol.
Continue reading the main story Traditional social lubricant
Kate Fox Social anthropologist The British believe alcohol is a disinhibitor, that it makes people amorous or aggressive.
But it is possible to change our drinking culture. Cultural shifts happen all the time, and there is extensive evidence to show it doesn't take much to effect dramatic changes in how people behave when they drink.
These show that even when people are very drunk, if they are given an incentive - either financial reward or social approval - they are perfectly capable of remaining in complete control of their behaviour.
Read the full article by Kate Fox from October 2011
Figures from 2006 show that the UK was not even among the top 10 per capita alcohol consumers in Europe. And alcohol consumption has been falling here for the past decade. Beer consumption has been declining for decades. And last year for the first time, wine sales fell. Even the worry about youth drinking may be overdone. 2010 NHS statistics showed that 55% of 11 to 15-year-olds have never drunk alcohol, an increase on previous years. Longton says these figures should give parents the confidence to be firm: "My children will say 'mummy everyone's doing it' but the statistics don't bear that out."
Bartlett says that exaggerating the problem can have negative effects. It leads to false "social norming" - people thinking that everyone else is binge drinking so why shouldn't they. "One reason university students go on a bender is because they overestimate the amount all their peers are drinking." But publishing the facts can challenge this. Some student unions have begun putting up posters giving the real drinking statistics for students, which are on average often far lower than expected. Once the true figure is displayed, students tailor their drinking accordingly. In other words, it doesn't do any good to hype up the problem.
Misell accepts that the UK is by no means at the top of the drinking league. But he argues that people are still drinking too much. "There's a big gap between the perception and reality of light drinking. For many it's three or four pints. But the advice from the Chief Medical officer is 3-4 units a day for a man and 2-3 for a woman. In some cases two pints would put you over the recommended limit."
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