Public Health England Alcohol Evidence Review

In 2016 Public Health England published an internationally acclaimed comprehensive overview of alcohol-related harm in England and the potential policy solutions. The review was commissioned by the Department of Health & Social Care. A short version appeared in the Lancet.

It provides a rigorous summary of the types and prevalence of alcohol-related harm, as well as presenting evidence for the effectiveness and cost-effectiveness of alcohol control policies.

The public health burden of alcohol is wide ranging, relating to health, social or economic harms.  As well as harms to the individual, alcohol also causes harms to other people, including relationship partners, children, relatives, friends and work colleagues.

The review finds that the economic burden of alcohol is substantial, with estimates placing the annual cost to be between 1.3% and 2.7% of annual GDP.

The extensive range of policies which seek to mitigate harms caused by alcohol are described along with evaluations of how they vary in their effectiveness and cost-effectiveness.  The main findings for effective policy options in the review are:

• That reducing the affordability of alcohol as the most effective and cost-effective approach to prevention and health improvement; finding that a combination of tax increases and setting a Minimum Unit Price is likely to lead to substantial reductions in harm and increases in government revenue.
• Robust marketing regulations are strongly supported by the evidence base, particularly those that reduce the levels of exposure in children.
• Policies that sufficiently reduce the hours during which alcohol is available for sale, particularly late-night on-trade sale, can substantially reduce the public health burden of alcohol and are cost-effective when simultaneously enforced and targeted at the areas with the highest alcohol outlet density.
• Health interventions aimed at drinkers who are already at risk such as Identification and Brief Advice (IBA) and specialist treatment for those with harmful drinking patterns and dependence are also found to be effective and cost-effective if delivered at scale.

Public Health England conclude that implementing a mix of policy interventions may create a critical mass effect, changing social norms around drinking to increase the impact on alcohol-related harm.

Implications for Drinkaware

The remit of Drinkaware (about us) is to provide alcohol education to the public, raising awareness of alcohol harm and helping people to make informed choices about their drinking. As such, our information, guidance and tools for people to self-assess and monitor drinking contribute to a wider mix of interventions and policies that should work together to reduce alcohol-related harm.

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A short version was also published in the Lancet and the aims, objectives and some of the implications of the review are discussed in a blog.