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Health experts react with alarm to findings of new alcohol study

Sue Taylor

Sue Taylor, Head of Alcohol Policy for Fresh and Balance

Posted 19/01/22

Balance together with doctors expressed alarm at a major new study showing that those already at risk of harm from drinking bought significantly more alcohol during Covid-19 lockdowns – with households in the North buying more.

The study, published today (Wednesday 19th January) in international scientific journal PLOS ONE, could help to explain why 2020 saw the biggest jump in alcohol-related deaths in the UK in the last two decades. The analysis also showed that the increase in purchasing was less pronounced in Scotland and Wales compared to England, which could be down to the Minimum Unit Pricing (MUP) policy currently in place in both Scotland and Wales – which has already been shown to reduce supermarket and store purchases of alcohol, particularly amongst some of the heaviest-drinking households.

Academics from Newcastle University and the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria, examined Kantar shopping data from 80,000 households and found that Britain’s heaviest drinkers - those in the top fifth of households that would consistently purchase the most alcohol - bought around 17 times more from shops and supermarkets than the bottom fifth during the lockdown period between March and July 2020.

The average purchase per adult within the top fifth group was significantly higher than any other group – at around 38 units per week – which equates to just under a litre of 40% ABV vodka or four bottles of 12% ABV wine per person.

2020 was a record year for alcohol deaths. The latest Office for National Statistics (ONS) data reveals there were 8,974 registered deaths from alcohol-specific causes registered in the UK in 2020 - an 18.6% increase compared with 2019 and the highest year-on-year rise in 20 years.

Sue Taylor, Head of Alcohol Policy for Balance, said: “This report highlights an urgent need for action - the UK was already at crisis point with alcohol long before Covid, but the pandemic saw a tipping point. Cheap alcohol together with the terrible anxieties of Covid created a “perfect storm” which resulted in millions more drinking at risky levels, problems for families and heavy use turning into dependency.

“There is strong support for more action from the Government to tackle alcohol harms in our communities. Alcohol is too cheap, too available and too heavily promoted. We need evidence-based action now before millions more families suffer, starting with a Minimum Unit Price to save more lives.”

Dr James Crosbie is a GP and consultant gastroenterologist with South Tyneside and Sunderland NHS Foundation Trust and argues that the spate of drinking deaths during the pandemic was a tipping point following decades of alcohol abuse. He said: “These figures are shocking and unacceptable, especially in the impact they are having in poorer communities and the North. Here in the North East we saw the worst rate of alcohol deaths in the country – often among people buying the cheapest strongest alcohol.

“Heavy drinking causes wear and tear on the body and both short and long-term health risks, from at least seven types of cancer including bowel and breast to heart disease and stroke, high blood pressure, liver disease and mental health problems. We can certainly see the impact of alcohol in the problems and the concerns that patients are presenting with in clinics. It’s perhaps no wonder when alcohol is sold so cheaply and promoted almost everywhere.”

But Dr Crosbie, who is Clinical Lead for Alcohol for the North East and North Cumbria Integrated Care System, added: “This is not a problem that will just come and go with the pandemic, unless we take action. A large proportion of alcohol deaths during Covid have been fuelled by liver disease which is now the third leading cause of preventable death in the UK. Liver deaths have been rising in the UK for decades and the pandemic was a dreadful tipping point.”

Alice Wiseman, Director of Public Health for Gateshead and lead Director of Public Health for the Association of Directors of Public Health has been a prominent voice during the pandemic, and said: “Just like COVID, the vast swathe of alcohol harm falls on the most deprived people in our communities. This is especially worrying for regions like the North East where even before the pandemic we already suffered from the highest rates of alcohol-related death and illness in England.
“As alcohol has got cheaper, the harm to individuals and communities has got worse. It is a scandal that people can drink a week’s worth of alcohol for the price of a coffee. It is particularly damning that in England we tolerate this harm while Scotland has a minimum unit price for alcohol and has not seen such a rise in deaths.”

Peter Henderson, 43, from Hebburn in South Tyneside is coming up to two years sober in February after undergoing treatment for alcohol addiction. His secret drinking spiralled and led to family breakup and losing his job. Now after being diagnosed with fatty liver disease, he has been told that drinking again could seriously harm his health.

He said: “When I look back at what I went through I do now shudder to think I could have been one of these statistics had I not stopped drinking just before the pandemic hit. I have been close to death, am now on medication and probably will be for the rest of my life but at least I am alive and no longer drinking.

“It is no surprise people drink at times of stress and worry. I’d drink, wake up feeling worse, emotions running riot, and start drinking again to feel normal. I’d get a pint down which was awful but you get through it and then move on to the vodka. It is still incredibly cheap – you see people asking for change so they can pull together enough to buy a few cheap strong cans.

“I began drinking at 13 with friends and it’s so easy when alcohol is so cheap and widely available and you could get it for 69 pence for a bottle of cider. And with the amount of advertising the pressure is always there to drink for people who are becoming dependent – whether it’s the summer, watching football or at Christmas.”

Liver specialist Professor Sir Ian Gilmore, Chair of the Alcohol Health Alliance, said: “This latest research on alcohol sales over the course of the pandemic highlights the urgent need for the Government to take action to protect the most vulnerable drinkers and disadvantaged communities from alcohol harm.

“We know the number of high-risk drinkers in the UK is on the rise. Numerous lockdowns, isolation, bereavement, and job losses have changed many people’s relationship with alcohol over the course of the COVID-19 pandemic. We have seen deaths linked to alcohol reach record numbers and one in five people in the UK currently drink alcohol in a way that could harm their liver.

“The alcohol harm crisis will continue to deepen if the Government doesn’t take action now. This study suggests that minimum unit pricing can make a difference to purchases – with household alcohol purchases from shops and supermarkets in Scotland and Wales not increasing by the same level as England over the course of the 2020 lockdown. By failing to implement minimum unit pricing as part of its plans for public health, England is now falling further behind the rest of the UK in the race to tackle alcohol harm.”

Adults buying around a litre of vodka each week
This latest research analysed recorded shopping data from almost 80,000 households between 2015 and 2020, which included around 5 million purchases of alcohol, to map-out buying habits over time.

The average purchase per adult within the top fifth group was significantly higher than any other group – at around 38 units per week – which equates to just under a litre of 40% ABV vodka or four bottles of 12% ABV wine per person. However, this was averaged out per household, which could mean individuals in many households were drinking much more than this amount. Also, the shopping data may not have included extra ‘top-up’ purchases of alcohol that weren’t recorded – meaning actual levels could have been higher.

Households in more socially disadvantaged areas also bought more, as did those living in the North of England.

Unravelling a paradox
The study was carried out in an attempt to unravel what appeared to be a paradox between purchase data, public surveys and alcohol deaths – where overall shopping sales data had suggested that alcohol purchases in Britain did not appear to significantly increase after Covid-19 lockdowns were first announced in March of 2020, once the missing sales in pubs, clubs, bars and restaurants had been taken into account. However, many public surveys had suggested an increase in alcohol-related problems, and ONS data showed a sharp rise in deaths that were directly linked to alcohol misuse, indicating that some people were drinking a lot more.

This new study looked at that shopping data again - this time linking it more closely to factors such as household income, geographical location, alongside how much alcohol households would typically buy before lockdown.

The new analysis showed that the top fifth of households in England that would normally buy the most alcohol in shops and supermarkets increased their purchases around 17 times more than the bottom fifth. Households in more socially disadvantaged locations also bought more.

The study also found that households in the North of England - including the North East and Yorkshire and Humber regions - increased their purchases more than in any other part of Britain, with the suggestion that this is probably because the North has more heavier-purchasing households.

Patterns were different in Scotland and Wales
The analysis also showed that the increase in purchasing was generally less pronounced in Scotland and Wales compared to England, which could be down to the Minimum Unit Pricing (MUP) policy currently in place in both Scotland and Wales – which has already been shown to reduce supermarket and store purchases of alcohol, particularly amongst some of the heaviest-drinking households.

The study comes as figures released earlier this week from the Government’s Office for Health Improvement and Disparities showed that around eight million people in England are drinking so much wine, beer or spirits at home that it is harmful to their health, with a large increase in the numbers of people drinking at levels considered to be dangerous.

Authors call for a focus on policies that reduce high levels of drinking

Lead author, Professor Peter Anderson from Newcastle University said:

“Our analysis has highlighted that the heaviest drinkers and those living in some of the most deprived communities in the UK have increased their household alcohol purchases significantly during Covid-19 lockdown periods, with undoubted consequences for both physical and mental health - and in many thousands of cases sadly leading to death.

“This suggests that a focus on policies to reduce high levels of drinking are even more important in extraordinary times, such as those we’ve seen since March 2020 - where a complex range of factors can lead to higher and potentially dangerous levels of longer-term drinking.

“It’s also interesting to see that the increase in purchases were much less-pronounced in Scotland and Wales, which could be down to the minimum unit pricing policy in these devolved areas – a policy that has been proven to reduce alcohol purchases amongst the heaviest drinkers.”

Report co-author Dr Amy O’Donnell from Newcastle University added: “When we look at the latest figures for alcohol-attributable deaths for 2020, most of these are related to chronic, longer-term conditions associated with continued misuse of alcohol.

“It’s therefore likely that the significant increase in alcohol-attributable deaths we’ve seen in 2020 will have been amongst those with previous history of alcohol misuse or dependence, and our latest analysis of buying habits appears to support this.”

Report co-author Professor Eileen Kaner, Professor of Public Health and Primary Care Research at Newcastle University and Director of the NIHR Applied Research Collaboration (ARC) North East and North Cumbria, said: “Our research paints a worrying picture, where those already at risk of health harms from higher levels of drinking appear to have increased their drinking even more during lockdown. This comes with potentially serious consequences for individual health outcomes as well significant impacts on health services including primary care, mental health services, addiction support services, acute care and more.

“Covid-19 has undoubtedly had an impact on drinking habits within the UK. As we continue to live in uncertain times whilst moving towards ‘recovery’ from Covid-19, it’s even more important that we focus on alcohol harm prevention strategies, including those that limit very low pricing of alcohol.”