A coalition of leading alcohol policy experts, researchers and treatment specialists has published an ambitious roadmap for addressing the UK’s escalating alcohol crisis. The comprehensive vision document sets out measurable targets and evidence-based policies to dramatically reduce alcohol-related deaths and health inequalities over the next decade.

A Crisis Demanding Urgent Action

Alcohol harm presents a growing problem across British society, with far-reaching impacts on health, crime rates, social services and economic productivity. The COVID-19 pandemic exacerbated existing trends, with sharp increases in higher-risk drinking, hospitalisations and alcohol-specific deaths. Research indicates that if consumption rates don’t return to pre-pandemic levels, England will see an additional 147,000 cases of alcohol-related disease and 9,900 extra premature deaths by 2035, with those in deprived areas experiencing the greatest impact.

The total cost to society in England exceeds £27.4 billion each year, equivalent to £485 per person. In 2023 alone, approximately 153,000 working years of life were lost due to premature alcohol-related deaths among individuals aged 16-64.

Policy Progress Has Stalled

Despite these alarming statistics, meaningful policy progress has been absent. The UK Government last published a comprehensive UK alcohol strategy over a decade ago in 2012, and officials shelved many of its most effective proposed policies before implementation. Whilst Scotland and Wales have made progress with pricing and promotion measures where devolved powers allow, central leadership from Westminster has been lacking.

An Ambitious Vision for Change

The expert consensus document, titled “A Healthier Future”, articulates a clear vision: a society where alcohol harm is rare and equal opportunities for good health and wellbeing exist for all. To achieve this future, the alcohol policy framework identifies three ambitious but realistic targets.

Target One: Halve Risky Drinking

The strategy aims to halve the prevalence of risky drinking from one in three UK adults to one in six over the next ten years. Almost one-third of UK adults currently drink at risky levels, and halving this number would dramatically improve the health and wellbeing of millions whilst easing pressure on the NHS and public services.

Target Two: Transform Treatment Access

The UK alcohol strategy proposes to increase the proportion of people with alcohol dependence accessing specialist alcohol treatment to 50% within five years, and build capacity in the system for 80% of people with alcohol dependence to have access to treatment within ten years. Several needs assessments have shown considerable unmet need, with at best one in four people with alcohol dependence who want treatment currently in contact with services. This target must be supported by improving the response to alcohol harm in the wider health and care system with a priority on effective pathways between primary health care, acute hospitals and specialist treatment and support.

Target Three: Reverse Rising Death Rates

The plan seeks to reverse the trend of alcohol-specific deaths, returning to the pre-pandemic rate within five years, and subsequently to 2012 levels within ten years. This would bring the alcohol-specific death rate down from 15.9 per 100,000 to 11.8 per 100,000 over five years and then sustain progress by securing a further reduction to 11.1 per 100,000. Meeting this target would represent a 30% reduction of alcohol-specific death rates across the UK, a return to the lowest rates this century has seen so far.

Eight Priority Policies for the UK Alcohol Strategy

The expert panel rated policy options on effectiveness, cost-effectiveness and ease of implementation. Their top recommendations for a comprehensive UK alcohol strategy include:

Price Controls Through Minimum Unit Pricing

Experts recommend minimum unit pricing at 65p per unit in England, with regular increases in line with inflation. This targets fewer cheap, high-strength products that cause the most harm whilst generating minimal impact on moderate drinkers. The roadmap visualises this as a key pillar of the strategy.

Reinstate the Alcohol Duty Escalator

Officials should reinstate the alcohol duty escalator at a minimum of 2% above inflation to address the fact that alcohol is now 91% more affordable than in 1987, reversing decades of declining real-terms prices. Revenue raised for public services with alcohol duty represents a dual benefit of the policy.

Restrict Alcohol Marketing

The alcohol policy framework calls for comprehensive restrictions on alcohol marketing, with higher standards for alcohol marketing to protect children and people impacted by alcohol harm. As a minimum, restrictions should equal those applied for unhealthy food and drink. The alcohol industry spends heavily to promote consumption and widen its customer base, with children particularly exposed.

Empower Local Authorities

The strategy proposes empowering local authorities to regulate hours of sale and online deliveries of alcohol, giving communities tools to manage the availability of alcohol according to local needs. The number of licensed premises increased by 11% between 2000 and 2022, and rapid online delivery services have proliferated without adequate oversight.

Invest in Prevention and Treatment Services

Increased and sustained investment in prevention and treatment services is essential for earlier intervention, better treatment options, and fewer children living with parental alcohol problems. Commissioners should design alcohol services to be attractive and readily accessible to all age groups, genders and backgrounds, with robust pathways between primary care, acute hospitals and specialist services. The move of alcohol detoxification admissions from specialist addiction units to acute hospitals in England has shifted work to non-specialist settings, resulting in a pattern of unplanned care with admissions of short duration.

Mandate Health Information on Labels

The UK alcohol strategy recommends mandatory alcohol product labels featuring clear health warnings, ingredients, nutritional information and the UK low-risk drinking guidelines to improve public awareness from clear and mandatory alcohol labelling. Currently, alcohol products face fewer labelling requirements than most food items.

Lower the Drink-Driving Limit

Experts propose lowering the drink-driving limit to 20mg/100ml (0.02%) for new and commercial drivers, and 50mg/100ml (0.05%) for all other drivers, with the ambition to reach 20mg/100ml for all drivers as soon as possible. A lower drink-driving limit to save lives would align England and Wales with Scotland and most European nations.

Protect Policy from Industry Influence

Government guidelines on managing interactions with the alcohol industry would protect policymaking from vested commercial interests. National and local government guidelines should address managing conflicts of interest and navigating interactions with alcohol industry representatives, whether intended or unintended. Evidence shows that industry activities have defeated, delayed or weakened policies to reduce alcohol harm.

Strong Public Support

Contrary to assumptions about public resistance, polling reveals strong support for evidence-based alcohol policies. Seventy-four per cent want government policies to prioritise public health over business growth, and support for public health measures spans the political spectrum.

Public Back Minimum Unit Pricing

Specifically, 45% of the public support 65p minimum unit pricing, far higher than the 29% who oppose it. Comparative polling indicates that support for minimum unit pricing is higher in Scotland, where the policy already operates, compared to England, and public attitudes became more favourable over time after officials implemented the policy in 2018.

Strong Support Across All Policy Areas

Ahead of the 2024 Autumn budget, 47% said increasing alcohol duty should be a priority to support public finances, with only corporation tax receiving more support for an increase. Almost three-quarters (74%) want stronger measures to limit children’s exposure to alcohol advertising. More than half (55%) support restricting alcohol sales in shops to between 10am-10pm, and 72% believe public health should be considered when licence applications are made for alcohol outlets.

Ninety-three per cent believe everyone needing support for alcohol problems should be able to access it. Seventy-two per cent favour full ingredient and nutritional information on alcohol labels, with 62% wanting mandatory health warnings. Over two-thirds (68%) support a zero-tolerance approach to drink-driving, whilst 70% support protecting government policy from alcohol industry influence.

Support Will Continue to Grow

Progress in other public health areas indicates support will only grow: public backing for smokefree legislation increased from 51% in 2004 to 82% in 2014.

A Comprehensive Alcohol Policy Framework

A comprehensive set of policy measures is required because no single intervention can address the complex drivers of harm, which span pricing, availability, marketing and social norms. Evidence consistently demonstrates that population-level approaches, when implemented together, deliver the greatest impact in reducing consumption, preventing harm and narrowing health inequalities.

Cross-Government Working Essential

These high-impact policies fall under the responsibility of multiple government departments, making cross-government working fundamental to success of any national UK alcohol strategy. Engagement with civil society organisations and experts by experience will also be essential to ensure policies remain relevant, effective and responsive to those affected.

Expert Consensus Through Rigorous Method

The project convened a group of leading independent experts in alcohol policy, research and treatment, using the Delphi method, to develop this long-term vision for tackling alcohol harm and identify key policy actions required to arrive there. The expert panel identified key barriers, with the influence of the alcohol industry cited most frequently. Evidence shows industry activities have defeated, delayed or weakened the design, implementation and evaluation of policies to reduce alcohol harm, which is why public policymaking must be protected from vested commercial interests.

As progress is made, barriers will decrease in impact, whilst external factors such as public support, political interest and public sector resources will shift to facilitate further change. The accompanying theory of change, available in the technical report, illustrates how these high-impact policies support people in drinking less and help achieve the 10-year targets.

Expected Benefits of the UK Alcohol Strategy

The roadmap visualises the societal benefits that will result from implementing this alcohol policy framework. Within the next decade, the vision anticipates less burden on public services, a healthier workforce, fewer health inequalities and more revenue for the public purse.

Addressing Health Inequalities

Alcohol harm links closely to health inequalities. Alcohol-specific mortality rates are twice as high in England’s most deprived areas compared to the most affluent. Incidents of liver disease, which alcohol consumption is a major contributor to, are around five times higher in the most deprived areas compared to the most affluent. Politicians urgently need to prioritise public health over profits to prevent further avoidable injustice.

The Path Forward

The recently published 10 Year Health Plan for England contains limited commitments to prevent alcohol harm, which has driven calls for a standalone strategy to get to grips with the alcohol emergency. This expert consensus document offers that blueprint, demonstrating how implementing a comprehensive alcohol policy framework aligns with core government missions of economic growth, safer streets and building an NHS fit for the future.

Society-Wide Benefits

Furthermore, tackling alcohol harm will better enable the government to meet its core missions. The benefits of change will ripple throughout society: stronger families, healthier communities, reduced pressure on health and public services, safer streets and a more productive economy. For those who do need help, person-centred, accessible and well-integrated support must be in place.

Political Will Required

Action on alcohol harm is urgently needed and requires political leadership to create a healthier, more equitable society. With strong public support, robust evidence and clear targets, experts have mapped the pathway for an effective UK alcohol strategy. What remains is the political will to follow it.

Source: dbrecoveryresources