Alcohol misuse: tackling the UK epidemic - London

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BMA Board of Science
Recommendation
Taxation on all alcoholic beverages should be increased at higher than inflation rates and
this increase should be proportionate to the amount of alcohol in the product.
Licensing reforms
Licensing interventions are one of the most influential methods for controlling alcohol consumption
and misuse through regulation of where, when and to whom alcohol can be sold. There is strong
evidence that increased opening hours are associated with increased alcohol consumption and
4, 57, 114, 115, 117
alcohol-related problems.
A literature review conducted by the Scottish Executive in 2003 on the impact of licensing and other
controls on public disorder found that, although there is inconsistent evidence relating to the impact
of licensing controls in the UK, there is international evidence to support the idea that longer hours
of alcohol sales may be linked to increased problems with alcohol-related crime and disorder. 129
A study in 2002 noted that past increases in hours of alcohol sales in Michigan, Perth, New South
Wales, Victoria, Tasmania, Brisbane, Finland and Sweden have been shown to result in increases in
road deaths and injuries and/or violence. 130
In a study in hotels in Perth, Australia, late trading was
found to be associated with both increased violence and increased levels of alcohol consumption
during the study period. 131
It is suggested that greater numbers of patrons and increased levels of
intoxication contributed to the observed increase in violence. 131
Several controlled and uncontrolled studies in Nordic countries with State alcohol monopolies have
shown that major relaxations in controls on beer strength or sales outlets were followed by
increases in alcohol consumption, drunkenness and alcohol-related hospital admissions. 132
The
extension of licensing hours in Reykjavik, Iceland, was found to result in net increases in police
work, in emergency room admissions, and in drink-driving cases. 123
The extension of opening hours
for pubs and clubs in the Republic of Ireland following the introduction of the 2000 Intoxicating
Liquor Act was found to result in a number of negative consequences including a significant rise in
binge drinking, especially among under-age drinkers. 4
Conversely, reductions in the opening hours
and the number of outlets are associated with reductions in alcohol use and related problems.
Reductions in licensing hours in Norway, Finland and Sweden led to a decrease in the alcohol
consumption of heavy drinkers. 133
In the UK, access to alcohol has increased significantly due to the doubling in the number of onand
off-licensed premises since the 1950’s. In 1953, there were 61,000 on-licensed premises and
24,000 off-licensed premises in Great Britain. 134
In 2001, the total number of on-licensed and offlicensed
premises in England and Wales was estimated to be 110,000 and 44,700 respectively. 135
Despite the evidence that increased opening hours and availability of alcohol are associated with
greater consumption and alcohol-related problems, recent and proposed changes to licensing
policies in the UK have favoured extended trading hours. The Licensing Act 2003 now permits
24-hour opening in England and Wales, while proposed changes to licensing in Scotland and
Northern Ireland will permit more modest extensions in opening hours. The licensing reforms in
England and Wales were introduced in 2005 with the aim of altering the drinking culture, reducing
binge drinking levels and reducing the tendency of drinkers to rush to consume alcohol immediately
prior to closing time. 4
Of particular note, however, is the fact that public health is not considered as
one of the licensing objectives in the 2003 Act. 136
By contrast, the Licensing (Scotland) Act 2005
specifically mentions ‘protecting and improving public health’ as one of the licensing objectives. 137
Alcohol misuse: tackling the UK epidemic