Preventing Alcohol-related Harm in Australia - Department of Health

on an informational approach, while still verycommon, have not been shown to prevent orreduce the harmful consumption of alcohol byyoung people, and in some cases have actuallybeen counterproductive by stimulating aninterest in drinking among young people.[13]In recent years, there has been a shift towardsnormative education, which aims to correctyoung people’s perceptions about their peers’drinking and thus de-normalise the harmfulconsumption of alcohol.[13] While this makesintuitive sense, it has been found that suchschool-based educational interventions, ingeneral, produce only modest results that areshort-lived unless accompanied by ongoingbooster sessions. Importantly, given there areconsiderable risks involved in school-basededucation, it has been recommended thatinvestment in such programs be accompaniedby a proportionate investment in evaluation.[7]There are some examples of sound outcomesbut these are relatively unusual. These generallyinvolve whole-of-community efforts and theyare usually associated with a close evaluationthat ensures they are implemented (withmodifications through feedback) as planned. InAustralia, these include the School Health andHarm Reduction Project (SHAHRP) in WesternAustralia[43] and the Gatehouse Project inVictoria, whose primary target was reducedschool bullying but where the side benefit wasa comparative reduction in the use of tobaccoand alcohol.[90] Related to alcohol educationprograms for school students are parenteducation programs. While some reviews citepromising signs of effectiveness, in general thereremains a lack of research to fully determine thevalue of such programs.[7]Low-risk drinking guidelines have beenadopted in many countries, including Australia,to provide advice on the health risks andbenefits of drinking at various levels for thegeneral adult population, and for particularsub-groups. Despite their popularity, thereis very little research that demonstrates theeffectiveness of guidelines.[13]However, guidelines do potentially fulfil animportant function as supporting informationfor other measures known to be effective,such as brief interventions in primary care, andas the basis for health promotion messagesand social marketing campaigns. In Australia,the current alcohol guidelines.[91] are underreview. New draft guidelines prepared forpublic consultation are due to be finalised andreleased in late 2008. The new draft guidelineshave been informed by updated modellingon the health risks of drinking, which haveproduced new estimates of the lifetime risksof alcohol-related harm. Emerging evidencealso indicates that previous studies claimingthe significant health benefits of alcoholconsumption have tended to overestimate theeffects. The consultation draft indicates themain changes are expected to include a newsimplified, universal guideline level for alcoholintake for both short-term and long-term risks,a new guideline with special precautions forchildren and adolescents, and a new guidelinefor pregnant or breastfeeding women.[18]Warning labels on alcohol products, while notrequired in Australia, have a high level of publicsupport. Evaluations of alcohol warning labelsare generally limited to the US experience,where labels were implemented in 1989. Whilethere is some evidence of effects on knowledgeand attitudes, there is no evidence that warninglabels influence drinking behaviour.[92] Bycontrast, the tobacco labelling experienceoffers strong evidence that warning labels canbe effective, not only in increasing informationand changing attitudes but also in changingbehaviour. These successes of tobacco warninglabels suggest that alcohol warning labelsshould be graphic and attention-getting,should occupy a considerable portion of thepackage surface, and should involve rotatingand changing messages.[92] Perhaps mostimportantly, they should complement and becomplemented by a wider range of strategiesaimed at changing drinking behaviour.36