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Changing Scotland's Relationship with Alcohol: A Framework for Action

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THE NEED FOR CHANGE

7. Alcohol is an integral part of Scottish life. Around the world Scotland is renowned for its whisky. Within Scotland we make many other types of alcoholic drink too, such as gin, vodka and liqueurs. We have breweries ranging from large plants to small craft breweries in even the most remote corners of Scotland and our high quality drinks are enjoyed both at home and abroad. The Scottish Government welcomes this positive aspect of our relationship with alcohol.

8. Despite this, it is possible to have too much of a good thing. Industry sales data shows that enough alcohol was sold in Scotland in each of the last three years for which figures are available, to enable every man and woman over 16 to exceed the sensible male weekly guideline on each and every week 4. Drinking above the Chief Medical Officers' recommended guidelines increases the risk of lasting health damage and there is clear evidence that increased consumption is driving increased harm. There were over 40,000 hospital discharges in 2007-8 5 due to alcohol related illness and injury, and alcohol related mortality has more than doubled in the last 15 years 6. In addition, we have one of the fastest growing rates of liver disease and cirrhosis in the world, leading the Chief Medical Officer to add alcoholic liver disease to the list of 'big killers' in Scotland, alongside heart disease, stroke and cancer. We see life expectancy in some parts of Scotland falling way short of life expectancy elsewhere, and we believe alcohol plays a significant part in these inequalities.

9. There are also social and economic costs of excessive alcohol consumption. Excessive drinking can cause families to break down; it can result in crime and disorder, especially at weekends; and it causes loss of productivity through sickness. We estimate that alcohol misuse costs Scotland £2.25 billion every year 7.

10. To be clear, we are not anti-alcohol. We recognise that Scotland has and will continue to have a relationship with alcohol. We also recognise that for many of Scotland's people, that relationship is a balanced, positive and enjoyable one. But there is also clear evidence that for a large section of the Scottish population their relationship with alcohol is damaging and harmful - to individuals, families, communities and to Scotland as a nation. The harm caused by alcohol misuse has become a major challenge affecting Scottish society and we are determined to meet that challenge - by taking action now to tackle an urgent problem through legislative change and improved services and treatment, and by building an environment that supports cultural change in the longer term.

11. Alcohol misuse is no longer a marginal problem, with up to 50% of men and up to 30% of women across Scotland exceeding recommended weekly guidelines. That's why we are aiming, consciously, to adopt a whole population approach. This isn't about only targeting those with chronic alcohol dependencies or those who suffer the greatest health inequalities, (although we recognise that these groups suffer the greatest harm and that they require specific supports and interventions). Neither is it about demonising young people; or focusing only on people who offend or become antisocial when drunk. Our approach is targeted at everyone, including the 'ordinary people' who may never get drunk but are nevertheless harming themselves by regularly drinking more than the recommended guidelines. If we can reduce the overall amount that we all drink in Scotland, and if we can change the way we drink, then we will all reap the benefits. As individuals, we will be at less personal risk of physical harm; as a population we will reduce the damage to families and communities across the country.

12. Sensible drinking guidelines are lower than people think. The recommended guideline is that women should not regularly drink more than 2-3 units per day and men should not regularly drink more than 3-4 units per day. In addition, Government recommends that everyone should aim to have at least 2 alcohol free days per week. Over the course of a week, therefore, it is recommended that women and men should not exceed 14 units and 21 units respectively. A pint of 5% beer is around 3 units; a 125ml small glass of 12% wine is 1.5 units whilst a medium glass (175ml) is over 2 units; a small measure (25ml) of spirits is 1 unit. A 2 litre bottle of strong white cider at 7.5% contains 15 units.

13. We want to encourage people to become more aware of what they are drinking as we know that many people underestimate their consumption. We are not asking individuals who already drink sensibly to drink even less, or necessarily change their drinking habits in any way. But for those who do drink beyond recommended guidelines we would ask them to reflect on their levels of drinking, the harm it is causing them and possibly those around them - particularly for parents where their drinking may be affecting children. We would encourage those individuals to look at reducing their consumption. We need to work together to create an environment which enables individuals to tackle their alcohol misuse, or prevent it happening in the first place. But most of all, we need individuals to look at their own consumption; look at their own relationship with alcohol.

14. When people recognise the harmful effects of alcohol they look to Government to pick up the pieces. The best way for Government to tackle this is to try to stop the harm before it happens. However, we can't sort out all of the problems alone. Alcohol misuse is a complex issue involving a multitude of factors, including socio-economic, cultural, educational, community-based, health-related, or linked to individual behaviours and choices. This means there is no "miracle cure" or "one size fits all" solution. Our Framework for Action must link to and work in conjunction with our policies in other, related fields, including on early years, poverty and health inequalities. And the Framework will only work if taken forward as a multi-stranded package of measures in which everyone has a part to play - whether in central government, local government, the police, the health service, the third sector, alcohol producers or retailers and the public.

15. What we need is real, lasting social and cultural change. That's not something any government can deliver on its own but it's a challenge on which we need to step forward and show leadership. We make no apologies for starting the debate and acting without delay to introduce the legislative proposals we believe are necessary to reduce consumption. We also recognise that real social change will come about not through legislation alone, and that only individuals can actually make the decision to change. But we will work with stakeholders and industry to create the climate for that change by encouraging ongoing honest debate; through education; through reflection; through everyone bringing ideas and actions into being.

16. All of this will not happen overnight and we are embarked on a journey which will challenge many of us to re-think some deeply held assumptions and beliefs. But attitudes to smoking are changing. We believe that attitudes to alcohol misuse can change too.