Transcript Slide 1

CLEAR HEADS
ALCOHOL WORKSHOP
YHPHO: helping Social Marketers develop Insight
Scott Anderson
Ceri Wyborn
22Sep09
What we’ll cover
• YHPHO support for Social Marketing
• What data is available for Alcohol
• Activity
The main message from this session…..
What we’ll cover
• YHPHO support for Social Marketing
• What data is available for Alcohol
• Activity
Of the five stages of a Social marketing project, the PHO
can contribute most to the vital first Scoping stage
Engaging stakeholders
& partners
Reviewing relevant evidence
& practice
Clarifying aims & intentions
Developing customer insights
Resources review
Relationship to other interventions
Considering ethical issues
Audience segmentation & focus
Potential behavioural focus
Developing behavioural goals
Developing an initial
‘proposition'
The role of the PHO
To share existing data, information, intelligence and insight from past
projects
To support the generation of new insights for local and regional SM
projects
We can help provide answers to some Killer Questions
•
Who experiences this issue the most? Why them? What makes them different?
•
What are their motivations in this area? What makes people act as they do?
•
What are the key factors/trends affecting society on this issue (positive & negative)?
•
What are the key triggers of action eg lifestyle change, event, time?
•
What are the key barriers that stop people doing things?
•
Who are the key influencers in this area and what impact do they have?
•
What other parts of NHS/organisations/bodies/DH might have related issues, and
what avenues are they exploring?
•
What programmes/policies have been most and least successful and why?
To do this, we are building on our existing area of expertise
Cost-effectiveness studies
Routine health data
National quantitative surveys
Local quantitative surveys
Qualitative research
Reviews of interventions
We have the people and tools to support this expansion
People
• 35, of which 8 are new HIYAH posts
• Analysts/Specialists, Knowledge
Managers and Health Economists
Tool
What is it?
One Stop Shop
Database of unpublished research
(NSMC)
Axciom
Lifestyle database
Social Marketing Forum
Hub
Web-site containing best practice
examples of SM in region
Acorn, Health Acorn,
Mosaic, P2, OAC
Geodemographics
Healthy Foundations
Segmentation, including
access to TGI
Based on wide range of health
attitudes and behaviours (NSMC)
We will concentrate on supporting major regional initiatives, but
the information and insights gathered will be available to all
projects in the theme area
Area
Timing
Project
Alcohol
22Sep09
Regional workshop
Sexual Health
Oct09
Scoping report on Teen Pregnancy in Whitby
Jan10
Regional workshop
Nov09
Regional Workshop
Breast-feeding
Cervical
Screening
Healthy Ambitions Pathways
Mental Health
End-of-life
Stroke
Primary Care
Obesity
What we’ll cover
• YHPHO support for Social Marketing
• What data is available for Alcohol
• Activity
What data is available for Alcohol
• Routine health data/national surveys
– Who is being treated for what? Who’s doing what?
• Segmentation
– Who should we target? Where are they? How do we reach them?
• Other research (qualitative, local surveys, systematic reviews)
– Why are they doing it?
– What works?
Routine health data/National Surveys
• North-West data
• Survey data
• Modelled estimates
• Analysis based on HES data
• Analysis based on mortality data
North-West Public Health Observatory
• Local Alcohol Profiles
• NI 39 datasets
• Alcohol attributable fractions
• Other reports e.g Regional
indications
Survey Data
• General Household Survey (GHS) Smoking and drinking among
adults, 2007
• Omnibus Survey - ONS Report No. 34 Drinking: adults’ behaviour
and knowledge in 2007
• Health Survey for England (HSE) Healthy lifestyles: knowledge,
attitudes and behaviour, 2007
• Drug Use, Smoking and Drinking among young people in England
2008 – ONS/ IC
• Infant Feeding Survey 2005, ONS
• Adult psychiatric morbidity in England, 2007 ONS/ IC
• Youth Survey 2008:Young people in mainstream education, YJB
• The Great Drink Debate 2009, DH
• Statistics on Alcohol: England, 2009, IC
Examples
Modelled Estimates
– Expected values based on the given characteristics of an area
– Uses data from Health Survey for England
– Available at different geographical levels
– Calculated 2003-05
Hospital Admissions/ Mortality Analysis
Yorkshire and Humber HES Analysis
• Complex data
• Data from Sept 2007- Feb 2009
• All Y&H PCTs
• Alcohol Specific Admissions
• Length of Stay
• Emergency Re-admissions – 1,2,3 and 10 times
• Further analysis done for N Lincs PCT
Mortality Analysis
• ONS – Alcohol Related Deaths
• NWPHO – Months of life lost
– Alcohol specific mortality
Hospital Admissions Analysis
Alcohol Specific Admission rates
Alcohol Specific Re-admissions –
Re-admitted Ten Times (percent)
Mortality Analysis (example – Leeds PCT)
Alcohol-attributable mortality – males
(all Y&H) PCTs
A number of Segmentation tools are currently available or
in development
• North-West segmentation
• CACI segmentation
• Healthy Foundations segmentation
North-West Segmentation uses Mosaic together with existing
datasets to estimate the prevalence of hazardous/harmful drinkers
Big
Drink
Debate
NW Regional
Lifestyle
Survey
TGI Lifestyle
Data
Mosaic
Source: Using Geodemographics to segment the market
for hazardous and harmful drinkers in Cheshire & Merseyside
(H Carlin, M Morleo, PA Cook, K Tocque, Dec08)
The analysis identified the incidence of hazardous/harmful
drinkers within each Mosaic segment
Proportion of Mosaic category who are:
Hazardous drinkers
Harmful drinkers
The combination of data gives a fairly rounded view for each
segment, of the lifestyles of households and their attitudes and
behaviours with respect to alcohol
Ties of Community
Close-knit, inner-city and manufacturing town communities
Strong social networks with friends and relations nearby
Younger than average; many with young children; significant numbers who
have experienced relationship breakdown
Higher than average unemployment, due in part to long-term illness or disability
Men tend to be less happy with their life than average
14% of men drink daily; drink of choice is beer; they tend to feel that ‘the point
of drinking is to get drunk’, and that ‘a real man can down several pints in
one sitting’
Not likely to entertain a great deal at home
A decision was made to prioritise heavy male drinkers within the
Ties of Community segment, so qualitative research was
conducted to provide more insight into this group
Method: combination of interviews - individual, friendship
pairs, couples, landlords (36 in all) – and in-pub
observation. Drink diaries.
Sample: 50% 35-44s, 50% 45-54s; all C2DE; 50% single,
50% married; all drinking at least 2 days/week; range of
heavy/medium/light drinkers
Key findings: Accept that excessive drinking can damage
health (liver disease)…but most underestimate their own
drinking and don’t see it’s a problem for them. Units are
known about, but not understood.
Heavy drinking is an expected rite of passage; key driver
of behaviour is reaction to life events – responsibilities
such as work/family lead many to moderate drinking;
divorce/unemployment may increase it.
Desire to socialise outside home leads men to pub which
leads to drink. Benefits of socialising/escape/reward
outweigh concerns about cost or health
Source: ChaMPs Alcohol Insight (Consumer Culture, Apr09)
Within Y&H, the Ties of Community segment is concentrated around major
conurbations – it’s likely that their behaviour/attitudes area similar to those in the
North West
An alternative segmentation based on CACI (Health Acorn)
is under development by DH
Hospital
Admissions
data
Qualitative Research
(2CV)
Health Acorn
Segmentation
TGI Lifestyle
Survey
North West acquisition pilot
East Midlands acquisition pilot
Family
Expenditure
Survey
CLEAR HEADS
ALCOHOL WORKSHOP
YHPHO: helping Social Marketers develop Insight
Scott Anderson
Ceri Wyborn
22Sep09
Healthy Foundations is an over-arching segmentation
to address a range of health behaviours, to be launched in
regions Spring/Summer 2010
Objectives
1. To provide a more robust understanding of the attitudinal
and environmental drivers of health related behaviours
2. To provide a comprehensive life stage analysis of the
population of England
Method
Theoretical Model/Hypothesis : developed by expert reference group.
Survey: face-to-face interviews with 5500 people aged 12-74 in England
Clustering analysis: to define 5 motivational segments based on attitudes
Fusion with TGI lifestyle data: to enrich picture of each segment
Qualitative research: to further flesh-out understanding of segments
Output
Segmentation based on 3 dimensions:
motivation: Health-conscious Realists to Unconfident Fatalists (5 groups)
environment: based on IMD quintiles (2/3 groups)
lifestage: Discovery Teens to Active Retirement (9 groups)
Other research
• Where’s it come from?
• Some examples
Other research has come from a wide range of sources
International
National
Regional
Local
Tools
Why?
Qualitative

Quantitative
eg Lifestyle
surveys

Systematic
Reviews
What
works?

It’s more useful to sort by target audience
General
Under-age
(street-drinking)
Young adults
(binge-drinking)
Older adults
(hazardous/harmful)
Also:
Male vs female
Urban vs rural
There’s a wide range of information, from a variety of
sources
General
Drinking places: where people drink & why
JRF, 2007
Attitudes towards alcohol in London
GLADA, 2002
Drinking in Scotland: qualitative insights into influences,
attitudes & behaviours
ISM,2008
Lifestyle surveys eg Hull, Rotherham
Under-age
Use of alcohol among children & young people
DCSF, 2008
Young people’s street-drinking behaviour: investigating the
influence of marketing and sub-culture
AERC, 2007
Underage ‘risky’ drinking: motivations and outcomes
JRF, 2005
Young people and alcohol advertising
OFCOM, 2007
Mine’s a Lambrini
Hull Citysafe, 2008
There’s a wide range of information, from a variety of
sources
Young adults
Drunk and disorderly: a qualitative study of binge-drinking
amongst 16-24 year olds
Home Office, 2003
Young people and alcohol: meanings, practices & contexts DCSF, 2009
Excessive drinking
NHS Barnsley,
2009
Older adults
Birmingham untreated heavy drinkers
2007
Systematic reviews
Effectiveness of brief alcohol interventions in primary care
populations
Cochrane review,
2007
Impact of alcohol consumption on young people
DCSF, 2009
Example 1: Young peoples street-drinking behaviour
(AERC, 2007)
Method
• 24 In-street group discussions
• Range of locations in Glasgow
• 16-25 year-olds (98 in total)
• Male (69) and female (29)
• Neds, alternative & mainstream
Source: Young People’s Street Drinking Behaviour:
Investigating the Influence of Marketing & Subculture (J Galloway,
A Forsyth, D Shewan, Glasgow Centre for the Study of Violence, Feb07)
Findings
•
For many, street-drinking is a forced choice, due to
exclusion from indoor settings by age, poor behaviour
or cost. However, for some it is a choice as it’s less
physically and socially restricting, and a chance to
preload on cheap alcohol before going to pub/clubs
later.
•
Preferred drinks are those that offer good value for
money (in terms of cost:strength ratio); have a
pleasant taste; are convenient for outside drinking
(easy to carry/conceal; screwtop for resealing). Neds
prefer Buckfast Tonic Wine; other groups reject it,
preferring vodka/Lambrini/etc
•
All tended to buy their alcohol from smaller offlicences or corner shops: underage because they felt
they’d be more successful; overage, because it’s a
more discreet way of buying brands associated with
street-drinking
Findings
•
Perceived risks are being detected
by police (particularly for Neds),
and the threat of violence
(particularly others, from Neds!).
Females felt less at risk of
violence, but had some concerns
about sexual harassment
•
Neds choose drinking locations to
avoid the police (moving around
between hidden locations); others
choose locations to avoid Neds.
•
Suggestions for reducing risk
included: more age-appropriate
leisure activities; lowering the age
limit for drinking in pubs/clubs;
designated areas for drinking
outside; plastic rather than glass
for recognised ‘street drinks’
Example 2: Excessive drinking (NHS Barnsley, 2009)
Method
• Desk research
• 6 Stakeholder depth interviews
• Immersion days – observation;
interviews with bar staff & customers
• 12 drinking-buddy mini-groups
–
–
–
–
3 females per session
Age range 18-35
Mix of hazardous/harmful drinkers
Mix of lifestage
Source: Excessive Drinking (K Siddall, J Walker, D Waring;
Quaestor, Mar09)
Findings
Why do they drink?
–
–
–
–
–
Nothing else to do
Stress relief/time-out from kids
Female bonding
To gain confidence
Why not? It’s not a problem, it’s normal
Attitudes
– Strong drinking culture passed down
through generations
– Not recognised as a health or social
issue
– Low awareness of (and interest in) longterm effects
– Little understanding of units
– Feel that it’s only regular drinking that’s
an issue; so more in control of their
drinking than when younger
Findings
How do they drink?
– Mainly in single-sex groups
– In-home (keep the kids busy together)
– In town (time to get away from the
kids)
– School holidays/weekends is a key
time
– Drink excessively twice a week rather
than moderately every day
Environment
– Many rely on Barnsley for
entertainment, but lack of social
facilities/amenities
– Very price-conscious, so cheap
alcohol promotions are appealing
– Key route around town, with
deviations to follow promotions
Example 3: Effectiveness of brief alcohol interventions
in primary care populations (Cochrane Review, 2007)
Method
– Selection criteria:
• Randomised controlled trials
• Patients presenting to primary
care not specifically for alcohol
treatment
• Brief intervention of up to 4
sessions
– Databases search yielded 29
RCTs (over 7000 participants)
Key findings
– After one year, those who received the brief intervention drank less
alcohol than the control group (averaging 38gms/wk less)
– For men, the difference was 57gms/wk; for women, there were no clear
differences
– Longer counselling had little additional benefit
Source: Effectiveness of brief alcohol interventions in primary
care populations (Cochrane Review Apr07)
What we’ll cover
• YHPHO support for Social Marketing
• What data is available for Alcohol
• Activity
Activity: the bottle bank
• Spend 10 minutes
looking for
something
interesting in the
bottle bank
• Find a partner
• Spend 5 minutes
sharing what you’ve
found
Key messages
YHPHO is ready to support Social Marketing projects in the
region
Over and above the data you’re used to, there’s a lot of
useful information out there to help you understand your
customers in more depth, and what interventions work
We can help you find it, separate the wheat from the chaff,
and make sense of it
So the main message from this session is…..
Pick up the
ne…before you…reinvent the wheel
Insight & action to help reduce levels of hazardous and
harmful drinking (DH, 2008)
Background
Early stage of DH Segmentation development
Method
• Pre-placement one week drinking diary
• Observation
• In-depth interviews/groups
• Alcohol reduction exercise
• Further in-home interviews
• High-end hazardous/harmful (including some high-end harmful)
drinkers
• Age 35-59; mix of male/female and of on-trade/off-trade drinkers
Source: Insight & action to help reduce levels of
hazardous and harmful drinking ( 2CV, Feb08)
Findings
• Alcohol is a backdrop to their life. Much of their
consumption goes un-noticed (by them) – they
only count ‘getting drunk’. They see their drinking
levels as normal vs peers.
• Alcohol is part of who they are – they believe it
enhances their personality and it’s a key factor in
how they form relationships.
• They are ambassadors for alcohol, holding
strong positive attitudes towards heavy
consumption. They see themselves as experts,
and drink under an illusion of control (vs say,
young binge-drinkers)
Nine segments were identified, which can be mapped on to
an underlying needs-based matrix
Two examples from the extremes of the needs-based
matrix: Conformist and Hedonistic
Impact of Alcohol Consumption on Young People: a
systematic review of published reviews (DCSF, 2009)
Method
– Selection criteria:
• Main focus on children 5-19 (but also looked at 20-25s)
• Reviews considered if included studies on consumption of alcohol and its
impact on health
– Search of databases using agreed terms yielded 162 papers (of which
102 used in report)
Selected findings
– The risk factors associated with alcohol misuse by children and young
people, include (amongst others) genetic predisposition and
physical/sexual abuse in childhood
– Excessive criticism of their drinking behaviour may not be protective,
but harmful
Source: Impact of alcohol consumption on young people:
a systematic review of published reviews ( D Newbury-Birch
et al, HIS, Newcastle Uni, 2009)
Selected findings
•
•
•
•
•
•
•
The location of a young person’s first drink
may be important: those who first use
alcohol in a home environment and learn
from parents are less likely to misuse it than
those who begin drinking outside the home,
experimenting with peers
Delaying the time of a young person’s first
drink may reduce the risk of harmful drinking
Religious affiliation, especially attendance at
religious services, may have a protective
effect
Adolescents who misuse alcohol are more likely to suffer from side effects
including appetite changes, weight loss, eczema, headaches and sleep
disturbance.
Alcohol abuse in adolescence poses a particular danger to the emerging brain
facilities of executive functioning and long-term memory
There is a relationship between adolescent alcohol abuse and mental health
problems
Young people of college age who use alcohol are more likely than abstainers
to use cannabis.
Drinking places; where people drink and why (JRF, 2007)
Method
• Fieldwork Sep04-Oct05 in two contrasting geographies:
– Stoke-on-Trent, a deprived urban area
– Eden Valley, an isolated rural area
• For each
– Archival studies on history of local drinking cultures
– Telephone survey with 500 residents on current patterns of drinking
– Mapping of selected places where alcohol is consumed, and
observation of participants
– Interviews with key stakeholders
– In-depth interviews with 20 residents (including photo-diaries)
Source:Drinking places; where people drink and why
(G Valentine, SL Holloway, M Jayne & C Knell,
University of Leeds, 2007)
Findings
•
•
•
In Stoke, for most people, drinking on a night out is
considered safe and pleasurable; likewise, in
Eden, popular and political depictions of drunkenness as generating violence and disorder, are
considered misleading. This suggests that threshholds of tolerance in relation to public drinking are
place-specific; secondly, that resources in these
areas are being over-focussed on public disorder
rather than others such as domestic consumption,
parenting practices and health issues.
Young people ignore the potential health
implications of binge-drinking; older people lack
awareness of the alcohol content of their drinks,
and the extent to which their drinking patterns
could be defined as binge-drinking. There are
significant levels of alcohol consumption within the
Muslim community, a group usually assumed to
abstain on the basis of faith.
A more liberal consensus is emerging in relation to
adults’ attitudes towards young people’s alcohol
consumption – health initiatives need to address
parenting practices and how young people learn to
drink.
Drinking in Scotland: qualitative insights into influences,
attitudes and behaviours (NHS Health Scotland 2008)
Method
• Fieldwork in four types of area (urban affluent; urban deprived; rural
affluent; rural deprived) in Central Belt of Scotland. For each type of
area, two pubs/bars were selected as focus points for research
• Across the total of the four areas:
– 24 depth interviews with bar management/staff
– A mix of one-to-one, paired and group discussions with a total of c60
customers
– A similar mix of interview techniques with a total of c90 residents of the
catchment areas of those pubs, all of whom who had drunk at least
moderately at home in the last week. Those who consumed selfmeasured drinks were ask to pour a typical one, which was measured
– A total of 70 drinking diaries, completed by a sub-set of these pubcustomers and in-home drinkers
– 5 stakeholder interviews
Source: Drinking in Scotland: qualitative insights
Into influences, attitudes and behaviours (S MacAskill,
D Eadie, R Gordon, ISM, May08)
Selected findings 1
•
•
•
•
•
•
Individuals had more than one drinking style and
behaviour varied according to settings and social
contexts, so drinking typologies were difficult to
establish
Home drinking was common, either for a social gettogether or for a quiet drink alone. Drinking wine
routinely with the evening meal was a common
pattern amongst affluent middle-aged respondents
Drinking in pubs was also common, especially for
males in deprived areas.
Social drinking at home was particularly common
amongst middle-aged women in all communities,
mirroring male social drinking in pubs.
Pub-based activities included watching football, pub
games and quiz nights, as well as pub meals, and
were often given as reasons for going
There was considerable variation in the volume of
home-poured measures of wine and spirits. On
average, home-poured vodka measures were twice
normal pub measures (c60mls) and for wine, mean
volume was c160mls.
Selected findings 2
•
•
•
•
•
•
Drinking was seen to have many positive aspects: a relaxant, a reward, a
social lubricant, creating a shared bond
Drunkenness was widely accepted behaviour amongst both younger
drinkers and those from deprived communities; in contrast, middle-aged
drinkers, particularly from affluent communities, tended to focus on youth
binge drinking as an issue, allowing distancing from the possible negative
effects of their own drinking. Equally, addiction was seen as quite distinct
from their own experience, in spite of heavy drinking.
Publicans and bar workers focussed on maintaining a peaceful bar, on
issues such as intoxication, getting a meal and getting home safely – while
they recognised ‘problem drinkers’, they tended not to intervene in their
behaviour.
Work and unemployment were regarded as both drivers and regulators of
alcohol consumption. Life-stage also had a strong influence, with the onset
of parenthood contributing to a reduction, and subsequent freedom
contributing to an increase.
Smoke-free legislation made home drinking more likely for some from
deprived areas, but also made pubs more attractive for others
Drugs were widely available in all areas and parallels were drawn between
drinking and drug cultures
Attitudes towards Alcohol in London (Greater London
Alcohol & Drug Alliance, 2002)
Method
• Fieldwork in inner and outer London, including
the City
• Eight qualitative focus groups
– 4 male, 4 female
– For each of male and female, one group each of
•
•
•
•
Steady drinkers
Moderate drinkers
Non-drinkers
Young drinkers (16-18)
Source: Attitudes towards alcohol in London (NFO
System Three, Nov02)
Selected findings
• The majority felt that generally there was no difference in alcohol use in
London vs elsewhere in the UK. However, some differences identified
were:
– Cost: because it’s more expensive in London, some thought that
consumption would be higher outside, particularly in the North. Younger
people felt that high pub prices encourage purchase from supermarkets to
drink (a lot, and quickly) before going out
– Abundance of drinking places: leading to Londoners drinking more than
elsewhere
– Commuting by train/underground: removing the restriction of car use; the
‘last train’ syndrome contributing to rushed drinking
• Workers in the City identified a number of
drivers of high consumption
– Work-related stress
– Business meetings and corporate
hospitality frequently involved alcohol
– Work place culture encouraged lunch-time
& post-work beer, with a stigma attached to
not drinking
Underage ‘risky’ drinking: motivations and outcomes (JRF,
2005)
Method
•
•
•
64 in-depth interviews
Young people (14-17) claiming experiences of getting drunk in
unsupervised, often outdoor, settings
South-east of England
Findings
Most common motivations were
– Social facilitation: to increase confidence, especially in securing a
sexual interaction
– Individual benefits: to ‘escape’ and forget problems (often done alone);
for the ‘buzz’; to relieve boredom
– Social norms and influences: peer guidance, rather than pressure;
getting drunk to achieve image of being older and more rebellious
Source: Underage ‘risky’ drinking: motivations and outcomes
(L Coleman & S Cater, Trust for the study of Adolescents,
Jan05)
Findings
• Outcomes and experiences of being drunk:
– Health: frequently regretted sexual experiences (often with lack of
contraception); injuries; hangover/feeling sick/collapse and vomiting;
lowering of resistance to drug use, or encouragement to continue on to it
when alcohol buzz has waned.
– Safety: irrational judgements on likelihood of getting home safely,
dangerous pranks, getting into a car with a drunk-driver
– Legal: mainly minor, such as having alcohol confiscated by police;
occasional arrest for eg vandalism
• The most striking variation was the
greater harms reported by the
younger age groups; it seems that
progressing to licensed
establishments (an opportunity
available earlier to young women
than men) offered a protective factor.
Use of alcohol among children and young people (DCSF,
2008)
Method
• Group discussions and interviews with stakeholders
(c25 in total)
• Sessions with parents/carers and with children/young
people, together and/or separately
– Observation:
• In-home
• Accompanied shops
• Drinking sessions
– Workshops involving c240 participants overall
– Interactive galleries involving c80 participants all in
Source: Use of alcohol among children and young people
(Define Research & Insight, 2008)
Selected findings 1
• All recognise underage drinking as an
issue…but for others, not them
• Personal defence is easy and natural since
they find justification and explanation for their
own drinking behaviours/attitudes everywhere.
Specifically, for adults in a parenting mindset,
the key issues lie not with them, but elsewhere
• For all, a raft of myths justify their own safe position:
– Alcohol is not a drug: vested interest in sustaining this, as reality is
unpalatable
– Alcohol ‘lite’ is fine: for children in particular, a perception of graduated
‘manageability’ of alcohol, resulting in a perception of low risk at the
‘beginner’ end, but also for some, a desire to quickly move up to a
more ‘mature’ level
– You learn by your own mistakes: drinking to excess and early is
assumed to lead to control being gained
– I am not at risk: arises from the (mis)perception of control from the
previous myths
Selected findings 2
• These beliefs are compounded by supporting myths:
– All children and young people will drink to excess: it’s a rite of
passage
– ‘over-parenting’ can make things worse
– The worst that can happen is vomiting and embarrassment
– Harmful drugs would not be allowed to be branded and sold to
the public without regulation
– That they know their own limits and know where to stop before
harm is done
• A ‘bigger picture’ of the problem
outcomes can motivate interest, but
long-term effects on children are
more interesting for parents than for
the children themselves.
“Mine’s a Lambrini” : a report examining alcohol consumption
among young people in Hull (hull citysafe, 2008)
Method
• May07-Feb08 at a variety of events and venues in Hull
• Individual interviews with young people aged 25 and
under
– 630 interviews completed
– Survey included the WHO’s AUDIT questionnaire,
devised to identify hazardous or harmful patterns of
alcohol consumption
Findings
•
•
•
•
79% of teenagers under 18 drink alcohol
Young girls tend to start earlier than boys, but boys consume more regularly
95% may be consuming at a level regarded as harmful; over a fifth may have
a serious addiction (boys more likely than girls); 80% may already be
experiencing alcohol-related harm
78% of under 18s say their parents know they drink alcohol; two-thirds say
their parents don’t know how much they’re drinking
Source: Mine’s a Lambrini: a report examining alcohol
Consumption among young people in Hull (L Baxter,
K Stevenson, Apr08)
Young people and alcohol: meanings, practices and
contexts (DCSF, 2009)
Method
•
Research conducted Oct08-Jan09 in three contrasting areas of deprivation:
– Outer London borough
– Seaside location in NE of England
– Rural town in SW of England
•
•
Individual interviews with c80 young people aged 11-19 (three-quarters male)
Interviews with c15 youth/alcohol professionals
Findings
•
•
•
•
•
•
Alcohol consumption plays an important, often central, role in their social lives
Gaining access to alcohol is rarely a problem
There are a number who do not consume alcohol at all, or moderately; some
of those, preferred using other drugs such as cannabis
Alcohol was first consumed at special family occasions eg Xmas, New Year,
birthdays; current consumption is mainly at weekends
On the whole, they prefer to drink in their own or friends’ homes, safer than
public places
Few spoke to their parents about drinking
Source: Young people and alcohol: meanings, practices
and contexts (I Warwick et al, TCRU, Uni of London, Jul09)
Young people and alcohol advertising: an investigation of
alcohol advertising following changes to the Advertising
Code (OFCOM, 2007)
Method
• Research conducted across the UK,
Feb-Jun07
• 11 discussion groups with young people
14-21 years old
• Quantitative survey
– c1500 14-21s
– To compare with benchmarking
survey from 2005 (pre changes to
Code)
Source: Young people and alcohol advertising: an investigation
of alcohol advertising following changes to the Advertising Code
( Ipsos MORI, Nov07)
Findings
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The proportion of 11-13 year olds who have never drunk alcohol has increased
from 31 to 46% (from 05 to 07)
Alcopops have declined in popularity, particularly for those aged 14+; however,
there has been an increase in cider consumption amongst that age group
There has been little change in the proportion of 11-17 year olds claiming they
regularly drink to get drunk
Changes in consumption of alcopops vs cider are mirrored by changes in
advertising media spend
Overall, children and young people are being exposed to fewer alcohol
commercials on television: a fall of c6% for 16-24s and c15% for 10-15s, from
2005 to 2006
Mirroring the changes in patterns of spend, recall
of alcohol advertising has declined
Likeability of adverts has not changed
young people are less likely to feel the adverts are
aimed at them; however, they are more likely to
say that the adverts make the drink look
appealing and that they will encourage people to
drink
Drunk and disorderly: a qualitative study of binge drinking
among 18 to 24 year olds (Home Office, 2003)
Method
• Research conducted in eight locations across England and Wales, a
mix of market towns, large towns, cities and metropolitan areas
• 16 focus groups with young people 18-24 years old
– 123 participants in total
– All binge-drinkers
– Majority had been involved in offending or disorder after drinking, either
as victim or perpetrator; remainder had behaved in ways that put them at
risk
– Mix of males/females; manual/non-manual/students/non-workers
Source: Drunk and disorderly: a qualitative study of binge
Drinking among 18 to 24 year olds (R Engineer et al, MORI
Social Research Institute Feb03)
Findings
Experiences of risk and disorder
• Few described themselves as ‘at risk’
when drunk, though reporting a range of
risky behaviours, taken through
perceived necessity or recklessness
brought on by alcohol
• Drunken fights were seen as a fact of life.
Those who had been in fights admitted
alcohol had influenced their judgment by
making them more aggressive or overconfident; some associated specific
drinks with aggression. Where people
had been beaten-up, the distinction
between offender and victim was often
unclear
• Many had committed drunken pranks,
often being ‘egged-on’ by friends
• Some used illegal drugs such as ecstasy,
cocaine or amphetamines to keep
drinking longer, intensifying the ‘high’
associated with both substances
Findings
Attitudes
• Many displayed a desire to push the limits on a big night out, mixing drinks or
drinking quickly to get drunk
• The majority find it difficult to judge their limits and to slow down once a session
is underway
• A significant minority saw getting ill, losing their memory or behaving out of
character as just ‘part of the fun’
• Drinking was often linked to personal freedom and independence
• Drinking deliberately to relieve stress or anger was identified by some as a
‘bad’ motivation, though it did not necessarily stop them from doing it
Social and peer group norms
• Some described behaving quite differently when out with different groups of
friends, or with mixed-sex vs same-sex groups
• Some felt that drunkenness is an acceptable excuse that mitigates an
individual’s responsibility for their actions
• Some felt they could rely on friends to stop them doing something foolish –
however, this may be a sense of false security as often friends all get very
drunk together and egg-on each other.
Drinking across the lifespan: findings from the
Birmingham Untreated Heavy Drinkers project
Method
• A ten-year study of the ‘natural history’ of heavy drinking
• 500 participants recruited in 1997 in West Midlands
– untreated for alcohol problems in last 10 years
– >50 (for men), > 35 (for women) units per week, for at least half
the weeks in the past year
– Age 25-55
• Interviewed every two years
– In 2007, c260 interviewed
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Questionnaire
Time-line follow back to determine last week’s alcohol consumption
Changes chart to determine any changes over last 2 years
Qualitative interview
Source: Drinking across the lifespan: findings from the Birmingham
Untreated Heavy Drinkers project (A Rolfe, Uni of Birmingham,
Presentation to the Society for the Study of Addiction Annual
Symposium, 2008)
Selected findings
• Over the ten years since 1997, there has been a reduction in mean
levels of alcohol consumption (volume & frequency) and dependence
• Considerable diversity across sample in drinking ‘careers’; three main
clusters emerging:
– Very heavy drinkers who stay very heavy
– Very heavy drinkers who reduce quickly
– Moderately heavy (and less dependent) drinkers, who reduce gradually
• Reasons for reducing:
– Life events
• health
• relationships (becoming a parent/carer,
new partner, conflict, bereavement)
• Employment (losing job, starting a new job)
• Moving house
– Practical reasons
• Wanting/needing to drive
• To have more money
– Moving on
• Growing out of it
• Wanting something different