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Why We Need to Change Our Drinking Culture

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Why We Need to Change Our Drinking Culture WHY WE NEED TO CHANGE OUR DRINKING CULTURE OUR DRINKING LANDSCAPE - ALCOHOL IS OVERSUPPLIED AND ADVERTISED HEAVILY Our drinking landscape has changed considerably over the last 30 years. We have seen increases in the number of places selling alcohol and the types of products available and strategies to advertise them, and reductions in the price of alcohol. Beginning in 1989, new liquor laws increased the availability of alcohol across NZ [1] - o wine and beer became available in supermarkets and grocery stores in 1989 and 1999 respectively [1]; o the minimum legal age to purchase alcohol was reduced from 20 to 18 years in 1999. 1 | P a g e The number of places that sold alcohol more than doubled from to 6,300 in 1990 to 14,200 in 2009 [2]. Today, around 75% of all alcohol in NZ is sold from off-licences: 43% from bottle stores and 32% from supermarkets and grocery stores [1]. More liquor outlets are concentrated in poor suburbs than rich suburbs [3]. The increasingly availability of Ready to Drinks (RTDs) has had a huge impact on heavy drinking in New Zealand, particularly among young girls. Alcohol has become more affordable over time [4]. In 2009, it was estimated that $200,000 was spent each day advertising alcohol in New Zealand [5]. Within prime-time television viewing in New Zealand, a scene depicting alcohol occurs every 9 minutes [6]. New Zealanders spend $85 million per week on alcohol ($4-5 billion per year). OUR DRINKING CULTURE 2 | P a g e New Zealanders typically drink large amounts of alcohol. Although, overall, we drink less than the Irish and British (and slightly less than Australians), we drink more than Americans, Canadians and South Africans. In 2016, 474 million litres of alcoholic drinks were available for sale (292 million litres of beer, 109 million litres of wine, 73 million litres or spirits/spirit-based drinks). This equates to 34 million litres of pure alcohol, or 9.4 litres of pure alcohol per person aged 18 and above [7]. To put this into perspective, it is the same as every person aged over 18 years consuming two standard drinks per person every day of the year (i.e. 2 cans of beer (330ml, 4% alcohol) or 2 glasses of wine (12.5%; 100ml) [7] However, in reality we know that most between 40-50% of all alcohol sold in NZ is consumed in heavy drinking occasions. In 2015/16, 4 in every 5 New Zealand adults (80%) drank alcohol in the past year [8]. 3 | P a g e In 2015/16, o around 780,000 adults were hazardous drinkers [8]; o Almost half (44%) of young men (aged 18 to 24 years) were hazardous drinkers [8]; o Males (29%) were twice as likely as females (13%) to be hazardous drinkers [8]. o Young adults aged 18 to 24 years had the highest rate (20%) of weekly binge drinking (six or more drinks standard drinks on one occasion) [8]. The percentage of adults with hazardous drinking patterns decreased from 18% in 2005/06 to 15% in 2011. However, since 2011 hazardous drinking has increased every year [8]. In 2015/16 the prevalence was 19% (when measured in standard drinks it is 21%). The largest increases in hazardous drinking has been seen in those aged 35-64 years old. Fewer adolescents are choosing to drink (61% current drinkers in 2007 versus 45% in 2012). However, adolescents who do drink continue to drink large amounts. Of particular concern, young adolescent females in New Zealand may actually be increasing the volume of alcohol they consume when drinking [9]. 4 | P a g e ALCOHOL IS A KEY CONTRIBUTING FACTOR TO INEQUALITIES There are a number of factors which give rise to groups in society experiencing more alcohol- related harm than others. Inequities in harm can be driven by our age, where we live and the number of alcohol outlets close to our homes, the socio-economic circumstances we live in, our exposure to racial discrimination and structural barriers that limit our opportunities, as well as our alcohol consumption patterns. Alcohol is a key contributing factor to health inequalities [10]. In 2015/2016, Māori adults were 1.5 more likely to be hazardous drinkers than non-Māori [8]. In 2015/16, adults living in the most deprived areas were 1.4 times more likely (25% vs. 19%) to be hazardous drinkers than those living in the least deprived areas [8]. Māori are approximately twice as likely as non-Māori to have alcohol use disorders even after taking into account age, sex, education and income [11]. 5 | P a g e Between 2004 and 2007, Maori deaths from alcohol were two and half times greater than non-Maori [12]. New Zealand Secondary school students who report experiencing ethnic discrimination are almost twice as likely to report binge drinking as those who do not [13]. In 2015/16 43% of Pacific past-year drinkers were hazardous drinkers. Pacific adults who drink were 1.5 times more likely to be hazardous drinkers than non-Pacific drinkers, after adjusting for age and sex [8]. Young Pacific people are less likely to binge drink if they had parental Pacific language use at home and had parents which knew where they were after school and at night time. However, participating in sports teams or a sports club was associated with an increased risk of binge drinking [14]. Harms from alcohol are more prevalent among drinkers in drinkers living in the most deprived areas [15]. HARMS FROM ALCOHOL VERSUS OTHER DRUGS 6 | P a g e Many people are aware that alcohol causes more harm than many other drugs available in our society. In a UK study measuring the harm score of different types of drugs, alcohol was found to be the most harmful drug with an overall harm score of 72, followed by heroin (55) and crack cocaine (54) [16]. The study measured - harms to users (e.g., drug specific death and illnesses, dependence and loss of relationships, etc); as well as harms to others (e.g. crime, injury and social costs). COST OF ALCOHOL TO SOCIETY Although the tax from alcohol consumption contributes to Government revenue, it does not match the costs of alcohol-related harm to our society. In 2016, alcohol contributed $950 million of government revenue in the form of excise tax [17]. 7 | P a g e Alcohol misuse is estimated to cost New Zealand society $5 billion each year (expressed in 2008 currency) [18]. This includes costs to individuals such as car insurance, lost wages and medical treatments, as well as cost to the government such as healthcare costs, road crashes, police and justice [18]. In comparison to alcohol, the social cost of other drug-related harms and intervention is estimated to be at $1.6 billion (expressed in 2008 currency) [18] and $1.8 billion in 2014/15 [19]. 11% of all ACC claims are attributed to alcohol-related injuries [20]. 18% of the New Zealand Police budget is spent on alcohol incidents. Alcohol also results in loss of productivity in workplaces and schools - o In 2012/13, male drinkers (4%) were 1.6 times more likely to be absent from work or studies than female drinkers (2.5%) [15]; and o In 2012/13, male drinkers (6.9%) were 1.4 times more likely to experience negative financial effects due to their drinking than female drinkers [15]. Every year, 147,500 adults take one or more days off work or school due to their alcohol use [21]. A total of 84,400 adults have experienced harmful effects on their work, study or employment because of alcohol [21]. In 2012, 6% of adolescent drinkers report having their work or school affected in the last year due to alcohol [22]. Among those students living in the most deprived areas, 8% report problems with work or school (exacerbating existing inequities in outcomes) [22]. 8 | P a g e OUR HARM PROFILE There are many, many direct and indirect harms resulting from alcohol use. Drinkers should be aware that the harms are both acute and chronic, and don’t just relate to heavy drinking. Lower levels of consumption can also cause significant harm. There are 60 different medical conditions that are caused by heavy drinking Alcohol is considered a Class 1 carcinogen. This means the strength of the relationship between alcohol and cancer is similar to that of asbestos, arsenic, tobacco smoke, Ionizing radiation, vinyl chloride and ultraviolet radiation A, B & C [23]. 9 | P a g e Around 570 children are born each year in New Zealand with Fetal Alcohol Spectrum Disorder [24]. Every year in New Zealand, 802 New Zealanders die younger than expected due to their current drinking behaviours [12] - o Injuries were responsible for 43% of alcohol-related deaths [12]; o Cancers were responsible for 30% of alcohol-related deaths [25]; o 27% of alcohol-related deaths were due to a variety of other long-term diseases (e.g. liver cirrhosis) and pneumonia [12]; o Twice as many deaths from alcohol are observed in men as women [12]. Alcohol and drugs contributed to 29% of all fatal road crashes in NZ in 2016 [26]. Among young adults aged between 15 and 29 years, road traffic injuries led to more than half of alcohol-attributable deaths followed by self-inflicted injuries [12]. Among women aged between 30 to 44 years, one in five women (22.8%) died younger than expected due to breast cancers attributable to alcohol use [12]. More than a third of these breast cancer deaths in New Zealand are attributable to drinking less that two standard drinks per day on average [27].
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