STATES OF JERSEY
r
AN ALCOHOL STRATEGY FOR JERSEY
Lodged au Greffe on 15th July 2003
by the Health and Social Services Committee
STATES GREFFE
PROPOSITION
THE STATES
are asked to decide whether they are of opinion -
(a) to endorse the strategy for concerted
and co-ordinated action to reduce the harm to individuals and the community
caused by the misuse of alcohol dated 2nd April 2002 and to approve the key
strategic aims set out in the Alcohol Strategy for Jersey;
(b) to agree that, in an attempt to reduce
per capita consumption of alcohol, impôts duties on alcohol should be increased
annually over and above the level of inflation if deemed advisable, following
consultation between the Health and Social Services Committee and the Finance
and Economics Committee;
(c) to agree that, in an attempt to reduce
alcohol-related assaults, malicious damage, anti-social behaviour, public
disorder and under-age drinking, and to promote a healthy lifestyle and
discourage intoxication, there should be a comprehensive review and revision of
the Licensing (Jersey) Law 1974, as amended, following consultation between the
Health and Social Services, the Home Affairs and the Finance and Economics
Committees;
(d) to agree that measures should be
introduced to reduce the incidence of alcohol consumption by persons under the
age of 18 years of age by –
(i) the introduction of proof-of-age cards
through the States smart card scheme or another suitable method as soon as
practicable;
(ii) the drafting of best practice guidelines
for the education and awareness of staff employed where alcohol is sold;
(e) to agree that steps should be taken to
increase opportunities to access effective treatment and support services for
those who misuse alcohol and to provide specialist support and advice to
professional groups working with individuals who misuse alcohol;
(f) to request the Health and Social
Services Committee to report to the States within a period of three years on
the progress of the Alcohol Strategy.
HEALTH AND SOCIAL SERVICES COMMITTEE
REPORT
Background
The States approved the Crime and Community Safety
Strategy and the Substance Misuse Strategy on 16th November 1999, including an
intention to reduce the level of harm caused by alcohol misuse. The following
proposals for a co-ordinated alcohol strategy have been prepared following
extensive local consultation and research into how other countries are tackling
alcohol-related problems.
The need for an alcohol strategy
For the majority of people who drink alcohol, it is a
pleasant adjunct to a wide range of recreational activities. However, alcohol
is also an addictive drug and a major cause of ill-health and social distress. Alcohol
is a major contributory factor in deaths from liver disease, cancers and heart
disease; and its misuse places families under stress, contributes to
unemployment and homelessness, and affects the wider community in terms of violence,
disorder and accidents.
In Jersey, average alcohol consumption per person has
been estimated to be up to twice that in the United Kingdom, and is considered
to be the highest in western Europe[1]. Furthermore, a survey on health and lifestyles in
Jersey has indicated that 9% of adult men and 7% of adult women are dependent
on alcohol.[2]
It is a misconception that drinking only harms a tiny
minority of the population who drink particularly heavily. In reality, the
range of alcohol problems go well beyond the medical concept of alcoholism. Problems
can arise from a single bout of drinking or repeated heavy drinking, giving
rise to physical, psychological and social harm.
Increased medical understanding of the effects of
alcohol consumption has led to an awareness that the health risks also affect
those who drink somewhat in excess of sensible limits.[3] There is also a greater recognition of the extent of
social harms caused by alcohol misuse and their impact on a community’s safety
and quality of life.
Proposals
The principles of the alcohol strategy are –
· a
focus on a whole population approach to alcohol misuse;
· promotion
of social welfare and equal access to helping services;
· use of
a range of measures to maximise the potential to reduce harm;
· implementation
of a well-defined strategy with a long-term and consistent approach.
Implementing the strategy will depend on a number of
co-ordinated initiatives related to controlling the supply and demand for
alcohol, changing attitudes and the provision of information, and support and
treatment services. These initiatives are summarised below.
Taxation and prices
There is good evidence that taxation and pricing have
an impact on reducing levels of alcohol consumption and misuse. It is proposed
to –
· maintain
increases in taxation on alcoholic products over and above inflation, and level
out taxation rates on different types of alcohol;
· reach
agreements with the alcohol industry to reduce the price of non-alcoholic
drinks relative to alcoholic drinks in licensed premises, encourage the sale of
non-alcoholic and low alcohol drinks, and discourage the use of sales
promotions which may lead to binge drinking.
Licensing
Licensing continues to be needed to regulate the sale
and consumption of alcohol, in order to protect the young, control excessive
consumption in the interests of health and safety and to prevent disturbance
and disorder.
It is intended to review and revise the Licensing
(Jersey) Law 1974, to develop legislation that will help to reduce
alcohol-related assaults, malicious damage, anti-social behaviour, public
disorder and under-age drinking, and to promote a healthy lifestyle and
discourage intoxication.
Community safety
Consideration of community safety issues is key to
reducing alcohol-related violence and disorder when planning public places and
housing. Options which focus on prevention and diversion are preferred to those
which criminalise drinkers.
Proposals are aimed to reducing alcohol-related crime
and nuisance in and around drinking venues, the town centre and other public
places, through promoting improved management and policing, introduction of
legislation enabling confiscation of alcohol in public places when there is a
risk of injury or disorder (as agreed by the States on adopting a proposition
of the Deputy of St. Martin, P.46/2002), and developing proposals to enhance
the role of public transport in preventing alcohol-related disorder.
Drink-driving
The aim of a drink-driving policy is to reduce
alcohol-related accidents on the roads. Measures need to be enforceable, and
policy decisions should focus on reducing the harm caused.
Proposals to reduce the number of alcohol-related road
accidents include a review of the permissible level of blood alcohol when
driving (currently 80mgs per 100mls) in line with limits in other
jurisdictions; improving public transport, with particular emphasis on late
night provision; encouraging the Courts to introduce, where appropriate, an
alcohol education order or a treatment order; and increased public education in
relation to drink-driving within driving test training and in schools.
The promotion of alcohol
It is proposed to promote a more balanced portrayal of
alcohol consumption and its outcomes in the media, and to protect young people
from product promotion or media influences which may encourage them to drink
alcohol prematurely or to excess in later life, or which exploit the young,
immature, or those who are mentally or socially vulnerable.
Options include a review of advertising codes to
reduce the number of advertisements likely to appeal to young people, and
regulating sponsorship, packaging and merchandising of alcoholic drinks.
Changing attitudes: Campaigns to promote responsible
drinking
Increased public education on the implications of
alcohol misuse can enable individuals to make informed choices about drinking,
and increase awareness of the full range of support facilities available.
Proposals include campaigns involving television and
other media; recommending alcohol misuse education within Health and Safety
plans of States Departments; specific guidance to schools and parents, and
enhancing the role of youth work in alcohol education; encouraging employers to
develop alcohol education programmes; and providing training and support for
those engaged in alcohol education.
Support and treatment
A range of services for those in need of support and
treatment should include screening for alcohol problems by G.P.s and hospital
staff, brief treatment programmes and longer-term specialist remedial
treatment, counselling services, self-help support and support for the children
and partners of problem drinkers.
Co-ordination will be required to ensure effective
links, for example for people with multiple needs, such as mental health
problems, illicit drug misuse and social problems, and between different
service providers, including the Alcohol and Drug Service, the General
Hospital, Courts and Probation Service, Prison Service and Police.
Under-age consumption
Under-age consumption of alcohol increases
substantially the risks of young people becoming involved in disorderly
behaviour. This may lead to criminal activity, under-achievement at school,
poor health and poor employment prospects, all of which can create additional
problems in later life.
To reduce the consumption of alcohol by under 18s, it
is proposed to rigorously enforce current legislation, actively promote a
proof-of-age scheme, exploring new measures to control the purchase of alcohol
by adults for under 18s in inappropriate circumstances, and consider
legislation to permit confiscation of alcohol in a public place where there is
a risk of a nuisance or misbehaviour.
Resources
The cost of implementing the Alcohol Strategy will be
primarily met from funds already allocated to/requested for the Crime and
Community Safety and Substance Misuse Strategies or from existing revenue
budgets of individual States’ departments.
Tackling alcohol on an Island-wide basis requires a
broad, all-embracing, partnership approach. Although the Health and Social
Services Committee will act as both a catalyst for change and the lead
Committee on this matter, the commitment of other States’ Committees and others
will be essential for the strategy to be effectively delivered.
Conclusion
A strategic approach is required to tackle alcohol
problems, and to provide a framework for resolving the often conflicting
commercial, recreational and welfare interests associated with alcohol
consumption. To meet concerns over the disjointed nature of alcohol policy
development, there is a need to co-ordinate the large number of agencies whose
work includes alcohol, and to ensure that alcohol issues are addressed.
The proposals contained in this Alcohol Strategy are
overarching. They make the case for far-reaching changes to alcohol policy
across the full spectrum of Island life. They address contentious issues and
recognise the significant difficulties of reform required to implement
effective intervention.
For many people, drinking alcohol is a social and
recreational pastime which adults indulge in sensibly and responsibly. Consequently,
such drinking habits are not an issue and this strategy seeks only to address
the harm caused by the excessive and inappropriate use of alcohol.
The
States of Jersey declared its intention to reduce the level of harm caused by
alcohol misuse when it approved the Crime and Community Safety Strategy and the
Substance Misuse Strategy on 16th November 1999. These proposals for a
co-ordinated alcohol strategy have been produced by the Alcohol Strategy
Working Party and have been endorsed by the Chief Officer Group. In producing
this document a great deal of emphasis has been placed in obtaining the views
and suggestions of others as well as carrying out extensive research into how
other countries are tackling alcohol-related problems.
Alcohol
is part of Jersey’s cultural tradition, has a significant recreational role
and, when consumed in small quantities, can have health benefits for certain
groups. For the majority of people who drink alcohol, it is a pleasant adjunct
to a wide range of recreational activities. However, alcohol is also an
addictive drug and a major cause of ill health and social distress. As well as
its role in liver cirrhosis, (between 1996-1999, 52% of deaths in Jersey,
associated with diseases of the liver, identified alcohol as a factor)[4],
cancers and heart disease, its misuse places families under stress, contributes
to unemployment and homelessness, and affects the wider community in terms of
violence, disorder and accidents. (50% [392] of all police attendances at
domestic violence incidents in Jersey, in 1999 involved alcohol or drug use.)[5]
A Canadian study has shown that victims usually report domestic violence after
approximately thirty three offences are committed against them. During 2002,
reported offences in Jersey went up by 17%, which may indicate a greater
willingness to report, but the level of repeat offences which dropped by 28%
during 2001, remained constant during 2002.
While
there are economic benefits associated with the alcohol industry, the financial
cost to society of alcohol misuse is substantial. They involve health, welfare
and criminal justice services’ costs, as well as the financial implications of
unemployment, accidents, anti-social behaviour, absenteeism and lost productivity.
The
cost of implementing the Alcohol Strategy will be primarily met from funds
already allocated to/requested for the Crime & Community Safety and
Substance Misuse Strategies or from existing revenue budgets of individual
States’ departments. It must be stressed at the outset that tackling alcohol,
on an Island-wide basis, requires a broad, all-embracing, partnership approach.
Therefore, although the Health and Social Services Committee will act as both a
catalyst for change and the lead Committee on this matter, the commitment of
other States’ Committees and others will be essential in order that the
strategy can be effectively delivered.
Policy
thinking on alcohol has too often been coloured by the misconception that
drinking adversely affects only a tiny minority of the population who drink
particularly heavily. In reality, there are a wide range of alcohol problems,
which go well beyond the medical concept of alcoholism. Problems can arise from
a single bout of drinking or repeated heavy drinking. Such problems exist in
the physical, psychological and social domains as indicated in the table on
Page 2.
Increased
medical understanding of the effects of alcohol consumption has led to an
awareness that the health risks do not only apply to heavier dependent
drinkers, but also affect those who drink somewhat in excess of sensible limits.[6]
There is also a greater recognition of the extent of social harms caused by
alcohol misuse and their impact on a community’s safety and quality of life.
To
achieve the recommendation made in the Substance Misuse and Crime and Community
Safety Strategies ‘to reduce the numbers of people drinking above sensible
limits’ will need a concerted effort by the community at large. Whilst the
overall consumption of alcohol in Jersey has fallen over the past ten years, it
is calculated to be in the region of 1½ times higher than that of the UK[7],
and recent research has shown a significant rise in the amount of spirits and
beers consumed by children.[8]
A
strategic approach is required to ensure that action is taken to tackle these
problems, and to provide a framework for resolving the often conflicting
commercial, recreational and welfare interests associated with alcohol
consumption. To meet concerns over the disjointed nature of alcohol policy
development, there is a need to co-ordinate the large number of agencies whose
work includes alcohol, and to ensure that alcohol issues are addressed.
|
Physical |
Acute
Accidental injury Injuries from fights Acute
medical complications |
Chronic
Brain damage Peripheral neuritis High blood pressure Heart disease Stroke Liver disease Chronic pancreatitis Cancers of: Oropharynx Larynx Oesophagus Stomach Liver Rectum Breast Skin diseases Endocrine disorders Blood disorders Disorders
of the immune system |
|
Psychological |
Impaired reaction time Impaired emotional control Suicide |
Short-term memory impairment Dementia Alcoholic hallucinosis Dependence Withdrawal fits Delirium tremers |
|
Social |
Work problems Crimes of violence Drink
driving accidents/injuries Family violence Anti-social behaviour |
Family breakdown Debt Housing problems Destitution |
The
administrative framework proposed to co-ordinate the implementation of the
strategy includes:
|
·
An Alcohol Working Party (Senior Officer
Group Sub-Group) to oversee the Strategy’s implementation. |
|
·
An Alcohol Advisory Forum to inform the
development of the Strategy drawn from those agencies, including the alcohol
industry, whose work involves dealing with alcohol. |
|
·
An Alcohol Research Subgroup to ensure the
necessary data is available and provide independent evaluation of the
Strategy. |
The
core principles at the heart of the Strategy are:
q A focus on a
whole population approach to alcohol misuse.
q The
promotion of social welfare and equal access to helping services.
q The use of a
range of measures to maximise the potential to reduce harm.
q The
development of a well-defined and accountable system with a long-term and
consistent approach.
How
the Strategy will be monitored and evaluated:
|
q To reduce
the per-capita consumption of alcohol. q To reduce
the amount of alcohol-related ill health. |
|
q To reduce
the number of alcohol-related injuries. |
|
q To reduce
the incidence of alcohol-related crime
and disorder. |
|
q To reduce
the number of alcohol-related road accidents. |
|
q To reduce
economic loss in the work place due to alcohol misuse. |
|
q To reduce
the incidence of alcohol consumption by young people. |
|
q To
increase opportunities for alcohol problem users to access treatment and
support. |
Detailed
proposals for achieving these aims are made in the next section which describes
the key areas relating to the control of supply and demand, changing attitudes
and the provision of information, support and treatment.
Taxation
and pricing have an impact on levels of alcohol consumption and misuse. At
current levels of consumption, it is appropriate to maintain the recent
practice of increasing taxation on alcoholic products over and above inflation.
(see Appendix A)
|
q Excise duties to continue to rise over
and above the level of local inflation. |
|
q Equalise taxation rates on alcohol. This will
address the anomaly that currently exists whereby a unit of alcohol in beer
is cheaper than a unit of alcohol in spirits[9].
q Reach an agreement with the alcohol industry to
reduce the pricing of non-alcoholic drinks relative to alcoholic drinks in
licensed premises. q Encourage the licensing trade to promote the sale of
non-alcoholic and low alcohol drinks in licensed premises and discourage the
use of sales promotions (such as happy hours), which encourage binge
drinking. |
Licensing
continues to be needed to regulate the sale and consumption of alcohol because
of its intoxicating and addictive properties, its potential to damage health
and its contribution to nuisance and disorder. The three primary aims of
licensing should be to protect the young, control excessive consumption in the
interests of health and safety and to prevent disturbance and disorder.