HC Deb 05 January 2004 vol 416 cc130-8

Motion made, and Question proposed, That this House do now adjourn.—[Charlotte Atkins.]

10.30 pm
Ross Cranston (Dudley, North) (Lab)

Marketing of alcohol, as with other products, has a real impact on consumers. Who does not know that Heineken refreshes the parts that other beers cannot reach or that Guinness is good for you? Those are extremely effective marketing slogans, part of our culture and, like other examples of the genre, about as true. I suggest in this Adjournment debate that it is time to draw a line. The consequences of alcohol abuse are now so great that there must be more effective controls over the marketing of alcohol. I declare my interest as chairman of the all-party group on alcohol misuse.

Let me start with the public health costs of the more extreme cases. In September last year, in my constituency, consultant heptalogists at Dudley NHS hospitals trust presented me with a petition whose signatures had been collected nationwide. The concern was with the effects of alcohol addiction, particularly with liver disease. Cirrhosis of the liver is an important cause of illness and death. In the year 2000 it killed more men than Parkinson's disease and more women than cervical cancer. There have been large rises in death rates from chronic liver disease in most age groups. Among 35 to 44-year-olds, there has been an eightfold increase for men and nearly a sevenfold increase for women.

My Dudley doctors were not concerned only with liver disease and other medical problems. A psychiatrist attended the presentation because alcohol addiction relates to dependence and psychiatric conditions such as depression and anxiety. In all, alcohol dependence syndrome accounts for more than 30,000 hospital admissions per year in the UK.

It is sometimes difficult to get a handle on the other social costs flowing from alcohol abuse. Domestic violence is a major problem. One in nine women experience domestic violence at any one time, with high rates of repeat victimisation. Importantly, there are other indirect consequences such as the psychological effects on children. The relationship with alcohol is complex. The Stella project, working under the auspices of the Mayor of London, argues that men can be violent to women with or without alcohol, but points out that perpetrators may help to create a dependence on alcohol as a tool of control and that victims may themselves become dependent on it to cope with the emotional trauma.

I shall now deal with the night-time economy. At one level, it means the regeneration of city and town centres, but there is a dark underbelly, where an aggressive hedonism is fuelled by the excessive consumption of alcohol. Traditional pubs catering for a wide range of customers have been replaced by multiple vertical drinking establishments geared to a youth market. Too often the accepted norm in such places is that customers will drink to excess. Violence and antisocial behaviour on the streets is the inevitable consequence, making the lives of those living nearby a misery. It can also result in the exclusion from those areas of older people and others who find the atmosphere alien and threatening.

Excessive alcohol consumption results in heavy demands for services such as ambulances, taking resources away from higher priority cases. Before Christmas, for example, west midlands ambulance service announced that 80 per cent. of its cases during the previous festive period were drink related. During the period between 22 December 2003 and last Friday, the police reported that in Dudley, North there were 84 incidents of alcohol-related offending, from drunken behaviour to violence either at licensed premises or elsewhere in the constituency.

What of the role of marketing in all that? George Orwell described advertising as the rattling of a stick in the swill bucket. The industry would say that the £220 million plus spent a year on alcohol advertising is a force for competition, innovation and consumer choice. The industry claims that the role of advertising is not to increase overall consumption, but rather to enable brands to compete with others in the sector and to gain market share as drinking fashions change. I beg to differ.

I am not suggesting that advertising is the source of all evil with alcohol misuse and the source of the public health consequences. Some marketing and advertising is clever, innovative and attractive, but the industry is selling a product that is not totally benign. It is a product that, in certain circumstances, has serious negative consequences for our health and society. The causal factors in alcohol misuse are many, and marketing is only one of them. Peer pressure can be a major factor among young people, for example. Nor am I suggesting that advertising always hits the target. I am also not suggesting that to ban advertising would solve the problem of alcohol misuse overnight.

The Government's strategy unit, in its interim analytical report on alcohol, has collected a great deal of useful information on the implications of alcohol for our society. In relation to advertising, it cites a recent study that used a large sample of time-series data drawn from 20 Organisation for Economic Co-operation and Development countries, including the United Kingdom. That study suggests that a partial or total advertising ban would be expected to lower consumption substantially. It contradicts earlier findings concluding that advertising bans would not reduce alcohol consumption.

Page 130 of the interim analytical report is devoted to the susceptibility of younger people to advertising. For example, young people are more conscious of and more likely to follow rapidly evolving trends and fashion. Since they are early in their drinking careers, they are less likely to have established strong brand and drink preferences. One study cited in the report associates advertising with increased binge drinking by young people. It notes the significant amount spent on advertising youth brands.

Of course, advertising is only one aspect of marketing. The interim analytical report quite rightly highlights sponsorships, product tie-ins and placements, contests and special promotions. It estimates that when those are taken into account, total spend on promotional activities in the UK could be in the range of £600 million to £800 million annually. There is also the use these days of the internet and mobile telephones in marketing campaigns.

Then there are point-of-sale promotions, many of which are initiated by retailers. In early December, the "Society" section of The Guardian reported on cut-price promotions in Newcastle and Manchester, but they are of course nationwide. The Nicholson report in Scotland identified such promotions as being of special concern in relation to binge drinking, a point to which I shall return.

Let me summarise my concerns. First, the industry spends enormous sums on promotion. Then there is the worrying trend in advertising targeting younger people, especially younger women these days, and associating alcohol with sexual and social success. That type of marketing gives the lie to the industry's claim that marketing is about brand switching. If that were the case, it would have concentrated on the heavy drinking young male. Advertising is also designed to recruit new consumers and increase consumption, and that is why it has in recent years targeted the young, especially younger women.

Secondly, we have one of the laxest regulatory regimes in the world. Television advertisements for alcohol are banned in France, and there are substantial restrictions in other European countries. Yet in the UK in 1995, we saw the end of the voluntary agreement among mainstream spirits producers not to undertake television advertising. We now have substantial advertising of premium, ready-to-drink products. Apart from self-regulation, there is virtually no control over marketing in magazines, at the cinema and on billboard advertisements.

Thirdly, the mainly voluntary controls are not working effectively enough. It is all very well to pray in aid, say, the steps taken by the Portman Group, such as the obligation for merchandise not to contain alcohol brand names if aimed at children, but there are loopholes in the code. The drinks industry can sponsor as many sporting events and teams as it likes, leading to conflicting messages. In my view, some advertisements step over the boundaries of taste and decency. There is the notion of drinking to excess being an essential part of living life to the full.

Some parts of the industry emphasise social responsibility. Some of the multinationals—the drinks industry is dominated by a limited number of multinationals, such as Diageo and Allied Domecq—have a social responsibility marketing section on their websites, but that is not the norm.

What are the options? The Government's forthcoming alcohol strategy will be an opportunity to send stern warnings to the industry about its marketing practices. I hope that the Government will keep the door open to imposing statutory regulation if the industry does not become significantly more responsible in its marketing. The Government's message should be that if the industry wants self-regulation, it will have to make significant and immediate changes. We need not just the occasional socially responsible drinking campaign but for all drinks advertising to be such as to change the drinking culture. I hope that co-regulation of alcohol marketing on television and radio by Ofcom and the Advertising Association will result in a thorough re-examination of the current lax approach. If full regulation is to be avoided, the self-regulatory codes must be enforced in spirit, not just to the letter, if they are to survive. The British Medical Association has called for a ban on all television advertising. Unless the industry takes steps now, the case for a ban will be overwhelming.

As part of a more responsible approach, particular marketing techniques need to be controlled. I have already mentioned some of the point-of-sale promotions that encourage binge drinking. Even the Portman Group, in its December briefing note, has seen the writing on the wall and calls for action by retailers to curb irresponsible promotions. The Nicholson committee in Scotland drew attention to some establishments whose extreme promotions were designed to attract customers regardless of the consequences to their health or to public order and the amenity of others. The committee proposed that there be a duty on all licensed premises to refrain from anything whether by way of promotional advertising, by way of offering discounted prices, or in any other way, which encourages excessive consumption of alcohol and which thereby prejudices, or is likely to prejudice, the licensing principles. Just before Christmas, the Glasgow Licensing Board adopted the Nicholson recommendations on promotions.

I also urge the Government to consider other specific measures in the alcohol strategy. People need to have information about levels of alcohol that are bad for their health and to be able to relate that to the drinks they consume. I have supported the Dudley hepatologists in their call for compulsory labelling of alcohol containers with the number of units of alcohol inside clearly displayed. Some in the industry are already labelling their products along those lines, which is welcome. Cains brewery in Liverpool now labels its 2008 ale with the number of units per bottle and also places a warning on the label:

ALCOHOL ADVICE: Robert Cain support responsible drinking. Excessive drinking can cause harm. Observe the daily guidelines for sensible drinking. Do not drink and drive. I commend the brewery for that. Yesterday, the Irish Government announced that they were seriously considering such warnings on all cans and bottles of alcohol.

Labelling would need to be combined with an awareness campaign on the relevance of units of alcohol, which brings me to the use of marketing to campaign for responsible drinking. We are not far off the time when the Government should consider using the creative skills in the advertising world to good effect. The Prime Minister's big conversation contains the question: Should alcohol advertising be taxed, with the proceeds going on treatment or responsible drinking campaigns? Alcohol advertising is already subject to a levy of one tenth of 1 per cent. of expenditure to support the Advertising Standards Authority. So the big conversation question does not raise any new issue of principle, and a positive answer would accord with the notion that any industry must take financial responsibility for associated social costs.

Alcohol, in the words of a recent WHO-sponsored publication, is no ordinary commodity. It has very serious costs. One in 13 adults is dependent on alcohol—some 280,000 in the west midlands alone. Among younger people, there is the particular problem of binge drinking, which is a cause of antisocial behaviour and violence, quite apart from the long-term health effects for them and costs to the NHS.

Some marketing techniques encourage messages about unacceptable drinking. The industry, regulators, the Government and Members of Parliament must urgently address the issue. The forthcoming alcohol strategy provides an important opportunity for everyone involved to take up the challenge of encouraging a more responsible attitude towards alcohol.

10.45 pm
The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson)

I congratulate my hon. and learned Friend the Member for Dudley, North (Ross Cranston) on his success in securing a debate on this important topic.

As we know, about 90 per cent. of adults in Britain drink alcohol and most of them drink sensibly for most of the time, but we are all aware of the harms associated with alcohol misuse. My hon. and learned Friend knows that the Government are committed to tackling those harms, which is why we are currently developing an alcohol harm reduction strategy for England. In the national health service plan, we said that we would implement the strategy during 2004 and I am pleased to say that we are on course to achieve that timetable. This will be the first time that there has been a co-ordinated and joined-up effort to tackle alcohol-related harm in England and I am pleased to be involved in the current work.

It is important to ensure that we develop a robust and effective strategy, so it is vital that we draw in the expertise of all the stakeholders, including the all-party group on alcohol misuse, which has contributed to the work to date. I thank the group for its contribution. Over the last seven months, since I took over the public health brief, I have been struck by the number of stakeholders, both inside and outside Government, involved in tackling alcohol-related harm. That demonstrates beyond doubt that a joined-up approach is needed, and that we will be able to build a successful strategy only if we recognise that the Government cannot tackle the problems of alcohol misuse alone. The contribution of the voluntary sector, the private sector and individuals themselves will be needed if the strategy is to make a real difference.

My hon. and learned Friend mentioned some of the harms associated with alcohol misuse. As he noted, the Prime Minister's strategy unit recently published its interim analytical report, which gives a comprehensive account of the types of alcohol-related harm that are most prevalent in modern-day England. My hon. and learned Friend has mentioned some, and I, too, shall refer to a few of them.

On the harm to health, we know that between 15,000 and 22,000 people die in England each year as a result of alcohol misuse, and that such misuse accounts for 150,000 hospital admissions each year. The strategy unit also commissioned research that indicated that about one third of all attendances at accident and emergency departments are alcohol-related. It is certainly clear that addressing health harms will need to be a cornerstone of the strategy.

My hon. and learned Friend mentioned alcohol-related crime and antisocial behaviour. He will be aware that the strategy unit's interim analytical report noted that the cost of alcohol-related crime in England has risen to £4.7 billion per year. Action to combat alcohol-related crime will also need to be at the forefront of the strategy.

Before moving on to other matters, I join my hon. and learned Friend in commending the Stella project. As he said, the project works with mainstream substance misuse services to ensure that they can offer non-judgmental help to both perpetrators and victims of domestic violence. The project provides a valuable resource for substance misuse services in the capital, and I add my praise to that of my hon. and learned Friend.

My hon. and learned Friend referred to the evening economy and the problems generated by alcohol-related crime and disorder in an evening economy that often seems to exist only to serve younger people. Supporting urban regeneration by developing a diverse evening economy that caters for a range of ages and leisure tastes will be quite a challenge for the Government, local authorities and leisure providers to meet.

I shall briefly mention some of the risk factors and the reasons why people misuse alcohol. Several factors were identified in the interim analytical report and without understanding what they are we shall not be able develop effective interventions. A number of individual risks were reported—personality, attitudes and beliefs, genetic make-up, age and gender, occupation and, indeed, even the region where people live—all of which have a role to play in whether someone develops a problem and misuses alcohol.

Of course, those individuals do not live in a vacuum, and the report also identifies a number of other factors in an individual's immediate environment that increase risk: family structure and parental divorce, parental drinking and parental attitudes to drinking, relationships with parents and pressure from and relationships with peers and friends.

Of course, risks are posed by the wider culture. The unit's analysis shows that culture and attitudes towards alcohol are driven by multiple influences. At various times, as we all know, many people will use alcohol to be sociable, to gain acceptance as part of a group, to relieve stress or to deal with trauma and to get drunk. The culture of getting drunk and going out to get drunk is particularly worrying, as my hon. and learned Friend and my hon. Friend the Member for Newcastle upon Tyne, Central (Mr. Cousins), who is also present, will agree. The strategy unit's analysis found that going out to get drunk was particularly associated with the 16 to 24 age group, and that, in turn, it could increase the risk of suffering certain alcohol-related harm, particularly alcohol-related violence.

The interim analysis also considered the extent to which the market for alcoholic drinks can pose additional risks for individuals. The unit found that price and availability could influence alcohol consumption and, presumably, could therefore influence alcohol misuse as well, but an individual's relationship with the alcohol market and the extent to which the market shaped drinking preferences or was shaped by them was far less clear. That lack of clarity comes to the fore when we consider the marketing and advertising of alcoholic drinks.

The relationship between marketing, advertising, attitudes and behaviour is, of course, complex. My hon. and learned Friend drew attention to the often conflicting evidence in that area, with one study noting that higher expenditure on alcohol advertising appears to be associated with higher alcohol consumption, while findings from other studies appear to suggest that an advertising ban would not lower alcohol consumption. Furthermore, the strategy unit found that seven in 10 people thought that advertising influenced the amount that others drank, but only one in 10 felt that advertising influenced the amount that they drank.

I think that it has been worth while spending this short time considering those risk factors, as they serve to show us that the reasons lying behind an individual's alcohol misuse can be very complex, and they demonstrate the scale of the challenge that the Government and our partners face in tackling alcohol misuse.

The unit is entering the final stage of its work on drafting the alcohol harm reduction strategy for England. I cannot yet discuss the detailed options that the strategy will contain, but I can say that it will be firmly based around effective interventions in the four main areas: education and communication, supply and pricing, health and treatment services and, finally, community safety and criminal justice. The final strategy will need to contain interventions in all four areas, and it will also need to ensure that the initiatives fit together into a coherent whole, as well as linking to other Government initiatives in the fields of health, crime, antisocial behaviour and so forth.

My hon. and learned Friend has made some valuable suggestions on ways to tackle alcohol misuse, and I should like to discuss them. He suggested the tightening of the current statutory and voluntary codes on advertising, with the option to regulate alcohol advertising in the future; cracking down on irresponsible retail promotions that encourage excessive drinking; displaying sensible drinking information in licensed premises; ensuring that reasonably priced non-alcoholic drinks are available; unit labelling of alcohol containers; an awareness campaign to raise the knowledge of alcohol misuse and its potential for harm; and a levy on alcohol advertising expenditure. As ever, my hon. and learned Friend has come up with some interesting and innovative suggestions, which will be considered by the strategy unit team.

We have seen that there is no evidence to suggest that there is a clear link between the advertising and the promotion of alcoholic drinks and alcohol consumption or misuse. However, as a society we believe that unrestricted advertising and promotion is not acceptable and, as my hon. and learned Friend has noted, we have a number of statutory and non-statutory codes that seek to ensure that the advertising of alcoholic beverages is not aimed towards young people, does not promote excessive drinking and does not suggest that alcohol consumption can be linked with physical, mental, social or sexual success.

My hon. and learned Friend mentioned some recent advertisements that do not appear to be in keeping with the spirit of the codes, and I certainly agree with him. He noted that some drinks manufacturers have begun to take their social responsibilities more seriously and have taken steps to ensure that their advertisements are in keeping with both the spirit and the letter of those codes. Like him, I commend those companies that have chosen to take that action. However, as he notes, there is a growing concern that the self-regulatory elements of our framework are not working as well as they could or should. Ensuring that we can have confidence in our arrangements for alcohol advertising is crucial, and proposals in this area will certainly form part of the strategy.

In relation to irresponsible retail promotions and my hon. and learned Friend's reference to the recent Nicholson committee review in Scotland, we too have read the report with interest and I am always keen to review the practices of and learn from others with an interest in tackling alcohol misuse. We will give careful consideration to the committee's proposals for dealing with those irresponsible retail promotions of alcoholic drinks that result in excessive drinking, even if they do not set out actively to encourage such drinking.

I assure my hon. and learned Friend that we will be looking very carefully at his other suggestions. An examination of the best ways of getting information about alcohol misuse to the public will be one of the fundamental parts of the strategy, and our work in this area will also cover issues such as the display of unit information and the sensible drinking message. I am looking forward to hearing what people have to say about the proposals for an advertising levy set out in the Labour party's big conversation.

In conclusion, I thank my hon. and learned Friend for the opportunity to discuss an interesting and useful topic and for the coverage that it has given to issues relating to the marketing of alcohol and to other issues that are crucial if we are successfully to tackle alcohol misuse. Again, I thank him and his colleagues in the all-party group for providing a valuable contribution to the ongoing development of our alcohol harm reduction strategy for England, and I promise him that it will not be too much longer before he will have the pleasure of seeing the finished piece of work.

Question put and agreed to.

Adjourned accordingly at three minutes to Eleven o'clock.