This is an uncorrected AI transcript for guidance purposes only
Alice Wiseman: I kind of feel like I’m on a call with people who are real experts in this space. So, obviously I have a very particular interest in alcohol harm. and being from the northeast and being a director of public health across two local authorities in the northeast, it is right that I have that concern at a population level. Half of our population are drinking in a way that’s harmful to themselves. but at the same time, I don’t have the sort of background academic expertise that you have with many people on the call. shall I go for it and say what I was going to say,…
Alice Wiseman: Andy, and then we can All right.
Andy Mohan: Sorry. Yes.
Andy Mohan: I’m just loading the presentation now.
Alice Wiseman: Brilliant. I mean, I was going to start with the kind of background for Gates Head and for Newcastle. and as I say, I’ve been director of public health in Gates Head since 2016, and I just took on the joint role across the two in 2024. you’ve probably heard this already, but we know that alcohol It’s 91% more affordable than it was in 1987, available for as little as 13 p per unit in the Northeast. And that was based on a balance survey of 2018. So there will be some changes in that. But we also know it’s way too available with over 8 and a half thousand premises just in the northeast alone. we are one of the areas that has the highest regional outlet densities across the whole country and that’s based on home office data.
Alice Wiseman: We know that it’s available 24/7, 365 days a year and in locations such as petrol stations and believe it or not soft play areas. it’s too heavily promoted. we’ve heard about that and we know that alcohol marketing does influence children. so we know that some research that was done that an awareness of alcohol brands demonstrated that children aged 10 before they leave primary school are able to identify various alcohol brands. It’s largely unregulated and especially online.
Alice Wiseman: And I have to say, I met with a mom of a 31y old who died just before Christmas in Gates Head and he’d managed to buy four liters of vodka on four separate occasions and have it delivered to the house with absolutely no safeguards in place. so there’s a whole issue that we’ve got around the online system, sponsorship of high-profile events. football is the most recent thing for us in the northeast at the moment with our success at the weekend. and we know also the alcohol industry has access to the heart of government. we saw this in February last year where there was a health select committee and the only people who were invited to speak at the first evidence gathering session were funded by the industry. And next slide please.
01:25:00
Alice Wiseman: So in terms of where we are in the northeast, just so you can give get an example and where we are specifically in Gates Head, we have the highest rate of alcohol specific deaths of any English region which is 25.7 compared to 15.9 per 100,000. So significantly higher. there were just under 700 alcohol specific deaths in the northeast in 2023 and that was an increase on the previous year where there was 576. So 100 people died in addition to the previous year in 2023 an increase of In Gates Heads that was just at around 60 deaths compared to only 43 in 2022.
Alice Wiseman: So this is an issue that we’re facing that’s getting worse over time. We know that there’s over 1 million related hospital admissions. Our rates have overtaken Scotland. and we know that the average age of deaths for somebody with alcohol specific mortality was of 57, but we also know that there’s significantly younger age groups affected where and when you look at the average age of death for all causes in the area that I work in, it’s se 78. So a real significant problem. increase in liver disease. You all know that and worse and we know locally by co-orbidities affected by health inequalities. so we know that half a million people are unable to work because of poor health that results from alcohol, tobacco and unhealthy food costing the UK economy 31 billion a year. so really if we’re focusing on the wealth and prosperity of the country, this is an issue that we can’t continue to neglect any longer.
Alice Wiseman: And next slide please. In terms of the breakdown of costs for Gates said we can see that it’s got a huge impact on community safety cohesion general being in the burough. We’ve got a really significant impact on our health services and hearing all the time about the pressures that we’ve got in our beloved NHS. again we can’t fail to address this as an issue if we’re going to resolve that problem. we’ve got a real issue again from an economic perspective in terms of presentersism, absenteeism and unemployment and per capita cost it’s around £541 in Gates Head per person compared to around 485 in England. And next slide please. So this is what we want and I’m sure that everybody on the call today will agree.
Alice Wiseman: We want a society where alcohol is less desirable and recognized as harmful. we do think that there’s an opportunity for alcohol advoc advocacy to be strengthened and particularly thinking about how we work more closely with tobacco and obesity colleagues and focus on reducing the impact of unhealthy commodities. we know that we need to focus on reducing harm in our most vulnerable groups and the alcohol paradox where we see greatest levels of harm in our most disadvantaged communities even when they are not consuming alcohol to the same extent as more affluent communities. We have got a positive emerging downward trend in conception in consumption amongst young people.
Alice Wiseman: So, how do we maintain that momentum moving forwards? Because we know that the age groups that are drinking in the most harmful way are kind of the 45 to 55 the age group that I myself sit in. we want a place where big alcohol in is an industry is excluded from policym in the same way that it is for tobacco. I just don’t find it acceptable that they are brought to the table to provide advice on prevention of harm when we know that the vast majority of their profits are based on, continuing and creating that harm. And we want a world where sobriety or low-risk consump consumption of social norms. So, not saying that we’re ever expecting it to become, sort of alcohol-f free, but at the same time, that place where social norms are completely changed. Next slide, please.
Alice Wiseman: So if I’m talking about this, I want us to think about we’re learning from history, and I think we’ve got some great progress that we’ve made on smoking that gives us an opportunity to think about what happened there and what can we learn from it. next slide, please. so this just gives you a kind of at the start of the framework of 1962 when the Royal College of Physicians wrote their first report around the linking tobacco and cancer. And there’s a really interesting BBC interview in the archives where they talk to people on the streets during that time and people are saying we don’t want them to take our cigarettes away. That’s something that we enjoy doing. When you watch it, it reminds me exactly where we are with alcohol now. But over the years we have made progress in terms of reducing smoking prevalence. But alongside those things we’ve taken action on advertising, marketing, labeling.
01:30:00
Alice Wiseman: I’ll move on to the next slide so you can see up to date to date just onto the next slide where we were looking at focusing on point of sale displays rises in age and alongside all of this we’ve seen increases in prices and more recently of over the last few months obviously we’ve got a real ambition around a smoke-free generation. Next slide please. So legislative measures work. We’ve seen it with tobacco. this is a cancer research UK slide which I have borrowed for the purpose of this. But you can see all of those interventions have contributed to that decline in smoking prevalence for both men and for women. Next slide, please. And the most important thing for me here is it’s contributed to a decline in smoking prevalence for our children and young people.
Alice Wiseman: So action on the adult world has changed the world that our children and young people grow up in. And I think that that’s really important to note because often what we find is industry talking to us around we need to educate young people. And we’ve seen some of the work that Mark Pedigrew’s done, sorry, around exposing the alcohol industry influence in our education systems, which is seeking to normalize the use of action on the adult world rather than education for children and young people is the most effective way of having that impact and reducing the harm that’s caused. Next slide please.
Alice Wiseman: So I know you all know this again but common industry tactics we know and we see an awful lot around lobbying and political party donations not just for alcohol we’ve seen it for gambling for all sorts of things manufacturing doubt and shifting the blame doing their own research and presenting that as factual and grant was highlighting some examples of that when I joined the call there. aggressive marketing and advertising and I do think marketing and advertising has an impact on the things that we do. I don’t believe that people would spend billions of pounds marketing and advertising if it didn’t influence the choices and the decisions that we make. self-regulation. So promoting that self-regulation which again we know has absolutely no direct impact on anything and we’ve seen that with the public health responsibility deal which have very little impact.
Alice Wiseman: But also things like community alcohol partnerships which are funded by industry and actually often seek to distract local areas from sort of having the conversations and taking the action in the spaces that are more impactful that issue of corporate social responsibility. So being able to see that they’re funding things like drinkware. look we’re being responsible. we’re trying to tackle the harm with you. We’re part of the solution. that focus on personal responsibility, actually trying to say that it’s okay for people to drink responsibly, to gamble responsibly, and I just thinking about taking that back to the individual distracts us again from the things that we need to do at a population level. to suggest that treatment services aren’t absolutely essential for those people who require that support.
Alice Wiseman: But actually what we need to do is to challenge the narrative of personal responsibility because that also challenges the stigma associated with people who are drinking in a way that is harmful. and I think that that is certainly locally in some research that we’ve done recently, one of the biggest barriers to accessing for treatment services is the fact that people feel really ashamed and stigmatized. And I’ve already highlighted the industry sponsored education and awareness programs which Mark has written about. And actually one of the things that really stood out to me when I was learning from that work was that they were teaching 11 year olds not to drink on an empty stomach. As opposed to teaching 11 year olds that actually drinking is harmful for their growing and adolescent brain. We were saying you’re going to drink so just make sure you don’t do it on an empty stomach. It just seems Yeah. crazy.
01:35:00
Alice Wiseman: Next slide, please. So, how have we done the work around tobacco across the northeast of England? So, taking this back to a local DPH perspective, we’ve been really fortunate that we’ve got had our regional tobacco office in the northeast since 2005, almost 20 years I think. massively based on international evidence provides that comprehensive tobacco control program which looks to encourage smokers to quit and prevent youth uptake but to also look at how we can protect people from tobacco related harm. It’s jointly funded by 12 local authorities across the northeast. We’ve always funded it and also now the northeastern and north integrated care board.
Alice Wiseman: and I’ll talk a little bit more about our alcohol equivalent in a moment, but you can see from the slide there that this isn’t about taking a single approach. This is about making sure that the Northeast has that voice and that advocacy at a national level. but also that we have the opportunity to think about, some of our mass media campaigns. If you want to move on to the next slide, and this is where I was thinking when I joined the call with Grants. I think I probably need to rewatch Grant’s presentation because I think what we found in the Northeast is that by raising awareness of the harm, we’ve supported people not only to access stop smoking services, but we’ve also built public support. So alongside these campaigns that we do and actually we use a lot of led work. So a couple of these are people who experienced a cancer journey as a result of smoking talking about the facts that they found it so hard to quit.
Alice Wiseman: And the lady on the right hand side Sue was talks about she took three attempts to quit despite having multiple cancer experiences and I think that bit around taking it back to the individuals. but it builds that public support for the measures that we need at a national level. So when it came to the smoking ban in 2008 I appreciate that’s a long time ago now. the northeast had the loudest voice. we provided the most returns nationally on what was needed because we had already built that work around public support. Next slide please. So in terms of learning from the lessons I think from tobacco and these are just my views there probably other things on the call. We need to recognize the problem is to be addressed and work on it together.
Alice Wiseman: And I’m talking about this from a local level, but also a regional level and a national level because there’s things I can’t do locally that I need national and regional to do. Making sure that we’ve got that comprehensive multistrand and long-term approach and it is about, sticking with it and holding the faith. So there was some work that was published I think yesterday, it was on radio 4 yesterday anyway that was talking about smoking prevalence across the country and saying the northeast has had seen the greatest declines and there are some areas of the country where smoking prevalence is possibly creeping back up again and I know we probably had the highest rates of smoking to start with.
Alice Wiseman: So there’s an element of that, but actually the reason I think that we’ve got that is because we have that comprehensive approach across all of the northeast working with all of our colleagues to try and ensure that that is delivered and also like I say holding the faith when things have been difficult. So evidence-based jointly owned actions and we need to look at monitoring working at scale I’ve mentioned that already because some things only need to be done once. if we could increase the price of alcohols through minimum unit price and taxation, we would only have to do it once. we think key messages and making sure that they’re communicated by many voices. So, I’ve talked earlier on about the fact that we’ve used local people to communicate those messages alongside some of our amazing clinicians that are working kind of at the front line dealing with the consequences of the harm caused. And then that visible and enthusiastic leadership at every opportunity, which is difficult.
Alice Wiseman: I think we’re winning there with tobacco, but sometimes when I talk about alcohol locally, I have people rolling their eyes or, having a little snigger because we’re not quite in the same place there. And sometimes it becomes hard to do that. But actually, I always think back to the public health colleagues in 1962 must have felt exactly the same. And so I feel it’s our duty to continue to do that as much as we can. Next slide, please. So communication strategy and again it’s around efforts to ensure that we’ve got that ongoing media presence making sure that people are informed making sure that we are building that public support because it is public support that shifts the politicians. they’re not going to do anything that they think is going to cost them votes and I understand they’ve got that challenge and that balance and reach that we don’t have.
Alice Wiseman: but building that public support means that you’ve often got them with you and sometimes they can come to it a bit later because individuals every politician I’ve ever spoken to gets it and I’m haven’t spoken to lots of senior politicians but at a local level definitely they all get it but there is also that fear around and voting so local champions including political leaders and actually from the smoking work we’ve had great leadership so Mary Foy MP was a local council portfolio lead for health when I first started in Gates Head and she led all of the local Gates Head work and when she became an MP for Durham, she’s continue to lead it and chair various committees that’s made a real difference. and having that broader understanding around the commercial determinance of health talked about awareness and support for change so that the public are with us and focus primarily on adults and this is again a difficult thing at a local level.
01:40:00
Alice Wiseman: People are often saying, we want to do more work in schools. We just need to talk to children about, the harms and it’ll change what they do. I don’t know about you, but when I was a teenager, I was probably completely the opposite to that, and the evidence doesn’t sit there at all. But some of the challenges we’ve got is that while we’ve got industry getting in there and trying to do stuff in schools, again, distracting from the real things that we need to do, trying to be responsible. and sometimes we feel like we’ve got to counter that by providing the education where we wouldn’t normally, but we’re trying to, make sure that industry aren’t there, in instead of us. And then just accepting that it is complex and it takes ages but like I say I hope it won’t take as long as it’s taken for tobacco from 1962 to now and still more to go. but equally we have to kind of stick with it. So next slide please.
Alice Wiseman: and again the point that was made, I think it was by Sheila before around trying to pick those things that we know we’ve got a potential appetite for at the moment, because we can’t necessarily do everything. And sometimes as much as you don’t want to, you have to compromise on those things that are acceptable. And I think COVID 19 was a really interesting natural experiment. We would never have got the ethics to do it and understandably so. because actually what we saw was harm from alcohol rising during the pandemic when our entree sales were predominantly closed. People were buying cheap supermarket alcohol and drinking to excess at home and we saw it skyrocket. We know that the industry uses the hospitality sector as a way of pushing back at us.
Alice Wiseman: So actually the conversation and also we know that entrade they tend to make more money from food now than they do from alcohol. They tend to sell above what we would have ever had as a minimum unit price. And there are safeguards on trade in that if a pub locally in Gates Head is to is selling to somebody who’s intoxicated then we can seek to review their license and withdraw their license from them. so there are measures in place to help us tackle the entree. So is there a conversation around focusing on the off trade as something that might be politically more acceptable? we know that the number of offlicicens has increased significantly over the last 30 years. we know that 90% of beer was sold in pubs whereas we’ve seen a real significant shift like I say in that drinking up to 80% following the pandemic.
Alice Wiseman: And we also know from our local because we do annual perception surveys in all of our local authorities as part of our balance program is that 95% of northeast residents feel that there are either enough or too many places selling alcohol. So we already have northeast public support and over half of our residents agree that offrade sales should be limited between 10 and 10. so we know that there’s public support there and as I’ve already spoken about the very tragic place that isn’t not an isolated incident of a dialer drink service and the impact of harm that causes. Next slide please. So I’ve already covered quite a bit of this. we know that the harm is being driven by treat strong offrade alcohol.
Alice Wiseman: there’s data on the slide there that you can see in terms of the average cost of laga on trade is £4.70 and off trade it’s 1.51. we heard, we’ve had adverts, articles where they’re highlighting that the attack on supermarket chiefs for selling booze at 1980s prices. and we know that this is a real shift and this is one of the reasons that we’re seeing this increase in the level and palm.
Alice Wiseman: So again linked to that if we’re thinking about reversing some of that then it is about reinstatement of the duty escalator minimum unit price wouldn’t impact on price in the tra on trade it might actually shift people to drinking on trade have a positive impact if we’re wanting to think of it that way but also learning from Scotland in terms of the ban on multi buy offers and alcohol promotions and I always remember a researcher talking to me about some research they did where they said this is a few years ago
01:45:00
Alice Wiseman: where you could buy three bottles of wine for 1010. And when the ban on multibby offers was in introduced, they just reduced the price to £3.33 per bottle. But actually what they found were people were buying the bottle they wanted rather than the three bottles they thought they had to buy to get the deal. So even that sort of shift would be helpful. Next slide, please. So obviously you’re on the call, I think probably because you get the importance of prevention. Next slide, please. So, we know the evidence of what works. So, I mean, if it was down to all of us, we know that we would be able to shift some of those things. So, I think that we need to continue to talk about a comprehensive evidence-based multi- strand approach. Again, like I say, learning from tobacco. We’ve got the World Health Organization evidence evaluation from 2016, which looks at those population interventions.
Alice Wiseman: they’re effective and as pointed out earlier cost effective in terms of at the moment we are subsidizing alcohol harm. the real importance I guess of cross-system working both locally like I say regionally and then nationally that voice is so much stronger when we all work together on it. I think there needs to be that focus on upwards opportunity for us to work together on advocacy and legislation around price promotion place and again using people who’ve got lived experience in this space is really powerful and try starting to shift the perceptions of individuals. so locally we do quite a bit of work around aware awareness raising.
Alice Wiseman: So, for example, in the Northeast about five or six years ago, it was only one in 10 people understood that there was a link between alcohol and cancer. And so, we’ve been doing work to make sure that we are promoting and ensuring that people do understand that there’s a link between alcohol and cancer. And we’re now crushing up to about 30 35%. So, still a long way to go when we know that one in 10 breast cancers, for example, is caused by alcohol next slide please. I think I’m getting to the end. So, building on what we talked about earlier on in terms of our fresh approach, we have a very similar approach across the northeast in terms of action on alcohol harm. we have a lot of support for local engagement. So again, there are things that we can do better across a larger footprint that we can’t do at a local level. And some of that is coming together and sharing practice.
Alice Wiseman: at the moment we’re looking at the work that Sheffield’s done, for example, on banning, advertising and, what can we learn from that and we use some of that work locally? But balance helps us to do that. Where’s the evidence? What’s working elsewhere, both locally, regionally, but also internationally and helps to almost navigate some of that for us as local DPH, you often don’t have time to do that. advocacy for evidence-based policies. again, Sue and Als from Fresh and Balance doing an amazing job of speaking at a national level, getting the voice of the Northeast there. we’ve got the communications I’ve spoken about making sure that we’re challenging that alcohol industry locally. So, we’ve had North Cumbria sessions with our integrated care board colleagues around commercial determinance of health that Mark and May came and spoke at.
Alice Wiseman: making sure that people really understand the harm that’s caused by industry. and then also, of course, research data. making sure that we’ve got that evidence base and we grow that evidence base locally. and also have that public opinion. So, I can go to my local elected members and go, we’ve got a lot of support locally to do this, and it just gives people that assurance. So, I think this is nearly my final slide. So, key advocacy opportunities. I’m sure you’ve talked about this already. price is absolutely critical. Evidence from Scotland is showing us that it’s working. we’re hoping that there’s some interest from the Treasury because actually the impact of the duty cuts and freezes over the last decade have not only meant that we’ve seen an increase in harm, but we’ve also seen a reduction in the money that would have been coming into government to support the public services that are able to respond to the harm.
Alice Wiseman: have talked about availability, but actually I think licensing laws need to be really revisited health as a licensing objective, again in Scotland, but actually also making sure that we can do that at the population level because often you’re looking at a license application unless you can tie it directly to the harm at that particular point in time. You have to wait until you’ve got a retrospective bit. So being able to look populationwike, we could look at cumulative impact for example for off trade as well as thinking about the kind of nighttime economy which has been easier. labeling and campaigns with the the public have the right And like I say that we do think that awareness changes, behavior, but also it changes the way people view the harm that’s caused and obviously continue to lobby with national and local government. this is the final slide, I promise.
01:50:00
Alice Wiseman: So yeah, we’ve got practical examples, local prioritization of alcohol within the local authority and wider system. So people signing up to, sort of codes of conduct and agreements about how we will work or the fact that we won’t work with industry, the fact that we will look at, sort of the evidence-based measures, making sure that we are thinking about protecting vulnerable groups from harm. Lots of people who are in our recovery communities have talked about the fact that it’s incredibly triggering to see many of these adverts and some around Christmas and what have you maximizing opportunities through licensing so we’ve developed a matrix where you can put in the postcode for a new license and it pops up with all the harm that’s caused in that area not just from the health perspective obviously because it’s not a licensing objective but also from the crime and disorder and protecting children and some of those other things that we have the opportunity
Alice Wiseman: to feed in with you making sure that we are feeding in around economic regeneration because actually diversification of that kind of economy of leisure services if you have been shown to be impactful in terms of we know that lots of people avoid the nighttime economy because they’re frightened which stops them from going to the theater or stops them from going to the cinema in the evening. but then also making sure that we are focusing on that kind of early intervention and prevention with people who have got already drinking in a way that’s harmful to themselves particularly focusing again in primary care and with our alcohol care teams in the NHS. So I shall stop there if that’s okay.
Andy Mohan: Thank you so much, That was very really interesting. lots of information provided there. and then I know we have some comments coming in. I suppose maybe I’ll just kick things off by asking around the media campaigns because I know with Grant’s presentation, we’re talking about I suppose the effectiveness of mass media campaigns and it was really interesting seeing the different campaigns that you have going on locally. and I was just wondering if I suppose that the effect of that has been measured or captured in any way.
Andy Mohan: Yes, of course. Yeah.
Alice Wiseman: So, all of our campaigns are evaluated and have shown an impact in terms of people considering cutting down. So, I’m not suggesting that that’s going to solve the world on its own at all. but raising public awareness of the homes because I think when people hear alcohol because of the way industries got into our heads people think of people who are lying in a gutter or people who are addicted to alcohol whereas like I said at the start half of our population who are drinking in a way that’s harmful to themselves and the vast majority of people do not understand the link between alcohol and cancer so I think in the same way that we had to build that understanding with tobacco and how harmful it was
Alice Wiseman: and to get that public support that’s kind of the aim that we’re having throughout this and I think that the only way that we’ve been able to do the mass media work has been to do it by collaboration across local authorities because we couldn’t afford to do it as individual local authorities expensive it would be even better if they did it nationally because I’m sure that would be even more effective at a national level and again using local people so there’s a woman a lady called Karen Slater who is from Newcastle who speaks really passionately.
Andy Mohan: Mhm.
Alice Wiseman: She’s written about her own journey through addiction. She actually came with us to parliament earlier in the year to talk to MPs about it as well. But she talks about the impact that advertising has on sort of triggering a relapse for her during her recovery journey. so making sure that you’ve got those local voices I think is also really important. we learned from COVID with the vaccine program. The best people to talk to, people who were reticent to get the vaccine were local people in the local community that had the same, life experiences as them. Not seen as preachy, but seen as,…
01:55:00
Alice Wiseman: kind of helpful. So I do feel there is a place for it. But I will watch Grant’s presentation back as well.
Andy Mohan: No, that’s good.
Andy Mohan: So is there anyone in the audience who would like to ask Alice a question? If you could please raise your hand or you could pop it in the chat. I suppose while people are considering Alice as well I note Alistister’s comment around health as a licensing objective I do a lot of work on alcohol licensing in Scotland and I guess Alistister’s point that we’re not necessarily convinced that even though we have the health as a licensing objective that it really works in reality.
Andy Mohan: I don’t know if you wanted to just comment on that a little.
Alice Wiseman: No, I mean it’s been interesting,…
Alice Wiseman: hasn’t it? Because we’ve looked at some of this when we’ve been trying to lobby for it. And I guess there’s something about building that public support for the wider measures that are needed and this being one of them. So on its own, absolutely. But at the same time, we’ve seen harm increase as we’ve seen availability increase. So, if we’re going to reverse that or at least freeze it, then there needs to be something that we can do to reduce the availability of it. I do think that we could focus differently. I think the licensing act is not fit for purpose as it is.
Alice Wiseman: So I had a conversation with licensing colleagues the other day and even with health as a licensing objective that like I say there’s limited impact that we can have because you’ve always got to look kind of retrospectively is that individual premise going to cause particular harm in that place. it’s much easier to look back and say they have caused harm because they’ve had so many antisocial behaviors or they’ve sold to children and then we can revoke the license So there is something about the current licensing act as it is not fit for purpose. But I think I always make representations where I can. There are times as a director of public health where I’m sat alone making those representations because health is not a licensing objective that often means you’re not listened to because if the police are not sat alongside you when you’re saying there’s antisocial behavior issues or children’s services are not sat alongside you when you’re saying I’m worried about harm to children. Then you kind of lose the argument.
Alice Wiseman: Whereas if I could go in and talk about health, then we would have a different position. And just to slightly extend this, but there was one situation we had where there was a licensing gates head they wanted to open from 8 in the morning instead of 10:00.
Andy Mohan: Yeah.
Alice Wiseman: So it probably felt like, why the stable doors already been opened and the horses bolted. Weather Spoons just down the street selling from 8:00 in the morning. And the reason the local place wanted to do it was because they wanted to compete with Weather Spoons. But it just felt not right. And so we pro provided all this evidence to the local licensing committee around extensions on the hours leading to increased levels of The harm that we saw in the area was around 7:00 in the evening. So by opening it two hours earlier, we were saying actually you bring that harm forward by two hours. It’s really tenuous.
Alice Wiseman: And we did win that locally…
Alice Wiseman: because the elected members that were sat around the table didn’t want children and young people to be exposed to that harm on their way from school after school clubs. But it always feels a bit tenuous and you always feel like you’re kind of David and Goliath in terms of the fight.
Andy Mohan: Yeah, definitely.
Andy Mohan: Okay, so Peter, would you like to come in with your question?
Peter Rice: Okay, and yeah, thanks that was really great, hearing it all pulled together and I think what you’re just saying there about the practical examples of that off license and Gates head I think maybe answer my question because I think what I was thinking about when you’re talking about home delivery systems is that they’re up and running have been for years and it’s very difficult to pull it back once it’s happening. So really what I was going to ask you is what systems you can picture that would prevent that happening. so that there would be an opportunity to stop things before they started if you like.
Peter Rice: so you partly I think answered that what you’re saying about needing the law to be revised but in your ideal world what would that process actually look like so that we weren’t shutting the stable door after the horse was over the rest.
Alice Wiseman: Yeah. I mean,… I guess there’s a couple of things. if I was thinking in advance it would be not only that the license was granted in the place where the premise was that was deliver doing the delivery but that it was actually taken consideration around the geographical area that it could deliver to because I think that that’s part of the problem. I mean at the moment you can pay an extra five quid for a bottle of wine and get the co-op to deliver for you. So I mean we are in a bit of a sort of stuck place with that. I’ll just use a slight link to a different piece of work that we did in Gates So in 2015 we banned any new hot food takeaway planning applications. so in areas where there was more than 10% childhood obesity, there was no new hot food takeaway planning applications. we have had not one new hot food takeaway since 2015. Now everybody said that’s not really going to do anything and it’s closing the stable door after the horse has bolted etc etc.
Alice Wiseman:
02:00:00
Alice Wiseman: However, what we have seen because we’ve had some change of use. So, we have seen a reduction in hot food takeaways. and what we have seen because there was some recent research that was just published before Christmas is in our most disadvantaged communities that had the highest prevalence of hot food takeaways, we’ve seen a reduction in childhood obesity when you compare Gates Head to an area of the Northeast that didn’t have the same policy. I think it was Lancaster University that did that research, but if I could share it or you could Google it. So, it’s that sort of thing that I think that we need to hold the faith with, because actually there is a demonstrable impact of closing the stable door after the horse has walled, albeit small. And I think that learning from the tobacco, it is about those small steps, but it does take local politicians to be really brave because they have been lobbyed multiple times about it.
Alice Wiseman: so with alcohol, that’s where I think we should be going. I mean, I’d love it if we didn’t have delivery available. I don’t think the safeguards are sufficient delivering to someone’s door, both from an age perspective and also from a sort of risk of serving to somebody who’s intoxicated. Once you’ve turned up at the door, you’re not going to not give them the drink, If you think they’re drunk because you run the risk of, violence what have you. So, I mean, ideally, we wouldn’t have it at all. And that’s why I’m saying I wonder if we focus on the off trade because it might be more acceptable to the public and therefore might get us over the line with some of the politicians.
Andy Mohan: Yeah, thank you for that, Peter. Sheila, would you like to go ahead with your question?
Sheila Gilheany: Hi Alison, I’m really really interested in that and just the whole question of a public health approach to licensing. I mean in Ireland public health isn’t given as a reason for licensing. Although there is a new piece of legislation that says that if you open or you seek a new license you have to inform the HSSE about that. But I don’t think there’s ever been any action taken, by the HSSE in relation to that.
Sheila Gilheany: I’m coming back to the idea of I suppose density of outlets as maybe a particular way in which this might be approached and I was just wondering if I was interested there with the linking of the hot food outlets with particular issues that are in place but have you done anything in relation to alcohol and density of outlets there in Ireland we have an amazingly big outlet density.
Sheila Gilheany: It’s, 3/4 of the population live within 300 meters of an alcohol outlet. So, it’s very dense.
Alice Wiseman: Yeah. So in Newcastle,…
Alice Wiseman: predating me, so I can’t claim any of the credit for it, there was work done on cumulative impact zones, but again that work was done on trade because it’s much more It’s much easier to see the harm. So Newcastle City Center is a cumulative impact zone in terms of not able to open new premises or if they do they have to pay significantly more for their licensing so that they then have to sort of contribute to the cleanup and actually many of the premises in the city have signed up to a minimum unit price so the problem for me in terms of density is I think the current licensing act means that we focus on the things where we can see it whereas for me the harm that
Alice Wiseman: is really increasing in our population is that bit that’s less visible in the home and I’m not aware of anybody being able to do anything around cumitive impact generally around density unless it’s got a really big nighttime economy…
Sheila Gilheany: Thank you very much.
Alice Wiseman: where I say it’s easy to show the whole yeah so I could check back but we haven’t in Gates Head or Newcastle I’m not aware of Okay.
Andy Mohan: Thank and I see we have a question from Mark Petru in the chat. so he’s asked, “What are the evidence gaps that need filled to support your work? I.e. What can academics and researchers do to support you that they are not currently doing
Alice Wiseman: Not currently doing that’s a tricky one because I use all of the research. I mean, Mark’s one of the people that I quote all the time in everything that I do. So, and think I guess, the being able to demonstrate things like I don’t know if I’m allowed to say it because I’m scared I’ll be taken to court, so I’ll not use names. But when Mark did some analysis around a school-based education program that was focused on alcohol, the ability to be able to do that and publish it meant that we could then share it without fear of litigation because I think that there’s always that issue locally that if you take it on individually and we have had emails where we’ve been told that we shouldn’t be saying certain things from industry sources.
02:05:00
Alice Wiseman: So that ability to be able to say to schools here’s the evidence that shows that that is ineffective sort of that is helpful I think the research it’s how we bring the public with us because we know what works don’t we know the things that we need to do but it’s how we bring the public with us so there is something about how do we build that public support for this how do we build the public understanding around the commercial determinance of health how do we do that work so that we can bring them with us? I guess it goes back to some of the framing stuff that I think Grant talked a bit about when I joined the call as well.
Alice Wiseman: there’s probably loads more I could think of afterwards, but at the moment, and I do use all the research, absolutely, like I say, in the license objection that I put in when they were looking to extend that, it was academic research that we used to demonstrate that by increasing your hours of opening by an hour, it would increase your harm and similarly with the hot food takeaway work, we demonstrated that if people were more likely to experience greater levels of harm if
Alice Wiseman: I think it was Cambridge Uni had done some research around, if they hopefully take away on their way home from work, they’re significantly more likely to. and then the other bit that I would say is around inequalities. because we often, focus on work, but actually how do we make sure that we, address for the alcohol paradox where the harm’s greater in almost disadvantaged communities. and I know that no and low is contentious so I’m interested to see the outcome of my big concern with that is it makes the industry look like they’re being responsible. It allows them to be part of the solution and I think the impacts at a population level and certainly with our most disadvantaged communities will be limited because it’s not a cheaper product.
Alice Wiseman: so there is something about being clear what if we are going to look at something like that the impact that it has not just sort of at the population level but on inequalities as well you’ve probably got loads of other things that I should have said Mark so apologies I mean I guess the other thing I’m thinking now you’ve said that is around sort of children and…
Andy Mohan: Yeah, definitely. Yeah.
Mark Petticrew: Thanks very much. the reason for asking was exactly that just continually trying to think about what’s actually useful to do and your presentation and grants beforehand were quite useful in terms of thinking what I mean there’s lots of things one could do but yeah what’s actually All
Alice Wiseman: exposure to and that bit around children being able to identify alcohol brands. There’s a bit of that already been done, but it’s kind of always useful to be able to use it because then when you’re talking to local politicians, they get the whole thing and local people, they get the whole protection of children from harm, So, actually, if we use that almost as a bit of a focus, but the way we protect children from harm isn’t through education. It’s through changing the adult world.
Andy Mohan: I think maybe at this point in time, Grant, I might just invite you. Don’t know if you had any kind of thoughts reflecting on Alice’s presentation in relation to what you’ve presented.
Andy Mohan: Hopefully, I’m not putting you on the spot there, Grant.
Grant Ennis: No, I really liked your last comment,…
Grant Ennis: I was typing it down just now that Let me see. I didn’t get a chance to finish it, but you were saying that the way that we improve things for children is not through children’s educ education, but through changing the adult world. I think that’s a great way of framing the material environment, the adult world. I think we can be using that a lot more. I think on the power of media to make sure that we’re framing the work that we’re doing and getting the word out there and building political support for what we do. Also labels, also education. I think we’re all in agreement on the value of it to get the word out.
02:10:00
Grant Ennis: I think where I just tried to make very clear the more we place the locus of responsibility or change on individuals be the label reader be the child or the person in the video clip the less we build support for political change and that’s very tricky and that gets an area of public health that we don’t discuss enough. It’s used to be called critical discourse analysis. it’s where is responsibility in a given sentence, in an image, in a video clip. And the personal story narrative rather than the societal story narrative is a very important distinction. Both can use a video clip.
Grant Ennis: both can be using a meme or an op-ed, but one builds support for policy and one removes support for policy and that’s a very difficult and fine line to walk. and I think we all are working on it together. Industry is definitely pushing for one direction and I think the more we can do to push in the more success we’ll have in saving lives. another thing I just wanted to say, nice to finally meet you, Alice.
Alice Wiseman: You too. I’ve read your book.
Andy Mohan: I guess for me kind of maybe just reflecting on…
Andy Mohan: what you just said Grant as well as Alice. so we have one of our spotlight sessions by Mary Martin Madden around alcohol brief interventions and actually alcohol brief interventions 2.0 door. really the kind of key point is that alcohol brief interventions the way that they stand at the moment are just no longer fit for purpose because they really focus on the individual and the individual’s ability to self-regulate the drinking without acknowledging all of these wider influences on drinking behavior.
Andy Mohan: And so if anybody has time please do go take a look at that spotlight session because it’s really interesting concept and I know recently public health Scotland they just provided a review of the Scottish alcohol brief intervention program and essentially the bottom line is also the same is that ABIS while I think in the past in
Andy Mohan: in I guess 20 plus years ago were really seen as a tool that could be used by GPS and other healthcare practitioners that actually do see a lot of population again over the recent I would say decade or so the number of ABIS being done or has been declining and so I think it’s really interesting I think that idea of the individual ual and the individual responsibility, considering, the huge attempts by the alcohol industry to really influence drinking at a level that’s not really conscious to a lot of us. So, yep, I just wanted to in introduce that point as well. does anyone have any questions?
Andy Mohan: So, I’m just seeing that a few people are put posting up some links to resources in the chat as well. so, I believe Phil we will be collecting those resources and sharing as well for attendees. Yes, Phil,…
Andy Mohan: would you like to come back in now?
Phil Cain: I will put back in there.
Phil Cain: Thanks very much. We’re actually coming towards the end. I was just going to make a comment which I didn’t make at the end of Grant’s thing about the bot farmer. I have to say I’ve never actually seen them in physical reality but that was quite a shocking image. But as somebody who’s at the sort of front lines of the information war, in online and on Twitter and so forth, a lot of it still does come from originate from, what we would consider old media that often that spawns a narrative and this kind of zone flooding that Grant I would say at the moment often around alcohol free drinks being the solution to all our ills.
Phil Cain: is something that I kind of deal with on a daily basis and this kind of zero sum game politically is kind of played out just in terms of the amount of space on a newspaper page or in these days on a website only got so much resources to go around and if you can fill it with something that doesn’t work that all to the good as far as the alcohol industry is concerned.