alcohol

Heavy marketing has created a buzz around alcohol-free beer diverting vital public attention from surging rates of alcohol harm. The stakes are too high to let commercial hype eclipse evidence-based action.

Alcohol deaths were up 33% on pre-pandemic levels in 2022 in the UK, for example. This astonished a BBC Radio 4 news anchor in May, so it is fair to assume the general public is probably less aware still of this dire situation. The US post-pandemic alcohol death surge is similar, at 31%, yet media coverage is sparse and the political response faltering. The WHO warned in summer “there has been little or no progress” in reducing alcohol consumption and harms in Europe.

As the death toll mounts the public is reminded, almost daily, of the success of alcohol-free beer. An alcohol-free beer garden at Munich’s Oktoberfest, for example, gained worldwide coverage, as if it were a sign humanity was turning the page on alcohol. And everything from the Olympics to Formula 1 promotes alcohol brands in alcohol-free clothing.  The unspoken implication is that this is a sign of spontaneous progress.

The rise of alcohol free beer story satisfies our fascination for novelties and craving for miraculous solutions. What’s not to like about a story about, say, a tiny island of non-drinkers in a giant sea of drinking at a Munich beer festival. Is this not a sure sign a quiet moderation revolution is afoot? “The problem is taking care of itself,” we can be tempted to think, “One less thing to worry about.”

But, then again, this positive impression is highly questionable. There is also the very real possibility that the alcohol-free Oktoberfest beer garden is a gimmick to pre-empt criticism and generate positive coverage. In this, it was a triumph, regardless of its popularity. And, more broadly, there is no firm evidence that alcohol-free beer makes any meaningful difference to alcohol consumption or alcohol harm.  We can be thankful some research is due in the next six months or so to quantify the effect, if there is any.

Nevertheless the media’s tireless trumpeting of alcohol-free beer, often from alcohol industry organisations. It is now “common sense” for non-specialists to see alcohol free beer as part of the solution to alcohol harm. In many cases we are falling for Potemkin villages constructed to show the market has the alcohol problem in hand. This is artful public relations triumphing over rational scientific and journalistic enquiry.

Alcohol-free beer has grown to quench a sizable share of the collective thirst in Europe. In France, Germany and Hungary alcohol-free beer is about 8% of the volume of beer in general. This is clearly progress, right? Well, again, maybe, maybe not. We do not know if alcohol-free beer replaces regular beer or if it is in reality chipping into soft drink sales. We might reasonably ask ourselves if alcohol producers would spend vast sums that cannibalise the sales of their core product? 

On an individual level there are more questions. The taste, look and smell of alcohol free beer can prompt some people to crave an alcoholic drink. And alcohol-free beer ads expose audiences including children and people trying to avoid alcohol drinking triggers. Alcohol free spinoffs duck advertising rules which would prohibit advertising the main alcoholic brand. And the imagery of alcohol free beer drinking means sparkling stock photos of attractive people in alcohol drinking situations are still fine.

Alcohol free beer also keeps drinking at the centre of the story. But people who try to avoid alcohol often find alternative activities far easier than attending alcohol drinking occasions sober. Why do we not see more coverage of the benefits of activities which have nothing to do with imbibing liquids, alcoholic or otherwise?  

Meanwhile alcohol interests enter alcohol free spaces, like schools, with self-serving “education” initiatives. And when there is an initiative like Men’s Sheds, mostly for middle-aged and older men to do some DIY, alcohol interests rocks up with some “education”. Tragically it is exactly this demographic who die most often from alcohol related causes.

Alcohol free beer is not all bad, of course. A lot of people like the taste of alcohol-free beer and it is not loaded with calories. And it can help us feel at ease avoiding alcohol at alcohol-dominated social occasions. Holding something that looks like a beer can flag we are ready to be sociable and placebo effects can be helpful to us. And there are some dedicated alcohol-free-only brands that might reduce triggering.

There is nothing inherently wrong with a new category of non-alcoholic drinks. But no alcohol-free beverage is automatically a remedy for large scale alcohol health problems. Our working assumption should be that the effect is minimal until proven otherwise. And the focus of media and policymakers should be on policies which are known to work, like those on price, availability and marketing.

We might also usefully look at promoting activities which do not revolve around drinking liquids of any type, like making things in sheds, for example. We can usefully facilitate these activities and protect them from alcohol marketing. This involves finding new ways to fund alcohol free spaces beyond selling drinks. Alcohol free drinks bars have struggled to survive, but alcohol free spaces offering games and other activities appear to have done rather better.

Hoping alcohol-free beer is reducing alcohol problems without evidence risks costing more lives. The stakes are too high to let uncertainty delay the implementation of evidence-based action to reduce record levels of harm. ■

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Hungarian health Commissioner-designate Oliver Varhelyi faces further questions having last night offered MEPs no clear reassurance he would deliver long-overdue alcohol health labelling proposals.

“We have just introduced a couple of labelling conditions for wine: ingredients, alergen content, but also the energy content. Let’s see how they sink in on the use,” he said when Alessandra Moretti of Italy’s centre-left Democratic Party asked if he would commit to producing proposals on alcohol labelling.

“I believe that we need to reflect on how to change the narrative on risk factors, including alcohol, and the economic determinants of health. Social attitudes can be a key driver for change,” he earlier wrote in a written answer to the same question.

He will be asked another set of written questions by MEPs who were unhappy with his answers, including those on protecting abortion rights, lack of clear plan for health and ties to his country’s authoritarian leader Viktor Orban. He won applause for defending the effectiveness of vaccines.

The Commission was meant to produce a proposal on nutrition and ingredients labels by the end of 2022 and warning labels by the end of 2023, according to the Beating Cancer Plan. Delivering this plan is part of the mission set out by Commission President Ursula von der Leyen in September.

Varhelyi is the first of the proposed commissioners to face such a redo. He will have to deliver his written answers by Monday. ■

by Cassandra Wright, Menzies School of Health Research; Beau Jayde Cubillo, Menzies School of Health Research; John Holmes, University of Sheffield; Mark Mayo, Menzies School of Health Research; Mark Robinson, The University of Queensland; Michael Livingston, Curtin University; Nicholas Taylor, Curtin University; Sarah Clifford, Menzies School of Health Research, and Tim Stockwell, University of Victoria*

[Read more…] about Guest post: Why Northern Territory alcohol reforms would be a disaster, according nine experts

Recommendations for alcohol and other drugs from Professor David Best of Derby University based on evidence he outlined at yesterday’s NHS Addictions Provider Alliance conference:

1. Get specialist help if you need it, including to deal with any trauma or long-term psychological health problems
2. You can rely on peer support. It can be but it doesn’t have to be mutual aid groups like AA or NA [Narcotics Anonymous]
3. Move away from using friends and find social groups that do not include alcohol
4. Do things—sport, education, hobbies—they build your social networks and your self-esteem 
5. You can help yourself a lot by helping others 
6. Be optimistic—you will get there—most people do

by Ian Hamilton, University of York

Increased drinking during the pandemic has created a group of people who don’t see themselves as alcoholics but have difficulty abstaining from alcohol for any length of time. This group, starting to be called grey-area drinkers, are at risk of alcohol-related health problems.

The relatively new term “grey-area drinking” describes people who consume more than a moderate amount of alcohol but don’t meet the criteria for dependence. Although they might not drink every day or have a drink first thing in the morning (the widely held view of an alcoholic) they are likely to be preoccupied with alcohol and have difficulty giving up. Many of these people don’t view themselves as in need of help.

Any widespread increase in levels of alcohol consumption matters. While most people are familiar with the risk of dependence there are a range of severe physical health problems associated with increased alcohol consumption that they are not so aware of. These include heart disease and a range of cancers, including bowel and breast.

Litres of alcohol bought in shops from April 2018 to 1 March 2021

Although overall consumption of alcohol has been slowly declining in recent years there is emerging evidence that some people have increased their consumption. The heaviest-buying segment of the population increased their purchasing by 5.3 million litres of alcohol (+14.3%) from 2019 to 2021. At the same time physical harm from alcohol has been increasing, with a significant rise in hospital admissions and alcohol-related deaths.

Public Health England collated the results of 18 surveys of self-reported alcohol consumption during the pandemic. Between 11% and 37% reported drinking less but between 14% and 26% of people reported drinking more than usual. This is especially concerning given that we know most people underestimate how much they drink by up to 40% in these surveys.

Pubs were closed during the pandemic, so drinking at home increased. This may have encouraged drinking in large quantities as people tend to pour larger measures of alcohol when drinking at home compared to the measures they are given in bars.

Evidence found that those who experienced stress during the pandemic increased the amount of alcohol they drank and how often. One international study exploring alcohol consumption during periods of self-isolation found that it was British drinkers who were most likely to increase the amount of alcohol they consumed – which they say was due to elevated levels of COVID-related stress.

These surveys found a noticeable increase in consumption for some once the pandemic began. Those who were drinking below the governments recommended weekly limits, continued to stay within these limits. However those who were already drinking above the 14 units a week increased their consumption.

Current UK guidance suggests no more than 14 units of alcohol should be consumed in a week (see illustration).

Levels of hazardous drinking are considered to be more than 50 units a week for men and 35 units for women. Evidence suggests that there was a 59% increase in those reporting drinking at these levels compared to before the pandemic.

Some argue that the alcohol industry embraces the perception that the majority of people drink responsibly. This has been one of the industry’s main arguments for resisting greater regulation. The industry points to the need for personal responsibility rather than corporate responsibility, although they fail to define what responsible drinking is. This shifts the onus onto the individual to make a change to their drinking habits rather than requiring the industry to make changes to its marketing or promotion techniques.

At a time when there is a clear need to tackle increased alcohol consumption, funding for specialist treatment and support has been withering. Some sections of the alcohol industry were encouraged to increase marketing spend as it would be more effective than ever. Some analysis shows that alcohol companies have also used lockdown for targeted social media activity. And the alcohol industry’s multi-million pound spend on marketing is huge, compared with the budget for public health messages, a truly David and Goliath struggle.

There has been little mention of alcohol or our unhealthy relationship with it during the pandemic by the government. For instance, off-licences were deemed to be essential services and stayed open during lockdown. The alcohol industry has proved to be adept at influencing government policy in its favour.

As treatment budgets are cut industry marketing increases and there is nothing to suggest that there will be any reduction in demand for hospital treatment due to alcohol or, sadly, coroners recording yet more alcohol-related deaths. ■

Ian Hamilton, Associate Professor of Addiction, University of York This article is republished from The Conversation under a Creative Commons license.

A heavily-criticised deal to promote beer brands at the next two Olympics covers all brands in AB InBev’s portfolio, Alcohol Review has learned.

The deal shows a “disgraceful disregard for the health and wellbeing of the millions of children” said the UK Association of Directors of Public Health on Monday, with Scottish health NGO SHAAP saying it is “very disappointing”,

The agreement between the International Olympic Committee (IOC) and AB InBev will cover “all the brands within AB InBev’s portfolio”, a spokesperson told Alcohol Review today, adding that there will be “a global focus on non-alcoholic beer products”. 

The deal includes “increased prominence and availability of these products for fans and athletes across the world to celebrate and encourage responsible drinking”, the IOC said. It said the  partnership will be “led globally” by AB InBev’s new no-alcohol brand Corona Cero. Olympic sponsors’ brands are not seen on the field of play as they would be in football.

“The proposed marketing activities are focussed on an adult audience only with a strong responsible drinking message as a key component. We are confident that this partnership will meet all appropriate industry standards in relation to its positioning and messaging,” said a British Olympic Association spokesperson.

Critics say the purpose of promoting a zero alcohol brand like this one is to simultaneously promote a near-identical alcoholic brand, hoping to sides-step advertising restrictions like those in France, which hosts the games this year. 

The IOC’s statement on Friday said AB InBev’s 3.5% Michelob Ultra brand will take the lead at the Los Angeles games in 2028. One of its selling points is being relatively low in calories. The Olympics have featured some alcohol sponsorship before but this is the first time an alcohol company has been a worldwide partner. ■