Alcohol in Australia: Key trends and recent developments

Michael Livingston

Background – why alcohol?

Contributes to an array of health and social problems –  Liver disease, heart disease, cancers, etc etc –  Injuries from accidents (e.g. falls, traffic), violence –  Mental health (e.g. Suicide, depression)

But: widely enjoyed, moderate consumption associated with improved health outcomes and psychological wellbeing

Societal ambivalence

Historical  consump/on  data  

0  

2  

4  

6  

8  

10  

12  

14  Alcohol   Spirits  

Wine   Beer  

Interna/onal  consump/on  data  

0

4

8

12

16

20

Interna/onal  consump/on  data  

0

4

8

12

16

20

Recent trends in consumption

Perception that alcohol is an increasing problem in Australia society –  “Epidemic of binge drinking” (Rudd) –  “Drink until you drop culture” (Scippione) –  “Binge drinking out of control” (AMA)

Per-capita consumption is at its lowest level since the mid 1990s

Distinct shifts in drinking behaviour among young people

Consumption

Underage drinking

0%

10%

20%

30%

40%

50%

60%

70%

80%

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

NDSHS (14-17) ASSAD (12-15) ASSAD (16-17)

Consumption

Age at first drink (of current drinkers aged 18-24)

12.0

12.5

13.0

13.5

14.0

14.5

15.0

15.5

16.0

2001 2004 2007 2010

Consumption

Risky drinking by young adults

0

10

20

30

40

50

60

2001 2004 2007 2010 2013

18-24 year olds 25-29 year olds

Consumption

But...

0

10

20

30

40

50

60

2001 2004 2007 2010 2013

18-24 year olds 25-29 year olds 40-49 year olds 50-59 year olds 60-69 year olds

Consumption trends Drinking among young people steadily declining

–  Particularly those under the age of 18 –  Trends appear to be consistent across an array of population

sub-groups (e.g. rich and poor, urban and rural) and not due to increasing cultural diversity

–  Not offset by illicit drug use

Drinking among older cohorts is steady or potentially increasing –  Some evidence that very heavy or ‘binge’ drinking is

extending into later adulthood –  E.g. 5% of 30-39 year olds drink 20+ drinks at least monthly,

up from ~2% 10 years ago

Source: National Drug Strategy Household Survey, 2001-2010, pop aged 14+

Attitude shifts

Clear evidence that public attitudes towards alcohol are shifting –  Greater media concern –  More worry about alcohol as a problem –  Increased support for restrictions –  Attitude changes not limited to particular subgroups of the

population

Drug of ‘most concern’ for the general community

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

2001 2004 2007 2010

Alcohol Tobacco Meth/Amphetamines Heroin

Drug causes the most deaths

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

2001 2004 2007 2010

Alcohol Tobacco

Meth/Amphetamines Heroin

Support for restrictive policies

0

0.5

1

1.5

2

2.5

3

3.5

4

1995 1998 2001 2004 2007 2010

Price Outlets Trading hours

Media focus of alcohol stories

Azar, White, Bland, Livingston, Room, Chikritzhs, Durkin, Wakefield (submitted) Something’s brewing: changing trends in alcohol coverage in Australian newspapers 2000-2011

Harm trends

Generally increasing harm rates over the past decade (although road injuries and deaths are steady)

0

10

20

30

40

50

60

70

2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13

Hospital admissions Ambulance attendances Treatment episodes

Assault Family incidents Emergency Department

Harm trends In spite of promising data on consumption, rates of

problems are high and increasing –  Recent research estimates that >5,000 die each year due to

alcohol, and more than 150,000 are hospitalised –  Harms are spread fairly evenly across the age spectrum

–  Higher rates of injuries among young people

–  Higher rates of chronic disease in older groups

–  Men generally experience higher rates of harm

Conclusions

Victorian and Australian alcohol trend data provides a confusing picture –  Reasonable evidence of harm increases

–  Generally stable levels of consumption, which obscure: •  Major reductions in teenage drinking •  Declines in risky drinking, particularly among young adults •  Some slight increases in drinking among older people

–  Big shifts in attitudes towards alcohol

Conclusions

Little evidence to explain these changes –  Increased public health presence in media coverage of

alcohol may be driving or reflecting changes in public attitudes

–  Declines in youth consumption may represent a reaction against heavier drinking cohorts

•  Reasonably good evidence that teenage consumption predicts future drinking behaviours, so current reductions are promising for ongoing gains

•  Alcopops tax and secondary supply may have contributed, but can’t explain the degree of change observed

•  The success of FebFast and Hello Sunday Morning may be a cause of or a reflection of changes in attitudes to drinking among young people