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CHIEF medical officer Sir Liam Donaldson has called for an alcohol-free childhood, but why is such an extreme measure necessary in the North East and will the public support it? The background to this is that alcohol consumption in Britain has been rising inexorably 121% since 1951 and as a result there has been an explosion in alcoholrelated harm.

One might reasonably ask, however, if this is not a problem with adults and why should children be involved.

Unfortunately, children frequently follow the example of adults and if adults drink too much and condone drunkenness, so will children. What therefore can we do to change society's attitudes towards alcohol so that we all drink responsibly? What is responsible drinking? In 1995 the Department of Health issued the sensible drinking message that adults do not regularly exceed, for men, three to four units daily and for women, two to three units.

Any day of heavy drinking should be followed by two alcohol-free days.

Unfortunately the public were not given any guidance on the unit content of alcohol products, so this advice has been largely ignored.

Also there was no advice about children except that it is illegal for children to be given alcohol below the age of five.

In recent years there have been alarming statistics about alcohol consumption and the harm it does children and it is on the back of these that the chief medical officer has considered it necessary to give parents explicit guidance on alcohol consumption by children.

In the UK an estimated 17 million units of alcohol - equivalent to 6.9 million pints of beer or 1.7 million bottles of wine - consumed in each week by 11- to 17-year-olds.

Surveys have shown 360,000 young people aged 11 to 15 were drunk in the previous week while within a 30-day period, 11% and 12% of 15- to 16-year-old boys and girls respectively reported that they had been drunk at least six times. Each year, 10,000 children aged 11 to 17 are admitted to hospital as a result of their alcohol consumption.

It is well known that starting drinking at an early age is associated with higher alcohol dependence in adulthood and thus the full range of adverse consequences, such as mental or behavioural disorders and organ damage which are associated with alcohol abuse in adult life.

In our unit, 40% of patients presenting with liver failure are now under 40 and many are in their 20s and 30s. In addition to health consequences there are many other adverse effects of alcohol consumption by children, including unprotected sex, unwanted pregnancy, trouble at school or with police, injury from assault or accidents.

The chief medical officer's guidance for an alcohol-free childhood is one of a raft of measures designed to curtail alcohol abuse in society. The first of these was a voluntary agreement in May 2007 between government and the alcohol industry to label all alcohol products with the unit content of the product coupled with daily safe limits for consumption and a message to avoid alcohol during pregnancy and conception.

Unfortunately the industry has largely ignored the agreement and only 2% of alcohol products were correctly labelled in 2008.

The second measure, announced on December 3, 2008, was that alcohol licensing law is to be amended to include a mandatory code of practice.

The details are to be the subject of public consultation, but we hope product labelling will be included so manufacturers will be forced to label products with the correct information which is large enough to be clearly visible and readable.

In light of the guidance, the label should now be modified to include "avoid alcohol below age 15".

The importance of parents in teaching children to drink safely is now soundly founded in the 2007 National Institute for Health and Clinical Excellence guidance on alcohol education in schools and school teaching programmes will include parental participation.

But education programmes alone are not enough to reverse alcohol abuse in society and measures to address price and availability are also required.

The 2003 Licensing Act liberalised alcohol availability mainly to address law and order problems associated with dispersal at closing times.

It has recently been found that 50% of alcohol consumed by children comes from their parents, but the other 50% must come directly or indirectly from trade purchases.

The penalties for selling alcohol to children have recently been strengthened and many council licensing departments now have test purchase programmes to ensure off trade compliance.

Despite this, children continue to obtain alcohol and unsupervised drinking in parks and woods is commonplace.

Police have the power to confiscate alcohol from underage drinkers, but curtailing the hours of alcohol availability in the off trade might also decrease consumption by children and young adults. This is being investigated by the Sheffield School of Health and Related Research.

For children, however, the greatest impact on alcohol harm is likely to come from measures to address alcohol prices.

Alcohol can be obtained in supermarkets for as little as 11p a unit so that the daily safe limits for consumption can be bought for the price of a packet of crisps. Three litres of cider containing 22.5 units (sufficient to kill a child) can be purchased for pounds 3, which is well within their pocket money range.

Urgent action is required to address this problem and the chief medical officer has called for a minimum price of 50p a unit.

Although this is a 24% average increase in 2006 alcohol prices, since only 10% of supermarket purchases by households in Britain are for alcohol, this could be offset by a 2.8% price reduction in the 90% of purchases which are for food and non-alcoholic drinks.

And since 80% of alcohol is bought by 30% of the population, the 70% of families who are responsible drinkers would no longer be subsidising the alcohol bought by the hazardous and harmful group and would be better off.

A minimum price of 50p a unit would also be the most effective way to control deep discounting of alcohol including loss leaders by supermarkets, which would no longer be able to compete for customers using alcohol as an inducement.

Worryingly, most 15- to 16-yearolds associate alcohol consumption with positive consequences and having fun. The need to provide better and more facilities to give youngsters fun in an alcohol-free environment is therefore urgent..

Traditionally youth activities were provided free by churches and scout or guide groups, but local authorities now need to take on this role and youth activity centres should be available in every locality.

Such centres could be the focus for environmental volunteers to help with Nature conservation, horticulture and other skills.

Sports clubs are another venue for alcohol-free activities but the expense of joining and attending puts them beyond the reach of a large section of society. Sports tuition should be provided free by local authorities at youth activity centres to encourage participation.

If an alcohol-free childhood is to be achieved, the provision of alternative entertainment and fun must be of equal priority to the provision of treatment facilities for those who have succumbed to alcohol harm despite a preventative environment..
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Publication:Evening Chronicle (Newcastle, England)
Date:May 4, 2009
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