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   Ngā mihi o te Kirihimete me te Tau Hou  
We look back at 2018 as a year that many countries and jurisdictions took important steps forward in the implementation of strong evidence-based policies to minimise alcohol-related harm.

In this edition, we highlight the national and international news and action from the last quarter. Don't forget to prepare your submission on the 2019 Budget Policy Statement - more information below.
  AOTEAROA NEW ZEALAND
Government Inquiry Into Mental Health And Addiction 

Last month, the Government Inquiry into Mental Health and Addiction released their report 'He Ara Oranga' detailing 40 recommendations to improve New Zealand’s approach to mental health.

The report showcases the number of New Zealanders that spoke bravely about the negative role of alcohol in mental health and their concerns regarding our drinking culture.

Chapter 9 specifically addresses the strong action required on alcohol and other drugs. It speaks to the lack of a bold, health-oriented approach to the misuse of alcohol and the failure to implement the strong recommendations of the Law Commission. It also acknowledges the vested interests that have held strong in their resistance to any change in our drinking culture.

Alcohol Healthwatch strongly agrees with the report’s recommendation #26 that we need to:

"Take a stricter regulatory approach to the sale and supply of alcohol, informed by the recommendations from the 2010 Law Commission review, the 2014 Ministerial Forum on Alcohol Advertising and Sponsorship and the 2014 Ministry of Justice report on alcohol pricing."

We look forward to the Government’s response to the report, due in March. We will keep you posted.
Mandatory Alcohol And Pregnancy Warning Labels Over The Line

On October 11, New Zealand and Australian Ministers voted in favour of tasking Food Standards Australia New Zealand (FSANZ) to develop a mandatory labelling standard in relation to alcohol and pregnancy warning labels. The label is to be developed as a priority and completed expeditiously.

Alcohol Healthwatch sincerely thanks New Zealand and Australian Ministers for their strong stance in supporting mandatory pregnancy warning labels.

This has been a long fight for the right of alcohol consumers and women of childbearing age in particular, to be fully and consistently informed that alcohol can cause permanent damage to the unborn child when consumed during pregnancy. Achieving a reduction in drinking during pregnancy rates will continue to require multiple actions across the board, and it is pleasing to see that the Governments of Australia and New Zealand are taking responsibility to require a consistent, visible, and clear warning message on all alcohol containers.

There are some important next steps in the process moving forward - FSANZ have put out an Administrative Assessment Report

Part of the process going forward is likely to include FSANZ consideration of regulatory options of maintaining the irregular voluntary status quo labelling or adopting the Government proposed mandatory option, undertaking a cost/benefit analysis, and further investigation of consumer understanding and interpretation of current labelling. The timeline for next steps are:
  • February 2019: targeted consultation
  • April - May 2019: public consultation
  • June 2019: Report to the FSANZ board (once approved)
  • July -  August 2019: Report to Forum on Food Regulation, who have 60 days to accept, reject or amend the proposal.
So look out for a public consultation on the issue between April-May 2019. Click here to read more.
New Zealand Health Survey 2017/18: Alcohol Consumption

The New Zealand Health Survey is an annual, representative survey of almost 14,000 New Zealanders. Within the comprehensive survey are questions about alcohol use. Although this is the largest survey of alcohol consumption in our country, research tells us that population surveys are likely to result in an under-estimation of alcohol use.

Key findings from the New Zealand Health Survey 2017/18:
  • 78.7% of New Zealanders had an alcoholic drink in the past 12 months, a significantly lower prevalence of drinking than in 2006/07 (83.6%)
  • 19.8% of New Zealand adults aged 15 years and above were classified as hazardous drinkers (around 775,000 adults)
  • Males (27.3%) were twice as likely as females (12.7%) to be hazardous drinkers
  • More than one-third (38.1%) of young men (aged 18 to 24 years) were hazardous drinkers
  • No significant changes in hazardous drinking over the past 3 years of comparable surveys were found
  • Persistent inequities remain in hazardous drinking (greater among Māori women and women living in neighbourhoods with high deprivation - in comparison to the relevant reference group)
Click here for a 4-page factsheet on the latest NZHS findings on alcohol use
Click here for Powerpoint slides to use in your presentations
Ministerial Meetings To Be Transparent

In an earlier e-news, we highlighted the Green Party’s move to publish all Ministerial meetings on this website.

In the last few weeks, it has been announced that all government Ministers will release details of their internal and external meetings. Honourable Chris Hipkins has kicked it off already, publishing his September and October meetings here.

Whether you work to reduce alcohol-related harm or not, this step is important. Transparency is a key ingredient for building trust and accountability in a democracy.

Also important is a mixed methods study published last month of tobacco, alcohol and gambling industry donations to Australian political parties. The paper was entitled "If someone donates $1000, they support you. If they donate $100000, they have bought you". You can read more here.
2019 Budget Policy Statement

Next year will be New Zealand’s first Wellbeing Budget. The Government believes that wellbeing belongs at the heart of policy making and that success of our country should reflect a wider definition that incorporates the health of our finances, natural resources, people, and communities.

                              The 2019 Budget Policy Statement is here.
  

Given the strong evidence on the importance of the social determinants in alcohol-related harm, we are thrilled to see the Budget's commitment to: lifting Māori and Pacific incomes, skills and opportunities; reducing child poverty and improving child wellbeing, including addressing family violence; and supporting mental wellbeing for all New Zealanders.

CALL FOR SUBMISSIONS SOON!

The Finance and Expenditure Committee will meet this week – so we are expecting the call for submissions to come very soon. Alcohol Healthwatch will develop a template to assist you with your submission. Watch this space. Submissions usually close around the end of January. We encourage you to use this important opportunity to have your say.
INTERNATIONAL NEWS
Ireland's New Public Health (Alcohol) Act 2018

As you can read from the title, this new legislation confers powers to the Minister of Health in relation to matters including the pricing and marketing of alcohol.

Advertising and marketing

Ireland now joins many other countries, such as Finland and Lithuania, in recently implementing strong laws on alcohol advertising.

Under this Act, alcohol advertisements featuring drinking occasions and people consuming alcohol will be prohibited. Advertisements will only be able to include the following:
  • Price
  • Brand/corporate name, trade mark, image or reference to the product
  • Country/region of origin, method and/or origin of production
In addition, all alcohol products and advertisements must carry three warnings and information below:
  • a warning of the danger of alcohol consumption, and
  • a warning of the danger of alcohol consumption when pregnant, and
  • a warning of the direct link between alcohol and fatal cancers, as well as
  • details of a Government website that provides public health information in relation to alcohol consumption.
Drink menus/publications in licensed premises must be available to customers and also need to contain these three warnings.

There will also be major restrictions on placement. These are to be phased in over time. There is to be no advertising:
  • on TV 3am-9pm any day, on radio 3pm-10am weekdays
  • at or close to (200m) schools, crèches, public playgrounds, or parks
  • on public transport vehicles or infrastructure
  • in cinemas (except R18 films/licensed premises)
  • at sports events or areas (this is one of the last to be implemented, from Nov 2021)
  • on children’s clothing
  • at events aimed at children or where majority of participants are children
  • at events involving driving or racing mechanical vehicles
Print publications must not use more than 20% of their advertising space for alcohol, with no alcohol adverts on front or back covers, or in publications with significant (20% or more) child readership.  

Exposure will also be addressed in retail outlets such as supermarkets:
  • From November 2020, in mixed retail outlets, alcohol products and advertising are confined to one of the following: an area separated by a 1.2 metre high barrier, or units in which alcohol products are not visible up to 1.5 metres in height, or up to three units that can be a maximum of 1 metre wide by 2.2 metres high. In addition, alcohol products can be contained but not be visible in a unit behind the counter.
Minimum Unit Pricing 

The Act also includes a minimum unit price of €0.10 per gram of alcohol or around NZD$1.70 per standard drink.

Unlike the Scottish 50p minimum pricing law that has a sunset clause (meaning that it will expire after six years unless an order is made to extend it, with a ‘review clause’ after five years of its operation), the Irish law allows the Minister for Health to make an order to increase the minimum price per gram of alcohol, from time to time, after three years of the first implementation of the MUP. The date for implementation of the MUP policy in Ireland is yet to be announced.
Australia Has A New National FASD Action Plan
 
During 2017, the Australian Government Department of Health undertook a range of consultations nationwide to inform the development of their National FASD Strategic Action Plan 2018 – 2028. The Strategic Action Plan was launched by Minister for Health, Honourable Greg Hunt, at the 2nd Australasian FASD Conference in Perth on the 21st November 2018. Read more here.
 
The Strategy, which has a Commonwealth Government budget of $7 million (building on the $20 million previously allocated) provides a national approach for all levels of government, organisations and individuals and has three key aims:
  • reduce the prevalence of FASD;
  • reduce the associated impact of FASD; and
  • improve the quality of life for people living with FASD.
Read the National FASD Strategic Action Plan here.
Spotlight On Public Health And Alcohol Industry Partnerships

This year, like many others, we have witnessed a number of health and alcohol industry partnerships. In the last few months in Aotearoa New Zealand, we have seen 3 mental health partnerships with alcohol companies, and many alcohol producers using mental health as a platform within their social media campaigns.

There are two important stories to tell from the past few months with regards to partnerships.

1) Public Health England (PHE) and Drinkaware

There was widespread criticism of the partnership between the above two organisations in a recent ‘drink-free days’ campaign. The partnership culminated in Professor Ian Gilmore quitting his role as a PHE advisor and an open letter of concern being signed by around 300 public health academics. Read more here.

Both the Lancet and British Medical Journal featured articles on this industry partnership:

2) Scottish Government's strong stance on alcohol industry partnerships 

In contrast, Scotland has taken a strong stance in their updated ‘Alcohol Framework 2018’ that details their national prevention efforts to reduce the harm from alcohol. Importantly, this strategy addresses pricing, availability and advertising.

Of note is Action #8 that details their stance on industry partnerships:

"We will work with the alcohol industry on projects which can impact meaningfully on reducing alcohol harms; but not on health policy development, on health messaging campaigns or on provision of education in schools and beyond the school setting."
World Health Organisation launch SAFER: Action package to support the global target of reducing harmful use of alcohol by 10% by 2025

SAFER is the "newest WHO-led roadmap to support governments in taking practical steps to accelerate progress on health, beat non-communicable diseases (NCDs) through addressing the harmful use of alcohol, and achieve development targets".

The SAFER Framework provides five high-impact, evidence-based strategic actions that are prioritised for implementation to promote health and development:
  • Strengthen restrictions on alcohol availability
  • Advance and enforce drink driving countermeasures
  • Facilitate access to screening, brief interventions, and treatment
  • Enforce bans or comprehensive restrictions on alcohol advertising, sponsorship and promotion
  • Raise prices on alcohol through excise taxes and pricing policies
Each country should adopt three key strategies to ensure success:
  1. Implement: Strong political will, adequate resources and technical and institutional capacity are critical to enacting the SAFER interventions at the country level.
  2. Monitor: Strong monitoring systems must support implementation, to enable accountability and track progress.
  3. Protect: Alcohol control measures must be guided and formulated by public health interests and protected from industry interference and commercial interests.
Alcohol Healthwatch supports these 'best buy' approaches given their effectiveness and potential to achieve the greatest reduction in alcohol-related harm inequities.
Research update
 
Hot off the press is a wealth of high-quality alcohol research. Email Alcohol Healthwatch if you do not have access to any of the full-text versions below.

We wish to highlight an important finding from a New Zealand study by Charlene Rapsey et al. at the University of Otago. It was found that 50% of New Zealanders with alcohol dependence had developed their disorder by 20 years of age, and 75% by age 25. This signals the importance of early intervention and prevention.

NEW ZEALAND

Conflict of interest and alcohol discourse—a new face but familiar messages 

Alcohol-related emergency department attendances after the introduction of the Sale and Supply of Alcohol Act 2012

Health and wellbeing of Māori secondary school students in New Zealand: Trends between 2001, 2007 and 2012

Cost-effectiveness of raising alcohol excise taxes to reduce the injury burden of road traffic crashes

Transitions Through Stages of Alcohol Use, Use Disorder and Remission: Findings from Te Rau Hinengaro, The New Zealand Mental Health Survey

Children's home and school neighbourhood exposure to alcohol marketing

Licence to swill: James Bond’s drinking over six decades

INTERNATIONAL

Pricing
Assessing cost-effectiveness of obesity prevention policies in Australia (Alcohol tax Section 5, p43)

Mapping discourse coalitions in the Minimum Unit Pricing for alcohol debate: A discourse network analysis of UK newspaper coverage

Assessing the impact of alcohol taxation on rates of violent victimization in a large urban area: an agent‐based modeling approach

Mental health, health risks
Can Suicide Attempt be Related to Problem Drinking: Cohort Study

A systematic review of the next‐day effects of heavy alcohol consumption on cognitive performance

Alcohol advertising, including social media
#drunktwitter: Examining the relations between alcohol-related Twitter content and alcohol willingness and use among underage young adults

Regulation of Alcohol Advertising in Australia: Does the Abac Scheme Adequately Protect Young People from Marketing of Alcoholic Beverages?

Meta-Analysis of the Association of Alcohol-Related Social Media Use with Alcohol Consumption and Alcohol-Related Problems in Adolescents and Young Adults

Alcohol Advertising on Facebook and the Desire to Drink Among Young Adults

Alcohol availability
Underage alcohol sales in community sporting clubs

Outlet Type, Access to Alcohol, and Violent Crime

Alcohol Outlets, Neighborhood Retail Environments, and Pedestrian Injury Risk

Young people
Parental drinking in Australia: Does the age of children in the home matter?

The effect of parental drinking on alcohol use in young adults: the mediating role of parental monitoring and peer deviance

Positive Attitude Toward Alcohol Predicts Actual Consumption in Young Adults: An Ecological Implicit Association Test

Harm to others
Harm from Known Others' Drinking by Relationship Proximity to the Harmful Drinker and Gender: A Meta‐Analysis Across 10 Countries

Labelling
Informing drinkers: Can current UK alcohol labels be improved?

Industry
Mixed methods study of tobacco, alcohol and gambling industry donations to Australian political parties

Is the alcohol industry doing well by ‘doing good’? 

How dependent is the alcohol industry on heavy drinking in England?

Drinking patterns
Is there gender convergence in risky drinking when taking birth cohorts into account? Evidence from an Australian national survey 2001–13

Identifying the Population Sources of Alcohol Impaired Driving: An Assessment of Context Specific Drinking Risks

Community interventions
Whole‐of‐community interventions to reduce population‐level harms arising from alcohol and other drug use: a systematic review and meta‐analysis

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