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Galway Healthy Cities Project How best to address alcohol problems in Galway City?. Dr. Ann Hope Department of Public Health and Primary Care, Trinity College, Dublin 18 th September, 2012. Outline of Presentation. Strategies that increase harm Evidence of effectiveness to reduce harm
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Galway Healthy Cities ProjectHow best to address alcohol problems in Galway City? Dr. Ann Hope Department of Public Health and Primary Care, Trinity College, Dublin 18th September, 2012
Outline of Presentation • Strategies that increase harm • Evidence of effectiveness to reduce harm • Turning Science into Action • Community Action –a road map • Key Ingredients for Success
Strategies that work to increase alcohol use & harm Price Availability Marketing
Free alcohol • Most common location – street fliers
Cheap Prices • One in every four alcohol marketing practices involved a price promotion
Policy measures that work to reduce harm • Alcohol taxes • Affordability • Regulating availability • Minimum legal purchase age • Restrictions on hours /days of sale, • Outlet density restrictions • Drink driving countermeasures • Random breath testing • Lowered BAC • License suspension • Graduated licensing for novice drivers Source: Babor et al 2010
. . Policy measures that work • Modifying drinking environment • Enforcement of laws and legal requirements • Server liability • Staff training with enforcement • Restrictions on marketing • Legal restrictions on exposure • Community action with multiple components • Treatment and early intervention • Brief advice with at risk drinkers • Mutual help/Self-help attendance • Medical detoxification • Talk therapies Source: Babor et al 2010
. . . Policy Measures that DON’T work to reduce harm • Voluntary code of bar practice • Alcohol education in schools • Advertising content regulations • Alcohol industry’s self regulation codes • Warning labels • Alcohol-free activities • Mass media campaigns Source: Babor et al 2010
SummaryEffective Measures to reduce harm All measures are NOT equal. Measures that influence the environment are more effective than targeting the individual drinker. Measures targeting young people only, are doomed to failure Education is a supporting rather than a lead strategy.
Evidence of Community Action success • Underage drinking • Intoxicated patrons • Drunk driving • Alcohol related violence WHO, Regional Office for Europe 2012
Community Action success. . • Increased community awareness • Wider acceptance of public health material • Sharing of local institutions to promote healthy lifestyle • Increased support for public health approach • Reduced underage drinking • Changed attitudes toward alcohol sales to minors • Reduced alcohol sales to minors • Delayed onset age of drinking
. . . . Community Action success • Reduced alcohol consumption • Reduced heavy drinking • Reduced drunkenness • Reduce intoxicated patrons • Reduced drunk driving • Reduced alcohol related violence
Community Mobilisation is when a community comes together when an issue is too big for one sector to tackle alone
Community Action “Community action seeks to change collective rather than individual behaviour” WHO, 2009
Community Alcohol Action Plan an integrated set of actions that tackle the community environmental factors (social, cultural, policy practices)
A roadmap for community action to prevent and reduce alcohol harm • Community Norms • High risk drinking encouraged/discouraged ? • Access and Availability • Alcohol that’s cheap and easy to get is linked to harm • Media Messages • Advertising etc glamorizes excessive drinking • Policy and enforcement • Shapes how alcohol is promoted, sold and consumed
Community action roadmap- Options 1. Community norms • Promote general community programmes • Recreational/Lifestyle programmes • Alcohol/Drug-free environments • Safe space for youth to hang out 2. Access and Availibility • Shape planning laws to limit density of outlets • Use powers to influence late openings • Limit drinking in public places • Discourage high risk promotions
Community action roadmap– options 3. Media messages • Reduce exposure of children to alcohol marketing • Ask local radio to avoid alcohol ads before 9pm • Avoid alcohol ads in public places • First step, no ads near child facilities, schools, youth centres, on school buses etc. • Cut link between alcohol and sport • Promote local festivals & events free from alcohol sponsorship • Influence attitude of parents to underage drinking
Community action roadmap– options 4. Policy and Enforcement • Increase enforcement of alcohol laws • Minimum age • Server liability • Stop supply of alcohol to youth (direct & indirect) • Test purchase checks • Stop supply to intoxicated persons • Last drink survey to identify hot spots • Develop specific programmes for vulnerable sub-populations (Youth / Young Adults)
Community Action roadmap - Options . . . 4. Policy and Enforcement • Put in place alcohol screening in relevant health/social services. • Provide brief advice for those involved in hazardous use of alcohol. • Develop treatment pathways for those with alcohol problems and those who are addicted. • Provide support services for those affected by other peoples drinking
Community Action - Process • Set up a local network of stakeholders • Undertake assessment • drinking culture • Negative consequences • Major influencing factors/triggers • Have a clear common goal • Develop key outcome indicators
Key Ingredients for Success . . • All relevant stakeholders working together towards a common goal • Clear assignment of responsibility • A community action plan should be • guided by evidence, • planned in response to local needs, • have measures to tackle environmental and individual factors. • Include training provision
. . . Ingredients for Success 4. Advocacy role central to • raising public awareness of the extent of alcohol related problems, • benefits of reducing alcohol harm • gaining public acceptance of the alcohol action plan and • communicating implementation of the action plan. • Community action to reduce alcohol problems takes time. Five year Action Plan • Integrate community action into local structures
High Risk groups Young Adults Young people (u18)
Protecting Children from harm PROTECT against pressures to drink 3. Limit marketing 4. Act as role model REDUCE supply 1.Stop access to alcohol 2. Server/seller liability 5. PROMOTE communities to act in best interest of children 7. SUPPORT children at high risk 6. SUPPORT families