Adolescent alcohol misuse in England and the role of media advertising - Essay Example

?Adolescent alcohol misuse in England and the role of media advertising Adolescent alcohol misuse in England has become a major social issue. In the Lifestyle Statistics, Health and Social Care Information Centre (2013) discussed that about 61% of men and 72% of women had either taken no alcohol in the week during the survey, or had taken alcohol at recommended levels of the day. Men (64%) drank more alcohol (21 units) in the week as compared to 63% of women who drank about 14 units a week. Twelve percent of adolescents drunk alcohol in the last week the survey was taken (Lifestyle Statistics, Health and Social Care Information Centre, 2013). These figures seem to be present declining figures from 2010 when the 13% of school children were reported to have drunk alcohol. Regardless of the decrease, 12% is still a considerable figure considering the fact that studies do claim that early alcohol intake often leads to higher possibility of adult alcohol intake (Institute of Alcohol Studies, 2013). There are various causes for alcohol misuse among adolescents with media advertising playing a major role in the misuse. This paper shall examine the literature on alcohol misuse among adolescents in England. It shall synthesise readings in the hope of providing a Position Statement for this topic, incorporating what should happen in the future. How is this considered to be a Public Health issue? The topic is considered a public health issue because it is a health problem which impacts significantly on the physical and psychological well-being of individuals (Sommer and Parker, 2013). Its impact does not only cover one individual but also covers other individuals, especially the immediate family and friends of the adolescent alcohol user (Aceijas, 2011). In England, a good portion of children have experienced drinking alcohol even before they reach the age of majority (18 years) and are also likely to have been drunk once in the last 4 weeks prior to the survey (Institute of Alcohol Studies, 2013). Some have even admitted to consumption of alcohol to harmful levels by 15 years of age. Surveys also indicate that alcohol has a significant role to play in the commission of crimes among young people aged 18 years or below (Institute of Alcohol Studies, 2013). What is the balance of causal factors for this issue? The balance of causal factors for this issue is based first on the determination of causes for alcohol misuse. The causes of this abuse are very much unclear and complicated. For the most part, it has economic and biological roots which are related to negative health effects (McArdle, 2001). Peer pressure serves as a major influencing factor for individuals in abusing alcohol; however, such influence from peers is mostly attributed to an inadequate appreciation of the risks involved in alcohol abuse (Moreira, et.al., 2009). Gelder and colleagues (2005) discuss how the widespread accessibility of alcohol is a major influence for young drinkers who are trying to live up to the social norms relating to drinking. Most young drinkers usually drink more as a means of keeping up with their friends especially as they believe that they are expected to drink more under specific social conditions in place. As a result, the amount of alcohol consumption can be higher than normal. The immediate impact of drugs causes the release of dopamine which further reinforces the behavior relating to the alcohol abuse (Carlson and Heth, 2010). Self-reports also indicate associations made between anxiety and depression and alcohol consumption (Carlson and Heth, 2010). Balancing the causes of alcohol misuse relates to the management of the physical and psychological elements causing the abuse. Like other health issues, prevention is the primary balancing factor which can help manage the problems. The management of these factors includes basic advice for those who have the least serious problems relating to misuse, and more specialized actions for those whose alcohol abuse is already very much serious (Duggan, 2011). At present, the responses at various levels of health care are very much inadequate. Lack of support is apparent for all levels of need and covering all stages of the health and justice system, including police contact, imprisonment, and possible rehabilitation (Duggan, 2011). What do current national or international policy documents say? How do they address the causal factors? The national policy documents for the UK shall be discussed in the paragraphs below. In the case of the international policy documents, the World Health Organization (WHO) has focused on the following documents and policies: Global Information System on Alcohol and Health (GISAH), Global Survey on Alcohol and Health, Global Status Report on Alcohol and Health, and the International guide for monitoring alcohol consumption and related harm (WHO, 2013a). The GISAH seeks to provide a rapid access on alcohol-related health variables. This is an important tool in evaluating the health-related trends on alcohol consumption, including harm stemming from alcohol misuse and policy responses from different countries. The Global Status Report: Alcohol Policy has been made part of the work from the WHO Global Alcohol Database focusing on the condition of alcohol policies globally, seeking to secure objective baselines and secure effective policies in the world (WHO, 2013a). The international guide for monitoring alcohol consumption and related harm secures estimates for alcohol consumption and where they occur. This guide seeks to improve the quality of alcohol-related information gathered. Ultimately, the WHO Member States would be able to secure epidemiological monitoring secure effective policy formation and to manage global as well as regional comparability for information on alcohol intake and health effects in order to manage improvements and to support research and risk assessment (WHO, 2013a). Moreover, these policies seek to secure general principles and guidance on securing realistic as well as effective indicators for alcohol intake and management of impact for countries with different types, qualities, and level of information and resources (WHO, 2013a). What is current public health practice in this area? Is this underpinned by evidence? Is it supported by policy? For the UK, their general policy has been to reduce alcohol misuse and the harm it is causing (Department of Health, 2013). In the UK, guidelines for alcohol intake indicate that men must not regularly drink more than 3 to 4 units a day and women must not take more than 2 to 3 units per day. Drinking beyond the recommended levels can bring about unfavorable health effects. For one, alcohol implies one of the highest behavioral risks relating to disease and death, with 2010 to 2011 period alone reaching about 1.2 million alcohol-related admissions, as well as 15,000 deaths (Department of Health, 2013). These figures imply a major burden on individuals as well as families, also a major impact on hospital and health resources and on public spending. About 21 billion pounds is the estimated cost for alcohol-related harm (Department of Health, 2013). The DoH admits that their public health policy in alcohol misuse would seek to secure changes in behavior in drinking excessively. Its policy also seeks to reduce the number of violent crimes related to alcohol intake; it also seeks to decrease the number of people engaging in binge drinking, as well as decreasing the number of alcohol-related deaths. Through the DoH’s Change4Life Campaign, the DoH also wants to inform the general population about the risks relating to drinking beyond the lower-risk standards and providing tools as well as standards on the reduction of drinking (Department of Health, 2013). The DoH also seeks to include their alcohol risk assessment within the NHS health check for adults from 40 to 70 years. Allocating 448 billion dollars on the improvement of the lives of the families affected by alcohol misuse has also become the DoH primary advocacy. In April 2013, the local councils were allocated public grants, mostly for alcohol services. Through the health boards, the councils are set to work with the NHS, including the local communities to understand better the local needs of the people as well as to secure health priorities (Department of Health, 2013). Councils will therefore be able to order prevention as well as treatment services which help fulfill the needs of the people, including the management of programmes secured by health professionals, mostly seeking to provide sufficient evidence, treat for alcohol dependence, as well as eventually change behavior. The DoH has also secured its drug and alcohol recovery pilot policy mostly focusing on service users being relinquished of their addiction to alcohol, as well as improving their general health and well-being. The Public Health Responsibility Deal has also been established in order to share responsibility with the alcohol industry, mostly in providing essential information about on alcohol, including unit information, warnings on pregnancy and drinking, as well as simple information on the alcohol units in the pubs (Department of Health, 2013). The Deal has also established lesser availability for cheap alcohol in order to discourage binge drinking among the general population. The Advertising Standards Authority and OfCom has also sought to secure ways in order to ensure that advertisements supporting alcohol use are not viewed during programmes watched by young people, that these standards would also apply online and to the social media, consider rules which would promote instead the use of lower strength alcohol products, and work with the industry to develop as system which can help verify the actual ages of the drinkers. In general, these strategies have also been secured under the DoH’s Alcohol Strategy for 2012, mostly seeking to reduce the demand for alcohol, restrict its supply, aim towards recovery, and support individuals wanting to live an alcohol free life (Department of Health, 2013). Fit between evidence – policy – practice At present, the fit between evidence, policy, and practice is not yet clear and strong. The evidence indicates that alcohol misuse among the young population is high, but policies are not specifically focusing on this population to reduce their alcohol misuse (Walker and John, 2012). There is still a huge gap between evidence and practice, including policy on the management of this health issue. Action is needed on at least three areas. For one, alcohol must occupy an equal place in relation with illegal drugs in providing services and supporting the offenders. A very wide range of responses, including the fielding of frontline workers who are adequately skilled in identification and basic advice in relation to alcohol treatment have not been adequately set in place (Duggan, 2011). As a result, most of the abusers end up in jail without any adequate treatment given to them. The focus on prevention is also still very much lacking, especially in relation to unit pricing and regulation of the night economy (Duggan, 2011). Ethical and equality considerations Ethical and equality considerations in relation to alcohol misuse relates to the fact that until and unless individuals submit themselves and admit to having an alcohol-related problem, no treatment can be imposed on them (Hazelton, et.al., 2003). This is in accordance with the ethical functions relating to the individual’s right to self-determination. However, it is also important to note that this right to self-determination has to be subordinated over the protection of public welfare. In any case, where an individual already poses a danger to society with his alcohol abuse, he must therefore undergo treatment for his health problem. The best treatment in this case still remains the voluntary treatment for alcohol abuse, with the patient submitting himself to treatment as a willing participant (Hazelton, et.al., 2003). What should change to address this issue more effectively? In order to address this issue more effectively, there is a need to focus on the young drinkers, especially those who are in their adolescent years. The policies must provide more strict guidelines on adolescent drinkers, and impose strict liabilities on pub owners or shop owners who sell alcohol to these young drinkers (Hunter, et.al., 2003). Another recommendation would have to include provisions for meaningful sanctions for those who violate advertisements policies for alcohol. Meaningful sanctions can cover high fines, including bans for a significant amount of time and covering a wider scope of consumers. The fines must also be substantial enough depending on the marketing budgets for companies involved (Alcohol Concern, 2013). As such, these impositions can have a more significant deterrent effect on the advertisers as well as the alcohol industry. Another recommendation would also be to restrict cinema advertising, especially on alcohol products. The restriction must be strictly imposed in cinemas shown to young people aged below 18 years (Alcohol Concern, 2013). This can help ensure that children below 18 would not be exposed to these advertisements when they would be watching movies. Where alcohol advertisements are included in cinemas, children below the age of 18 must not be allowed to enter these cinemas. What would need to be done to improve practice? Does more research need to be undertaken? In order to improve practice, there is a need to focus on preventive measures which can be set for the young population. Where the young population can be prevented from starting to abuse alcohol at a very young age, there would likely be fewer alcohol abusers (Wilson and Mabhala, 2009). More researches are needed on what policy changes can best help the adolescent population in avoiding early alcohol misuse. A change in policy would also help, but a stricter implementation of current policy would likely help even more. Health impact assessments can also help in determining the specific impact of alcohol misuse on the health, helping the youth understand the effect of alcohol on their bodies, and motivating them to make the necessary changes in their drinking habits to reverse and stop any negative effects of drinking on their bodies (WHO, 2013b). This is based on the principles relating to the HIA which includes, democracy in allowing individuals to participate in implementing policy which would affect their lives; equity, which would help assess the distribution of effects on the general population; sustainable development, which would consider the short and long term aspects of the policy; and ethical use of evidence which would allow for the identification and use of best quantitative and qualitative evidence in the assessment (WHO, 2013b). How can sustainability be ensured? Sustainability can be ensured by allowing for consistent policies on alcohol misuse to be implemented. If the focus of the government would be on reducing alcohol misuse and the harm it is causing, all its policies must work towards such end (Ewles, 2005). The government must also pass legislation in order to support such policy. Annual allocation of funds to implement such policy and laws must also be ensured in order to sustain the goals of the health program against alcohol misuse (Scriven and Garman, 2005). All the implementing rules and actions must be aligned in order to support such policy (Lloyd, et.al., 2007). Sustainable development refers to ensuring consistent and development which would last for a long period of time. The alcohol misuse policies needs specific rules for the different public agencies and private institutions involved in the health issue, including the alcohol industry and the implementing agencies against alcohol abuse (Earle, 2007). Gaps which would call for more studies in alcohol misuse have been observed in relation to fit between evidence and practice, as well as evidence and policy (Aveyard, 2007). There are limited studies in this area, but these are areas of study which can help improve the management of alcohol misuse. Identifying where the gaps in evidence and practice as well as policy are would help provide target areas which need to be filled in and improved (Oliver, 2012). References Aceijas, C., 2011. Assessing Evidence to Improve Population Health and Wellbeing. ‘Transforming Public Health Practice’ Series. Learning Matters, Exeter. Aveyard, H., 2007. Doing a Literature Review in health and Social Care: a Practical Guide. OUP McGraw- Hill Ed Department of Health, 2013. Reducing harmful drinking. Available at: https://www.gov.uk/government/policies/reducing-harmful-drinking [Accessed 01 December 2013]. Duggan, S., 2011. 'Alcohol misuse is the most daunting of public health challenges'. Available at: http://www.nursingtimes.net/nursing-practice/clinical-zones/public-health/alcohol-misuse-is-the-most-daunting-of-public-health-challenges/5023736.article [Accessed 01 December 2013]. Earle, S et al., 2007. Theory & Research in promoting Public Health. Sage/OU. Ewles, L., 2005. 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Health Impact Assessment: Why use HIA?. Available at: http://www.who.int/hia/about/why/en/index.html [Accessed 01 December 2013]. Read More