Alcohol Use

Figure 9.15 displays average alcohol consumption by type in the United Kingdom between 1899 and 2013. Great increases in alcohol consumption were seen between the 1960s and 1990s, with increasing consumption of wine, spirits and cider and decreasing consumption of beer.  Average consumption peaked in 2004 and has been decreasing ever since, driven by reductions in alcohol use in recent years which have fallen most in younger age groups.

 Figure 9.15, Litres of pure alcohol consumed per person per year by type, United Kingdom, 1899 to 2013

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Source: British Beer and Pub Association, 2014

The proportion of adults binge drinking (men who have consumed more than eight units of alcohol and women more than six units at least once in the past week) has also generally reduced from 18% in 2005 to 16% in 2014 for all persons. Figure 9.16 shows the pattern by age which shows the greatest reductions have been seen in the 16 to 24 age group (32% to 22% for males, 27% to 17% for females), whilst increases in binge drinking have been seen for those aged 45 and over. Levels of binge drinking in the 16 to 24 age group are now identical for the 25 to 44 and 45 to 64 age groups for males, and to the 25 to 44 age group for females.

 More affluent adults are likely to consume more alcohol than less affluent adults. The 2014 Office for National Statistics Opinions and Lifestyle Survey highlighted that 31% of unemployed people were teetotal compared to 14% of people in employment; 6% of unemployed people drank at least five days per week compared with 10% in employment, and 18% of unemployed people were binge drinkers compared with 21% for those in employment. The Opinions and Lifestyle Survey also reveals that drinking increases with income, with those on incomes of £40,000 per annum or more the most likely to both drink regularly and binge drink, and the least likely to be teetotal. However, adverse effects of alcohol disproportionally affect those living in areas with higher deprivation, with people living in the most deprived areas much more likely to be admitted for an alcohol-related condition or die from an alcohol-related cause than those in the least deprived areas.

Figure 9.16, Binge drinking in men and women by age group, UK, 2005 to 2012

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Source: Opinions and Lifestyle Survey, General Lifestyle Survey and General Household Survey; Office for National Statistics, 2016

Two related measures of alcohol-related hospital admissions exist. The first is a narrow definition, used in the Public Health Outcomes Framework, which covers admissions where the primary diagnosis was alcohol-related or where there was an alcohol-related external cause including accidents, self-harm and intentional injury. The broad definition also includes admissions where secondary diagnoses were alcohol-related, which captures a wider range of chronic health conditions where alcohol is a contributory factor. The further analyses in this report use the broad definition of alcohol-related hospital admission to better represent the overall impact on alcohol use.

There were around 15,000 alcohol-related admissions to hospital for Devon residents in the year to December 2015. The direct age standardised rate (1792.8 per 100,000) was below the South West (1963.2), local authority comparator group (1968.8), and England (2150.3) rates.  Rates within Devon are highest in Torridge, North Devon and Exeter.  Rates are higher in more deprived areas. Alcohol-Related Admission rates vary by age, with the highest rates in older age groups, reflecting the long-term effects of alcohol-use through life.  Acute admissions (accidents and poisonings) are most common in young adults, mental health admissions in persons in their 40s and 50s, and admissions for chronic conditions in older age groups.  Admission rates are higher for males than females.

Figure 9.17 shows the alcohol-related admission rate compared to the local authority comparator group. Figure 9.18 highlights the trend in admission rates by deprivation, revealing increases in rates for all groups over recent years and a persistent gap between the rate in the most deprived (2733.9 in 2015-16) and least deprived (1782.5 in 2015-16) areas.

Chronic long-term conditions make up the largest group of alcohol-related hospital admissions accounting for 74.6% of all admissions, with mental illness the next biggest group

(18.6%), and acute conditions the smallest group (6.8%). Acute risks to health, such as injury and poisoning occur more frequently in younger age groups, with admissions for alcohol-related mental health conditions peaking in the 40s, 50s and 60s, and chronic long-term health conditions increasing in later life. The ageing population in Devon will lead to considerable growth in both chronic and mental conditions.

Figure 9.17, Alcohol-related hospital admissions, direct age standardised rate per 100,000, Devon local authority comparator group, 2015

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Source: Local Alcohol Profiles for England, 2016

Figure 9.18, Alcohol-related hospital admissions, direct age standardised rate per 100,000, trend by deprivation

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Source: Local Alcohol Profiles for England, 2016