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Between 30 and 40% of 18-year olds in England, Wales and Northern Ireland enter tertiary education (university) each year. Young adulthood (ages 15 to 25) is the usual period in which problems with alcohol, drugs or other behaviors begin to emerge, and yet these issues have received limited study in the UK. Government policy dictates that a full continuum of treatment and recovery services should be available in each area of the country, but uptake of these services by university students appears to be limited. In this discussion paper we describe the background to, and components of, the Collegiate Recovery Program (CRP), an initiative that has grown rapidly in the USA in the past decade. We then describe how the first UK University-led CRP was set up, before outlining what has been learnt so far and the potential challenges facing this approach. [ABSTRACT FROM AUTHOR]

This commentary reflects on the strengths of the paper by Warde et al. entitled "Situated drinking: the association between eating and alcohol consumption in Great Britain". It suggests that practice-theoretical approaches towards studying contemporary connections between foods, food events and alcoholic drinks provides an excellent basis for overcoming the analytical limits of fields such as food studies, drinks studies, alcohol studies and related areas. This is especially so if Warde et al.'s quantitative methodology were to be yoked to two further sources of inspiration, namely Mary Douglas's structuralist analysis of food combinations within food events and Stephen Mennell's utilisation of the concepts and concerns of Norbert Elias to produce a systematic historical sociology of food. An extended inter-paradigmatic approach to the study of how alcoholic drinks relate to foods and eating practices emerges as a result. [ABSTRACT FROM AUTHOR]

Aims The literature review aimed to identify the barriers the Punjabi and/or Sikh community have in accessing support for alcohol addiction. Method A systematic review of the literature was undertaken of four scholarly databases, Google Scholar and grey literature on UK-based research conducted after 1980 into alcohol addiction in the Punjabi and/or Sikh community. Fourteen papers met the inclusion criteria outlined in the paper and were included in the review. Results Ten main barriers to accessing support were found; stigma, religion, lack of understanding of addiction, over reliance on a medical model of treatment and disregard of therapy, cultural implications of being a member of the Punjabi and/or Sikh community and the addiction community, gender and generational differences and a lack of government commitment to alcohol support for BME communities with a lack of culturally specific services. Conclusion Despite the many barriers explored, the role of stigma remained a powerful theme throughout often underpinning other barriers. A key recommendation across many papers was the need for culturally sensitive support services. Several areas for future research were identified. [ABSTRACT FROM AUTHOR]

Introduction: Evidence shows that price is an important policy lever in reducing consumption of alcohol and tobacco. However, there is little evidence of the cross‐price effect between alcohol and tobacco. Methods: This paper uses an econometric model which estimates participation and consumption elasticities, on data from the UK Living Costs and Food Survey 2006–2017 and extends the literature by, for the first time, estimating joint price elasticities for disaggregated alcohol and tobacco products. This paper presents new price elasticities and compares them to the existing literature. Results: The own‐price elasticity estimates are all negative for both participation and consumption. There is no pattern to the estimates of cross‐price elasticities. The elasticity estimates, when used in the Sheffield Tobacco and Alcohol Policy Model, produce bigger changes in consumption for the same change in price compared to other elasticity estimates in the existing literature. Discussion and Conclusions: Consumption of alcohol and tobacco are affected by the prices of one another. Policymakers should bear this in mind when devising alcohol or tobacco pricing policies. [ABSTRACT FROM AUTHOR]

In this paper we explore the importance of relationality and care for understanding women's alcohol use, using a theoretical framework comprising concepts from feminist ethics of care, the sociology of personal life, and feminist approaches to governmentality. A key focus is how care giving responsibilities and expectations in families appear to be particularly significant for creating or constraining possibilities for drinking practices. We draw on findings from a qualitative study about alcohol use and stress with 26 women, aged 24-67 years, in the North East of England, UK. We consider how care practices in families feature in the accounts of alcohol use by women with and without children, and how the symbolic and material aspects of social class interact with care to alter the drinking practices women engage in. The interpretation extends scholarship on women's drinking, by adopting a relational approach to identity and linking private care practices and alcohol use to social and political structures. Public health approaches for preventing or reducing heavy drinking practices are predominantly situated within biomedical or psychological paradigms. Intervention approaches to reduce women's drinking that draw on our theoretical framework could offer potential for reducing harmful alcohol use in a more meaningful way. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to offer a viewpoint on the impact that the COVID-19 pandemic has had on people's engagement with an online alcohol service in the UK. This paper examines whether self-reported mental health concerns increased during the pandemic compared to pre-pandemic times. Design/methodology/approach: A comparison was made between service data captured in one contract area – West Sussex, England – pre-pandemic (April 2019 to March 2020) and during pandemic (April 2020 to March 2021). Findings: Self-reported mental health treatment needs increased during the pandemic period (71.2% of presentations compared to 50% pre-pandemic) via the online coaching service. Male referrals increased by 74% during the pandemic period compared to the previous year. Female referrals decreased by 4% in the same time period. Feelings of shame and guilt as well as loss of a confidential space to engage in online interventions were common concerns reported by service users. Research limitations/implications: Research limitations include the relatively small sample size, the sample comprised of self-referred treatment seeking clients, and there was no control group. All data collected is self-report therefore subjective and not necessarily meeting diagnostic criteria. Practical implications: Of note was the impact of the pandemic on women and their reduced access to the online service during the pandemic. Commissioners and services must adapt their service design and delivery alongside the new "normal" way of living and working. Routine screening of mental health and alcohol use are recommended. Originality/value: This paper offers insight from an established online/digital service and the impact of the pandemic on people's engagement with the service. [ABSTRACT FROM AUTHOR]

This paper draws on data from one strand of a six-strand, exploratory study on end of life care for adults using substances (AUS). It presents data from the key informant (KI) strand of the study that aimed to identify models of practice in the UK. Participant recruitment was purposive and used snowball sampling to recruit KIs from a range of health and social care, policy and practice backgrounds. Data were collected in 2016–2017 from 20 KIs using a semi-structured interview approach. The data were analysed using template analysis as discussed by King (2012). This paper focusses on two of seven resulting themes, namely "Definitions and perceptions of key terms" in end of life care and substance use sectors, and "Service commissioning and delivery." The KIs demonstrated dedicated individual practice, but were critical of the systemic failure to provide adequate direction and resources to support people using substances at the end of their lives. [ABSTRACT FROM AUTHOR]

This paper draws on a ‘palette’ of interdisciplinary methods to explore young people’s alcohol consumption practices and experiences in the hyper-diverse suburban locations of Chorlton and Wythenshawe, Manchester, UK. This paper contributes to literature on the emerging theme of hyper-diversity by exposing the heterogeneity of young people’s drinking experiences, with a focus on bars, pubs, streets and parks. I demonstrate how young people’s inclusion and exclusion from such spaces is bound up with the traditional identity markers of age, gender and class, alongside more performative, embodied, emotional and affective aspects; for instance, the atmospheres, smell and soundscapes of particular drinking spaces. More than this, the paper enhances understandings of hyper-diversity by elucidating the ways in which young people’s everynight alcohol-related mobilities and diversity interpenetrate each other. Through analysing young people’s alcohol consumption practices and experiences, I show how young people are hyper-diverse in terms of their alcohol-related lifestyles, attitudes, and activities. [ABSTRACT FROM AUTHOR]

Background and Aims Exposure to alcohol marketing is considered to be potentially harmful to adolescents. In addition to statutory regulation, industry self-regulation is a common way to protect adolescents from alcohol marketing exposures. This paper critically reviews research designed to evaluate the effectiveness of the alcohol industry's compliance procedures to manage complaints when alcohol marketing is considered to have violated a self-regulatory code. Methods Peer-reviewed papers were identified through four literature search engines: PubMed, SCOPUS, PsychINFO and CINAHL. Non-peer-reviewed reports produced by public health agencies, alcohol research centers, non-governmental organizations, government research centers and national industry advertising associations were also included. Results The search process yielded three peer-reviewed papers, seven non-peer reviewed reports published by academic institutes and non-profit organizations and 20 industry reports. The evidence indicates that the complaint process lacks standardization across countries, industry adjudicators may be trained inadequately or biased and few complaints are upheld against advertisements pre-determined to contain violations of a self-regulatory code. Conclusions The current alcohol industry marketing complaint process used in a wide variety of countries may be ineffective at removing potentially harmful content from the market-place. The process of determining the validity of complaints employed by most industry groups appears to suffer from serious conflict of interest and procedural weaknesses that could compromise objective adjudication of even well-documented complaints. In our opinion the current system of self-regulation needs major modifications if it is to serve public health objectives, and more systematic evaluations of the complaint process are needed. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients and the running of wards and explore with staff what resources would be most useful to more effectively manage substance misuse and dual diagnosis on PICUs. Design/methodology/approach: The paper used a mixed-methods approach, using a quantitative survey to determine the extent of substance use in PICUs and a co-design workshop to understand the impact of substance misuse on PICU wards, staff and patients. Findings: The estimated rate of substance misuse in PICUs over a 12-month period is 67%, with cannabis the most frequently used substance. Despite the range of problems experienced on PICUs because of substance misuse, the availability of training and resources for staff was mixed. Research limitations/implications: The findings may not be fully generalisable as research participants were members of a national quality improvement programme, and therefore, may not be representative of all PICUs. Data was collected from clinicians only; if patients were included, they might have provided another perspective on substance misuse on PICUs. Practical implications: This paper emphasises the importance of substance misuse training for PICU staff to adequately respond to patients who misuse substances, improve the ward environment, staff well-being and patient outcomes. Originality/value: This paper provides an updated estimation of rates of substance misuse in PICUs over a 12-month period and make suggestions for a training programme that can better support staff to address substance misuse on PICUs. [ABSTRACT FROM AUTHOR]

Although there has been significant research on the relationship between alcohol consumption and demographic and psychological influences, this does not consider the effect of social influence among older drinkers and if these effects differ between men and women. One aspect of social influence is social capital. The aim of this paper is to examine whether relational and cognitive social capital are associated with higher or lower risk of alcohol use among adults aged 50 years or older and to assess the extent to which this relationship differs between men and women. To investigate this, data were collected from a cross-sectional questionnaire survey of adults over the age of 50 in the United Kingdom who were recruited from general practitioners. The sample consisted of 9,984 individuals whose mean age was 63.87 years. From these data, we developed proxy measures of social capital and associate these with the respondent's level of alcohol consumption as measured on the Alcohol Use Disorders Identification Test (AUDIT-10) scale. In the sample, just over 20 per cent reported an increasing risk or dependency on alcohol. Using two expressions of social capital – relational (social relationships) and cognitive (knowledge acquisition and understanding) – we found that greater levels of both are associated with a reduced risk of higher drinking risk. Being female had no significant effect when combined with relational capital but did have a significant effect when combined with cognitive capital. It is argued that interventions to enhance social relations among older people and education to help understand alcohol risks would be helpful to protect older people from the damaging effects of excessive alcohol consumption. [ABSTRACT FROM AUTHOR]

Introduction: The closure of licensed venues during the COVID‐19 pandemic meant that most alcohol has been consumed at home during lockdown periods in the UK, a phenomenon that remains under‐researched despite the public health implications. Methods: This article draws on a study consisting of online semi‐structured interviews and focus groups with 20 UK drinkers, conducted between the first and second 2020 UK lockdowns. The study aimed to explore changing and enduring UK drinking practices within home spaces during the pandemic. Results: Our findings illuminate specific ways in which assemblages and contextual factors may come together to encourage or mitigate against the consumption of any (or excessive) volumes of alcohol at home during the lockdown. For example, the physical presence of alcohol bottles may both encourage consumption (e.g. compulsion to finish an open bottle of wine) and cue reflection on one's drinking (through the potentially confronting presence of empty bottles after domestic drinking). We also highlight the significance of the home as a space separate from—and different to—public drinking spaces. Discussion and Conclusions: With the increasing normalisation of domestic drinking during a global pandemic, this paper illuminates several factors that may encourage or curtail domestic alcohol consumption and invites us to consider the importance of assemblages, space and context. Such findings have wider applicability; for example, consideration of specific (and perhaps unique) push and pull factors of home spaces could inform future alcohol policy, health promotion messages and how guidance around 'moderation' or risky drinking is communicated. [ABSTRACT FROM AUTHOR]

Contribution analysis (CA) is being increasingly favoured as a policy evaluation tool. This includes application to evaluate alcohol and drug policies. This paper reflects on one such example and begins by providing a brief overview of CA as an evaluative research method. It then describes the way in which CA was applied to evaluate alcohol and drug policy in Wales, one of the constituent countries of the UK. This paper reports on two issues. First, how the theory of CA was translated into practice. Second, the key learning points for us as evaluators that arose out of the utilisation of this method. The article highlights that our use of CA enabled a rich exploration of programmes within their contextual setting, and had a range of limitations and considerable challenges associated with identifying and explaining causalities. Within these methodological discussions, we also illustrate how the policy was more successful in elements closer to its nomenclature framing; i.e. harm reduction, than it was to other incorporated aims. The analysis presented in this paper will be useful across a range of jurisdictions where the need to evaluate drug and alcohol policy and practice initiatives may arise. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore how the NUS (National Union of Students)' Alcohol Impact programme is attempting to change patterns of student drinking using findings from the 2017 Students and Alcohol national survey conducted by NUS as context. Design/methodology/approach: The 2017 Students and Alcohol national survey results were gathered via the distribution of the survey using the NUS' database of NUS extra cardholders. A total of 2,215 responses was collected. Using this information, the author has approached this paper as a case study of NUS' Alcohol Impact Programme. Findings: Results from the 2017 Students and Alcohol national survey demonstrated that although there was a misalignment between what students perceived their peers were drinking prior to university and what they were actually reporting drinking, there was the persistence of harmful behaviours reported after consumption of alcohol. Feedback from partnerships involved in the Alcohol Impact programme has shown measurable improvements in areas including the inclusion of non-drinkers and anti-social behaviour. Originality/value: Rolled out nationally, Alcohol Impact could be used to take positive steps in addressing the harmful consequences of student alcohol consumption. [ABSTRACT FROM AUTHOR]

Alcohol marketing influences drinking practices, and this helps shape how gender identities are constructed. This paper presents research exploring how women who are sober manage and negotiate their non-drinking and sober identities in neo-liberal contexts that market alcohol products and consumption as a defining feature of feminine identities. Semi-structured in-depth interviews (n = 15) and online content produced by sober women active in the positive sobriety community on the social media platform Instagram were analysed using thematic analysis. Women negotiated marketing messages within their everyday experiences of sobriety, with associations between drinking and motherhood, female friendship and empowerment, discussed as impacting their drinking, lived experience and sense of self. They negotiated such messages, and created alternative ways of 'doing femininity' as sober women, through distancing themselves from their previous drinking identities; rejecting, reworking and countering marketing that links alcohol use to femininity; and alternative consumption practices. Instagram allowed women to publicly critique and counter marketing messages in ways that unlinked alcohol use, but not consumption more generally, from femininity, in traditional and news ways. Marketing regulation should consider how those experiencing problematic alcohol use may be particularly vulnerable to marketing messages, in ways that are gendered. [ABSTRACT FROM AUTHOR]

With the United Kingdom experiencing a series of 'lockdowns' in 2020 and 2021 that disrupted leisure and socializing, the COVID-19 pandemic presents a 'critical juncture' which has facilitated alterations to – and reflections on – drinking practices. Drawing on online semi-structured interviews and focus groups conducted between the first and second UK lockdowns, we highlight three stages in the development and maintenance of UK drinking practices using critical junctures as a theoretical framework. Firstly, we consider the antecedent conditions – such as dominant drinking cultures - that shape pre-pandemic drinking practices and form the backdrop against which changes to behaviors are made. Secondly, we explore the 'cleavage' or initial moment of disruption which gives rise to shifts in drinking practices and consider how this critical juncture stabilizes and is reproduced. Finally, we examine the possible 'legacy' of the critical juncture. The paper highlights implications for healthcare/policy including the importance of considering wider social context when seeking behavioral change. We also stress that alternative explanations – such as declining drinking rates and the growth of Temporary Abstinence Initiatives – must not be ignored when exploring people's shifting drinking behaviors, even during periods of unprecedented social change. [ABSTRACT FROM AUTHOR]

British supermarket-panel data suggest no increases in overall sales and purchases of alcohol following COVID-19 lockdowns, yet survey and mortality data suggest otherwise. This paper attempts to unravel the paradox. Based on purchase data of 79,417 British households from Kantar Worldpanel, we undertake controlled interrupted time series analysis of the impact of COVID-19 confinement introduced on 23rd March 2020, and variably applied during 2020, compared to purchases during 2015 to 2019 as controls. We also undertook Poisson regression analyses to estimate if changes in purchases differed by household socio-demographic and economic factors. Excess off-trade household alcohol purchases (expressed as grams of ethanol) following the introduction of confinement, were 29.2% higher (95% CI = 25.8% to 32.5%) for the post-confinement months of 2020, being larger until mid-July 2020 (37.5%, 95%CI = 33.9 to 41.26%) when pubs re-opened with restrictions, and smaller (24.6%, 95%CI = 21.6 to 27.7) thereafter. During the time of complete pub closures, and fully adjusting for no on-trade purchases, household purchases of alcohol did not change when compared with the same time period during 2015–2019 (coefficient = -0.9%, 95%CI = -5.6 to 3.8). Excess purchases from 23rd March to 31st December 2020 varied by region of Great Britain, being higher in the north of England, and lower in Scotland and Wales. Excess purchases were greater in the most deprived households, compared with the least deprived households. Excess purchases increased substantially as the amount of alcohol normally purchased by a household increased, with the top one fifth of households that normally bought the most alcohol increasing their purchases more than 17 times than the bottom one fifth of households that bought the least alcohol. That the heaviest buyers of alcohol increased their purchases the most, with some independent impact of socio-economic disadvantage, might explain why reported alcohol problems and recent alcohol-related death rates might have increased. A conclusion of this is that alcohol policy to reduce high consumption of alcohol, and the availability of help and treatment to reduce alcohol consumption become more important during extraordinary times, such as COVID lockdowns. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol poses a range of potential problems to people taking medications, but health professionals are usually not comfortable talking about drinking with patients. The Medicines and Alcohol Consultation aims to increase the capacity of pharmacists to conduct person‐centred reviews in which alcohol is regarded as another drug to be discussed alongside medications. This paper explores sensitivities in discussing alcohol and views on the legitimacy of the Medicines and Alcohol Consultation intervention concept at a pharmacy‐user intervention co‐design workshop. Methods: A co‐design workshop was held with 14 people recruited from UK community pharmacies who regularly drank alcohol and took medications for long‐term conditions. This formed one element of a broader, iterative, intervention co‐production process. Workshop discussions were audio‐recorded and analysed thematically. Results: The basic intervention concept resonated well, though not entirely unproblematically. Participants were interested in receiving information on how medications interact with alcohol and how this might affect their own conditions, with which to make their own informed choices. Linking alcohol use to medicines gave legitimacy to pharmacists to raise alcohol in medicines reviews. Sensitivity in talking about alcohol was linked to vulnerability to negative judgement. Discussion and Conclusions: Changing the framing of alcohol in medicines reviews, away from being regarded as a 'lifestyle issue' to being considered a drug directly linked to medicines use, safety and effectiveness, was welcomed by participants in this study. [ABSTRACT FROM AUTHOR]

Background This paper reviews the early work of Griffith Edwards and his colleagues on alcohol in the criminal justice system and outlines the direction of research in this area in the Addiction Research Unit in the 1960s and 1970s. The paper outlines the link between that work and work undertaken in the more recent past in this area. Methods The key papers of the authors are reviewed and the impact of this work on policy and practice is discussed. Conclusions There is a rich seam of work on deprived and incarcerated populations that has been under way at the Addiction Research Unit and subsequently the National Addiction Centre, Institute of Psychiatry, London. Griffith Edwards initiated this work that explores the risks and problems experienced by people moving between the health and criminal justice system, and demonstrated the need for better care and continuity across this system [ABSTRACT FROM AUTHOR]

This paper explores the relationship between sexual health and alcohol in young people in contemporary society, and the role of personal, social and health and economic education (PSHE). This research was prompted by the decision of the Department of Health (DH) not to publish National Institute for Health and Care Excellence (NICE) guidance on PSHE in January 2011. The guidance was requested following a Department for Education internal review into PSHE education. This paper will review qualitative and quantitative research, and data pertaining to the issue of sexual health behaviour and alcohol use among young people in the UK and the role of PSHE education. NICE guidance remains the 'gold standard' for evidence-based healthcare service provision and its implications for sexually transmitted infection and teenage pregnancy rates remains a high priority. Equally, research supports that addressing the issue of alcohol is an increasing priority in young people. This paper will argue that the NICE PSHE review findings should be updated, published and implemented. [ABSTRACT FROM AUTHOR]

Background and Aim: Public health policy development is subject to a range of stakeholders presenting their arguments to influence opinion on the best options for policy action. This paper compares stakeholders' positions in the discourse networks of two pricing policy debates in the United Kingdom: minimum unit pricing for alcohol (MUP) and the soft drinks industry levy (SDIL). Design Discourse analysis was combined with network visualization to create representations of stakeholders' positions across the two policy debates as they were represented in 11 national UK newspapers. Setting: United Kingdom. Observations: For the MUP debate 1924 statements by 152 people from 87 organizations were coded from 348 articles. For the SDIL debate 3883 statements by 214 people from 175 organizations were coded from 511 articles. Measurements Network analysis techniques were used to identify robust argumentative similarities and maximize the identification of network structures. Network measures of size, connectedness and cohesion were used to compare discourse networks. Findings The networks for both pricing debates involve a similar range of stakeholder types and form clusters representing policy discourse coalitions. The SDIL network is larger than the MUP network, particularly the proponents' cluster, with more than three times as many stakeholders. Both networks have tight clusters of manufacturers, think‐tanks and commercial analysts in the opponents' coalition. Public health stakeholders appear in both networks, but no health charity or advocacy group is common to both. Conclusion: A comparison of the discourse in the UK press during the policy development processes for minimum unit pricing for alcohol and the soft drinks industry levy suggests greater cross‐sector collaboration among policy opponents than proponents. [ABSTRACT FROM AUTHOR]

This paper explores and develops issues raised by recent debates about the cost of alcohol to England and Wales. It advances two arguments. First, that the commonly used estimates for alcohol harm in England and Wales are outdated, not fully reliable and in need of revisiting. These estimates rely on data that are between 4 and 12 years out of date and sensitive to questionable assumptions and methodological judgements. Secondly, it argues that policymakers, academics and non-governmental organizations should be more careful in their use of these numbers. In particular, it is imperative that the numbers quoted fit the argument advanced. To help guide such appropriate usage, the different types of cost of alcohol are surveyed, alongside some thoughts on the questions they help us to answer and what they imply for policy. For example, comprehensive estimates of the total social cost of alcohol provide an indication of the scale of the problem, but have limited policy relevance. External cost estimates represent a 'lowest common denominator' approach acceptable to most, but require additional assumptions to guide action. Narrower perspectives, such as fiscal, economic or health costs, may be relevant in specific contexts. However, optimal policy should take a holistic view of all the relevant costs and benefits. Similarly, focusing solely on tangible costs may be less controversial, but will result in an under-estimate of the relevant costs of alcohol. [ABSTRACT FROM AUTHOR]

Young people's drinking in the UK remains a matter of medical, social, media and political concern. The notion of transition and drinking styles in the move from childhood to adulthood and from education to employment has been central to understanding young people's drinking behaviour, but little is known about how the drinking patterns of those not in education or employment, both men and women, develop over time. This paper reports on research which aimed to examine the current drinking habits and drinking careers of young people not in education employment and training who are traditionally described as hard to reach. In‐depth qualitative interviews were undertaken with 23 young people: 15 women and 8 men aged between 14 and 23. The findings are presented with respect to three stages of drinking: starting, continuing or increasing, and decreasing or stopping. The conclusions indicate that for the majority of these young people, alcohol is a significant factor in their lives and that peers, gender, time and place combine to structure both their current alcohol use and drinking career. The paper argues that an understanding of young people's drinking career development and current alcohol use will help target effective social work and multi‐agency intervention. [ABSTRACT FROM AUTHOR]

Background and Aims The concern that alcohol advertising can have detrimental effects on vulnerable viewers has prompted the development of codes of responsible advertising practices. This paper evaluates critically the concept of vulnerability as it applies to (1) susceptibility to alcohol-related harm and (2) susceptibility to the effects of marketing, and describes its implications for the regulation of alcohol marketing. Method We describe the findings of key published studies, review papers and expert reports to determine whether these two types of vulnerability apply to population groups defined by (1) age and developmental history; (2) personality characteristics; (3) family history of alcoholism; (4) female sex and pregnancy risk; and (5) history of alcohol dependence and recovery status. Results Developmental theory and research suggest that groups defined by younger age, incomplete neurocognitive development and a history of alcohol dependence may be particularly vulnerable because of the disproportionate harm they experience from alcohol and their increased susceptibility to alcohol marketing. Children may be more susceptible to media imagery because they do not have the ability to compensate for biases in advertising portrayals and glamorized media imagery. Conclusion Young people and people with a history of alcohol dependence appear to be especially vulnerable to alcohol marketing, warranting the development of new content and exposure guidelines focused on protecting those groups to improve current self-regulation codes promoted by the alcohol industry. If adequate protections cannot be implemented through this mechanism, statutory regulations should be considered. [ABSTRACT FROM AUTHOR]

In this paper, we use Bakhtin's theory of carnival in a literary analysis of young people's accounts of the role of alcohol in their social lives. Bakhtinian themes in the focus-group transcripts included the dialogic character of drinking stories, the focus on parodic grotesquery, ribald and satiric laughter, and the temporary subversion and reversal of social norms and roles in a world turned ‘inside out’. We suggest that our analysis of the UK's drinking ‘culture’ hints at a previously untheorised complexity and force, and points to a deep contradiction between young people's lived experience of alcohol and government policy discourses based on appeals to individual moral responsibility. We conclude that the carnivalesque resonance of drinking is such that the UK's alcohol problem will continue to worsen until the availability and cultural presence of alcohol is subject to stricter controls. [ABSTRACT FROM PUBLISHER]

This paper considers licensing as a governmental tool for controlling crime and disorder in the night-time economy while simultaneously shaping that economy's social mores. Using recent contrasting examples from the English and Welsh experience – the regulation of live music events and lap dancing – the paper shows how licensing frameworks endorse particular social, cultural and economic forms while criminalizing, delegitimizing and suppressing others. Regulation of alcohol sales and entertainment (through licensing) sits in uneasy relationship with contemporary youth/young adult cultures and local leisure scenes. Young people's identities are constructed, in part, by and through their experiences as ‘consumers’ of nightlife. Within this context, heavy sessional alcohol consumption remains an important motif for young people; a culture of intoxication, combined with wider sources of social tension and fragmentation, governs the ‘life of night’ informally and in more subtle, pervasive and effective ways than formal dicta could hope to achieve.Crime Prevention and Community Safety (2009) 11, 219–234. doi:10.1057/cpcs.2009.15 [ABSTRACT FROM AUTHOR]

Violence in the night-time economy is a key priority for the police, crime and disorder reduction partnerships (CDRPs) and local authorities (LAs) across England and Wales, and there have been a plethora of new policies and strategies introduced to help tackle the problem in recent years. This paper discusses the effects of key policy changes, including the introduction of the Licensing Act 2003 and the publication of the National Alcohol Strategy, on the day-to-day delivery of frontline services. This paper highlights how national crime reduction initiatives and strategies, such as the tackling violent crime programme (TVCP) and alcohol misuse enforcement campaigns (AMECs) were implemented at a local level. Other interventions, such as the use of head-mounted cameras for evidence gathering and the introduction of the Best Bar None scheme are also discussed in relation to reducing night-time economy violence.Crime Prevention and Community Safety (2009) 11, 189–203. doi:10.1057/cpcs.2009.13 [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to detail developments in UK alcohol policy for older people over the past 20 years, based on evidence for a growing public health problem with alcohol misuse in older people. Design/methodology/approach: A literature search was carried out using health and social care databases, including grey literature. Findings: There has been considerable progress in areas such as screening and brief intervention, low-risk drinking and service provision for integrated care in older people with dual diagnosis. Research limitations/implications: There remains a dearth of research and policy for older people with alcohol misuse and dual diagnosis prior to 2011. Although there remains limited empirical evidence for public health interventions to improve health outcomes from alcohol-related harm, improvements in population health from implementation of recent policy changes and intervention programmes remains to be seen. Practical implications: This review has implications for best practice in the provision of integrated care to reduce harm and improve health and social outcomes in older people with alcohol misuse and dual diagnosis. Originality/value: This review draws together a large area of research and policy on alcohol misuse in older people that has the potential to improve public mental health for older people who are at risk of alcohol-related harm. [ABSTRACT FROM AUTHOR]

During the past few years, debate surrounding depictions of a 'British disease' of binge drinking in contrast to civil European drinking cultures has been a central feature of popular and political debate in the UK. This paper investigates the ways in which these drinking categories have been constructed and identifies how they have become key elements in the production and consumption of public space. Empirical findings are presented from a city in the UK to show how these labels are being translated into policy agendas through the construction of models of citizenship and ways of behaviour and operationalised through the designation and regulation of particular spaces via exclusion zones, quartering, planning and policing. The paper also highlights the ways in which discourses relating to British binge- and European-drinking are being adopted and interpreted by consumers and unpacks how this impacts on perception and experience of public space. [ABSTRACT FROM AUTHOR]

Within the UK, there is a drive to encourage the delivery of alcohol screening (or identification) and brief advice (IBA) in a range of contexts beyond primary care and hospitals where the evidence is strongest. However, the evidence base for effectiveness in non-health contexts is not currently established. This paper considers the case of housing provided by social landlords, drawing on two research studies which were conducted concurrently. One study examined the feasibility of delivering alcohol IBA in housing settings and the other the role of training in delivering IBA in non-health contexts including housing. This paper draws mainly on the qualitative data collected for both studies to examine the appropriateness and feasibility of delivering IBA in a range of social housing settings by the housing workforce. Findings suggest that while it is feasible to deliver IBA in housing settings, there are similar challenges and barriers to those already identified in relation to primary care. These include issues around role inadequacy, role legitimacy and the lack of support to work with people with alcohol problems. Results indicate that the potential may lie in focusing training efforts on specific roles to deliver IBA rather than it being expected of all staff. [ABSTRACT FROM PUBLISHER]

Purpose: The assessment of patterns in risky drinking and its association with dual diagnosis in community services for older people remains under-explored. The paper aims to discuss this issue. Design/methodology/approach: Drinking risk using the Alcohol Use Disorders Identification Test (AUDIT) and the presence of co-existing mental disorders was examined in 190 people aged 65 and over. Findings: In total, 24 per cent of drinkers drank above lower risk levels and 22 per cent reported binge drinking over the past 12 months. Those scoring 1 or more on the AUDIT were more likely to be male and to have greater cognitive impairment than non-drinkers and those reporting no past problems with alcohol. Research limitations/implications: Given the limitations of the Mini Mental State Examination in the detection of alcohol related cognitive impairment (ARCI), the use of other cognitive screening instruments in larger study populations is also warranted. Practical implications: Greater attention needs to be paid to the assessment of risky drinking in older male drinkers and those with cognitive impairment. Originality/value: There is considerable scope for the routine detection of cognitive impairment and dementia in older people with alcohol use within mainstream mental health services, particularly in those with binge drinking. As ARCI is associated with loss of function and independence, early detection and intervention can improve health and social outcomes. [ABSTRACT FROM AUTHOR]

Background: There is evidence that mental health problems are increasing and substance use behaviours are decreasing. This paper aimed to investigate recent trends in mental ill health and health-related behaviours in two cohorts of UK adolescents in 2005 and 2015.Methods: Prevalences in mental health (depressive symptoms, self-harm, anti-social behaviours, parent-reported difficulties) and health-related behaviours (substance use, weight, weight perception, sleep, sexual intercourse) were examined at age 14 in two UK birth cohorts; Avon Longitudinal Study of Parents and Children (ALSPAC, N = 5627, born 1991-92) and Millennium Cohort Study (MCS, N = 11 318, born 2000-02). Prevalences and trend estimates are presented unadjusted and using propensity score matching and entropy balancing to account for differences between samples.Results: Depressive symptoms (9% to 14.8%) and self-harm (11.8% to 14.4%) were higher in 2015 compared with 2005. Parent-reported emotional difficulties, conduct problems, hyperactivity and peer problems were higher in 2015 compared with 2005 (5.7-8.9% to 9.7-17.7%). Conversely, substance use (tried smoking, 9.2% to 2.9%; tried alcohol, 52.1% to 43.5%, cannabis, 4.6% to 3.9%), sexual activity (2% to 0.9%) and anti-social behaviours (6.2-40.1% to 1.6-27.7%) were less common or no different. Adolescents in 2015 were spending less time sleeping (<8 h 5.7% to 11.5%), had higher body mass index (BMI) (obese, 3.8% to 7.3%) and a greater proportion perceived themselves as overweight (26.5% to 32.9%). The findings should be interpreted bearing in mind limitations in ability to adequately harmonize certain variables and account for differences in attrition rates and generalizability of the two cohorts.Conclusions: Given health-related behaviours are often cited as risk factors for poor mental health, our findings suggest relationships between these factors might be more complex and dynamic in nature than currently understood. Substantial increases in mental health difficulties, BMI and poor sleep-related behaviours highlight an increasing public health challenge. [ABSTRACT FROM AUTHOR]

Introduction and Aims: This paper reports on an exploratory ethnographic observation study which aimed to understand how alcohol fits into routine service provision in the New Medicine Service (NMS), Medication Use Reviews (MUR) and pharmacists' everyday practices in UK community pharmacies.Design and Methods: Observations were undertaken in five community pharmacies featuring nine community pharmacists. This involved observation of 16 MURs and 15 NMS consultations and informal interviews with pharmacists as they conducted their work. Fieldnotes were subjected to a constructionist thematic analysis.Results: Pharmacists were underprepared and unconfident in discussing alcohol in medicine consultations. Most pharmacists raised alcohol consumption in the MUR and NMS as part of a 'lifestyle check'. They reported that alcohol was difficult to raise, and to discuss and that people were reluctant to talk about their drinking. Their main concern was that raising the topic would alienate customers.Discussion and Conclusions: These findings raise questions regarding a range of issues about how pharmacists discuss alcohol in medicines consultations, why they lack a clear sense of purpose in doing so and therefore where alcohol fits into UK community pharmacy practice. [ABSTRACT FROM AUTHOR]

Extant literature is sparse with regards to the relationship between caregiver reports and neuropsychological tests of executive functioning in Fetal Alcohol Spectrum Disorders (FASD). The goal of this paper was determining the clinical utilities of executive functioning measures used in the United Kingdom national FASD clinic. We examined relationships between outcomes on the Behavior Rating Inventory of Executive Function (BRIEF) and the Delis-Kaplan Executive Function System (D-KEFS), as part of an ongoing service evaluation. Profiles of executive functioning measures were reported in order to contribute to delineating a profile of executive dysfunction in FASD. Caregivers of 49 people with FASD completed the Parent BRIEF, and 61 people with FASD were administered the D-KEFS. Pearson's Correlations between all 11 BRIEF scales and the 18 selected D-KEFS subscales showed little relationship. The BRIEF showed a profile of clinically significant elevations in all three Index scores and seven out of the eight Scale scores. Several D-KEFS tests showed below average executive functioning. Both executive function measures have separate clinical utility in demonstrating executive function deficits in FASD. The sample population used in this study also show a similar pattern to FASD populations internationally, suggesting a similar neuropsychological profile is seen in the United Kingdom. However, caregiver reports display little relationship to neuropsychological tests. These measures likely monitor different aspects of executive functioning in different settings. Future research should focus on identifying tests that better relate findings from clinical settings to behavior in daily life. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine the prevalence of alcohol use disorders (AUDs) amongst young people in the criminal justice system (CJS) in the North East of England and to compare the ability of the Alcohol Use Disorders Identification Test (AUDIT) to the Youth Justice Board ASSET tool in identifying alcohol-related need in Youth Offending Team (YOT) clients. Design/methodology/approach – A validated screening tool (AUDIT) was used to identify alcohol-related health risk or harm. Findings from AUDIT were compared with those of the standard criminogenic risk screening tool used in CJS (ASSET). An anonymous cross-sectional questionnaire was administered during a one-month period in 2008. The questionnaires were completed by 11-17-year-old offenders who were in contact with three YOTs, one Youth Offending Institution and one Secure Training Estate. Findings – In total, 429 questionnaires were completed out of a possible 639 (67 per cent). The majority (81 per cent) of the young offenders were identified as experiencing alcohol-related health risk or harm and 77 per cent scored within a possibly alcohol-dependent range. In total, 77 (30 per cent) of young people completing both assessments were identified as having an AUD by AUDIT but not identified as needing alcohol-related treatment using ASSET. Research limitations/implications – This research was confined to one geographical area of England, however, the results show that even in this area of high drinking by young people the levels of AUDs amongst young people in the CJS are very high. Social implications – There are major social implications to this research. It is imperative for changes to be made to the care pathways in place in the UK for young people coming through the CJS with alcohol-related issues. Originality/value – This paper adds to the evidence base by using well-validated tools to measure alcohol use amongst young people in the CJS in the UK. [ABSTRACT FROM AUTHOR]

This paper explores the sensitivities and cultural complexities of engaging in research about substance use with a Sikh Punjabi community in England, from the perspective of cultural outsiders. The objective of the research was to explore the feasibility of developing a Community Alcohol Support Package (CASP) within the community, where existing alcohol service provision was felt to be limited, using ethnographic research methods. Tensions between a strict religious prohibition against drinking and a cultural acceptance of a heavy drinking culture created the conditions for the research and its particular challenges. This paper reports on the process of conducting the research and the transferable lessons for social work teaching and practice. Two key methodological challenges are highlighted together with reflections on how they were addressed: first, the problem of engagement and negotiating access to the community in focus; second, the challenge for outsiders of tuning into the socio-political context of the community and the power dynamics within it. Overcoming these challenges required high levels of sensitivity to the concerns of the community, while maintaining research integrity, and demonstrable openness and honesty in the course of developing research relationships. The lessons for social work education and practice are discussed. [ABSTRACT FROM AUTHOR]

This paper frames the debate on ‘binge’ drinking amongst young people within the perspectives of materialism and cultural geography. Drawing on the concept of social practice as interpreted through the perspective of urban design, the research investigated spatial variations in youth drinking using a case study approach to examine two urban areas in England. The study confirmed that the social practice of the ‘big night out’ has become an established feature of youth drinking. The research found the practice constituted in specialist ‘clusters’ of venues and it is argued that place-based characteristics form a significant component of its production and experience. The paper concludes with a reflection on the challenges the evidence poses to previous interpretations of leisure divisions within mainstream nightlife and to the theorisation of place-based differences in drinking milieux oriented towards young people. The implications for public policies are considered. [ABSTRACT FROM PUBLISHER]

Recent years have seen an expanding 'no and low alcohol' (NoLo) drinks market in the United Kingdom and other high-income countries. With the UK government pledging to increase the availability of NoLos and encourage their consumption, further research is required to underpin policy and explore the potential for NoLos to ease – or exacerbate – alcohol-related harm. This paper draws on original primary research on NoLo marketing and consumption in the UK; analysis of two NoLo marketing campaigns and semi-structured interviews with both drinkers and non-drinkers who consume NoLos. Addition marketing was identified in the promotion of NoLo products, encouraging consumers to incorporate NoLo consumption into new spatial and temporal contexts on top of their typical weekly drinking patterns. However, there was resistance towards these practices from consumers, who stressed they were more likely to drink NoLos in place of alcohol and incorporate them into their existing drinking routines. This paper expands a currently very limited evidence base and contributes directly to ongoing debates around 'addition' versus 'substitution' (i.e. whether NoLo products are being used on top of or in place of alcohol). Findings highlight both some of the challenges and opportunities of the expanding market, pointing towards the problematic presence of 'addition marketing' but also highlighting the ways consumers might challenge this and use NoLos flexibly to reduce consumption. As a result, NoLo promotion could function as one tool amongst many to help at least some consumers drink in moderation, alongside a broader package of measures such as education and wider social change. [ABSTRACT FROM AUTHOR]

Purpose -- An increasing literature points to the efficacy and importance of mutual aid groups for people recovering from substance dependency. However, there is a paucity of qualitative evidence into the experiences and perceptions of service users attending UK-based mutual aid groups, and the implications they could have for recovery and mental wellbeing. The paper aims to discuss this issue. Design/methodology/approach -- A phenomenological approach was chosen to explore the experiences and perceptions of service users and mentors at a mutual aid group in Leeds. Semi-structured interviews were conducted with service users and mentors (ex-service users) involved with the project. Thematic analysis was used to analyse the data. Findings -- This paper focuses on the influence of mutual aid attendance on mental wellbeing. It was found that attendance seemed to have positive influences on providing structure, reducing stress and boredom, "broadening the mind" and providing service users with a social network that supported their recovery and mental wellbeing. However, it was also found that for those that have little outside the project, dependency on the group could develop, resulting in negative consequences on mental wellbeing. Originality/value -- This paper provides an increased understanding of why mutual attendance has influences on mental wellbeing, as well as the implications such impacts have on recovery trajectories. [ABSTRACT FROM AUTHOR]

This paper draws on data from a national survey of social workers and social care practitioners in England undertaken in 2010–2011. It focuses on practitioners working in services for adults with either learning or physical disabilities and, in particular, their experiences of responding to alcohol and other drug use among their service users. Based on secondary analysis of survey and focus group data from the earlier study, the paper outlines the extent to which workers in these areas of practice encounter alcohol and drug problems and discusses the key challenges this poses for them. The findings show that between 4% and 10% of adults' practitioners' service users have alcohol and drug problems depending on the nature of the disability. Regardless of the type of disability, practitioners reported difficulties in talking about substance use with their service users as well as identifying tensions around life-style choice and risk management. They also reported the need for education and training in a number of areas. Social work education and subsequent training in working with substance use problems needs to be available to adults' practitioners and it needs to address the specific issues and needs in different areas of social work practice. [ABSTRACT FROM PUBLISHER]

Despite evidence suggesting some convergence between the drinking practices of men and women in recent years, alcohol-related behaviour appears to remain significantly gendered in the UK, with males being more likely to drink alcohol and to drink greater quantities of alcohol than females for instance. The authors of this paper view alcohol-related behaviour as one particular sphere of practice through which gender may be performed and normative gender identities accomplished. The authors ask where the next generations of alcohol consumers learn to ‘do’ gender in relation to alcohol. We argue that the depictions and treatments of alcohol-related behaviour to be found in the magazines that young people claim to read may function as one very important cultural resource in this respect. The paper subsequently offers an analysis and discussion of the ways in which alcohol and alcohol-related behaviour is depicted within a range of magazines read by 11–18-year-olds in the UK. The analysis presented herein illustrates that the treatment of alcohol-related behaviour in these magazines is indeed highly gendered and gendering. Males and females are depicted as engaging in different drinking practices, for different purposes, in different contexts, and to different consequences/effects for instance. Furthermore, the way in which the alcohol-related behaviours of males and females are treated in these magazines varies considerably between those magazines targeted at males and those targeted at females. It is thus acknowledged that these magazines might have a crucial role to play in the reproduction of gender in relation to alcohol-related behaviour specifically. [ABSTRACT FROM AUTHOR]

This paper interrogates the multiple spatialities bound up with the consumption of units as the dominant means of diagnosing 'health-related' alcohol problems and measuring 'drunkenness' in international alcohol policy and research. In order to question the power afforded to units, we work at the intersection of theoretical debates concerning biopower and governmentality; emotional, embodied and affective geographies and actor network theory. Presenting empirical research from the UK we contribute to geographical agendas that seek to consider the ontological and epistemological understandings of alcohol, drinking and drunkenness. The paper concludes by calling for dialogue between social, health and medical scientists in order to develop more pertinent ways of understanding and representing the risks and benefits of alcohol consumption. [ABSTRACT FROM AUTHOR]

On 30 October 2009, the home secretary in the UK asked David Nutt to resign from his post as chairman of the government's advisory council on the misuse of drugs. The previous day, the Centre for Crime and Justice Studies at King's College London had published Nutt's paper, 'Estimating drug harms: a risky business?'. This is an edited version of his Eve Saville memorial lecture, delivered at Kings College in July 2009. The paper points out that ecstasy and LSD are less dangerous than alcohol. He had previously clashed with the home office over his editorial, 'Equasy - an overlooked addiction with implications for the current debate on drug harms', published in the Journal of Psychopharmacology in January 2009. This reflects on the reality that ecstasy is overall less harmful than riding. The home secretary was not amused, and the relationship between academic publication and scientific advice to government was cast into the limelight. David Nutt is now chair of the Independent Scientific Committee on Drugs. [ABSTRACT FROM AUTHOR]

This paper argues that social work education in the UK has persistently failed to equip its social workers with the knowledge to work effectively with people with alcohol and drug problems. In spite of continuing criticism of the profession's unwillingness or inability to engage with substance use issues, social work education has failed to respond to the calls for better training on this subject, even when specific guidance has been issued about course content. This results in a failure to meet the needs of our service users as well as social work staff who remain frustrated at their inability to intervene. The paper explores the historical and current debate about social work training in relation to alcohol and drugs and identifies the barriers to its inclusion in qualifying and post-qualifying (PQ) curricula. Finally it offers a strategy for improving social work training as well as an overview of programme content requirements. [ABSTRACT FROM AUTHOR]

Aims This paper estimates how far monthly changes in prevalence of cigarette smoking, motivation to quit and attempts to stop smoking have been associated with changes in prevalence of high-risk drinking, and motivation and attempts to reduce alcohol consumption in England. Design Data were used from the Alcohol and Smoking Toolkit Studies between April 2014 and June 2016. These involve monthly household face-to-face surveys of representative samples of ~1700 adults in England. Measurements Autoregressive Integrated Moving Average with Exogeneous Input (ARIMAX) modelling was used to assess the association over time between monthly prevalence of (a) smoking and high-risk drinking; (b) high motivation to quit smoking and high motivation to reduce alcohol consumption; and (c) attempts to quit smoking and attempts to reduce alcohol consumption. Findings Mean smoking prevalence over the study period was 18.6% and high-risk drinking prevalence was 13.0%. A decrease of 1% of the series mean smoking prevalence was associated with a reduction of 0.185% of the mean prevalence of high-risk drinking 2 months later [95% confidence interval (CI) = 0.033 to 0.337, P = 0.017]. A statistically significant association was not found between prevalence of high motivation to quit smoking and high motivation to reduce alcohol consumption (β = 0.324, 95% CI = -0.371 to 1.019, P = 0.360) or prevalence of attempts to quit smoking and attempts to reduce alcohol consumption (β = −0.026, 95% CI = -1.348 to 1.296, P = 0.969). Conclusion Between 2014 and 2016, monthly changes in prevalence of smoking in England were associated positively with prevalence of high-risk drinking. There was no significant association between motivation to stop and motivation to reduce alcohol consumption, or attempts to quit smoking and attempts to reduce alcohol consumption. [ABSTRACT FROM AUTHOR]

Background & Aims: Increasingly populations are both overweight/obese and consume alcohol. The risk of liver disease from the combination of these factors is unclear. We performed a systematic review and meta‐analysis to address this important gap in evidence. Protocol registered with PROSPERO(CRD42016046508). Methods: We performed electronic searches of Ovid Medline, Embase Classic + Embase, until 17th June 2020 for cohort studies of adults without pre‐existing liver disease. Primary outcome was morbidity/mortality from chronic liver disease. Exposures were alcohol consumption categorised as within or above UK recommended limits (14 units/112 g per week) and BMI categorised as normal, overweight or obese. Non‐drinkers were excluded. A Poisson regression log‐linear model was used to test for statistical interaction between alcohol and BMI and to conduct a one‐stage meta‐analysis. Results: Searches identified 3129 studies—16 were eligible. Of these, nine cohorts (1,121,514 participants) had data available and were included in the analysis. The Poisson model showed no significant statistical interaction between alcohol consumption and BMI on the risk of chronic liver disease. Compared to normal weight participants drinking alcohol within UK recommended limits, relative risk of chronic liver disease in overweight participants drinking above limits was 3.32 (95% CI 2.88 to 3.83) and relative risk in obese participants drinking above limits was 5.39 (95% CI 4.62 to 6.29). Conclusions: This meta‐analysis demonstrated a significantly increased risk of chronic liver disease in participants who were both overweight/obese and consumed alcohol above UK recommended limits. This evidence should inform advice given to patients and risk stratification by healthcare professionals. [ABSTRACT FROM AUTHOR]

Public houses have long served an important social role in the United Kingdom, yet in recent decades the conditions under which they operate have changed dramatically. While research has examined adaptations in the pub sector, there is little analysis of how this relates to social change as experienced in the lives of individuals and communities. Pubs are therefore a useful topic of sociological inquiry. Using focus groups data, this article examines how people experience the changing form and function of pubs reveals insights into perceptions of social change. Findings show that participants were aware of how pub culture has changed over recent decades and that this was linked to perceptions of wider social and cultural changes in society. Talking about pub going was a means to express dynamic feelings of belonging and attachment, particularly where they arise at the intersection of personal life changes and wider social transformations. [ABSTRACT FROM AUTHOR]

• Online sober communities offer alternative spaces of support to Alcoholics Anonymous. • Women rejected and reproduced the discourse of alcoholics anonymous in their accounts of sobriety. • Abstinence was promoted as the most effective way of gaining control over drinking. • Online sober communities may fail resonate with people on the Alcohol Use Disorder spectrum. In recent years, reductions in drinking in the UK and the rise of online 'positive' sobriety communities have been observed, yet peer led support groups such as Alcoholics Anonymous (AA) and neo-liberal discourses of control and responsibility dominate public understandings of (problematic) alcohol use. This paper presents research exploring how women active in the 'positive sobriety' community on Instagram position and construct their non-drinking identities and relationships with alcohol within these overlapping discourses. Semi-structured interviews (n=15) and online content produced by women active in the positive sobriety community on Instagram were analysed using thematic analysis. Women challenged, reproduced and amalgamated AA discourses of addiction, and the broader discourses of neo-liberalism, in ways that positioned (alcohol) consumption, agency, control and individual responsibility as defining features of feminine identity making. Drawing on these discourses, binary understandings of problematic drinking, the identity of the 'alcoholic', and the need to reach 'rock bottom' in the recovery process were rejected and challenged, but at times reproduced. Whilst a broader framing of problematic drinking that situated drinking problems on a spectrum was constructed, abstinence was engaged with and promoted as the most effective way of gaining control and responsibility over drinking in gendered ways, and in establishing an authentic sense of self. This paper contributes to emerging research on online 'positive' sobriety communities, their gendered nature, and the intertwined presence of traditional recovery and neo-liberal discourses in women's accounts. Online sober communities offered alternative spaces of support and allowed for sobriety and sober femininities to be framed more positively than within traditional AA conceptualisations. However, those involved may experience tensions around (a) the need to 'tell' their personal stories of complete abstinence whilst still appealing to those who seek to 'moderate' and (b) the pressure to create and craft an 'authentic' sober self on an online platform that demands a carefully curated self-image and personal 'brand'. Further research should aim to gain more understanding of the role social media plays in "doing" sobriety and non-drinking, how this is done by people of different genders, the intersectional experiences of those participating, and how these communities can be made more equally available and accessible to those who do not consider full abstinence as necessary, whilst still appealing to those that do. [ABSTRACT FROM AUTHOR]

The aim of this paper was to provide insights into alcohol misuse within UK veterans to inform as to whether their presentations differ from the general public. This was done by exploring differences in the severity of alcohol misuse between UK veterans and the general public admitted to a general NHS hospital over an 18 month period using retrospective data. All patients admitted to the hospital were screened for alcohol misuse. Those deemed as experiencing problems were referred for specialist nurse-led support. A total of 2331 individuals were referred for this supported and administered with a standardised assessment that included measures of the severity of alcohol difficulties (AUDIT), dependency levels (LDQ), and assessed for the presence of withdrawal symptoms (CIWA-Ar). In addition, information was collected on service utilisation, referral category (medical or mental health), other substance misuse, and demographic characteristics. No differences were found between the severity of reported alcohol difficulties between veterans and non-veterans. Evidence was found to suggest that veterans were more likely to be referred for support with alcohol difficulties at an older age and to be admitted to hospital for longer periods of time. This could have considerable cost implications for the NHS. It was more common for veterans to present at hospital with physical health difficulties prior to being referred for support for alcohol. [ABSTRACT FROM AUTHOR]

Background and Aims If socio-economic disadvantage is associated with more adolescent smoking, but less participation in tertiary education, and smoking and tertiary education are both associated with heavier drinking, these may represent opposing pathways to heavy drinking. This paper examines contextual variation in the magnitude and direction of these associations. Design Comparing cohort studies. Setting United Kingdom. Participants Participants were from the 1958 National Child Development Study (NCDS58; n = 15 672), the British birth cohort study (BCS70; n = 12 735) and the West of Scotland Twenty-07 1970s cohort (T07; n = 1515). Measurements Participants self-reported daily smoking and weekly drinking in adolescence (age 16 years) and heavy drinking (> 14/21 units in past week) in early adulthood (ages 22-26 years). Parental occupational class (manual versus non-manual) indicated socio-economic background. Education beyond age 18 was coded as tertiary. Models were adjusted for parental smoking and drinking, family structure and adolescent psychiatric distress. Findings Respondents from a manual class were more likely to smoke and less likely to enter tertiary education (e.g. in NCDS58, probit coefficients were 0.201 and -0.765, respectively; P < 0.001 for both) than respondents from a non-manual class. Adolescent smokers were more likely to drink weekly in adolescence (0.346; P < 0.001) and more likely to drink heavily in early adulthood (0.178; P < 0.001) than adolescent non-smokers. Respondents who participated in tertiary education were more likely to drink heavily in early adulthood (0.110 for males, 0.182 for females; P < 0.001 for both) than respondents with no tertiary education. With some variation in magnitude, these associations were consistent across all three cohorts. Conclusions In Britain, young adults are more likely to drink heavily both if they smoke and participate in tertiary education (college and university) despite socio-economic background being associated in opposite directions with these risk factors. [ABSTRACT FROM AUTHOR]