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07/04/2011

UK: MP calls for new measures to protect children from alcohol advertising

London, 28 March 2011. MP Sarah Wollaston put forward a private member's bill urging the government to adopt a new approach to protect UK children from alcohol advertising.

The bill calls on the government to adapt the French “loi evin” that allows alcohol advertising in media aimed at adults but not children, and ensures that promotional messages are factual and verifiable.

The loi Evin was introduced in France in 1991 to protect their children from alcohol marketing and has been a key plank in France's effort to reduce its alcohol problems. Alcohol consumption in France has been falling consistently since 1960.

In contrast, the UK has opted for self regulatory codes and now has one of the highest levels of binge drinking and drunkenness among schoolchildren in Europe, say the authors.

In 2008, there were more than 600 alcohol-related deaths – almost two a day - among 15-24 year-olds in England and Wales, significantly more than the combined toll from cancer, heart disease, and respiratory disease in this age group.

Added to this are problems of anti-social behaviour, unwanted pregnancies and sexually transmitted diseases.

Meanwhile, the UK drinks industry spends £800m a year promoting alcohol compared with a budget of just £2.6m for the UK's biggest alcohol education initiative in 2010. “For every £1 spent advising young people about the downsides of drinking, several hundred pounds are spent encouraging them to drink more”, say the authors.

In the long term the bill will change drinking behaviour in young people, they write. Evidence clearly shows that alcohol promotion encourages children to drink at an earlier age and in greater quantities than they otherwise would. A recent study found that 96% of UK 13 year olds were aware of alcohol advertising.

“Removing this profoundly unhealthy influence is, unsurprisingly, recognised as a key public health priority,” they conclude. “So, along with their café culture, the “loi evin” is a French innovation that the UK needs.”

In an editorial published on bmj.com last week, Professor Gerard Hastings and Dr Nick Sheron set out why we urgently need to tackle the excessive drinking of our young people and their massive exposure to alcohol advertising. See below the full editorial

Alcohol marketing to children

A new UK private member’s bill provides a simple, clear, and effective way forward

A private member’s bill on alcohol marketing to be put forward by Sarah Wollaston on 30 March tackles two pressing and uncontested problems: the excessive drinking of young people and their massive exposure to alcohol advertising.

The most recent European school survey project on alcohol and other drugs (ESPAD) of 35 European countries shows that only Denmark and the Isle of Man have higher levels of binge drinking and drunkenness in schoolchildren than the United Kingdom. In 2008, 2843 deaths occurred in 15-24 year olds in England and Wales, and almost one in four (23%) of these was attributable to alcohol; that is, more than 600 deaths—almost two a day—significantly more than the combined toll from cancer, heart disease, and respiratory disease in this age group. In addition, alcohol is linked to antisocial behaviour, unwanted pregnancies, and sexually transmitted disease. Alcohol marketing not only facilitates these problems but also seems to suspend critical analysis: the ESPAD survey asked schoolchildren to rate five positive aspects (such as “feel happy,” “feel relaxed,” and “forget my problems”) and six negative aspects of drinking (such as “harm my health,” “do something I would regret,” and “get into trouble with the police”). UK schoolchildren reported the highest positive and least negative expectations for drinking alcohol of any country in Europe.

The Cabinet Office estimates that £800m (€920m; $1300m) is spent on alcohol marketing each year, far more than on alcohol education budgets—for example, the Drinkaware Trust, which is the UK’s biggest such initiative, had a budget of just £2.6m in 2010. For every £1 laid out on advising young people about the downsides of drinking, several hundred pounds are spent encouraging them to drink more. This is money well spent by the alcohol companies: a study funded by the Medical Research Council recently showed that in the UK 96% of 13 year olds were aware of alcohol advertising and had, on average, come across it in more than five different media. No wonder a leading British brewer is able to boast that young men “think of four things—we brew one of them and sponsor two of them” and proclaim that its marketing aim is to “become the most respected youth brand.” The World Health Organization points out that in such a profoundly pro-drinking environment, health education becomes futile.

In the long term the bill will change drinking behaviour in young people. Evidence clearly shows that alcohol promotion encourages children to drink at an earlier age and in greater quantities than they otherwise would. As the Science Committee of the European Alcohol and Health Forum concluded in 2009: “Based on the consistency of findings across the studies, the confounders controlled for, the dose response relationships, as well as the theoretical plausibility and experimental findings regarding the impact of media exposure and commercial communications, it can be concluded from the studies reviewed that alcohol marketing increases the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol.” Removing this profoundly unhealthy influence is, unsurprisingly, recognised as a key public health priority.

These public health concerns need to be balanced against the commercial freedom to promote a product that is legal and acceptable for adults to consume in moderation. The French found a solution to this problem 20 years ago with a measure called the “Loi Evin.” They recognised that protecting children from alcohol marketing required action on both the advertising media used and the messages transmitted. With elegant simplicity they legislated to allow alcohol advertising in media aimed at adults but not children, and to ensure that promotional messages are both factual and verifiable.

The UK, meanwhile, has clumsily imposed self regulatory codes listing the things advertisers cannot say. As last year’s Health Select Committee inquiry showed, this has resulted in such preposterous contradictions as a proscription on marketers associating alcohol with sporting prowess or youth culture while allowing them to sponsor premiership football and music festivals.

In contrast the “Loi Evin” works crisply and cleanly. It protects French children by ensuring that their media and cultural environment is alcohol free. It is also a key part of France’s successful strategic effort to reduce its alcohol problems: in contrast to the UK, consumption there has been falling consistently since 1960. The law has also been tried and tested in the French courts and strongly endorsed by the European Court of Justice, which found in 2004 that the measure is proportionate, effective, and consistent with the Treaty of Rome.

So, along with their café culture, the “Loi Evin” is a French innovation that the UK needs. Sarah Wollaston’s bill will adapt it for the UK context and update it for the digital age. In practical terms (see box) it will allow alcohol advertising in media that adults use, including press, radio stations, public events, and films aimed at adults. It will remove it from media that children enjoy and engage with, including television, social media, youth certificated films, and the sponsorship of cultural and sporting events.

The “Loi Wollaston”: a private member’s bill to protect children from alcohol* marketing

The bill is based on tried and tested French legislation known as the “Loi Evin,” which was introduced there in 1991

It will permit the promotion of alcohol in media that adults use, including press, radio stations, and cinema with an adult audience and at point of sale in licensed premises and at local producer events (such as real ale festivals and distillery visitor centres). Here, advertisers will be permitted to make verifiable factual statements about their products, such as alcoholic strength, composition, place of origin, means of production, and patterns of consumption. All advertisements will also carry explicit health information

Alcohol promotion will not be allowed elsewhere—for example, television, social media, and youth certificated films. The alcohol industry will also not be allowed to sponsor cultural or sporting events with youth appeal

*Alcoholic drinks are defined as those with more than 1.2% abv (alcohol by volume)

In their adult oriented marketing, advertisers will be permitted to make verifiable factual statements about their products, such as alcoholic strength, composition, place of origin, means of production, and patterns of consumption. As in France these advertisements will also carry explicit health information.

The alcohol industry will no doubt protest and claim, as the tobacco industry did a generation ago, that it will do little for public health and only succeed in restricting our sports stars. The French have disproved this last point just as effectively as they have the first: they have managed without alcohol sponsorship since 1991 and their football team has won both the World Cup and the Euro Championship; in the alcohol sponsored UK the four home countries have, between them, only managed one semi-final appearance in either tournament.

Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work, no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; NS is secretary of the Alcohol Health Alliance UK, a trustee of the Drinkaware Trust, a member of the Department of Health Responsibility Deal Alcohol Network, and has various other related commitments, none of which are paid; GH is an Executive Committee member of Alcohol Focus Scotland and sits on the Advisory Board of the Institute for Alcohol Studies

Provenance and peer review: Not commissioned; externally peer reviewed.

1 Hibell B, Guttormsson U, Ahlstrom S, Blakireva O, Bjarnson T, Kokkevi A, et al. The 2007 European School Survey Project on Alcohol and Other Drugs (ESPAD) report. 2007. www.espad.org/documents/Espad/ESPAD_reports/2007/The_2007_ESPAD_Report-FULL_091006.pdf

2 Jones L, Bellis MA, Dedman D, Sumnall H, Tocque K. Alcohol attributable fractions for England; alcohol attributable mortality and hospital admissions. North-West Public Health Observatory and Department of Health. 2008. www.cph.org.uk/showPublication.aspx?pubid=403

3 Standerwick K, Davies C, Tucker L, Sheron N. Binge drinking, sexual behaviour and sexually transmitted infection in the UK. Int J STD AIDS 2007;18:810-3.

4 Morgenstern M, Isensee B, Sargent JD, Hanewinkel R. Attitudes as mediators of the longitudinal association between alcohol advertising and youth drinking. Arch Pediatr Adolesc Med 2011; online 7 March.

5 Cabinet Office. Strategy unit alcohol harm reduction project: 8 interim analytical report. 2003:129. www.cabinetoffice.gov.uk/media/cabinetoffice/strategy/assets/su%20interim_report2.pdf.

6 House of Commons Health Committee. Alcohol. First report of session 2009-10. Volume I. www.publications.parliament.uk/pa/cm200910/cmselect/cmhealth/151/151i.pdf.

7 Hastings G. “They’ll drink bucket loads of the stuff.” An analysis of internal alcohol industry advertising documents. Written evidence to the House of Commons Health Committee Alcohol, Memorandum AL 81. 2010. www.publications.parliament.uk/pa/cm200910/cmselect/cmhealth/memo/alcohol/al81memo.pdf.

8 Babor R, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K, et al. Alcohol: no ordinary commodity. Research and Public Policy. 2nd ed. Oxford University Press, 2010.

9 Anderson P, de Bruijn A, Angus K, Gordon R, Hastings G. Impact of alcohol advertising and media exposure on adolescent alcohol use: a systematic review of longitudinal studies. Alcohol Alcohol 2009;44:229-43.

10 Anderson P, Chisholm D, Fuhr DC. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet 2009;373:2234-46.

11 European Public Health Alliance. French Evin law is declared compatible with EU law. 2004. www.epha.org/a/1360?var_recherche=loi±evin.

12 Court of Justice of the European Communities. Opinion of Mr Advocate General Tizzano delivered on 11 March 2004, Commission of the European Communities v French Republic. Case C-262/02. Page I-06569. 2004. http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:62002C0262:EN:NOT.

Cite this as:BMJ 2011;342:d1767