A fascinating array of thinkers and specialists were brought together by Clair Fox, Chair of The Moral Maize and Director of the Institute of Ideas in June.
An opening treatise was made by Kate Fox, a social anthropologist and co-director of the Social Issues Research Centre (SIRC) who is bestselling author of ‘Watching the English: The Hidden Rules of English Behaviour’; ‘Passport to the Pub’ and ‘Pubwatching with Desmond Morris’.
Other guests included Roger Howard, chief executive, UK Drug Policy Commission, Chris Heffer, deputy director, Alcohol and Drugs, Department of Health, Dr Alena Buyx, leader, Emmy-Noether Research Group’s ‘Bioethics and Political Philosophy’; UCL and Muenster University; adviser, Nuffield Council on Bioethics, Jonathan Birdwell, head, Citizens Programme, Demos, Dr Mike Fitzpatrick, GP and author, The Tyranny of Health: doctors and the regulation of lifestyle, Simon Wessely, head, department of psychological medicine, Institute of Psychiatry, King’s College London and Honorary Consultant Advisor in Psychiatry to the British Army.
The matter for debate was Boozy Britain – a critical discussion on binge drinking and young people. The following statement was circulated before the debate:
The UK Coalition government has recently revealed its proposed alcohol strategy, launching war on binge-drinking. Policy seems particularly concerned with targeting young drinkers. The alarming figures and anecdotes around the impact of alcohol are well rehearsed,: young Britons are allegedly drinking twice as many units a week than twenty years ago, with nearly 65,000 requiring hospital treatment each year, and with countless other supposed effects from promiscuity to anti-social behaviour.
Baroness Newlove, the Government’s champion for Active Safer Communities, recently launched a £1m fund to tackle binge-drinking, with very much a focus on youth behaving badly in local communities fuelled by alcohol. Similarly, Cllr Flick Rea, chair of the Local Government Association’s culture, tourism and sport board, says that ‘anything we can do to avoid high streets being trashed by binge-drinking teens, booze-fuelled louts setting on passers-by, or children having their stomachs pumped in hospital, can only be a good thing’. The likes of Alcohol Concern have urged England and Wales to follow Scotland’s lead in introducing minimum pricing specifically to tackle young people binge-drinking, whilst various campaigns have stressed the responsibility of parents and harsher penalties for those caught selling or procuring alcohol for minors.
But social anthropologist Kate Fox has recently argued that the problem is more one of an ‘ambivalent’ drinking culture, where alcohol is treated as an illicit disinhibitor rather than ‘integrated’ into daily life. Campaigns that demonise alcohol and its effects, she argues, only worsens this tendency to recklessly abuse it rather than treat it responsibly.
Other research tends to indicate that prejudices around young people inform policy responses more than the facts. For example, unit-based binge-drinking has been falling steadily since around 2005, especially among young adults, and researchers observe that a threshold for a ‘binge’ can be set unreasonably low for the average, sensible drinker at 6 units for women (2 large glasses of wine) and 8 units for men (3 or 4 pints). How then to explain the caricatured town-centre-trashing loutish teen drunks? And what of solutions?
And other questions need to be tackled: Why do we assume it’s inevitable that young people drinking will cause social problems? What are the cultural factors that lead some young people to behave badly while under the influence, while for others, drinking alcohol can be a sociable and fun activity? Are there different responses needed to tackle different aspects of irresponsible drinking? What is the relevant role for parenting, peer pressure, advertising, alcohol companies, availability, pricing? How do we maintain freedom, choice and encourage personal responsibility?
Fox concluded that unless we are told that alcohol does not make you violent, disorderly or offer you an excuse for your behaviours, then entrenched attitudes to drinking will not change in UK. Fox drew an analogy with coffee, similar to alcohol in that caffeine is a psychoactive drug that leads to irascible behaviour in excess, palpitations and is damaging to health saying she could easily introduce a culture of binge drinking of coffee by restricting its availability and making it a taboo.
Binge drinking needs to be broken down into a range of definitions – excessive drinking, extreme drinking
It became clear early on in the debate that definitions of ‘binge drinking’ vary widely from government measurements to public perceptions that binge drinking represents a range of behaviours by drinkers rather than an amount drunk. The consumer and media perception of binge drinking revolves around the antisocial consequences of drinking to drunkenness including vomiting, public nuisance and disorder, violence and criminal damage. Is binge drinking going out with the intention of getting drunk? - i.e. is it an attitude and behaviour rather than a quantity, or is it double the responsible drinking guidelines? – This is the statistical definition in the UK at consumption at levels of 6 units or more (2-3 glasses of wine) for women (12% of women drink at this level) or 8 units for men, or 3-4 pints (19% of men drink at this level), which may be harmful to health on a regular basis, but is unlikely to result in ‘binge drinking behaviours’. For medical studies, binge drinking is broadly defined as five or more ‘drinks’ in quick succession.
Definitions of binge drinking also need to include the context as well the speed of drinking - i.e. if you pace yourself over the evening and drink with food - is this still binge drinking? A person could drink the same amount or more than someone having five drink’s in quick succession for example, or should this have a different definition. An older couple drinking 10 units during a long dinner with friends? Is this part of the same debate or should we be calling this group by another name?
Public and media perceptions of binge drinking in particular focus on the behaviour of young people in public spaces. Media coverage is extensive and dramatic headlines abound: ‘Drunken yob blitz to reclaim city streets’; ‘Binge drink deaths soar’; ‘Drunk and disorderly: Women in the UK are the worst binge drinkers in the world’ are just a few examples. What’s commonly becoming known as ‘passive drinking’ whereby the actions of a sizeable minority have anti - social consequences - ruining other peoples evening with their noise, violence, rudeness and mess.
International comparisons - important not to see the UK in isolation
Drinking is a social activity, and the way people behave when drunk is the result of a complex set of individual, environmental, and cultural influences, which vary widely across Europe.
Young men will drink at a younger age and more regularly in Italy for example, yet rarely get drunk - unlike youth in Denmark and the UK, for example, who follow more of a ‘binge and purge’ pattern of drinking for the effect and not consuming alcohol as a component part of going out and having a good time. Dr Paul Wallace, Medical advisor to Drinkaware cited how you never see public drunkenness in Italian cities, but Helena Conibear did draw attention to the growth of the giant street parties in Spain, the ‘Botellon’ and the ‘Apero Geant’ in France where huge groups of young people group together in public spaces and binge drinking, mess and nuisance form part of these events in contrast to the ‘Mediterranean culture of sipping a glass of wine in a café or en famille that is associated with our perception of Mediterranean cultures. We have the dubious honour of having exported the term ‘le binge drinking’.
So, the way people drink and how they behave when drunk cannot be reduced simply to how much alcohol people drink: or indeed how cheap alcohol is. Denmark and the UK have two of the three highest prices for alcohol due to tax in the EU 35 - yet Denmark tops the list of binge drinking in the EU, certainly among 15 and 16 year olds.
Is a binge drinker born or created?
Is binge drinking a learnt behaviour or part of a personality group? Talking of her work in schools for The Alcohol Education Trust, Helena Conibear shared how both teachers and parents could often identify those vulnerable within the class. These personality types divide between the intelligent risk takers pushing boundaries who see drinking as a rite of passage and the vulnerable follower wanting to be part of the ‘in’ crowd, particular special needs profiles and those with difficult home profiles. Parents often despair of a certain child’s behaviour, while other siblings have not been a problem although their home environment and schooling have been the same.
Among this important sub group (13% of 11 – 15 year-olds drink weekly) it is important to recognise change in perception between ages 11 and 15. At age 11 only 1% drink and overwhelming majority see it as socially unacceptable to get drunk. This changes at age 13, what is known as ‘the tipping point’.
Kate Fox criticised the stance of most alcohol education, which tells young people that drinking excessive amount of alcohol leads to violence, antisocial behaviour and ‘you doing things you regret’. She argues that alcohol slows your reactions, you do lose your inhibitions etc, but it does not make you violent, disruptive or antisocial. Allowing people to blame alcohol for their behaviour absolves individuals from personal responsibility. It was noted that an important change in the law that formerly had allowed you being drunk to be a mitigating circumstance for you behaviour has been changed. Henry Ashworth of The Portman Group argued that unless individuals were held accountable for their actions with fines, court appearances and perhaps letting their employer know, then at present there were few incentives for antisocial individuals to moderate their behaviour. As binge drinking declines across the UK, as it has over the last decade, then the behaviour of the persistent anti-social binge drinking minority needs to be more effectively targeted with punitive measures.
Fox highlighted the danger of changing young people’s perceptions of alcohol - as an ‘addictive drug’, from a choice of beverage that can be enjoyed in a civilised way with friends as part of an evening to something you take ‘a commodity’ or ‘substance’ for its effect - not for its taste, or for social and relaxing purposes.
A lively and stimulating debate continued over dinner with a surprising amount of common ground among the diverse participants. It was concluded that much had been done and trends are in the right direction, especially among 11–24 year-olds, but that there is no simple solution to Britain’s boozy culture.