Alcohol Harm Commission: Report 2020

Baroness Finlay of Llandaff Excerpts

Thursday 22nd April 2021 Grand Committee

Asked by

[Baroness Finlay of Llandaff]

To ask Her Majesty’s Government what assessment they have made of the report by the Commission on Alcohol Harm 2020 ‘It’s everywhere’—alcohol’s public face and private harm, published on 14 September 2020.

[Baroness Finlay of Llandaff (CB)]

My Lords, I had the privilege of leading a group of 16 experts to investigate one of the most pressing issues of the day: the harm caused by alcohol. I extend my sincere thanks to each of those 16, who gave their time and expertise so generously in their dedication to reducing alcohol harm. The findings of the Commission on Alcohol Harm were stark. One cannot overstate the sheer scale of the harm caused by alcohol every day to individuals, those around them and society. Alcohol is linked to 80 deaths every day across the UK and, most worryingly, it kills people when they are young. Alcohol is responsible for more years of working life lost than the 10 most frequent cancers combined.

However, the commission found that alcohol harm extends beyond health. We heard a great deal about the impact on families: 200,000 children are estimated to live with an alcohol-dependent parent, making them five times more likely to develop eating disorders and three times as likely to consider suicide. Some children are harmed even before they are born. Exposure to alcohol in the womb can cause foetal alcohol spectrum disorder, a lifelong developmental condition found in up to 17% of UK children.

The links between alcohol, violent crime and anti-social behaviour are strong. Alcohol fuels almost 40% of violent crimes and half of domestic violence. Drunk-driving causes almost 9,000 casualties and 260 deaths a year. Police Sergeant Mick Urwin told us that

“delivering a death message to a parent, brother, sister, son or daughter to inform them that someone has been killed by a drink driver is not something I ever got used to”.

The burden falls on all society, particularly public services. There are 1.26 million alcohol-related hospital admissions annually and alcohol costs the NHS £3.5 billion. The cost of alcohol-related crime is even higher, at £11.4 billion per annum. That is why sentencing to alcohol abstinence and monitoring is so important, with its high compliance rate allowing people to face and tackle their harmful drinking, and it has been shown to decrease repeat offending.

The extent of these harms is truly shocking but is no surprise, as alcohol is ubiquitous. That is why we titled the commission’s report It’s Everywhere—a quote from a witness. We heard how alcohol is all around us: at social gatherings, on TV, in supermarkets, card shops and the workplace, and at all times of day or night. People told us they could not escape from alcohol; “relentless” was a word we heard repeatedly. Although national consumption has fallen from 2004’s historical high, especially as more young people abstain, the increases in measures of harm and deaths persist.

Alcohol’s harm is often hidden in plain sight, leaving people to deal with it alone, unsupported. The stigma of harmful drinking makes people conceal their problem. Children instinctively understand that they are expected to keep quiet about their parents’ drinking. To quote another witness:

“Families and children like us didn’t and won’t discuss it for fear of being separated, being taken away from parents, being singled out ... feeling embarrassed, scared of repercussions and fear of retribution”.


The alcohol industry’s “personal responsibility” framing blames individuals for their drinking. Stigmatisation makes it harder to seek help. Blame lies within the product itself: alcohol is addictive. It can turn people’s lives upside down, as anyone listening to “The Archers” at the moment will know. It warrants careful regulation, hence the commission’s recommendations.

First, we call for an alcohol strategy. The last was almost 10 years ago. Revision is urgently needed—last year, alcohol deaths reached their highest level since records began. The updated strategy needs to include evidence-based policies to reduce the affordability, availability and marketing of alcohol. These tools, recommended by the World Health Organization, proved effective at tackling tobacco use. Let us look at each in turn.

Alcohol harm and price are directly linked. The alcohol duty system is inconsistent and perverse—white cider at 19p a unit feeds addiction. Affordability has grown significantly in the last four decades, driven by low prices in off-trade settings. Cuts to alcohol duty at the annual Budget have not helped—beer duty is now 21% lower than in 2012-13 according to the Institute of Alcohol Studies. We urgently need minimum unit pricing in England, as already introduced in Scotland and more recently in Wales. Tax should be proportionate to the harm caused.

The commission heard from witnesses how the constant availability of alcohol affects those who drink. One individual told us:

“My dad can’t help drinking. Every day we need bread, milk etc from the shop next to our house. When he goes in, the temptation is too much for him. It’s not his fault when it’s staring him in the face. Maybe if we didn’t live near a shop he wouldn’t be able to get drink as easily.”


Local authorities told us that they struggle to reduce availability under the current licensing regime. The UK Government could follow Scotland to allow local authorities to consider public health as a distinct licensing objective when assessing licensing applications.

Advertising and marketing set the tone for our relationship with alcohol. The alcohol industry spends hundreds of millions of pounds on advertising, much of which can be seen by children and vulnerable individuals, such as those with addiction. Children’s exposure to alcohol marketing makes them more likely to consume alcohol and to start consuming it at an earlier age. Opinion polling carried out for the Alcohol Health Alliance showed that 75% of the public support reducing children’s exposure to alcohol advertising. Many countries, such as France, restrict such marketing to better protect their populations. We should follow suit.

Consumers have a right to know what they are drinking. It is bizarre that currently there are fewer legal requirements for information on a bottle of wine than on a carton of orange juice. Unlike soft drinks, alcoholic drinks do not have to list their calories or sugar content or ingredients. Consumer information is grossly inadequate, as there is no statutory requirement for drinks to carry a health warning, warnings about alcohol in pregnancy, or the weekly guideline for low-risk consumption. Without label information, consumers are unaware of the risks and cannot make informed decisions.

Time does not allow me to cover the toll on the NHS and social care, where the burden of alcohol harm ultimately falls. Suffice it to remind your Lordships that alcohol is the leading risk factor for death, ill health and disability in 15 to 49 year-olds in England. It was causal in almost 12,000 cancers in 2015—that is 33 people a day—particularly cancers of the mouth, pharynx, oesophagus, larynx, breast, bowel and liver. It is also a factor in over 200 other diseases and injuries, including hypertension, heart disease, stroke, gastrointestinal disorders, brain damage and mental illness. Deaths from alcohol liver disease have increased 400% since 1970.

The Government have tackled tobacco harms and shown in their recent obesity strategy a willingness to take bold action to protect the public’s health. With an estimated 1.6 million adults in England having some degree of alcohol dependency, I hope that the Government will show the same boldness and heed our report’s recommendations.