Polarized drinking patterns and alcohol deregulation

This paper sets out to chart key trends in alcohol consumption and harm, and of related policy activity in the UK between 1990 and 2010. As a journal paper cannot provide a comprehensive picture, the focus will be on England as the most populous region, with comments on salient developments in the other regions where these are different. The paper draws on a variety of data sources, especially general population surveys, government reports, industry figures, National Statistics products, and recent reviews of data trends. It is structured around the themes: 1) trends in volume and patterns of consumption in adults and children; 2) trends in major alcohol-related harms; 3) changes in the affordability and availability of alcohol; 4) influences of major players including policy makers, media and industry and 5) the current (mid-2010) status of policy efforts. The reviewed data show that the UK has seen significant changes in the patterns and contexts of consumption during the 1990s and 2000s. Major consumption changes include falling per capita consumption, a rise in heavy episodic drinking, increasing preference of higher alcohol content beverages and a polarisation of the distribution of consumption in the population where heavy drinkers consume even higher volumes whilst moderate drinkers appearing to decrease their average intake. Context changes include rising availability and affordability of alcohol, with few alcohol control policy efforts, and a switch from predominantly on-trade to off-trade drinking. Such trends help explain the current rapid increase in alcohol-related admissions and other heavy end consequences in the context of falling per capita consumption.