OUTLET - Alcohol.org.nz

October 2012 | Vol.2 No.1
healthpromotion.org.nz
WHAT’S THE ISSUE WITH
OUTLET
DENSITY
AND AVAILABILITY?
AlcoholNZ October 2012 | Vol.2 No. 1
AlcoholNZ is published twice a year
by the Health Promotion Agency.
An editorial committee oversees
the magazine.
The Health Promotion Agency is a Crown entity formed
by the merger of the Alcohol Advisory Council (ALAC),
the Health Sponsorship Council (HSC) and some health
promotion programmes previously delivered by the
Ministry of Health.
To receive a copy, contact:
The New Zealand Public Health and Disability
Amendment Act 2012 setting up the Health Promotion
Agency was passed by Parliament
in June 2012 and the HPA officially came into
existence on 1 July 2012.
Health Promotion Agency
PO Box 5023
Lambton Quay
Wellington 6145
New Zealand
Phone Call free Fax Email (04) 917 0060
0508 258 258
(04) 473 0890
[email protected]
© Health Promotion Agency 2012
healthpromotion.org.nz
ISSN 2230-374X (Print)
ISSN 2230-3758 (Online)
Editor: Michael Johnson
The aim of the Health Promotion Agency is to inspire
New Zealanders to lead healthy lives.
The Health Promotion Agency (HPA) leads and
delivers innovative, high-quality and cost-effective
programmes and activities that:
• promote health, wellbeing and healthy lifestyles
• prevent disease, illness and injury
• enable environments that support health and
wellbeing and healthy lifestyles
• reduce personal, social and economic harm.
It also has functions specific to providing advice
and research on alcohol issues.
02
Contents
MESSAGE FROM MINISTER DUNNE
04
MESSAGE FROM MINISTER GOODHEW
05
INTRODUCTION TO THE
HEALTH PROMOTION AGENCY 06
WHAT’S THE ISSUE WITH
OUTLET DENSITY & AVAILABILITY
10
MANUKAU CITY VS THE WORLD
16
DENSITY & COMMERCIAL AVAILABILITY
MATTER, BUT SO DOES SOCIAL AVAILABILITY
18
THEM & US
20
WHERE TO FROM HERE?
22
DENSITY MATTERS
24
ABOUT THE WRITER
26
BINGE DRINKING IS SO YESTERDAY...
28
YOUNG WOMEN:
PERCEPTIONS & REALITIES
32
BRIEFS
38
03
AlcoholNZ October 2012 | Vol.2 No. 1
Message from minister
Message from minister
Peter Dunne
Associate Minister of Health
Jo Goodhew
Associate Minister of Health
Dunne
T
he work of the Alcohol Advisory Council
(ALAC) has entered a new chapter, with ALAC,
along with the Health Sponsorship Council (HSC)
and some Ministry of Health functions, being
merged into a new organisation, the Health
Promotion Agency (HPA).
The drivers of the change are to improve value-formoney, innovation and high quality public services.
In particular, the Health Promotion Agency
is intended to improve coordination, reduce
fragmentation and result in greater effectiveness
of services.
The new agency will continue the work that was
carried out by ALAC and the HSC (including ALAC’s
autonomous advisory function and the alcohol
levy) and has a broad health promotion focus
based on the Ottawa Charter.
These proposals received widespread support from
the health sector, as was evident during the select
committee hearings on the legislation setting up
the new agency.
It is encouraging that many recognise the benefits
the new agency will provide, with its strong focus
on integrated health promotion.
The Government believes that the integration
of ALAC, the HSC and other health promotion
functions will lead to real administrative
efficiencies and better health and wellbeing
outcomes for New Zealanders.
I know that many of ALAC’s stakeholders, while
supportive of the establishment of the new entity,
are also concerned to ensure the momentum
around alcohol continues.
Goodhew
I
And many who appeared before the select
committee raised specific concerns over the need
to retain ALAC’s independent advisory function and
to ensure all its functions were retained – not just
its health promotion functions.
n January this year I was appointed as the
Associate Minister of Health with responsibility for
aged care, public health, rural health, HealthCERT,
the Health Quality and Safety Commission and the
Health Promotion Agency.
As the Minister responsible for ALAC for the past
four years, and as someone who is well aware of
the good work done by the organisation, I want to
assure you, the stakeholders and partners of ALAC,
that the work is continuing albeit in a different
organisation.
Since this is my first article here, I will take some
time to briefly introduce myself. I have held the
seat for Rangitata since 2008, having been elected
to Parliament as the MP for Aoraki in 2005. While
in opposition, I was a member of the Health Select
Committee and the National Party spokesperson
for Aged Care and Rural Health. As a member of the
National-led Government, I was the Chair of the
Social Services Committee before being promoted
to Junior Whip. I am currently Minister for the
Community and Voluntary Sector, Senior Citizens
and Women’s Affairs.
On a more personal note, many will be aware that
early in my career I had the pleasure of working in
some senior roles at ALAC before I embarked on my
political career.
Not only have I since then had huge respect for the
organisation, I have also had a great affection for it.
When change comes and an organisation comes
to an end, there is always a degree of sadness.
But there is also hope for the future in new
structures and new energies. I am sure that hope
will be well founded in this instance, even as we
take this time to appreciate the work that ALAC
has done over the years.
In the longer term, having one agency responsible,
effectively, for the whole range of health
promotion campaigns is extraordinarily exciting,
and, I think, offers lots of exciting opportunities.
My pre-Parliament background was in the
health and community sectors. I started out
as a registered nurse in 1982 and practised in
New Zealand and the United Kingdom in both
hospitals and general practice. I also tutored in
Health Sciences at Aoraki Polytechnic and was a
recruitment coordinator for Breastscreen South
Ltd. I was employed as a coordinator for the Timaru
Safer Community Council immediately prior to
campaigning for the Aoraki seat.
My voluntary community involvement has included
membership in a number of organisations,
including the South Canterbury DHB Community
and Public Health Committee, Timaru Plunket, the
Aoraki Community Organisation Grants Scheme
committee and Victim Support.
As the Minister responsible for the new Health
Promotion Agency (HPA), I am very excited by the
opportunities provided by the new organisation.
The HPA has been formed by merging the
Alcohol Advisory Council (ALAC) and the Health
04
Sponsorship Council (HSC) and transferring some
of the health promotion programmes from the
Ministry of Health. The HPA’s key objective is to
inspire New Zealanders to lead healthy lives.
The agency draws on a wide range of relationships
and expertise to lead programmes that promote
health, wellbeing and healthy lifestyles, disease
prevention, and illness and injury prevention. The
agency will be able to achieve greater coordination
and integration of programmes that were
previously delivered by a number of Government
organisations.
The work of the HPA is not limited to only social
marketing campaigns. Rather, there is sufficient
scope for the HPA to carry out a wide range of
interventions. This is crucial because many of the
public health and preventive health issues the HPA
is tackling are complex and challenging.
ALAC’s independent, evidence-based advisory
function is retained within the new entity.
Alcohol harm reduction programmes continue
to be funded through a dedicated levy on alcohol
consumption.
I would like to take this opportunity to recognise
the work that has been carried out by both ALAC
and the Health Sponsorship Council. This merger
is not a negative reflection on those two agencies,
which have both made a significant contribution to
the wellbeing of our country.
Rather, the formation of the HPA strengthens the
focus on health promotion activity and is creating
more opportunities for innovative and targeted
approaches to those people and communities
with multiple health issues. This is not a faceless
organisation; it is one with true focus, and I look
forward to working closely with the HPA Board
and staff to deliver better health outcomes for
New Zealanders.
05
AlcoholNZ October 2012 | Vol.2 No. 1
Introduction to the
health
promotion
agency
This edition of AlcoholNZ is the
first since the Alcohol Advisory
Council (ALAC) was merged along
with the Health Sponsorship
Council (HSC) and some health
promotion programmes from the
Ministry of Health into the new
Health Promotion Agency (HPA).
06
Although ALAC is now part of a bigger
organisation, the work and commitment to
reducing alcohol-related harm continues.
In fact, the legislation setting up the HPA
sets out alcohol-specific functions.
The HPA has an overall function to lead and support activities
for the following purposes:
• promoting health and wellbeing and encouraging
healthy lifestyles
• preventing disease, illness and injury
• enabling environments that support health and wellbeing
and healthy lifestyles
• reducing personal, social and economic harm.
It also has functions specific to providing advice and
research on alcohol issues.
The ALAC levy has been retained by the HPA to fund
the alcohol-related functions of the new agency.
Along with a new organisation, we also have a new
Board and a new management team.
07
AlcoholNZ October 2012 | Vol.2 No. 1
Health Promotion Agency Board
The HPA is governed by a seven person board
Dr Lee Mathias – Chairman
A nurse, Dr Lee Mathias has
an extensive background in
health service management
and governance, and currently operates the
consultancy firm Lee Mathias Ltd. Lee was elected
to the Auckland DHB and appointed its Deputy
Chair in 2010. She is also a current member of
the Midwifery Council. Previous governance
roles have included directorships of the Accident
Compensation Corporation (Chairperson of
ACC Healthwise), Birthcare Auckland Ltd, and
Pacific Health Ltd.
Rea Wikaira – Deputy Chairman
Rea Wikaira is the former Chair of
ALAC. Rea is the National Operations
Business Manager, and Board
Secretariat, of the National Hauora Coalition
(National Màori PHO Coalition). He is a former
Executive Trustee of the Central Region Emergency
Services Trust and prior to this he was Chief Executive
of the Auckland Westpac Rescue Helicopter Trust. He
has previously served on a number of government
boards in various roles including: Director of Health
Waikato; Vice Chair of the Lottery General committee
of the New Zealand Lottery Grants Board; and Chair
of the ‘Year of the Màori Language’ Grants Board
committee. He has also been a serving Justice of
the Peace for the last 20 years.
Dame Susan Devoy
Dame Susan Devoy is a former
squash champion and is a Dame
Commander of the New Zealand
Order of Merit. She is a former board member
of the Health Sponsorship Council. She is the
Director of Women Walking Ltd and is currently
a board member of the Sustainability Council of
New Zealand. She is also a current member and
former Chair of the Halberg Trust as well as the
former CEO and Chair of Sport Bay of Plenty. Dame
Susan served as a board member of the Auckland
District Health Board (2000–03). She is a trustee of
TECT (Tauranga Energy Consumer Trust) and the
Chairperson of BNZ Partners, Bay of Plenty.
08
Management Team
Katherine Rich
Katherine Rich is the current Chief
Executive of the New Zealand
Food & Grocery Council. She was a
member of Parliament for three terms, holding
a range of portfolios including Education, Social
Welfare, ACC and Associate Health. Following her
retirement from Parliament in 2008, she has held
a range of governance roles including chairing the
Plunket Foundation and Child, Youth and Family’s
Fresh Start Panel, a fund supporting innovative
community programmes to support youth at risk. Professor Grant Schofield
Professor Grant Schofield is an expert
in aspects of public health relating
to physical activity and nutrition.
He is currently Professor of Public Health at AUT
University and Director of AUT’s Centre for Physical
Activity and Nutrition. His research and teaching
in New Zealand and Australia have focused on
physical activity and nutrition, particularly as they
relate to children and youth, primary care, and
workplaces as settings for health promotion.
Barbara Docherty
Barbara Docherty is a registered
nurse, Clinical Lecturer at The
University of Auckland and Director
of the TADS (Training and Development Services)
Behavioural Change training programme, delivered
nationally to health workers in primary health
care and community, Màori, Pacific and youth.
Barbara’s background includes 23 years as a
general practice and primary healthcare nurse with
extensive research and practical experience in early
prevention and early identification of unhealthy
lifestyle behaviours and mental health risks. Jamie Simpson
Jamie Simpson is an insurance broker
providing insurance and risk advice
to commercial clients. He is Chair of
Life Education Trust Canterbury. The Trust raises
significant funds to support the health-based
teaching programme of Life Education in local
primary schools. Jamie has a Bachelor of Science
and a Bachelor of Arts from the University of
Canterbury. He also has a Diploma of Financial
Services (Insurance Broking) and is a Senior
Associate of the Australian and New Zealand
Institute of Insurance and Finance.
Clive Nelson
Chief Executive
Tane Cassidy
General Manager Stakeholder Relations
Clive Nelson has worked in senior roles with
a strategy, communications and change
management focus in both the public and private
sectors. MBA qualified, he began his career
as a journalist and newspaper editor before
moving into general management and executive
management roles. Clive previously worked for
Watercare Services Ltd, Auckland’s publicly-owned
water utility, and was seconded to the Auckland
Transition Agency for a major local government
reorganisation.
Of Ngapuhi decent, Tane Cassidy has held a
number of senior roles in the New Zealand public
sector since the late 1990s, particularly in the
areas of health and social policy. Before joining
the HPA, Tane worked for the Health Sponsorship
Council where he managed the Tobacco Control
Programme and Business Development Unit. He previously worked within the District Health
Board (DHB) Funding and Performance team at
the Ministry of Health and has worked on Crown
Funding Agreements with DHBs, negotiating
primary and secondary health service contracts,
and managing a range of diverse projects
with government agencies, non-Government
organisations, Màori, private businesses, and
community groups.
Dr Andrew Hearn
General Manager Research, Policy and Advice
Dr Andrew Hearn has worked in senior
management roles in a range of Government
departments and Crown entities, where he has
been responsible for strategy, policy, research,
planning and monitoring. The majority of his
work has been in the area of harm reduction. His
career started in community corrections and then
corrections policy, moving on to include road safety
policy and strategy, and social housing and building
issues. Most recently, he was the General Manager
Strategy at the Alcohol Advisory Council of New
Zealand (ALAC).
Laurianne Reinsborough
General Manager Operations
Laurianne Reinsborough has an extensive
background in operational management and has
worked in the hospitality, volunteer and injury
prevention sectors prior to joining the Health
Sponsorship Council (HSC) as their sun safety
manager. Canadian-born, Laurianne has a Bachelor
of Arts degree in Sociology from St Francis Xavier
University, Antigonish, Nova Scotia, and an MBA
with expertise in marketing and communications.
Chris Allen
General Manager Corporate Services
Chris Allen is a member of the New Zealand Institute
of Chartered Accountants (NZICA) and a member
of the Institute of Directors in New Zealand(IoD).
Chris has previously operated his own Wellingtonbased financial management firm, contracting to
a variety of Government, Crown entity and local
body agencies, and has a wealth of experience
in the corporate services and finance industries.
This includes service in senior management and
consulting roles in both the public and private
sectors. Before joining the Health Promotion Agency,
Chris was the Corporate Services Manager at the
Alcohol Advisory Council (ALAC).
09
AlcoholNZ October 2012 | Vol.2 No. 1
WHAT’S THE ISSUE WITH
OUTLET
DENSITY &
AVAILABILITY?
Pushback from communities opposed
to more liquor outlets and greater
availability of alcohol in their areas
has attracted significant media
attention of late.
...those selling alcohol to be
consumed elsewhere such
as retailers, bottle stores
and supermarkets – tended
to be located in areas of
high social deprivation and
high population density.
P
ublic marches, street and online petitions,
lobbying of MPs and the hundreds of written and
oral submissions received last year by the Alcohol
Reform Bill Select Committee all signal community
willingness to unite to limit the number of liquor
outlets and the availability of alcohol in their area.
Home to one of this country’s largest Màori and
Pacific Island populations and densely peopled
by New Zealand standards, Manukau is one of
our poorest areas, and where the 2006 Census
recorded 44 percent of people aged 15 years and
over received an annual income of $20,000 or less.
Behind the opposition is alarm about social harm
associated with alcohol and the effect this can have
on individuals, their families and friends and the
community surrounding them.
It’s also an area where the loosening of regulations
contained in the 1989 Sale of Liquor Act have had
an obvious and marked effect, particularly around
alcohol availability and liquor outlet numbers.
But should communities fear a rise in the number
of outlets selling alcohol in their vicinity, or the
greater availability of alcohol generally? Can
links be drawn between levels of density and
availability and social harm? And if so, are other
factors involved?
A principal effect of the Act was to liberalise the
market in which premises supplying alcohol could
operate, including allowing, for the first time, wine
to be sold in supermarkets and grocery shops.
While international studies confirm the impact
of liquor outlets is likely to be highly context
specific, a range of recent New Zealand studies
has sought to better understand if indeed there
is a correlation between density and availability
and increased social harm in our communities.
10
The study reveals that the effect of the law change
on the number of outlets supplying alcohol
in Manukau City between 1990 and 1995 was
immediate and substantial, with active liquor
licences in the area increasing from
148 in 1990 to 494 by February 2008.
One such study was that funded by ALAC, in
partnership with Manukau City Council, and
undertaken between 2008 and 2011 by Waikato
University’s Population Studies Centre researchers.
A key finding from the research was that in 2009
‘off-licence’ liquor outlets – ie those selling alcohol
to be consumed elsewhere such as retailers,
bottle stores and supermarkets – tended to be
located in areas of high social deprivation and high
population density.
Led by Waikato University senior lecturer in
economics Dr Michael Cameron and released in
January this year, Research into the impact of liquor
outlets in Manukau City examined the impact of
liquor outlets in the south Auckland city.
In contrast, ‘on-licence’ liquor outlets – ie where
alcohol is sold to be consumed onsite such as bars,
clubs, restaurants and cafes – were more likely
to be found in main centres and areas of high
amenity value.
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AlcoholNZ October 2012 | Vol.2 No. 1
For each type of outlet
a clear association was
established between outlet
numbers and the level of
harm due to drinking...
Further key results included:
• Price and non-price competition had led to
lower alcohol prices as well as longer opening
hours where off-licence liquor outlets density
was higher.
• On-licence and off-licence density of clubs, bars,
restaurants and cafes was associated with
a range social harm indicators, including various
police events and motor vehicle accidents.
• Areas with a high density of liquor outlets
relative to other parts of the city were more likely
to be sited in Manukau City’s more vulnerable
communities, that is in areas of high social
deprivation and high population density.
• Substantial increases in the number of both onand off-licence liquor outlets had been matched
with an escalation in the level of community
unease about alcohol-related harm.
Research by other Kiwi academics has also raised
concerns about the relationship of both liquor
outlet density and the availability of alcohol to
social harm.
12
This includes research published this year by
Canterbury University’s Geography Department
(Day, Breetzke, Kingham & Campbell, 2012) which
put the association between geographic access to
alcohol outlets and serious violent crime in New
Zealand under the microscope.
Earlier research undertaken by Connor et al,
reported in 2010 in the Journal of Epidemiology and
Community Health (Connor, Kypri, Bell & Cousins,
2010) also used geocoded licensed premises to
estimate outlet density, but focused on outlets
within walking distance of home.
For each type of outlet, a clear association was
established between outlet numbers and the level
of harm due to drinking reported by people living
within 1 km. Types of harm surveyed included
effects on work performance, relationships,
physical health and finances.
Using data on violent offences recorded between
2005 and 2007 from New Zealand’s 286 police
station areas, the study revealed significant
negative associations between distance (access)
to licensed outlets and the incidence of serious
violent offences. Greater levels of violent offending
were recorded in areas with close access to licensed
premises, compared with areas with less access to
on-licensed or off-licensed premises.
Entitled Alcohol outlet density, levels of drinking and
alcohol-related harm in New Zealand: a national
study, it explored the association of outlet density
with self-reported patterns of drinking and related
problems in the general population throughout
New Zealand.
The survey also found people with more off-licences
close to home were more likely to be binge drinkers.
With each extra off-licence alcohol outlet within
1 km, the odds of binge drinking increased by about
4 percent; that is, compared with five off-licences
in an area, having 15 meant 48 percent more binge
drinking and 26 percent more alcohol-related harm.
The report concluded that greater geographic
access to alcohol outlets was associated with
increased levels of serious violent offending across
study areas, with the implication that alcohol
availability and access promoted under the current
liberalised licensing regime were important
contextual determinants of alcohol-related harm
within New Zealand communities.
Here, cross-sectional data from a nationally
representative alcohol survey was used with 1,925
participants asked detailed questions about their
drinking patterns, including whether they had
experienced any of a range of harms due to their
drinking in the last 12 months.
The number of alcohol outlets of each type
(off-licences, bars, clubs and restaurants)
within 1 km of each participant’s home was
independently identified by comparing the
participants’ geocoded residential addresses
with the distribution of outlets.
Given the availability of individual information
about socioeconomic status from the survey, as
well as the NZ Deprivation Index from addresses,
the study was able to explore whether the
association that had often been observed between
outlets and harm was explained by the same
socioeconomic factors being related to both.
The study’s conclusion that socioeconomic
confounding did not account for much of the
association of outlets with drinking patterns and
harm supported the hypothesis that outlet density
did contribute to binge drinking and harm.
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AlcoholNZ October 2012 | Vol.2 No. 1
CPted guidelines
now available
In 2008, the study Density of alcohol outlets and
teenage drinking: living in an alcogenic environment
is associated with higher consumption in a
metropolitan setting (Huckle, Huakau, Sweetsur,
Huisman & Casswell, 2008) examined the
relationship between physical, socioeconomic and
social environments and alcohol consumption and
drunkenness among a general population sample
of drinkers aged 12–17 years.
Conducted in Auckland, the study looked at
environmental measures including alcohol
outlet density, locality-based willingness to
sell alcohol derived from purchase surveys of
outlets, and a locality-based neighbourhood
deprivation measure.
A random telephone survey was also utilised to
collect information from respondents including
ethnicity, frequency of alcohol supplied socially (for
example, by parents, friends and others),
the young person’s income, frequency of exposure
to alcohol advertising, recall of alcohol brands, and
self-reported purchase from alcohol outlets.
The study found alcohol outlet density was
associated with quantities consumed among
teenage drinkers, as was neighbourhood
deprivation.
In addition, supply by family, friends and others
also predicted quantities consumed among
underage drinkers; both social supply and selfreported purchase were associated with frequency
of drinking and drunkenness. The ethnic status of
young people also had an effect on consumption.
In 2007, the distribution of alcohol outlets by level
of neighbourhood deprivation was the subject of
a paper entitled Spatial variation in the association
between neighbourhood deprivation and access to
alcohol outlets (Hay, Whigham, Kypri & Langley,
2007) presented at the 19th Annual Colloquium
of the Spatial Information Research Centre at the
University of Otago. The study was published in
2009 as Neighbourhood deprivation and access
to alcohol outlets national study (Hay, Whigham,
Kypri & Langley, 2009).
Developed to establish and maintain a safe and secure
environment in all licensed premises, the guidelines should assist
those involved in the design, development and refurbishment of
licensed premises, as well as those wishing to implement their
principles in existing premises.
The results of the study showed that in deprived
urban areas distances to bars, licensed clubs, and
off-licences were considerably shorter than in
affluent areas. Conversely, distances to licensed
restaurants and cafes were greatest in the most
deprived areas. Findings were more complex for
rural areas.
The paper concluded that research into the
association between deprivation and access to
alcohol should consider rural areas separately from
urban areas, rather than combining the effects of
the two areas together.
The authors note that:
“In public discourse about liquor licensing…an
increase in the prevalence of licensed restaurants
and cafes has been promoted as a means of
encouraging entertainment whose primary focus
is food rather than alcohol, by way of reducing
public disorder.
“It is therefore a concern that in poorer areas of
New Zealand, pubs and bars are more common
and restaurants less common than they are in
wealthier areas.
“The greater access evident for people in poorer
communities may be a mechanism for increasing
deprivation and thereby widening gaps in
socioeconomic status and health.” (p 1092)
References
Connor, J., Kypri, K., Bell, M.L & Cousins, K. (2010). Alcohol outlet density, levels of drinking and alcohol-related harm in New Zealand: a national study. J Epidemiol Community Health
doi:10.1136/jech.2009.104935.
Day, P., Breetzke, G., Kingham, S. & Campbell, M. (2012). Close proximity to alcohol outlets is associated with increased serious violent crime in New Zealand. Australian and New Zealand Journal of
Public Health 36(1): 48-54.
Hay, G. C., Whigham, P.A., Kypri, K., & Langley J. D. (2007) Spatial variation in the association between neighbourhood deprivation and access to alcohol outlets. Presented at SIRC 2007 – The 19th
Annual Colloquium of the Spatial Information Research Centre, University of Otago, Dunedin, New Zealand, December 6th-7th 2007.
Hay, G. C., Whigham, P.A., K. Kypri, K., & Langley J. D. (2009) Neighbourhood deprivation and access to alcohol outlets: a national study. Health Place 2009 Dec;15(4):1086-93.
Huckle, T., Huakau, J., Sweetsur, P., Huisman, O., & Casswell, S. (2008). Density of alcohol outlets and teenage drinking: living in an alcogenic environment is associated with higher consumption in a
metropolitan setting. Addiction. 2008 Oct;103(10):1614-21.
14
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AlcoholNZ October 2012 | Vol.2 No. 1
Manukau city
vs
the world
Dr Cameron says the Manukau
City research findings are
similar to a lot of international
research, where alcohol outlet
density has been shown to
be associated with a range
of negative effects including
violent and other crime, property
damage, drink driving, motor
vehicle accidents, child abuse
and neglect, and health costs
and hospitalisations.
Michael Cameron is a senior lecturer
in economics at Waikato University,
where he gained his PhD in 2007 with
the thesis “The Relationship between
Poverty and HIV/AIDS in Rural Thailand”.
As well as the social impacts of liquor
outlet density, Dr Cameron’s current
research interests include population,
health and development issues such
as the economics of communicable
diseases, especially HIV/AIDS, health
applications of non-market valuation,
and health and development project
monitoring and evaluation. He is also
interested in population modelling
and stochastic modelling, and
economics education.
The most important take-away message for
the public from this research is that concerns
expressed in some communities about alcohol
outlet numbers may be warranted.
While on-licence outlets tend to group together
in areas such as town centres, off-licence outlets
tend to spread themselves out throughout the
area. They do this to reduce local competition.
Having said that, more off-licence outlets in
Manukau are located in areas of high population
density and in areas of high social deprivation.
Because the outlets are located closer together
in those areas, they compete more vigorously
with each other, including by lowering prices
and by opening longer hours.
We also showed that there is a clear association
between the density of alcohol outlets and the
number of police events. This association remains
even after we control for local social deprivation,
population density, and neighbourhood effects.
Clubs and bars were associated with more violent
offences, drug and alcohol offences, property
offences, anti-social behaviour, dishonesty offences
and traffic offences. Off-licence outlets were
associated with more violent offences, sexual
offences, and drug and alcohol offences.
The Alcohol Reform Bill that is before Parliament at
the moment would allow for local communities to
have a bigger say in liquor licensing in their areas.
If passed in its current form, the Bill will allow
local authorities to develop binding Local Alcohol
Policies, which may regulate the location and/or
density of alcohol outlets.
Local communities could then have greater input
into the number of outlets in their areas, both
through engaging with the development of Local
Alcohol Policies, and through making objections
to licensing applications.
This research, and the follow-up research for the
North Island, will provide further New Zealand
evidence for communities to use in this process.
16
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AlcoholNZ October 2012 | Vol.2 No. 1
Density & commercial availability matter,
but so does
social
availability
Outlet density is associated
with increased consumption
among young people both
here and internationally.
Taisia Huckle is the Quantitative
Team Leader at SHORE (Social and
Health Outcomes Research and
Evaluation), and Whariki Research
Centre, School of Public Health,
Massey University.
Dr Huckle works on a range of
research projects in the area of alcohol,
including the International Alcohol
Control Study (a multi-country study
to assess effects of alcohol policy), and
has also undertaken studies on alcohol
outlet density, ready-to-drinks, the
lowering of the minimum purchase
age and assessed trends in alcohol
consumption and harms over time
in the New Zealand population.
18
Our study results fit with what is known overseas:
namely, that outlet density is associated with
increased consumption among young people.
While our study showed that outlet density is an
important predictor of increased quantities of
alcohol consumed by young people, it also showed
that the wider environment in which young people
access alcohol is also very important.
One example is the ease with which young people
can buy alcohol themselves, which highlights the
importance of the minimum purchase age and the
need for its effective enforcement, and the ease
with which young people are supplied alcohol
socially, for instance by friends, parents and others.
Our study revealed that social supply, in particular,
was an important predictor of heavier
consumption among teenagers in New Zealand. From a policy perspective, our research suggested
that comprehensive policy action was needed to
reduce heavier consumption among young people,
including raising the minimum purchase age,
reducing outlet density and introducing effective
restrictions on the social supply of alcohol.
19
AlcoholNZ October 2012 | Vol.2 No. 1
THEM
&US
While previous
international research
asked a range of slightly
different questions, local
research into alcohol
availability and density
of outlets is generally
consistent with overseas
findings. However, it also
fills a few gaps, says
Professor Jennie Connor.
Jennie Connor is head of Preventive
and Social Medicine at the University
of Otago. An advocate for evidencebased alcohol policy, Professor
Connor is a public health physician
and epidemiologist with a research
interest in prevention of alcoholrelated harm.
Previous research has found density of alcohol
outlets to be associated with a range of alcoholrelated harms. These harms have usually been
measured ecologically – for example, as rates
of assault or drink-driving crashes, and in
urban populations.
However, confounding by socioeconomic
factors may affect many of these studies and
existing evidence of an association between
outlet density and level or pattern of alcohol
consumption has been mixed.
The study we undertook demonstrated the number
of off-licence outlets within 1 km was associated
with increased odds of binge drinking in an
unselected national population. Associations were
also seen between the number of off-licences, pubs/
bars, clubs and restaurants within 1 km of home and
the level of self-reported harm from alcohol.
In our study, socioeconomic confounding did not
account for much of the association of outlets
with binge drinking or harm, which supports the
hypothesis of a causal relationship.
Most of the previous research used outcome
measures such as that routinely collected by police
or traffic authorities etc, and therefore represented
the severe end of the spectrum and only events
that had come to the attention of the authorities.
In contrast, we asked people to report on harm to
themselves, in other words give a personal account.
We found that for the self-reported harms to
people’s quality of life from alcohol there was a
clear association with density of all types of alcohol
outlets, and that this did not appear to be due
to socioeconomic factors.
With serious events that involve more interaction
with the environment (eg problems with
employment, the law, or fighting due to drinking)
the association with outlets was seen, but seemed
to be partly explained by socioeconomic factors.
One of the main differences therefore between our
study and others is that it involved a sample of the
whole ‘normal’ population, not just urban or high
risk, and showed that more outlets were linked to
more binge drinking, and to more self-reported
harm from alcohol.
21
AlcoholNZ October 2012 | Vol.2 No. 1
Where
to from
here?
Further research has been
commissioned to build on
the Manukau findings to
cover all of the North Island.
A
nnouncing the new research, HPA Chief
Executive Clive Nelson said it was hoped that this
would for the first time provide local authorities in
New Zealand with an evidence base to determine
the impact of new liquor outlets on
their communities.
The Alcohol Reform Bill currently before
Parliament proposed making local authorities
consider the effects on the community of
renewing or issuing new liquor licences, and
widening the grounds for objecting to the issue
or renewal of a licence to include the effect
“on the amenity or good order of a locality”.
Mr Nelson says if the law is changed to widen
the grounds for refusing a liquor licence,
evidence will still need to be produced around
any resulting harms.
Although the Manukau results were specific to
that area, the model it had developed could be
used in other areas to determine what impact
extra liquor outlets would have on a district.
22
The research project will be overseen by
researchers in the National Institute of
Demographic and Economic Analysis (NIDEA,
formerly the Population Studies Centre) at the
University of Waikato. The research will be led
by Dr Michael Cameron, and will include
Dr Bill Cochrane from NIDEA, Michael Livingston
from Turning Point Alcohol and Drug Centre in
Melbourne, and Dr Craig Gordon from the
Health Promotion Agency.
The research will use data from 2005 to 2011, and
will be able to develop locally-specific estimates
of the relationship between alcohol outlet density
and both police events and motor vehicle accidents,
for every community in the North Island.
It is anticipated that preliminary results of this
research will be presented at the Public Health
Association and World Safety conferences later this
year, with a final report available in early 2013.
23
AlcoholNZ October 2012 | Vol.2 No. 1
Increasingly, research is finding that these
increases are more than coincidental, with studies
demonstrating positive relationships between
alcohol outlet density and:
• night-time assaults (Livingston, 2008)
• domestic violence (Livingston, 2011)
• chronic disease (Livingston, 2011)
• heavy drinking (Livingston, Laslett
& Dietze, 2008).
The findings of these studies have been particularly
strong for off-licence alcohol outlets, which are the
most associated with all of the problems examined
except for night-time assaults. While supermarkets
themselves cannot sell alcohol in Victoria, the
off-licence sector is dominated by the two major
supermarket chains, who own nearly 40 percent of
all off-licence outlets and sell more than half of all
alcohol sold in the state.
The Alcohol Reform Bill currently
before Parliament could provide
New Zealand with a key
opportunity to reduce alcohol
harm, says Australian research
fellow Michael Livingston.
M
y recent visit to New Zealand made it
clear that there, as in Victoria, improved liquor
licensing policy has the potential to dramatically
reduce rates of alcohol-related harm.
The similarities between the two jurisdictions
are striking: both have seen marked deregulation
of their liquor licensing regimes in recent
decades, both have seen sharp increases in rates
of harm from alcohol and, in both places, local
governments and communities are attempting to
limit the continual growth of alcohol outlets.
The proposed New Zealand Alcohol Reform
Act will provide New Zealand communities
with a key opportunity not available to those in
Victoria, namely the ability for local councils to
set enforceable policies on the density of alcohol
outlets and their hours of trade. This opportunity, if
supported by reliable evidence and used in a public
health framework, could provide the means to
reduce alcohol-related harm substantially.
In Victoria, local controls over the density of
alcohol outlets have never been available.
Local governments can object to new licence
applications, but have consistently found their
24
objections either ignored by the state liquor
licensing agency or overturned in tribunal hearings.
This is despite a growing body of evidence that
demonstrates the substantial health and social
impacts of alcohol outlet density at the local level.
Since the late 1980s, Victoria has seen a series of
deregulatory reforms to the legislation governing
liquor licensing. These reforms have resulted in
a dramatic expansion of the market, with the
number of pubs increasing by 35 percent, offlicences by 100 percent and restaurants and bars
by more than 700 percent since 1990 (Responsible
Alcohol Victoria, unpublished data).
While reliable data on harms is not available
from 1990, more recent trends suggest this
expansion has occurred at the same time as
substantial increases in rates of alcohol-related
harm. For example, between 1999 and 2008,
rates of alcohol-related hospital admissions
increased by 47 percent, night-time assaults by
49 percent, alcohol-related domestic violence
by 43 percent and alcohol-related ambulance
presentations by 167 percent (Livingston,
Matthews, Barratt, Lloyd & Room, 2010).
This is also the segment of the market that local
governments have fought the hardest against in
Victoria. In a series of hearings, councils
representing socioeconomically disadvantaged
communities with high rates of alcohol problems
have objected to new off-licensed outlets (often
large warehouse-style outlets) and have repeatedly
been unsuccessful.
This lack of success reflects the limited legislative
power given to local governments in the Victorian
system and highlights the potential benefits of New
Zealand’s new act. The Local Alcohol Policies that are
outlined in the soon-to-be-passed Alcohol Reform Bill
provide New Zealand councils and the communities
they represent with meaningful controls over alcohol
outlet density and trading hours. These powers are
in line with community expectations.
A recent study found that nearly 60 percent of
New Zealanders thought that “it is up to local
government to make sure alcohol does not
become a problem in the community”
(Maclennan, Kypri, Langley & Room, 2012).
The emphasis on local controls over trading
hours provides another avenue for local
governments in New Zealand to reduce alcoholrelated harm. There is growing international
evidence that reducing late night trading hours
is an effective way to reduce alcohol-related
violence. For example, 2008 restrictions imposed
in the New South Wales city of Newcastle that
forced pubs to close by 3 am have produced
sustained reductions in rates of assault and
alcohol-related injury of more than 30 percent
(Kypri, Jones, McElduff & Barker, 2011).
The formal incorporation of local controls over
trading hours and outlet density in the proposed
Alcohol Reform Bill thus represents a critical step
towards a liquor licensing regime that is more
responsive to community desires and more able
to curb alcohol-related harm in New Zealand.
It is essential that these components of the new
bill are robust to legal challenge, and that councils
are adequately supported to develop sufficient
evidence and expertise to produce appropriate
local policies.
Local governments and alcohol researchers in
Victoria will be watching with interest to see
whether the local control that we have been
advocating can fulfil its potential and produce
lasting public health improvements.
References
Kypri, K., Jones, C., McElduff, P. & Barker, D. Effects of restricting pub closing times on night-time assaults in an Australian city. Addiction, Volume 106, Issue 2, pages 303–310, February 2011.
Livingston, M., Laslett, A.M. & Dietze P. Individual and community correlates of young people’s high-risk drinking in Victoria, Australia. Drug and Alcohol Dependence. 2008 Dec 1;98(3):241-8.
Epub 2008 Jul 21.
Livingston, M. A longitudinal analysis of alcohol outlet density and assault. Alcoholism: Clinical and Experimental Research. 2008 Jun;32(6):1074-1079.
Livingston, M., Matthews, S., Barratt, M.J., Lloyd, B., & Room, R. Diverging trends in alcohol consumption and alcohol-related harm in Victoria. Aust N Z J Public Health. 2010 Aug;34(4):368-73.
Livingston, M. A longitudinal analysis of alcohol outlet density and domestic violence. Addiction: Volume 106, Issue 5, pages 919–925, May 2011.
Livingston, M. Alcohol outlet density and harm: comparing the impacts on violence and chronic harms. Drug and Alcohol Review. 2011 Sep;30(5):515-23.
Maclennan, B., Kypri, K., Langley, J & Room, R. Public sentiment towards alcohol and local government alcohol policies in New Zealand. Int J Drug Policy. 2012 Jan;23(1):45-53. Epub 2011 Jul 13.
Responsible Alcohol Victoria – unpublished data.
25
Recently in New Zealand on an ALAC-funded speaking tour,
his presentations in Wellington, Auckland and Christchurch
outlining the results of his research attracted significant
public, industry and media interest.
Q: Where do you work in Melbourne?
A: I’m a public health researcher at Turning Point
Alcohol and Drug Centre, specifically in the Alcohol
Policy Research Centre.
A: In particular that alcohol outlet density is
associated with rates of violence, heavy drinking
and chronic disease.
Q: What does Turning Point do?
Q: Has this research had any impact outside
academia?
A: Turning Point was established in 1994 to
provide leadership to the drug and alcohol field in
Victoria, Australia. The organisation amalgamated
with public health provider Eastern Health in
2009 and is these days formally affiliated with
Monash University.
Turning Point is also part of the International
Network of Drug Treatment and Rehabilitation
Resource Centres for the United Nations Office
on Drugs and Crime, and a member of the
International Harm Reduction Association. Plus
we’re a Registered Training Organisation (RTO) and an accredited Higher Education Provider.
Q: What’s your role at Turning Point?
A: I work in a team of eight, led by Professor
Robin Room, which undertakes quantitative and
qualitative research into issues relevant to alcohol
policy. My work focuses on studying the impact
of alcohol policies and on policy-relevant
alcohol epidemiology.
Q: What’s your background as a public
health researcher?
Michael Livingston is
the author of a PhD
thesis examining the
impact of liberalisation
of the liquor licensing
system in Victoria,
Australia during the
1980s and 1990s.
26
Q: What were some of the key findings?
A: My specific skills are quantitative, and my main
area of work has been examining the relationship
between changes to liquor licensing policies in
Victoria and rates of alcohol-related problems.
Q: It’s an area that obviously influenced your
choice of PhD subject.
A: My PhD examined the impact of the
liberalisation of the Victorian liquor licensing
system that took place throughout the 1980s
and 1990s. In particular, it focused on the local
level implications of the changes to alcohol outlet
density that occurred following the deregulation
of the licensing system here.
A: It’s had significant impact on policy in
Victoria and has also been widely published
in academic literature, including Addiction
and Drug and Alcohol Review.
Q: You’ve been presenting your findings recently
at several seminars in New Zealand. Have you
noticed any similarities between the two countries
in this area?
A: The most striking thing about presenting
my work in New Zealand has in fact been the
similarity of the New Zealand experience to
Victoria. New Zealand has gone through the
same dramatic expansion of the alcohol market
and, particularly at the local level, governments
are wrestling with similar policy issues to those
in Victoria.
Q: What are your thoughts on the content of our
Alcohol Reform Bill currently before Parliament?
A: I’m impressed that the Bill proposes some direct
local powers over outlet density and trading hours.
Local governments in Victoria are crying out for
mechanisms like this to give them more control
over the alcohol environment in their community.
Q: Will we be seeing you back here in future?
A: One of the reasons for my trip to New Zealand
was to meet with the project team that’s about
to start a study examining the impact of alcohol
outlet density on a wide range of harms across
the North Island.
I’ll be part of that project, and hope that it will
produce specific estimates of how outlet density
influences harm across the Island, and therefore
give local communities critical evidence to help
them develop future policies in their area. 27
AlcoholNZ October 2012 | Vol.2 No. 1
Perhaps surprisingly, the
survey shows a steady
decline in the proportion of
pupils who drink alcohol...
A
recent survey of drinking patterns
among United Kingdom secondary school pupils
has thrown up some surprising results.
The Smoking, Drinking and Drug Use Among
Young People in England in 2010 survey, carried
out for the NHS Information Centre by the
National Centre for Social Research and the
National Foundation for Educational Research, is
the latest in a series monitoring tobacco, alcohol
and drug use among English secondary school
pupils aged 11–15.
Published in 2011, the survey reports on
information obtained from 7,296 pupils in
246 schools throughout England in the 2010
autumn term.
Perhaps surprisingly, the survey shows a steady
decline in the proportion of pupils who drink
alcohol, with a more pronounced decline than
previously year-on-year between 2010 and 2009.
While future surveys in the series will establish
how the 2010 estimates fit into the longer-term
trend, current results show that:
• the proportion of pupils who had never drunk
alcohol rose from 39 percent in 2003 to 55
percent in 2010
• less than half (45 percent) of pupils aged
between 11 and 15 said that they had drunk
28
alcohol at least once in their lifetime. This
increased with age from 10 percent of 11 year
olds to 77 percent of 15 year olds
• the proportion of pupils who had drunk
alcohol in the last week fell from a peak of 26
percent in 2001 to 18 percent in 2009. In 2010,
this trend was maintained, although the fall
in prevalence was greater than expected,
dropping five percentage points to 13 percent
• as in past years, similar proportions of boys
and girls had drunk alcohol in the last seven
days, and older pupils were more likely to have
done so than younger pupils (from 1 percent
of 11 year olds to 30 percent of 15 year olds)
• in 2010, the mean amount of alcohol
consumed by pupils who had drunk in the
last week was 12.9 units
• mean consumption levels have varied
between 11.6 units and 14.6 units since 2007,
with no clear trend
• most pupils who had drunk in the last week
had done so on one or two days (56 percent
and 29 percent respectively). On the days
they did drink, more than half (59 percent)
drank, on average, more than four units.
The survey showed pupils were more likely to
be given alcohol than to buy it, and then most
commonly by family or friends.
29
AlcoholNZ October 2012 | Vol.2 No. 1
Pupils who had never drunk
alcohol were most likely to
believe that people of their
age drank to look cool
(83 percent), or through
peer pressure (70 percent).
About half (48 percent) of pupils who drank also
said they bought alcohol, despite being well below
the age when they can legally do so (ie 18 years old).
The survey also showed that, in 2010, pupils who drank
were most likely to buy alcohol from friends or relatives
(26 percent), someone else (16 percent), an off-licence
(16 percent) or a shop or supermarket (12 percent).
Since the late 1990s, the proportion of pupils who
bought alcohol from other people has declined,
as has the proportion of those who bought alcohol
from off-licences, pubs and bars.
Differences between the settings in which younger
and older pupils were likely to drink were also
highlighted in the survey, with 68 percent of 11 and
12 year olds who drank alcohol usually drinking
with their parents, and a similar proportion (65
percent) saying they usually drank at home.
However, by the age of 15, pupils were most likely
to drink with friends of both sexes (74 percent of 15
year old drinkers), less likely than younger pupils to
drink at home (45 percent) and more likely to drink
in other locations.
Of these, 57 percent drank at parties with friends,
51 percent in someone else’s home, and 29 percent
‘outside’, that is on the street, in a park
or somewhere else.
When it came to drinking behaviour, the survey
revealed the extent to which pupils were
influenced by the attitudes and behaviour of their
families, with results highlighting that they were
less likely to drink if their parents disapproved, and
more likely to drink if drinking was tolerated by
their parents. The survey showed that:
• more than half (51 percent) of pupils said their
families didn’t like them drinking
• almost as many (48 percent) said their families
didn’t mind them drinking, as long as they
didn’t drink too much, while a small proportion
(1 percent) said their parents let them drink as
much as they liked
• most pupils (85 percent) who said that their
parents would not like them to drink had never
drunk alcohol, compared with 27 percent of
those whose parents didn’t mind them drinking,
as long as they didn’t drink too much.
30
Similarly, pupils were more likely to drink if they
lived with other people who did. The proportion of
pupils who drank alcohol in the last week increased
from 4 percent of those who lived in non-drinking
households to 26 percent of those who lived with
three or more people who drank alcohol.
The survey showed pupils becoming less tolerant
of drinking and drunkenness among their peers.
For example, in 2010, 32 percent agreed that it was
OK for someone of their age to drink alcohol once a
week, compared with 46 percent in 2003.
Over the same period, the proportion who thought
it OK for someone of their age to get drunk once a
week also fell, from 20 percent to 11 percent.
Pupils aged between 11 and 15 were most likely to
believe that people of their own age drank to look
cool in front of their friends (76 percent in 2010), to
be more sociable with friends (65 percent), because
their friends pressured them into it (62 percent)
or because it gave them a rush or buzz (60 percent).
There were also differences between the perceptions
of pupils who drank and those who did not.
Pupils who had never drunk alcohol were most
likely to believe that people of their age drank to
look cool (83 percent), or through peer pressure
(70 percent).
Those who had drunk alcohol in the last week were
most likely to think their peers drank to be more
sociable (84 percent), or because it gave them a
rush or buzz (78 percent), or to feel more confident
(71 percent).
Interestingly, the survey showed behaviour
patterns associated with having drunk alcohol in
the last seven days were not unlike those related to
smoking tobacco. Regular smokers and recent drug
users had an increased likelihood of having drunk
alcohol in the last week, along with pupils who had
played truant from school.
The full text of the survey, which also includes
findings on pupils’ patterns of drinking, being
drunk and other consequences of drinking,
attitudes and beliefs, is available at
www.ic.nhs.uk/pubs/sdd10fullreport
31
AlcoholNZ October 2012 | Vol.2 No. 1
YOUNG
WOMEN:
Perceptions & Realities
Much attention has been placed recently
on the ways young women misuse
alcohol. Headlines such as ‘Women hit
the bottle like men’ (Coursey & Savage,
2007), ‘Rude, crude and drunk: women
at their worst’ (Broatch, 2008), ‘Severely
drunk women shock police’ (Ash,
2011) and ‘Girls just wanna get totally
smashed’ (Newton, 2011) frequently
grace our news sites.
32
T
here are reports that young women now
account for approximately 60 percent of drunken
admissions to hospitals (Quigley cited in Palmer,
2009). But while there may be some women
drinking to excess, are women really drinking
more, say, on a population level? And can we call
it a trend? Locating this attention within some
of the broader concerns about New Zealand’s
‘culture of intoxication’, this paper takes a look
at what the local data is really saying about how
young women are drinking. It then looks at the
risks of excessive alcohol use that are specific to
women and explores some other times in which
the subject of women and alcohol has attracted
considerable interest.
New Zealanders have a history of alcohol misuse
(McEwan, Campbell & Swain, 2010), and we are
without doubt big drinkers. A Ministry of Health
survey (Ministry of Health, 2009) found that
85 percent of New Zealanders aged 16–64 drank
an alcoholic drink in the past year. Three in five
(61.6 percent) of these persons drank more than
is advisable for a single occasion at least once in
the past year. An earlier study identified that one
in six adults over 15 years of age have a potentially
hazardous drinking pattern (Ministry of Health, 2008).
Moreover, survey data over the period 1990-2012
indicates that the quantity binge drinkers consume
per occasion has increased over time (Huckle, You
& Casswell, 2010; Huckle, Pledger & Casswell,
2012; personal communication with Taisia Huckle,
Research Officer, Massey University, 2012). Figures
and statistics aside, what is especially disquieting is
that a number of young people feel that it is quite
acceptable to drink to excess “as long as it’s not every
day” (ALAC, 2005; see also Hutton, 2012).
Our ‘culture of intoxication’ is not a stand-alone
culture by any means. Measham and Bain (2005)
argue that a distinctive post-industrial pattern
of binge drinking can be seen in most Western
nations. Commentators argue it is due to the
radical relaxation of alcohol laws over the past
20 years (see, for example, McEwan et al, 2010;
McPherson, Casswell & Pledger, 2004; Measham
& Brain, 2005). In New Zealand, for instance, a
number of initiatives were implemented with a
vision that the public would embrace a culture of
moderate drinking like that of southern Europe.
33
It may be that women’s
drinking attracts attention
because the risks of excessive
alcohol consumption are
gender-specific.
In 1989, a review of the Sale of Liquor Act liberalised
the licensing application process. As a result,
New Zealanders saw a rapid expansion in the
number of licensed premises and a broader range
of places selling alcohol (Palmer, 2009). In 1992,
alcohol advertising was permitted in mainstream
media with little restriction or control, leading
to a widespread increase in televised alcohol
advertising (Huckle, Pledger & Casswell, 2012).
Ready-to-drink beverages (RTDs) were introduced
to the New Zealand market in 1995 with changes
to customs policies. These were instantly popular,
especially amongst young women (Huckle,
Sweetsur, Moyes & Casswell, 2008). In 1999, the
age of purchase was reduced from 20 to 18 years.
Sunday trading was also extended at this time, and
supermarkets, superettes and corner dairies were
permitted to sell beer and wine (Palmer, 2009).
While these changes did initiate the economic
and cultural development of a vibrant night-time
economy, they also brought with them increased
anxiety about increases in alcohol-related harm
(Hutton, 2009). As two reports published by the
New Zealand Law Commission (2009) document,
there are significant levels of concern about a
“catalogue of harms” on behalf of professionals
in the health, social, education and justice sectors,
as well as from the public and from those in the
alcohol industry itself. The fiscal cost of these
harms is estimated to be in the billions (Palmer,
2009) and the “subtle, chronic and unseen”
(Babor, 2011) social costs immense.
34
It is within these broader discussions that a
heightened degree of concern has emerged
about the level at which young women are
drinking. This is also not particular to New
Zealand; in debates about binge drinking in both
Australia and the UK, there is a focus on young
women (Brown & Gregg, 2012). The perception
is that young women are “catching up with
the boys”, which is predominantly attributed
to the increased social capital now enjoyed
by young women. Young women are earning
more money, are no longer bound by traditional
female caretaking roles, and are not subject to
the same level of stigma attached to women
who drink excessively as were their mothers and
grandmothers (McEwan et al, 2010).
Yet thus far, the evidence to suggest young women
are indeed ‘catching up’ is equivocal. While there is
some data to suggest that women’s drinking as a
whole did increase in the late 90s (MacPherson et
al, 2004; Ministry of Health, 2008; Ministry of Social
Development, 2009), things appear to have since
stabilised. Data from the New Zealand Alcohol
and Drug Use Survey 2007/08 found no significant
changes in binge drinking behaviours between
men and women aged 16-24 years in the past
decade (Ministry of Health, 2009).
An alcohol monitoring study commissioned by
ALAC also found that drinking habits have not
changed significantly over the past few years
(Fryer, Jones & Kalafatelis, 2011). This study also
found that non-drinkers are significantly more
likely to be women. Further, all of these studies
found that men drank more than women.
It may be that women’s drinking attracts attention
because the risks of excessive alcohol consumption
are gender-specific. There are health risks, for
example, that are particular to women. The protein
in the stomach wall which breaks alcohol down
is much less active in women than it is in men,
as is the enzyme found in the liver (Institute of
Alcohol Studies, 2008; Phillips cited in ‘Young
women facing’, 2012). Alcohol is also connected
with an increased risk of breast cancer (Ministry
of Health, 2009; Room, Babor & Rehm, 2005).
What is more, miscarriage, low birth weight,
stillbirth and premature birth, and abnormalities
in the developing foetus (leading to foetal alcohol
spectrum disorder) are the recognised effects
of alcohol misuse while pregnant (Abel, 1997;
Fingerhood, 2007; Ministry of Health, 2009).
The social consequences of young women’s
risk-taking behaviours while drinking are also
particular. Unwanted pregnancies are more
likely to occur after an episode of binge drinking
(Standerwick, Davies, Tucker & Sheron, 2007).
While young women who engage in binge drinking
are seen in terms of behaving “like men” (Day,
Gough & McFadden, 2004), drinking alcohol can
be risky for women insofar as they may be seen
as having invited unwanted attention from men,
that is, “she was asking for it” (Abbey & Harnish,
1995). There is also a view that the behaviour of
young women operates as a barometer of sorts for
the social health of a society, so if young women
are behaving badly it is a clear indication that the
nation is in trouble (see Skeggs, 2005; Jackson
& Tinkler, 2007). This might explain why we see
notions of disgust at the behaviour young women
engage in when drinking, just as we do in some
of the headlines quoted above. It is interesting
that this behaviour does not have to transgress
too far outside of traditional gender norms to be
considered worthy of concern. Recent attention
toward a photograph published in the Taranaki
Daily News of a bride who had entered a Bride of
the Year competition swigging from a beer bottle
illustrates this well. The paper received many calls
from people expressing their displeasure and
online comments called the photo “disgusting”
(Rilkoff & Burnell, 2012).
35
AlcoholNZ October 2012 | Vol.2 No. 1
Historians note, for example,
a fervent public discourse
about the ‘modern girl’or
flapper of the 1920s. The
typical modern girl was
depicted as a hedonistic
consumer of cocktails and
champagne, who would
subsequently engage in
behaviour that was deemed
vulgar, immodest and
unbecoming.
Indeed, it may be for these reasons that there
have been recurring episodes of concern – across
time – about alcohol use and women, particularly
young women. Historians note, for example, a
fervent public discourse about the ‘modern girl’ or
flapper of the 1920s. The typical modern girl was
depicted as a hedonistic consumer of cocktails and
champagne, who would subsequently engage
in behaviour that was deemed vulgar, immodest
and unbecoming (see Jackson & Tinkler, 2007).
The modern girl was also seen to be more prone to
tumours, cancer, and deterioration of the brain, and
to have problems in childbirth. Jackson and Tinkler
(2007) suggest that fears about health were in part
shaped by anxieties about the directions in which
society was heading and whether young women
would be ‘fit’ to bear the next generation. And,
once more, women’s newfound social and financial
freedoms were held responsible. This is illustrated
superbly in an editorial in the Auckland Star that
pondered: “has woman freed herself, only to destroy
herself?” (‘Topettes: Society and cocktails,’ 1923).
36
Further back in time, in the infamous gin craze
of 18th century Britain, women began to drink
alongside men in ‘gin shops’, an activity that
was previously restricted to men in ale houses.
These women were considered by reformers
to be promiscuous, adulterous, and active in
endangering the wellbeing of the next generation
of soldiers, sailors and labourers (see Skinner, 2007).
The fictional character of Madame Geneva, who
featured in William Hogarth’s print ‘Gin lane’,
personified such women. With syphilis sores on
her legs and a child falling from her arms, Madame
Geneva “is the image of failed motherhood and
immorality” (Skinner, 2007, p 5).
References
Given that binge drinking certainly happens and
that there are risks and harms resulting from
excessive alcohol use that are particular to women,
the topical nature of young women’s drinking is
neither surprising nor inappropriate. However, it is
important to cast a critical eye across the headlines,
and to reflect on the social and historical backdrops
against which concerns about young women
materialise. It is essential that the evidence used
to develop public health policies and practices is
both accurate and reliable. In particular, we need
to be sure that interventions in this area address
the realities, rather than just perceptions, of young
women’s binge drinking.
Fingerhood, M. I. (2007). Alcoholism and associated problems, (pp. 382-410)
in N. H. Feibach, D. E. Kern, P. A. Thomas, R. C. Ziegelsten (Eds.), Principles of
Ambulatory Medicine, Philadelphia, PA: Williams and Wilkins.
Abel, E. (1997). Maternal alcohol consumption and spontaneous abortion.
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Abbey, A., & Harnish, R. J. (1995). Perception of sexual intent: The role of gender,
alcohol consumption, and rape supportive attitudes. Sex Roles, 32, 297-313.
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Ash, J. (2011, February 7). Severely drunk women shock police. [news item]
Retrieved from http://www.stuff.co.nz
Babor, T. F. (2011). Commentary on Laslett et al. (2011): Alcohol-related
collateral damage and the broader issue of alcohol’s social costs.
Addiction, 106: 1612-1613.
Broatch, M. (2008, March 9). Rude, crude and drunk: Women at their worst.
[news item], Sunday Star Times, p. 9.
Brown, R. & Gregg, M. (2012). The pedagogy of regret: Facebook, binge
drinking and young women. Continuum: Journal of Media and Cultural
Studies, 26 (3): 357-369.
Coursey. M. & Savage, J. (2007). Women hit the bottle like men. [News item],
The New Zealand Herald. Retrieved from http://www.nzherald.co.nz
Day, K., Gough, B. & McFadden, M. (2004). Warning! Alcohol can seriously
damage your feminine health. Feminist Media Studies, 4 (2), 165-183.
Fryer, K., Jones, O. & Kalafatelis, E. (2011). ALAC Alcohol Monitor – Adults and
Youth, 2009-10 Drinking Behaviours Report. Wellington, New Zealand:
Research New Zealand.
Huckle, T., Sweetsur, p., Moyes, S. & Casswell, S. (2008). Ready to drinks are
associated with heavier drinking patterns among young females.
Drug and Alcohol Review, 27, 398-403.
Jackson, C. & Tinkler, P. (2007). ‘Ladettes’ and ‘Modern Girls’: ‘Troublesome’
young femininities. Sociological Review, 55 (2), pp. 251-272.
Lyons, A., & Willot, S. A. (2008). Alcohol consumption, gender identities and
women’s changing social positions. Sex Roles, 59: 694-712.
McEwan, B., Campbell, M. & Swain, D. (2010). New Zealand culture of
intoxication: Local and global influences. New Zealand Sociology, 25 (2), pp. 15-37.
McPherson, M., Casswell, S. & Pledger, M. (2004). Gender convergence in
alcohol consumption and related problems: Issues and outcomes from
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Measham, F. & Brain, K. (2005). ‘Binge’ drinking, British alcohol policy and the
new culture of intoxication. Crime, Media and Culture: An International Journal,
1, 262-283.
Measham, F. & Østergaard, J. (2009). The public face of binge drinking: British
and Danish young women, recent trends in alcohol consumption and the
European binge drinking debate. Probation Journal, 56 (4): 415-434.
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New Zealand Health Survey. Wellington, New Zealand.
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Newton, K. (2011, February 12). Girls just wanna get totally smashed. [news
item], The Dominion Post, p. 6.
Palmer, J. (2009). Alcohol, Health, and the Law Commission’s Liquor Review.
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May 15, 2009, Wellington, New Zealand.
Rilkoff, M. & Burnell, C. (2012, May 15). Storm in a stubbie over beer-drinking
bride. [News item]. Retrieved from http://www.stuff.co.nz
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365: 519-530.
Skeggs, B. (2005). The making of class and gender through visualizing moral
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30 (4). 366-371.
Skinner, E. (2007). The gin craze: Drink, crime and women in 18th Century
London. [Online essay post] Cultural Shifts. Retrieved from http://
culturalshifts.com
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Hutton, F. (2012). Harm reduction, students and pleasure: An examination of
student responses to a binge drinking campaign.
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37
AlcoholNZ October 2012 | Vol.2 No. 1
University ponders
alcohol-free zones
BRIEFS
HEADLINES FROM AROUND THE WORLD
Europe
Finnish Ministry
alcohol advertising
Finland’s Social Affairs and Health Ministry has
drafted a comprehensive law aimed at banning
the public advertising of alcoholic beverages. The
ban, which would cover places such as bus stops
and sports facilities and even athletes’ shirts, would
also limit alcohol ads to displaying a picture of the
product and its price. As in France, the law aims to
avoid positive associations between alcohol and
sexual, social or professional success. Timeslots
available for alcohol advertisements on TV would
move from after 9 pm to after 11 pm under the
proposed law.
www.eucam.info/eucam/home/news.html?1881-1690
AUSTRALIA
Locals unimpressed
with Aussie alcohol industry
This year’s Foundation for Alcohol Research
and Education’s Annual Alcohol Poll found 79
percent of Australians see no end to the country’s
alcohol-related problems and believe the
issue will get worse or, at best, remain the same
over the next five to ten years.
Those polled were also critical of the alcohol
industry, with 68 percent identifying alcohol
companies as not doing enough to tackle alcoholrelated harms. When asked which industry
was doing the most to address harm from their
products, only 5 percent of respondents nominated
the alcohol industry, compared with 12 and 15
percent for the gambling and tobacco industries
and 21 percent for the fast food industry.
www.fare.org.au/wp-content/uploads/2011/07/
FARE-Media-Release-Annual-Alcohol-PollFinal-170412.pdf
38
New criteria raise
problem drinker numbers
Australian drug researchers believe the number
of people in the country who will fit the criteria
for problematic alcohol use will rise by about 60
percent – or half a million people – under new
criteria recently added to the Diagnostic and
Statistical Manual of Mental Disorders.
www.smh.com.au/national/health/new-guidelinescould-define-one-in-10-as-having-an-alcoholdisorder-20120223-1tqmi.html#ixzz1uKYkXJI1
UK
Middle-class kids most
likely to try alcohol by 12
Middle-class children are far more likely to have
drunk alcohol by the age of 12 than those from
lower social groups, according to the UK charity
Drinkaware. Funded by the alcohol industry
to promote sensible drinking, Drinkaware’s
Ipsos Mori poll recently surveyed more than
500 middle-class parents and their children
and found more than one in three children
aged between 10 and 17 born in professional
households had downed a full glass of alcohol
before reaching their teenage years. This figure
was almost twice the level found among 12
year olds across all economic groups. While
some middle-class children secretly raided
their parents’ drinks cabinets, many more were
allowed to drink by parents who believed the
approach helped them develop more mature
attitudes towards alcohol.
www.telegraph.co.uk/health/healthnews/9204672/
Middle-class-children-most-likely-to-try-alcoholby-12.html
USA
Wellington Offices
Health Promotion Agency
Level 13, Craigs Investment Partners House
36 Customhouse Quay
PO Box 5023
Wellington 6145
Phone: (04) 917 0060
Fax: (04) 473 0890
Email: [email protected]
Health Promotion Agency
Level 3, 181 Wakefield Street
PO Box 2142
Wellington 6140
Phone: (04) 472 5777
Fax: (04) 472 5799
Email: [email protected]
Auckland Regional Office
Health Promotion Agency
Level 2, Ascot Central
7 Ellerslie Racecourse Drive, Greenlane East
PO Box 11791
Ellerslie, Auckland 1542
Phone: (09) 916 0330
Fax: (09) 916 0339
Email: [email protected]
Southern Regional Office
Please contact Wellington
Customhouse Quay Office.
For further information
Visit
healthpromotion.org.nz
Freephone
0508 258 258
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