The social and economic cost of our drinking

The social and economic cost of our drinking culture Promoting Responsible Drinking conference, 20 th November 2007, London Ben Baumberg, Institute of Alcohol Studies and London School of Economics and Political Science

Institute of Alcohol Studies Our funding Core funding – AHF, formerly the UK Temperance Alliance This work – partly European Commission & World Health Organisation funded Our only aims To promote scientific understanding Promote measures that reduce problems Promote research for the public benefit

This presentation Looks at three different areas of harm: Health costs Social costs Overall economic costs Also looks briefly at benefits: Primarily economic Conclusion

Copyright © 2002 BMJ Publishing Group Ltd. White, I. R et al. BMJ 2002; 325: 191. What is harmful drinking?

Copyright © 2002 BMJ Publishing Group Ltd. White, I. R et al. BMJ 2002; 325: 191. What is harmful drinking?

Health

Leontaridi 2003 for the Prime Minister’s Strategy Unit Alcohol-attributable disease Low High AAA (direct) 5, 789 Cancer 4, 682 5, 838 Heart disease 3, 030 3, 211 Other 57 5, 304 Total 20, 142 13, 558

Leontaridi 2003 for the Prime Minister’s Strategy Unit Alcohol-attributable injury Low High Assaults 103 Traffic accidents 758 764 Other accidents 1, 649 1, 708 Suicide 1, 007 Total 3, 517 3, 582

Alcohol morbidity in the EU

Health cost studies

Economics and alcohol policy “From the perspective of the group of analysts who care most about monetary matters – economists – the economic issues in tobacco are interesting but not fundamentally important. The fundamentally important issue is the four million people killed by tobacco each year, and the 10 million who will follow annually three decades hence” Kenneth Warner (2000)

Social

Alcohol and crime Estimates for association of alcohol: Assault: 45% (new-ADAM) Criminal damage: 47% (new-ADAM) Domestic violence: 73% alcohol before, 62% a ‘feature’, 44% BCS Child abuse: 16% (WHO estimate) Also mugging, robbery…

Other social harms Source: ECAS

Cost of crime Some are not ‘real’ savings: £ 5 bn PMSU estimate for pain and suffering due to violence alone – but not economic Few savings for police costs (part of £ 2 bn) BUT others are genuine: Savings on courts and prisons share (£ 1 bn? ) Savings on drink-driving damage (My est. ≈ £ 1. 5 bn) Savings on crime prevention (£ 1. 5 bn) Savings on criminal damage (£ 1. 4 bn)

Economic

SIMPLIFIED costs by sector UK jobs (000 s FTE) Adjustment costs Drinks production 22 Medium-high Specialist shops (16) Medium Bars & restaurants 282 Low-medium Agricultural inputs 10 Low-medium Supermarkets (16) Very low Advertising 2 Very low

Everyday adjustment

Worldwide cost studies

Problems with estimates Premature mortality Assumes full employment (alcohol-dependent people are irreplaceable at work) Unemployment International estimates from zero to 0. 2% GDP Absenteeism Maybe £ 1 -2 bn? Hard to estimate Productivity, social services, early retirement, workplace and other accidents, ‘criminal careers’…

Demographic effect Source: WHO GBD study (Rehm 2005)

Conclusions

Summary Economy Possible low-medium cost Possible low-medium benefit Social – large but unquantifiable impact Health Medium benefit at low levels Large human cost at high levels Crime – large human cost

A harmful drinking culture? Some have argued for ‘no free lunch’ from alcohol (Jackson et al 2005): Heart benefits may occur more at higher levels of (non-binge) drinking Pleasure occurs more at higher levels Economic benefits due to greater overall consumption, especially in pubs/bars

A harmful drinking culture? But costs – esp. from binge-drinking – likely to outweigh benefits: Crime Social harm Accidents Most people’s view for heart disease Most health conditions And – sometimes – the economy

Institute of Alcohol Studies www. ias. org. uk +44 (0)207 222 4001 Ben Baumberg b. p. baumberg@lse. ac. uk bbaumberg@ias. org. uk

Sources unless specified Anderson, P and Baumberg, B (2006). Alcohol in Europe: a public health perspective. London: Institute of Alcohol Studies. Available from http: //ec. europa. eu/health-eu/news_alcoholineurope_en. htm Baumberg, B (2006). “The global economic burden of alcohol: a review and some suggestions. ” Drug and Alcohol Review, 25(6): 537552 Baumberg, B (2006). The value of alcohol policies: a review of the likely economic costs and benefits of policies to reduce alcohol-related harm on the global level. WHO, pending publication. Baumberg, B. and Anderson, P. (submitted). “Alcohol in the economy: the costs and benefits of alcohol and the alcohol trade. ”