Table of contents


Background papers: Lifestyle and wider determinants :: Alcohol :: Summary


Alcohol is a prominent commodity in our communities, with an increase in the number of premises licensed to sell alcohol, particularly shops, since 2005 [1]. For many it is associated with positive activities. However, 10 million or more people drink at levels which increase their risk of health harms, and alcohol consumption is a leading factor for ill-health. Among those aged 15 to 49 in England it is the leading cause for ill-health, early mortality and disability [2].

Increased affordability of alcohol in the 1980s and 1990s, a shift to higher strength products and an increase in consumption by women has led to an increase in sales in England and Wales of 42% since 1980. Most alcohol is now bought from shops and drunk at home [1].

Many indicators of alcohol-related harm have seen an upward trend over recent years. Alcohol related hospital admissions and mortality are increasing. This is particularly apparent in the most deprived third of the population. More working years of life are lost in England as a result of alcohol-related deaths than from cancer of the lung, bronchus, trachea, colon, rectum, brain, pancreas, skin, ovary, kidney, stomach, bladder and prostate, combined [2].

The annual economic burden of alcohol is estimated as being between 1.3% and 2.7% of annual GDP [2]. There is a considerable body of international literature showing that policy and treatment for alcohol issues is both effective and cost-effective [3].

This needs analysis considers alcohol issues in adults only.

Key issues and gaps

• Compared to the South East, Medway has high levels of hospital admissions for alcohol conditions and high levels of alcohol related mortality.
• Hospital admissions for alcohol related liver disease, mental and behavioural disorders and alcohol related conditions, are rising in Men.
• Males between 40 and 64 years are showing a rapid rise in alcohol related hospital admissions where an alcohol-specific illness is the main reason for admission.
• Females between 40 and 64 are also showing a growth in hospital admissions where an alcohol-specific illness is the main reason for admission.
• Overall mortality caused by deaths from alcohol-specific conditions for persons of all ages, is worse than the South East.
• There is a need for effective strategies to address alcohol misuse in hard to reach groups, such as the Eastern European community and the homeless.
• The provision of community rehabilitation and post treatment support needs to be improved.
• There is a need for improved mental health support for those in treatment.
• There is a need for a coherent and comprehensive approach to street drinking.

Recommendations for commissioning

Commissioning of the substance misuse and treatment service, which includes alcohol treatment services, was completed in 2018. Once the service is embedded a Health Impact Assessment should be conducted to identify remaining or new gaps.


[1]   Home Office. Alcohol and late night refreshment licensing England and Wales 31 March 2016 2016; .
[2]   Public Health England. The public health burden of alcohol and the effectiveness and cost-effectiveness of alcohol control policies: an evidence review 2016;
[3]   Duncan Raistrick CG. Review of the effectiveness of treatment for alcohol problems 2006; NHS National Treatment for Substance Misuse. .