This website is now part of Public Health Scotland. Publications released after 16 March 2020 are now published on the Public Health Scotland website.
Improving health
Previously NHS Health Scotland

Alcohol misuse and, particularly, the pattern and levels of alcohol consumption, have harmful consequences for individuals, their family and friends as well as wider society and the economy. You will find our resources to help you deliver alcohol related interventions with patients below.

Alcohol consumption and related harms are significant public health issues in Scotland.

  • On average 24 people in Scotland died from illnesses wholly caused by alcohol every week in 2016.
  • People are being diagnosed with alcohol related diseases, such as liver cirrhosis, at a younger age.
  • 20.2 units of alcohol were sold per adult per week in 2016, 17% more than in England and Wales.
  • On average 96 hospital admissions a day in 2015/16 were due to illnesses wholly caused by alcohol.
  • Although alcohol related mortality and morbidity in Scotland have fallen, they remain high, and higher than England and Wales.
  • Alcohol misuse is estimated to cost the Scottish economy 3.56 billion per year in 2007, equivalent to £900 per adult.

Alcohol misuse is also a public health issue because it:

  • has been shown to
    • cause death
    • cause cancer
    • cause fertility problems
    • affect the immune system
    • cause high blood pressure
    • damage the brain and nervous system
    • cause chronic liver disease and cirrhosis.
  • harms not only the excessive drinker, but often also harms the people around them
  • is commonly associated with a number of anti-social behaviour offences such as assault, vandalism and breach of the peace
  • is linked to:
    • child neglect
    • serious crime
    • family breakdown
    • domestic violence.

You can read more data on alcohol use and misuse on the Scottish Public Health Observatry (ScotPHO) site (external site). You will also find data on key alcohol indicators in Scotland in the latest MESAS monitoring report.

Alcohol and health inequalities

The amount and the way a person drinks is influenced by a number of factors. This includes social conditions like where a person lives, whether they have a job and if so what it involves, childhood experiences and social networks. The availability of alcohol and how much it costs is also important.

Average weekly levels of self reported alcohol consumption tend to be higher in more affluent groups. However

  • levels of binge drinking are higher in less affluent groups
  • the heaviest drinkers are less likely to be fully represented in surveys
  • heavy drinkers in less affluent groups tend to consume more than heavy drinkers in other groups.

This means that alcohol-related harm is socially patterned with higher levels of alcohol-related harm in less affluent groups. Inequalities in alcohol-related harm have been falling in Scotland, but they remain wide. The latest figures show that

  • alcohol-related mortality rates for those living in the most deprived areas are six times the rate for those in the least deprived areas
  • the rate of alcohol-related hospital admissions for those living in the most deprived areas are almost nine times the rate for those in the least deprived areas.

Local and national actions

Alcohol framework

Scotland’s Alcohol Framework 2018: Preventing Harm (external site) updates the 2009 Framework for Action (external site).

The updated Framework retains three central themes, which are well accepted and understood.

  • Reducing consumption.
  • Positive attitudes, positive choices.
  • Supporting families and communities.

 The 2018 Framework includes a number of new actions, such as

  • ensuring children and young people are involved in the process ode developing preventative action
  • proposals to consult on alcohol marketing such as public spaces and online
  • investigating the impact of telephone and online alcohol sales,
  • reviewing the impact of the licensing system on the public health
  • pressing the UK Government to enable Scotland to protect children and young people from pre-9pm TV advertising
  • a national marketing campaign to promote the revised CMO weekly drinking guidelines and work to raise awareness of the link between alcohol use and cancer
  • reviewing the national programme of delivering Alcohol Brief Interventions (ABIs) including efforts to assess their quality.

Alcohol brief interventions (ABIs)

ABIs are short, evidence-based, structured, and non-confrontational conversations about alcohol consumption. Guidance for the delivery of ABIs is set out in ‘The Local Delivery Plan Standard: Alcohol Brief Interventions National Guidance 2018-19 (external site).

We know that ABIs can have benefits for individuals, but we don’t know the scale of their impacts on population health and health inequalities.  So ABIs are one of the interventions we included in our ‘Informing Interventions to reduce health Inequalities’ (Triple I) project. 

Using the interactive tool you can

  • alter the number of individuals given an ABI
  • alter the targeting strategy (e.g. to deprived areas)
  • estimate results for local areas as well as for Scotland.

We found that ABIs could help to reduce health inequalities if targeted to the most deprived areas.

Framework for local partnership on alcohol and drugs

It is the responsibility of Scotland's 30 Alcohol and Drug Partnerships to commission treatment services to meet the needs of their resident populations. This is done in line with the Framework for Local Partnerships on Alcohol and Drugs (external site), which clarifies the roles, responsibilities and accountability of all bodies involved in tackling alcohol and drugs problems.

Alcohol Focus Scotland guidance and information

A Community Licensing Toolkit (external site) has been produced by Alcohol Focus Scotland for anyone who would like to have a say on how alcohol impacts on their community. Alcohol Focus Scotland have also designed a Licensing Resource Pack (external site) for professionals involved in Scotland’s licensing system.