Working to reduce alcohol harm

Women and alcohol: time for a re-think?

Women experience greater health risks from alcohol than men and the onset of alcohol-related health problems begins earlier.

They are more vulnerable to tissue damage, cirrhosis of the liver and alcohol dependence. Women’s bodies process alcohol differently resulting in higher concentrations of alcohol in their blood when drinking equal amounts of alcohol to men. Women have lower body weights, less body water and higher percentages of body fat than men.

Alcohol use is causally related to more than 60 diseases and conditions, some of which are wholly caused by alcohol, while alcohol is a contributory factor in others.[i] The risk of developing the following conditions increases as the amount of alcohol consumed increases:

  • Liver cirrhosis
  • Cancer of the mouth and oropharynx
  • Liver cancer
  • Breast cancer
  • Oesophageal cancer
  • Laryngeal cancers
  • Acute pancreatitis
  • Cardiovascular diseases including stroke and coronary heart disease

However, women do not need to drink as much alcohol as men to run the equivalent risk of developing the above conditions. For example, a man who drinks six or more standard drinks (7.5 UK units) a day is 13 times more likely to develop cirrhosis of the liver compared to a non-drinker.

A woman, however, need only drink four standard drinks (5 UK units) a day to increase her risk of developing cirrhosis to the same degree. Four standard drinks (5 UK units) is the equivalent to about a half bottle of wine or two pints. Women who drink this amount a day are five times more likely than non-drinkers to develop mouth, oropharynx and laryngeal cancers and eight times more likely to experience haemorrhagic stroke.[ii]

Particular to women is the risk of breast cancer. Drinking one standard alcoholic drink a day is associated with a 9% increase in the risk of developing breast cancer, while 3”‘6 drinks a day increases the risk by 41%. The more a woman drinks, the greater the risks to her health. [iii] One in five alcohol-related cancer deaths in the EU is of a woman who has died from an alcohol-attributable breast cancer.

In addition to the health risks associated with the frequency of alcohol consumed, episodes of heavy drinking carry an additional set of risks. These include injuries and death as a result of falls, road crashes, deliberate self harm, as well as unwanted and/or unprotected sex.

The role of alcohol in lowering inhibitions, increasing impulsive and risk-taking behaviours as well as negatively effecting co-ordination and judgement all contribute the risk of harm, injury and death. Alcohol use is often a contributory factor to poor mental health.

How much are Irish women drinking?

In recent decades, it has become more acceptable for women to drink heavily and frequently, with younger women drinking more alcohol, more often.[iv] The most recent survey of drinking among 15 and 16-year-olds once again highlighted the pattern of drinking whereby Irish girls have been matching, and at times exceeding, the drinking levels of Irish boys, a trend which has been ongoing since 1995. Irish girls outnumbered boys when it came to having had a drink in the past 30 days, binge drinking and being drunk.[v]

Among adult drinkers, four out of ten women report a harmful drinking pattern – their drinking is already causing damage to their physical and/or mental health.[vi] Women are now drinking more than previous generations. The impact of this change in Irish women’s drinking patterns has shown in a number of worrying trends:

  • One in four Irish women discharged from hospital for alcohol”‘related conditions were aged under  30, compared to one in six men [vii]
  • Between 1995 and 2004, there was an increase of 29% in the proportion of Irish teenage girls aged under  18 discharged from hospital for alcohol”‘related conditions compared to an increase of 9% for boys [viii]
  • Women account for a quarter of all alcohol-related discharges, but among those aged 17 and under, the proportion of discharges from hospital is almost half, at 47% [ix]

As women develop alcohol-related health complications earlier than men, it is likely that, if current trends continue, we will see significantly higher numbers of middle-aged women at increased risk of dying as a result of alcohol-related conditions. [x]

Factors influencing changing drinking patterns

There are a number of factors that have influenced this change in drinking patterns. Alcohol has become more available, the liberalisation of licensing laws having led to a massive jump in the number of off-licences, with alcohol available from an increased range of outlets including convenience stores, supermarkets and petrol stations. In addition, alcohol has become more affordable – at current prices, a woman can reach her low-risk weekly limit for about €6.30 a week.

Alcohol marketing has become more focused and intense in targeting women, often with drinks high in alcohol content such as wine and spirits. Note how such drinks are marketed to women through the sponsorship of TV programmes aimed at women and the prominent placement of wine, in particular, in supermarkets.

Working in a similar way to the tobacco industry, the alcohol industry segments its market into number of target populations. Marketing alcohol to women involves the use of fashion blogs, girls’ nights in and out, as well as ’light’ products to meet the demands of the calorie counting woman. In the UK, Coors established a unit to develop beer brands and marketing techniques to appeal to women; its mission statement, to create “a world where women love beer as much as they love shoes”.[xi]

One current campaign uses fashion blogs and social media to promote Thursdays as the ultimate girls night out, inviting potential customers to events across Ireland featuring beauty bars, fashion tips and a complementary drink. These experiential marketing events provide a space for potential customers to “experience” the product and personally connect with the brand, increasing its image and awareness.

Teenage boys and girls are neither immune nor protected from alcohol marketing in their online social worlds. A recent survey on alcohol marketing found that one in three Irish 16 to 17-year-olds said they had seen an ad or pop-up for an alcohol product on their social networking page while four out of ten said they owned alcohol branded clothing.[xii]

Women as parents

Many women have parenting responsibilities, and women tend to carry the bulk of those responsibilities. When a mother has a problem with drinking, it can also become a problem for her children, sometimes negatively affecting their health, development and welfare. One in 11 children in Ireland say their lives were negatively impacted by parental drinking.[xiii]

There also exists a lack of awareness among women of the risks associated with drinking alcohol during pregnancy. A study of 43,318 women who attended the Coombe Women’s Hospital found that although roughly half of the women surveyed said they gave up smoking during pregnancy, only 13.2% stopped drinking.[xiv]

The Department of Health and Children gives clear advice on drinking during pregnancy:

Given the harmful drinking patterns in Ireland and the propensity to binge drink, there is a substantial risk of neurological damage to the foetus resulting in Foetal Alcohol Spectrum Disorders (FASD). Alcohol offers no benefits to pregnancy outcomes. Therefore, it is in the child’s best interest for a pregnant woman not to drink alcohol during pregnancy.”

What needs to happen?

The Steering Group of the National Substance Misuse Strategy identifies effective policies and actions to reduce the harm caused by alcohol and Alcohol Action Ireland calls for the recommendations of the Steering Group to be implemented in full. The Report makes a number of recommendations on how best to reduce the harms caused to women by alcohol, both as a result of their own drinking and the harms that result from some-one else’s drinking. These are:   

  • Commence of Section 9 of the Intoxicating Liquour Act 2008, which legislates for the segregation of alcohol from food and non-alcoholic beverages in supermarkets, convenience stores, petrol stations and other mixed trade premises
  • Implement policies and clinical protocols in all healthcare settings to prevent, assess and respond to issues arising in relation to pregnant women affected by alcohol use
  • Labels on alcohol products sold in Ireland to include information on alcohol content, calorific content and health warnings in relation to consuming alcohol during pregnancy
  • Increase the price of alcohol over the medium term to ensure that alcohol becomes less affordable through excise duties and minimum pricing
  • Develop a comprehensive outcomes and evidence-based approach to addressing the needs of children and families experiencing alcohol dependency problems

In addition, Alcohol Action Ireland recommends the following action to reduce levels of alcohol-related harms for women

  • Develop and launch a national social marketing campaign aimed at women. The campaign would provide information about the impacts of alcohol use on physical, mental and social harms including parenting capacity and would facilitate women to make informed choices about whether and how they drink

Follow this link for the facts on women and alcohol in Ireland.

 

References

[i] World Health Organisation (2002) The World Health Report 2002: Reducing Risks, Promoting Healthy Life. Geneva: World Health Organisation

[ii] Hope A (2008)  Alcohol Related Harm in Ireland Health Service Executive – Alcohol Implementation Group

[iii] Mongan et al (2007) Health-Related Consequences of Problem Alcohol Use Overview 6. Dublin: Health Research Board

[iv] See iii

[v] Hibell B. et al (2012) The 2011 ESPAD Report: Substance Use Among Students in 36 European Countries. The Swedish Council for Information on Alcohol and Other Drugs (CAN) and the Pompidou Group at the Council of Europe. Stockholm: Sweden

[vi] Morgan, K. et al (2009)  SLÁN 2007: Survey of Lifestyle, Attitudes and Nutrition in Ireland. Alcohol Use in Ireland; A profile of drinking patterns and alcohol-related harm Alcohol use in Ireland. Department of Health and Children. Dublin: the Stationery Office

[vii] See iii

[viii] See iii

[ix] See iii

[x] See iii

[xi] The Wall Street Journal/ WSL.com (15th August 2008) U.K. Brewers Try to Tap Women’s Market

[xii] Behaviour and Attitudes (2010) Have We Bottled It? Alcohol Marketing and Young People Survey. commissioned by Alcohol Action Ireland

[xiii] ISPCC (2010) “If they’re getting loaded, Why Can’t I?” National Children’s Consultation. Dublin: ISPCC

[xiv] Barry S, Kearney A, Lawlor E, McNamee E and Barry J (2006) The Coombe Women’s Hospital Study of Alcohol, Smoking and Illicit Drug Use 1987-2005 Dublin: Coombe Women’s Hospital