73% of European Countries require alcohol prevention in school

The World Health Organisation in Europe report that 73% of European countries have a legal obligation to include alcohol prevention in the school curriculum and just over half have national guidelines for the prevention and reduction of alcohol-related harm in school settings.

As readers of my last post will know England, unfortunately, won’t be part of that majority that require school based alcohol prevention.  This despite the fact that the country comes 9th for early drunkenness according to the Health Behaviours in School-age Children report.

But they can however point to NICE guidance on interventions in schools to prevent and reduce alcohol use among children and young people.

I can’t help noticing that the NICE guidance was produced in November 2007 and is due to be reviewed again next year.

One can only hope that it doesn’t suffer the fate of the guidance on sex and relationships education and alcohol which has been in suspended animation for the last three years.

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School Health Services

I’ve been meaning to write about the contribution that school nurses can make to drug prevention and this report from WHO Europe from 2009 that I came across today has prompted me to at least point out some of the things we know.

Across Europe it appears that most school health services have some responsibility for substance misuse prevention.

school nurses

Cross referencing this with the PSHE mapping exercise carried out by researchers from Sheffield Hallam University a few years ago suggests that quite a lot of the drug and alcohol prevention activities that school nurses in England undertake are outside the classroom.  That review found that 17% of schools (both primary and secondary) used school nurses to deliver at least some of their drug education.

Health England when they looked at preventative spending in the NHS were able to show that of the £5 billion being spent on prevention and public health services in 2006/07 £159 million (3%) went to school health services.  They were able to split this down between primary (£44m) and secondary (£115m) prevention, and noted that £17 million could be attributed to the national Health Schools Programme.

Since then the government have issued a new vision for school health services, Getting it right for children, young people and families, which says:

School nurses will be part of teams providing ongoing additional services for vulnerable children, young people and families requiring longer term support for a range of special needs such as disadvantaged children, young people and families or those with a disability, those with mental health or substance mis-use problems and risk taking behaviours. School nursing services also form part of the high intensity multi-agency services for children, young people and families where there are child protection or safeguarding concerns.

There is a useful brief overview of this vision produced by the Department of Health and the LGA aimed at councillors, which can be downloaded here.

Also worth examining is the NICE guidance on school based interventions for alcohol, which makes the following recommendations (identifying school nurses as one of the groups who should take action):

  • alcohol education should be an integral part of the school curriculum and should be tailored for different age groups and different learning needs
  • a ‘whole school’ approach should be adopted, covering everything from policy development and the school environment to staff training and parents and pupils should be involved in developing and supporting this
  • where appropriate, children and young people who are thought to be drinking harmful amounts should be offered one-to-one advice or should be referred to an external service
  • schools should work with a range of local partners to support alcohol education in schools, ensure school interventions are integrated with community activities and to find ways to consult with families about initiatives to reduce alcohol use.

Finally below is a presentation that the Drug Education Forum had at one of the seminars we ran. It describes a multi-agency approach to improving health and wellbeing for young people in Bury, which included school health services.

European Alcohol Profiles

The image above is taken from the by The Prime Minister’s Office Flickr Stream and gives some context to what is to follow.

The World Health Organisation have produced alcohol profiles for countries in the region.  As you’ll see they’re focused on adult drinking, but hold some interesting data.

Looking at the UK figures the first thing that jumps out is that adults drink 13.4 litres of pure alcohol per person per year.  That’s

an additional 1.2 litres of pure alcohol per person than the average European – and as that includes Russia and other Eastern European countries I suspect the average would be considerably lower if we were to just look at Western Europe.

If I’ve done my maths right* that means that this means that every one over the age of 16 drinks 42.2 pints of larger (5% abv) more than our continental cousins over the course of a year.

There are about 49,619,840 of us over the age of 16.  So that’s 2,093,957,248 extra pints as a nation.  Or, if you’re more of a wine person that’s the equivalent of 610,324,032 extra bottles of wine.

There are also some interesting difference between men and women.  Men who drink are putting away an average of 21.58 litres of pure alcohol a head per year (or if you’d rather 999 pints of pale ale (3.8% abv)), while women drinkers are much more abstemious drinking 9.46 litres (or 860 bottles of alcopops (4% abv)) over the course of a year.

Another interesting part of the briefing is the estimated social costs of alcohol – from which they’ve excluded Northern Ireland for some reason.  They calculate the figures in US dollars and I’ve taken a conversion rate of $1 to £0.6237.

WHO say that the total social costs that we bear as a result of our alcohol consumption comes out at about $32 bn (which comes to about £20 bn).

They break this down a little so we see that about $3.5 bn (£2.2 bn) of the total comes from the health budget, and $12.2 bn (£7.6 bn) being spent in criminal justice expenditure.

The rest comes from what they call direct and indirect costs – unfortunately they don’t seem to define what those costs might be.

* 10 ml of pure alcohol = 1 unit, so 1.2 lt of pure alcohol = 120 units