1. IT STARTS HERE:
A Conversation About Alcohol
in the City of Kingston
Cathy Edwards
Public Health Nurse, KFL&A Public Health
Coordinator, Safe & Sober Community Alliance
Wellington Guelph Harm Reduction Forum
March 20, 2013
3. Reducing Alcohol-related harm
" Harm reduction is any policy or program
designed to reduce drug-related harm
without requiring the cessation of drug use.
Interventions may be targeted at the
individual, the family, community or society.“
CAMH and Harm Reduction: A Background Paper on its Meaning and
Applications for Substance Use Issues, CAMH, 2002
4. Distribution of Alcohol-related
Risk in Canada, 2009
8,915,000 8,961,000
6,081,000
number of persons
1,623,000
No-risk Low-risk Moderate-risk High-risk
Source: Canadian alcohol and drug use monitoring survey (CADUMS 2009).
5. The Prevention Paradox
• “A large number of
people exposed to
a small risk can
create many more
cases of harm than
a small number
exposed to a high
risk.”
6. , Cultural, and Envir
n omic onm
eco ent
cio al
l So Wo rking Condi Co
ra and tion nd
e ing s
Liv
n
ito
Ge
ns
d Community In
l an flu
cia en
So c
al Lifestyle Fa
es
idu ct
div
In
or
s
Age, sex, and
heredity factors
Framing the Issue
Alcohol and the Determinants of Health
7. • Pricing and affordability of alcohol
• Availability and accessibility of alcohol
• Regulations for Alcohol marketing and promotion
• Alcohol laws
• Work environment
• Income
• Education
• Early childhood development
8. • Alcohol advertising and local business promotions
• Bar environments and staff training
• Liquor enforcement capacity
• Parental attitudes and role modelling
• Individual choice
• social circle, consumption patterns
• Education and informed choice
• Individual resilience
9. • Youth and young adults more susceptible to risk taking
• Older adults more vulnerable to alcohol and related harms
• Women at increased risk because alcohol is processed
differently in women’s bodies
• Certain hereditary factors can predispose individuals for
alcohol addiction
11. Percentage of those w ho are heav y drinkers
by age group in Ontario, 2009 - 2010
3.8
13.7
16.2
18.6
percentage
32.5
Age group
12. How much are we drinking?
Patterns and Trends in Ontario
Young Adults (ages 18-29 in Ontario)
Weekly heavy drinking increased from 11% in 1995 to 26% in
2007,
Hazardous or harmful drinking increased from 22% in 2002 to
39% in 2007.
A significantly higher proportion drink above the Low Risk
Drinking Guidelines* than any other age group in Ontario.
13. How much are we drinking?
Patterns and Trends in Ontario
Youth (grades 7-12)
About 22% of students reported drinking 5+ drinks on one
occasion at least once during the past month (this represents
about 223,500 Ontario students).
5% reported binge drinking four or more times in the past month.
One third reported drinking hazardously and harmfully in 2011.
One in 10 students reported injuring themselves or someone else
as a result of their drinking. These behaviours were most common
in students in grades 11 and 12, with both boys and girls equally
likely to engage in these dangerous patterns of drinking.
14. How much are we drinking?
Patterns and Trends in Ontario
Older Adults (ages 65+)
Average number of drinks consumed per week has gradually
increased from just over 3 drinks per week to almost 5 per week.
That is a 67% increase between 1996 and 2009.
Women
Trends indicate that Ontario women are fast approaching the
consumption patterns of men.
Past year drinking in women increased from 72% in 1998 to 78%
in 2007.
Daily drinking increased from 2.6% in 2001 to 5.3% in 2007, and
Hazardous or harmful drinking increased from 5% in 1998 to 8% in
2007.
15. How does alcohol impact communities?
SECOND HAND EFFECTS OF
DRINKING
18. Second hand effects – Alcohol and Crime
• Provincial Liquor
(LLA) offenses
• Drinking and
driving
• Alcohol and
violence
• Domestic
violence
• Alcohol and
sexual assault
19. Alcohol and Sexual Assault
• A 2004 survey showed that the rate of sexual
assault for Canadians aged 15 to 24 was almost
18 times greater than for adults over 55.
• In a University of Alberta study, almost half of the
sexual assaults that young adults experienced
took place under the influence of alcohol
• Data from police-reports in Canada for 2007
indicate that in 82 percent of the cases where the
relationship could be determined, the victim
knew the perpetrator.
20. Second hand effects - FASD
“Prenatal alcohol exposure can produce
lifelong brain dysfunction that, without
support and treatment, severely impacts an
individual’s ability to function in school, the
workplace and to become a contributing
member of society.”
Dr. James Reynolds, Queen’s University
23. Revenue Cost Analysis for Ontario
Comparison of Direct Alcohol-related Revenue and Costs,
Ontario, 2002-2003
Deficit= $456,390,738
$45,700,000
$2,500,000,000
$1,160,104,734
$2,000,000,000 $619,402,996
$1,500,000,000
$1,000,000,000 $1,406,451,000
$1,276,440,000
$500,000,000
$0
Direct Costs Direct Revenue
(2002) (FY2002/03)
Enforcement Costs Health Care Costs Other Costs Net Revenue Sales Taxes
Source: Thomas, Gerald. The Economics of Alcohol Control Policy in Canada, Alcohol
Policy Network webinar, September 2010.
25. Regulating Physical Availability
Sample policy
strategies:
• 1. Limit alcohol
outlet density
• 2. Confine hours of
service
• 3. Limit alcohol
allowed public
events
26. Strengthen local
zoning regulations to
avoid density and
congestion
Evaluate liquor license 51% agreed or strongly agreed that
there should be a limit on the
applications based on number of alcohol retailers and
potential community licensed establishments that can exist
in a given area in the City of Kingston.
impact
Evaluate license
application process
considering health and
safety decisions
27. 61% agreed or strongly agreed
that people should be
Advocate for stricter required to have a special
permit to buy beer kegs
controls on the sale of
large volume containers 51% agreed or strongly agreed
e.g. beer kegs that there should be a ban on
alcohol delivery services.
Advocate for the
authority to restrict or
ban alcohol delivery
services within the
municipality
29. Work with communities 52% of Kingston
respondents agreed or
and government to strongly agreed that the
implement minimum price of alcohol should be
pricing laws, volumetric based on its alcohol
content.
mark-ups, and penalties
for drink discounting
violations
Appeal for government
to index prices to cost of
living. Keep at or above the
consumer price index
30. Restrictions on marketing
Sample policy
strategies:
• Pursue local
regulations
• Support counter-
advertising
• Appeal for
healthier alcohol
advertising policies
and practices
31. 73% of Kingston
respondents would support
the Ontario government
establishing stricter
advertising standards for
alcohol.
Strengthen local restrictions on alcohol
advertising such as imposing constraints on
number, location, size, content of ads
File advertising concerns and complaints to
Advertising Standards Canada and advocate for
new standards
32. Modify the Drinking Context
Sample policy strategies:
• 1. Regulate special occasion events
• 2. Improve conditions of on-premise alcohol
outlets (e.g. bars, restaurants)
33. Enact responsible beverage
92% of respondents
service training and in-house bar agree or strongly
policies agree that bar
training to reduce
alcohol problems
and violence should
Mandate Safer Bars training as
be required to
part of licensing to reduce obtain a license.
problems and violence in bars
Provide inspectors and police
with data on problem areas and
assist with targeted policing
initiatives
34. Taking Shared Responsibility
• Municipal Government – Mayor, City Council, City Administrators
• Provincial and Federal Governments – Politicians
• Health Care Professionals and organizations
• Enforcement agencies
• Licensed establishments
• Business community
• Media
• Post Secondary institutions
• Teachers and School Boards
• Parents
• Students
• Community Members
