Introduction and Background

Alcohol plays a major role in many social events and is widely used to enhance bonding in social events. However, excess consumption is linked with negative impact on health, family and society at large (Carvalho et al., 2019). Despite the negative impacts associated with alcohol misuse, many people who misuse alcohol consider themselves moderate users indicating a distorted understanding of the risks and issues related to their alcohol consumption.

In the United Kingdom, alcohol misuse and alcohol-related illnesses are a public health burden with chronic alcohol disorder having the highest weight on hospital utilisation (Balakrishnan et al., 2009). In 2019 study research on the impact of alcohol misuse on emergency department attendance and hospital admissions in the United Kingdom indicated that around 6,7% of the 1,2 million people had more than one alcohol misuse issue accounting for 11,7% of emergency department attendance, 9,2% of hospital admissions and 7,2% total bed days (Phillips et al., 2019.)

The Sustainable Development Goals (SDGs) aim at providing a more equitable and sustainable future for all people by 2030 (UN, 2019). Alcohol consumption is interconnected with several goals and targets of 2030 Agenda for Sustainable Development. To achieve the agenda, countries all over the world need to reduce alcohol-related harm and increase the chances of reaching the health targets (WHO, 2019). Nderesis’ research 2024, objective is to identify the major causes of alcohol misuse in the United Kingdom. The research aims to identify possible interventions for alcohol misuse and create awareness of the causes and underlying factors associated with alcohol misuse in the United Kingdom.

Planning and Implementation

The research is a systematic literature review applying integrative review method. The article reviewed in the research were obtained from CINAHL Ultimate and PubMed databases using Boolean search tools (“alcohol dependence” OR “alcohol abuse” OR “alcohol addiction” OR “alcohol misuse”) AND (“Great Britain” OR “United Kingdom” OR “Britain”). Inclusion criteria deemed appropriate for the research were articles published between 2017 and 2023, in English language and the United Kingdom as the location. All articles that were not in English, had no full text available, addressed Europe and/or USA were excluded from the research.

The abstract of the articles obtained after implementation of search criteria were reviewed to identify those that address alcohol misuse/prevention and address ways to prevent alcohol misuse in the United Kingdom. Resulting articles were then appraised using the JBI appraisal checklist tools for systematic reviews and research syntheses to ensure the maintenance of rigour and trustworthiness of the data. A total of sixteen articles were used in the research.

Thematic content data analysis was applied in the research using qualitative data analysis software MAXQDA 2022. Each research finding, results and discussion were read and open-coded based on the research objectives and aims. The open codes were then grouped into broader potential themes. Codes addressing causes of alcohol misuse in the United Kingdom were grouped to one theme while codes that addressed measures used to detect and prevent alcohol misuse were grouped to another theme.

Causes Of Alcohol Misuse in The United Kingdom

In United Kingdom, alcohol advertisement in different media influences the misuse of alcohol by attracting new users while encouraging current users to consume more. Advertisement influences alcohol consumption in different ways which include attracting new consumers while influencing maintenance/increase in the amount consumed by already existing consumers. It plays an important role in the initiation of drinking as well as maintaining the market share for the already existing drinkers.

Mental health-related issues are one of the main causes of alcohol misuse in the United Kingdom. Persons with mental health disorders report higher alcohol intake to cope with the mental health disorder. Individuals with depression and anxiety drink and misuse alcohol compared to others without such mental health problems.

Alcohol misuse alcohol in the United Kingdom is also due to a lack of awareness of adverse effects on their health due to hazardous drinking habits and misuse. Individuals who misuse alcohol lack the awareness of health risks related to alcohol misuse. Lack of insight into alcohol addiction among alcohol misusers leads to delayed meaningful engagement with addiction services thus resulting in complex and complicated health case presentation in hospitals.

Many people experience social pressure to drink alcohol in their life span either overtly and aggressive, or subtly and friendly. In the United Kingdom, adults and adolescents drink and misuse alcohol due to friendly, overt, and aggressive social pressure from peers, family, and friends. Individuals engage in hazardous alcohol drinking patterns as a mechanism of coping with distressing thoughts, and loneliness, forgetting the past, and escaping from troubles or the past. Young people drink more to cope due to social pressure compared to older adults above 50 years. Life changes such as divorce, relationship breakdown, financial difficulties, or loss of employment cause individuals to drink to cope with the stress associated with such occurrences.

Serving in the military is a leading factor in alcohol misuse in the United Kingdom. Evidence shows that alcohol misuse and dependency in the armed forces is higher compared to the general population. In the military, alcohol is identified as a big part of the military culture thus leading to the normalization of excessive and regular consumption of alcohol. In addition, after leaving the military, ex-militants continue to align with the alcohol culture they acquired during their service thus continue to abuse alcohol and remain reluctant to seek help for fear of being perceived as weak.

Interventions to prevent alcohol misuse in the United Kingdom

As a measure to reduce alcohol misuse in the country, there is a need to formulate stricter restrictions on alcohol marketing and advertisements on marketing channels especially to vulnerable groups of adults. United Kingdom should consider a comprehensive way of limiting exposure to alcohol advertisements to adolescents and young adults such as in countries like Norway (EUCAM, n.d.).

The research indicates that there is a link between alcohol misuse, mental health, and other social issues. This calls for multiple interventions to eliminate and address alcohol misuse in the context of psychological and social problems. The public needs to be made aware of the alcohol services available since most of the alcohol misusers are not aware of where to obtain help. Service providers should focus on providing both health and social services and prioritize clients’ needs and goals even if they are not directly related to alcohol misuse. In addition, there is a need to raise awareness about the high probability of militants and veterans’ susceptibility to alcohol misuse thus coming up with new strategies for identifying those in need of support.

Front-line alcohol misuse healthcare workers lack adequate training in psychological language and skills to deliver interventions and support to service users. This highlights the need to train the health workers on how to meet the needs of militants and veteran service users. There is a need for veteran peer-led service where the health worker is linked or has prior experience in military services. Health care workers and service providers should be trained on how to be more empathic, and supportive, avoid labelling and use of non-confrontational body language and speech tone.

CONCLUSION

The research findings provide vital insight into causes of alcohol misuse in the United Kingdom as well as interventions that can be utilized to prevent alcohol misuse in the country. These findings can be used by health professionals and affiliated agencies to develop interventions for alcohol misuse and promote awareness of the factors identified in the research as contributing to alcohol misuse. Furthermore, governments and policymakers may use the findings to develop proposed alcohol advertising legislation to prevent alcohol misuse.

Authors:

Mburu Nderesi, Master’s program in Global Public Health, Savonia University of Applied Sciences

Maria Luojus, Principal lecturer, Savonia University of Applied Sciences

Reference:

Balakrishnan, R., Allender, S., Scarborough, P., Webster, P., & Rayner, M. (2009). The burden of alcohol-related ill health in the United Kingdom. Journal of Public Health, 31(3), 366–373. https://doi.org/10.1093/pubmed/fdp051

Carvalho, A. F., Heilig, M., Perez, A., Probst, C., & Rehm, J. (2019). Alcohol use disorders. The Lancet, 394(10200), 781–792. https://doi.org/10.1016/S0140-6736(19)31775-1

Phillips, T., Coulton, S., & Drummond, C. (2019). Burden of Alcohol Disorders on Emergency Department Attendances and Hospital Admissions in England. Alcohol and Alcoholism, 54(5), 516–524. https://doi.org/10.1093/alcalc/agz055

UN, (2019). Home.:. SDG Summit 2019. https://sustainabledevelopment.un.org/sdgsummit Accessed 18.02.2023.

WHO, (2019). Global status report on alcohol and health 2018. World Health Organization.