Youth drinking in decline with Dr Melissa Oldham

In this episode we talk to Dr Melissa Oldham about why alcohol consumption appears to have fallen amongst children and young people over recent decades. Evidence shows that overall falls in UK consumption have been driven entirely by young people abstaining more frequently from alcohol, and when they do drink drinking less, and less often. However, the reasons for the these falls remain uncertain. For instance what role have changes in parenting, availability, social media and other cultural shifts affecting children and young people had, and what can we learn from this?

Dr Melissa Oldham is a Research Fellow at University College London's Tobacco and Alcohol Research Group. If you are interested in taking part in research about drinking less, please visit www.ideastrial.co.uk.

Chapters

• 0:08 Intro
• 4:04 Why declines in youth drinking? Drugs? Social media? Parenting?
• 9:40 Supply and access to alcohol?
• 11:50 Should parents teach 'responsible' drinking?
• 13:17 Generational shifts?
• 17:56 Positive sobriety
• 20:37 Drinking identity and abstience vs moderation
• 24:38 A future focused 'best life'?
• 25:41 Mental health challenges
• 27:50 Reflections on Dry January
• 30:24 Where next for youth drinking trends?

Transcript

James Morris: 0:00

So thanks so much for joining me Melissa, can you tell us a bit about your research areas and how you got into this subject?

Dr Melissa Oldham: 0:08

Hello. So I'm primarily interested in alcohol through a kind of public health or health psychology lens. And I originally started off when I was doing my PhD looking at appetite and obesity research, and I got interested in the world of alcohol, because I just think it has such an interesting place in society. It's so ingrained in our way of life in terms of marking celebrations or events, even kind of to the point where you have different kinds of beverage that are associated with different events. So is it a celebration? If you don't have Prosecco? Are you upset and brooding, if you're not drinking whiskey, and I just think it's, that's really interesting. So I'm very interested in helping people who want to cut down on their drinking cut down. And part of the reason for that is because I think it's one of the only vices really where there's quite so many societal cues and peer pressure and things like that, to carry on engaging in that behaviour. So I've got two primary research areas. So one, like I said, is looking at developing behavioural interventions to help people who want to reduce their alcohol consumption. And I'm particularly interested in looking at targeted interventions, so targeted to particular contexts in which people drink. And then the second research interest is in examining trends in youth drinking, which is more what we're going to be talking about

James Morris: 1:26

And in terms of when you say targeted today. interventions, can you give some examples, you know, to mean things like apps or

Dr Melissa Oldham: 1:32

Yeah, so Well, there's a couple of things. So the one thing that I'm working on the moment is we're running a trial looking at Digital interventions. So we're comparing two different digital interventions, to see how effective they are in helping people reduce their alcohol consumption. And actually, that is ongoing. So if people are interested in reducing their alcohol consumption, they can visit ideas, trial co.uk, to learn more about that, and to potentially sign up, and then there's this other side, which I'm increasingly getting interested in, which is kind of looking at the contextual factors of drinking occasions, so where people drink who they're drinking with, and to try and essentially work out interventions that work for different people and different types of drinkers. Absolutely. I think that's so important that, you know, perhaps one of the limitations or big things that, you know, holds back things like recommended guidelines is that they don't take account of the huge number of different individual differences in in terms of the way in which people drink their motivations and their environmental influences on that.

James Morris: 2:36

So that sounds really important. And in terms of the digital interventions, how would you class those generally, sort of I mentioned apps, but there's also web based stuff.

Dr Melissa Oldham: 2:46

Yeah, so there's lots of kind of different support tools out there. There's quite a lot of websites which offer different strategies and tips and hints. So there's the NHS website, or there's alcohol change UK offer some tips on that as well, I think the apps are particularly helpful in terms of helping people track what they are drinking them to kind of set goals and to monitor progress against that, which we know is a really useful strategy to help people reduce their alcohol consumption. So yeah, there are lots of different ones. So I suppose it's very much people thinking about what what they want, and selecting one which works best for them.

James Morris: 3:22

So you know, we're kind of here really to talk about what's been happening with changes in alcohol consumption over the last few decades. So, you know, famously, there's been significant decline in drinking, almost exclusively driven, isn't it by younger people. So whilst we had a long period of overall rising consumption, around 2004, that seemed to peak and then has kind of been declining, but driven by falls in in kind of younger age groups. Can you tell me a bit more specifically about you know, what's behind that? And then some of the theories in terms of why maybe that's happening?

Dr Melissa Oldham: 3:57

Yeah. So as you said, we know that at a population level, youth drinking has declined quite substantially over the past 20 to 30 years. So it young people are drinking less, they often start drinking later on, when they do start drinking, they drink less frequently, and they drink less per occasion. So it does seem to be, you know, pretty consistent in that respect. What isn't completely clear yet, and something that we've been doing some work upon, is to work out how consistent that is across all young people. So one possibility is that it decreases in consumption amongst kind of the light or moderate drinking, majority of young people could actually mask maintained or increased consumption in those heavier drinking groups. And we know there's this dose response relationship that alcohol has where the more people drink, the more at risk they are. So that is a concern. And it's something that we we need to clarify. So we have done a little bit of work in this area, as I said, and it seems like we do see a little bit of a divide by So when we look at 11 to 15 year olds, so these are kind of school age underage drinkers, it does seem that the declines that we see, at least in our kind of school samples are consistent. So it seems that all young people lighter, moderate, and heavier drinkers are drinking less over time. But this isn't necessarily the case for slightly older young people. So when you look at 16 to 24 year olds, there is some polarisation in those trends. So what I mean by polarisation is that amongst lighter and more moderate drinkers, we do see these declines over time. But amongst heavier drinkers, actually, we see either small increases or maintain consumption. So this is a bit of a concern, because as I say, we know that kind of the harms of alcohol are are more likely in those heavier drinking groups. And we think part of the reason for this differentiation is potentially because of people are partaking in different life trajectories, or they've got different things going on. So in England, people leave school at 16. And they can go down quite different paths, they can either continue with education, and a levels and university or they might get jobs, they might go down to kind of a more vocational route terms of training. And it's possible that these different lifestyles are associated with different drinking patterns, though, for example, we know students are particularly heavy drinkers, but to go back to kind of that younger age group, which is kind of where those declines are most focused. There's lots of different reasons that people give for why this might be happening. So the first one that everyone always asks you about conferences and talks is, is drugs. So everybody always assumes that young people are just turned into drugs instead. And cannabis in particular is one that that comes up a lot. But the thing is that drug use or reported drug use amongst 11 to 15 year olds has has gone down in line with drinking. So it doesn't seem that young people are just shifting from alcohol to cannabis or to other drugs, it does seem that there's this very real decline across behaviours, particularly smoking as well, which has dropped really substantially. So to try and get into this a bit more. We've done some research at the University of Sheffield. And my colleague Victoria spoke to young people themselves to talk to them about what they thought the reasons were and to try and to kind of centre their voices in the debate and an actual fact the the reasons that they kind of gave and spoke about overlap a lot with those which are typically discussed in research. So I think two things that came out of those conversations and other research papers, which I think are really interesting and overlap quite a lot are around access, and also parental approach. So we know that regulations with the introduction of challenge 21 and challenge 25 policies, and it's much harder for young people to access alcohol now. And in fact, when you look at these kind of big national surveys, we know that where most people or most underage drinkers get their alcohol from is it is actually their parents. And one possible explanation for the decline is that this increase in focus on parental supply is being used as a kind of strategy of damage limitation. So it's possible that parents will give their kids a little bit , a smaller amount, or, you know, weaker alcohols, they might be more likely to buy them a few beers to try and avoid them going and finding a bottle of spirits from elsewhere, which is, you know, you get drunk much quicker and is more more likely to experience harms potentially,

James Morris: 8:30

That makes sense. Also, parental attitudes have probably shifted, you know, I think that over the last 20 years, we have seen a bit of a shift a positive shift in terms of recognising alcohol a bit more as a potentially harmful drug is way behind the curve in terms of smoking. But we are starting to see a think positive shift is kind of media and broader conversation, I think has really picked up so I suppose a tightening of parental control on children's access to alcohol, I think does make sense in that context. But also, you know, very anecdotally, I was a teenager in the 90s. And, you know, it was certainly very easy to get alcohol from off licences in particular. And I don't think that's the case now, I think there has definitely been a big tightening up of accessing alcohol directly from shops. But as you say, yeah, it's that kind of home route fire kind of parental supply, whether whether it's people kind of helping themselves behind their parents backs or wherever it's, as you say, a kind of more deliberate or controlled direct feed, and that comes in as well to where they're drinking it.

Dr Melissa Oldham: 9:38

So again, if you kind of look at these big data sets, and you look at trends in the locations people report, they are also increasingly report drinking at home at their own or another's home. So again, anecdotally, but when I was younger, we definitely drank more without our parents permission and we used to drink in public places in the park. Sorry to my mom, who will definitely listen to this at some point. But yeah, I definitely think there's been a shift in that and young people now are drinking at home. And I think that's again, I think it is probably this approach of damage limitation, I think it feels, to me as though there's kind of more threat around young people in public places, and perhaps more concerned about are the risks and if they're intoxicated than being more vulnerable to those kinds of things. So I think in terms of people keeping their kids in their own house and kind of giving them a little bit of alcohol, you can understand why parents would kind of go down that route.

James Morris: 10:34

Yeah, I think that's maybe a bit of a reflection of the cultural shift that alcohol was, and obviously, to some degree still is seen as a bit of a rite of passage of growing up, you know, when you're young, you party and have fun, and that, you know, invariably involves alcohol for many people, you know, part of that shift is maybe just towards bringing that into a bit more of a balance in terms of recognising Actually, there are very significant risks and dangers to it, not just in terms of personal safety, but now we know more about the negative effect of alcohol use on the adolescent developing brain. But in terms of giving alcohol to children, you know, again, a lot of parents will say, well, it's better that I kind of train my children to drink alcohol responsibly. But I don't think that really stacks up. I mean, yes, there is, it's true, that it's better there in a supervised environment where parents are seeing it, but the sort of idea of teaching people to drink responsibly, I think is is kind of flawed in lots of ways, not least just because of the negative effect of alcohol on adolescent brain. But you know, again, it goes back to what you're looking at in terms of the context, you know, drinking responsibly, or, you know, to use a better term drinking sort of moderately on low risk with your parents doesn't mean that you necessarily can do that when they're not that definitely,

Dr Melissa Oldham: 11:53

I think that's it is really interesting to know, there's a charity called balance in the northeast, and they've done a lot of work with parents in that region, where that that's something that they were hearing a lot is, we're teaching them to drink so that they exactly carry on doing that responsibly. And I do think that is, although you can understand it, I do think it's quite fluid logic, because we know that, you know, the younger young people start to drink, and the more they drink does predict what they drink later. So I think trying to speak to children about alcohol is is certainly a good idea and to discuss with them, you know, the benefits and the negatives of it. But yeah, whether you actually take that to train them to drink, I think is is a different story that's complicated.

James Morris: 12:36

And what about the sorts of pro social modelling or you know, influence in terms of parents own relationship with alcohol, that there was some theories that fall in drinking was because younger people didn't want to be like their parents who you know, kind of a boozy generation. But then actually, the evidence suggests that kids who have parents who drink more and more likely and overall to end up drinking problematically Is that right?

Dr Melissa Oldham: 13:01

Yep, absolutely. So there's, I think it's long waves theory, which says that essentially, different generations rebelled against what came before them. And it kind of goes both ways. And I think they're kind of lad ladette culture of the 90s was kind of in retaliation almost to those kind of more premiers occurred before. And there are people who, who Yeah, suggests that the the declining consumption now is in response to not wanting to be like their parents and wanting to do their lives differently. They definitely think for some people, you do see that. So to go back to those interviews with young people, you know, some some people did talk about parents who had heavy drinking at home and how that had put them off drinking themselves, because they didn't want to get into those habits. But as you say, I think overall, the relationship is there that if you are heavier drinking parent, there's more chance that the children will go on to drink more heavily as well. So how much that actually stands out at a population level? I'm not sure.

James Morris: 14:00

And it's also so difficult to you know, separate those confounding effects of heavy drinking parents, you know, are no is it? Is there a direct influence of seeing your parents drink more? And it's kind of normalising the idea of alcohol consumption? Or is it because parents who drink more like most people who drink more have a wider range of other issues, you know, mental health problems, stress, lower socioeconomic status, etc? It's just so hard to untangle all those kind of possible contributors.

Dr Melissa Oldham: 14:32

Yeah, absolutely. And the data is not great, either in terms of linking, you know, the, the adult data with the with the child's data to really unpick those issues and to and to get at it. So, yeah. What about this massive shift in terms of digital and social media? You know, obviously, as you said, a lot of people say probably, they're not quite right in saying, Oh, well, you know, they're probably just using drugs instead.

James Morris: 14:59

But you know, this idea that social media, you know, via a number of possible routes has contributed to drinking less? What are the sort of main ideas behind that? And do they stack up?

Dr Melissa Oldham: 15:09

Yeah, so it's such an interesting one. So one thing to know, with the declines are that they are very widespread. So they're also seen in Australia, North America and Europe. So you know, it's, it's doesn't really stack up to say that it comes down to one discrete thing. But I do think there have been such changes to people's lives in terms of social media and the effect that that's had on kind of norms and cultures for different age groups. And I do think that that is probably one of the big influences. So there's lots of research on it. But the problem that we have is that social media is such a vast and an amorphous concept, it's really difficult to study. So when I was growing up, we had MySpace, and Bebo, and that was about it. Whereas now there's all these different different platforms. So Instagram, there's Tick Tock weebo, there's probably 100, much cooler ones that I've never even heard of. It's so hard to kind of to get out what effect that has, because the different platforms will attract different kinds of groups and young people. So we do have some studies, which suggests that young people who use social media more are more likely to drink more. And a couple of kind of the mechanisms that people think might explain that is because they might be more exposed to marketing. So there's a lot of social media marketing around alcohol, or it could be that those groups who are using social media more are generally more sociable, have more friends, and more likely to go to parties. Whereas there's other studies which have shown kind of the reverse of that, so that people who use social media more or have less face to face contact with their friends and more online contact, actually drink less them. So you just, it's very difficult to quantify exactly the effect that that's had. But I do think in terms of thinking more generally about social media, and the influence that that has had it kind of young people now I would say, are a lot more aware of, you know, the world outside of their own, and other things that are going on. And there's this kind of idea in social media of living your best life and and showing your best life, whether that's representative of your natural life or not. And I think that that's one thing that young people don't want to be seen to just be drunk every weekend, or they want to engage in kind of these different exciting activities, whether that's art and cultural activities, or whether it's more sports. So I think that kind of lenses as adjusted alcohols position in young people's lives, and it's not the same kind of focus as maybe it once did.

James Morris: 17:48

I think that's so relevant, because, you know, it's related to, is to what we've seen in terms of positive sobriety or sober lifestyles, or however it's best described? Again, it's hard to say, to what extent that might be kind of a reflection or a driver of of kind of falls in youth drinking, but you know, there is a really strong, you know, certainly social media presence around these kind of more, as you say, lifestyle or living your best life type lenses in which kind of not drinking has really become predominant. And, you know, we can can name lots of different movements or influences who who kind of maybe embody that. But yeah, do you have any thoughts on how that might be is connected?

Dr Melissa Oldham: 18:33

Yeah, I think it is really interesting, you see, so there was some research that was done in Australia. And they found actually, that young people talked about kind of authenticity when they were talking about alcohol. And I think some work that was done, you know, in the 90s, showed that people kind of used alcohol as a way to be more themselves and to loosen their inhibitions and to be who they really were. Whereas young people, at least in that study, kind of talked about alcohol owes as doing the opposite of that. And they thought actually, the not reliant on alcohol, where they might get a bit silly, or they might say things that they they didn't mean, they thought it was actually better to kind of be sober and be true to themselves and their personality. So I thought that was really interesting. And when you look at university students now I think university students are a particular group that are kind of synonymous with this really heavy drinking culture. But you do see groups of students who are really going against that, and they kind of have this identity almost that's that's formed by their abstinence, or at least is kind of what links them and they kind of champion doing different activities that aren't where the focus isn't alcohol. So I think there was a group that did a lot of like rollerblading and things like that to try and kind of get away from those traditional kind of socialisation activities.

James Morris: 19:55

Yeah, so interesting, and I think we know from addiction recovery researchThat drug or alcohol use can be, you know, really important, or really significant part of your, your social identities. So recovery is often marked by this big shift in identity in terms of how, you know, you kind of perceive yourself, you know, which, when you're maybe in the height of substance use or addiction, that's a big part of who you are. And you frame it may be, you know, by focusing on the positives, and that's supported by all your social networks, but equally, when people have kind of rejected that and moved into recovery, the same happens, but you know, in reverse, so I think, you know, so much to be said about that, because alcohol is such has such a prominent place in society, you almost have to set out your stall in terms of what your relationship is, with alcohol in so many different social contexts, you know, do you drink? Or are you not a non drinker? And if so, you kind of there's a lot of pressure or expectation for people to kind of mark that or kind of communicate or signal in some ways. And I think for me, that's a bit of the problem with the kind of, you're either abstinent or you're not type idea, because there's lots of people who might cut down or moderate their drinking, but that's quite a difficult or absent identity in the kind of general culture that you know, people call as Adrian Charles says, they can't quite compute the idea of moderation. So you have to kind of set your stall out as either an abstinent or a kind of drinker of some sort.

Dr Melissa Oldham: 21:24

I think it's just so much more grey as well, that kind of moderation element. And I do feels to me as though it's more open to peer pressure. And people kind of say, No, come on, come out. Or if you're there, or why you have in lemon sodas, come on, have a beer Don't be a wuss, and that that kind of attitude, whereas I think if someone is kind of has this identity as No, I don't drink at all, I'm sure they do experience some some peer pressure. But I imagine, you know, after a while, people would be less likely to do that, perhaps.

James Morris: 21:54

Yeah, I think I mean, certainly from my own experience that, you know, I didn't drink for eight years. And the challenges in terms of peer pressure were quite different, but similar in some ways. So in some cases, you are just obviously ostracised for not drinking at all. But your store was very clear, you weren't going to drink and nothing was going to change that. But I think in both you kind of developed strategies to manage those situations. So now as a moderate drinker, you can fit in or blend in with heavier drinkers if you need to. And just pace yourself as long as you avoid by rounds or so. Yeah, I kind of agree it's, but it's, I guess, I guess, yeah, again, it depends so much on the context and the individual and the motivations.

Dr Melissa Oldham: 22:38

I suppose the other thing about kind of that moderate drinking, and I mean, I'm talking about this, from a personal perspective is once I've had a couple of drinks, I think I'm definitely more susceptible to having a couple more. So I think that would kind of be I mean, obviously, that's in kind of a more social context. But I think I would definitely be firmer at the start of a night that I was only going to have two pints say, then I will be by the time I'd had those two pints, if people were Yes, you know, say, Go and have another one.

James Morris: 23:07

Well, that marries up with the sort of evidence in terms of succeeding at control, drinking or moderation. You know, it really does rely on having very clear boundaries, which you you know, you don't really they're not really up for negotiation, if you like, but at the same time, you know, when I started moderate drinking, I was crystal clear about what those boundaries are. And now I've just kind of relaxed a bit, because I know, you know, I've just got used to my social networks, and my identity, and the expectations on me aren't so great to kind of pressure me to drink more, if you like. And so in terms of these falls in youth drinking, are there any other kind of key factors that we haven't touched on that may be contributing to this? So we kind of talked about, you know, changes in parental styles, possible roles of social media and drugs, and these changing social norms may be an identities?

Dr Melissa Oldham: 23:59

Yeah, I think one thing that came out of some of the research, which I think is really interesting is that young people are more future focused. So I think this is partly to do with disposable income and the economy and all those kind of elements. But there is this sense amongst young people that they really need to spend their time doing schoolwork and getting to a point where they'll go to university or they'll go down a different path, but they'll have a good job at the end of it. And they young people certainly think of themselves as being more future focused than previous generations, in interviews with them. And I think that is really interesting, because you do see there a difference between different socio economic status groups. So that kind of attitude and outlook is is definitely more prevalent amongst the kind of higher sex or the more well off groups. So how much of that is kind of been driven by parental influence or those kind of elements? I'm not sure but That is definitely something which Yeah, there does seem to be a discrepancy there.

James Morris: 25:04

And I can't help but wonder, you know, there's a lot of worrying figures about kind of mental health issues that younger people are facing overall. And you know, I can't help but think that so much of that is linked to the pressures that young people face and the uncertainties they face about know what kind of job that they might possibly be able to get or what kind of career because those opportunities just seem to be diminishing and kind of longer term?

Dr Melissa Oldham: 25:30

Absolutely. I mean, with the effect of COVID-19 and the lockdowns on inequalities adjust are already huge and are the worrying thing is that it probably will just make them more ingrained and just have such a long term impact. If you look at kind of the data, young people are one of the groups who are citing kind of the most negative effects to their well being and like you say, a big part of that is because the uncertainty about where they're going to be and the the opportunities they're going to have what's going to happen with schoolwork and university and all those elements where it's you know, it's obviously it's an incredibly worrying time for everybody. But I think at least if you're kind of set in a career path, or you've, you've got a job and you've got experience, then perhaps it doesn't feel quite as World altering. So I have two sisters 16 and 18. One started uni during the pandemic and one who's kind of going through the process of a levels, and the disruption to them has been absolutely enormous. They've had exams cancelled, you know, schools on and then it's off again, and they're encouraged to go to holes, and then they're encouraged not to, and it's just affected kind of every element of their lives. So you can completely understand why young people are experiencing all these negative effects.

James Morris: 26:49

Absolutely. It's so worrying. And I do think, you know, as well as the older groups who are particularly vulnerable in health terms, I really just feel for the younger people, you know, thinking back about how important my social life was to me in my younger years. And so, you know, we discussed a bit about, We fess d up about our some of our pa t drinking in parks and whatno. But did you attempt to d y January? And if so, what was t e sort of experience you had wi h i

Dr Melissa Oldham: 27:17

Um, yeah, so I did do dry January, actually. It's normally forbidden, because my best friend, it's her birthday in January. So I'm never normally allowed to do it. But I took the opportunity of social isolation this year to do it. And actually, I must say, I've quite enjoyed it. So I would say that I like to drink and, you know, sometimes perhaps drink too much. I think particularly over Christmas, because I live in London, and I wasn't able to kind of go home and see family. Don't get me wrong, I'll put my violin away, because we did have a lovely time, but to whom it was we definitely kind of got into the habit of drinking more while we had a bit of time off over Christmas. So I think it kind of got to that point where January started, we thought I was quite a good opportunity and to stop for a while. And I thought I'd struggle a lot more than a half. But I suppose for me, I'm quite a social drinker. I like going out with friends. And I like going to the pub. So had those elements been there. Perhaps I would have struggled a lot more with it. I'm not sure. Yeah, it's interesting, because on our previous episode on defensive and MC, one of our our guests said that she found not drinking a lot easier because she knew the pubs were closed. So I would say there was one night I can't remember what we were watching now. But we were watching something and someone handed some what a glass of whiskey and I was like, oh, maybe I'll get a drink. And then and then I remembered it. But that was one of the only times really that I've felt like that craving. But yeah, I do think it would definitely be different if I was more of a more of a home drinker.

James Morris: 28:51

Yeah. It's interesting, because, again, in the previous episode, Emily and Dawn, did some research, you know, found the people that some people that they spoke to lockdown, and the change in circumstances actually triggered this kind of reflection reflective process, and to really carefully evaluate, you know, what does it mean if I'm drinking at home, and what my reasons for doing that? And yes, I suppose that is a such an outlier this year, assuming that God forbid, will be some form of lockdown again next January. But But yeah, but yeah, again, it goes back to your kind of work around the contexts. It's it's just so significant isn't it was different environmental and social factors that influence our drinking motives?

Dr Melissa Oldham: 29:35

Yeah, absolutely. We're actually in started a paper drafting paper, which looks at kind of the differences between people who are doing dry January this year compared to last year to kind of the different drinking characteristics and socio demographic groups that are kind of more engaged with it, perhaps this year or less engaged with it this year. So I think that will be really interesting because, as you say, it's just absolutely catastrophic changes to people's lifestyles and routines. So, we know that you know the pandemic and the lockdowns have had a polarising impact on drinking where some people are drinking more, some people are drinking less. So I think it would be really interesting to see those groups who are kind of engaging with dry January, perhaps for the first time this year. And so in terms of thinking forward about youth drinking and the trends, I think there's some evidence that young people in Britain still drink more than the European average. So even though overall, the decline is really positive, certainly in terms of like 11 to 15 year olds, you wouldn't want to see any drinking amongst those groups. But do you have a sense of where we might kind of go from here, what might happen with those trends, or how we might best be thinking about kind of taking some of those lessons into a be think about how we can achieve reductions in drinking amongst other age groups where there haven't been those falls, but also, there's some very harmful drinking patterns and consequences. Yeah, it's really interesting. So in terms of Great Britain's kind of position, into in terms of Europe, at least, we have actually changed quite a lot. So I think we used to be one of the worst, perhaps even the second worst, around 2002. So this is adolescent drinking. And actually, the declines in kind of youth drinking are bigger in Great Britain than in than in other places. So we've actually, we're not quite as bad as we used to be when you kind of look at cross country comparisons. But definitely, there are still, you know, there's still too much drinking amongst particularly 11 to 15 year olds where, like you say you, you wouldn't want to see any rarely, because they are so vulnerable to kind of the negative effects. I mean, nobody really knows what's going to happen with the, with the trends. So one thing we have seen in the last three or four years is actually those declines are levelling off, at least in England or the UK. So they seem to kind of have got to a point and now they're just been maintained. So whether that will, you know, stay a stable level or whether it could potentially start creeping back up? Again, nobody's really sure. And I think that's one of the reasons that people are kind of so invested in understanding what's driven the decline so that we can kind of capitalise on that and encourage further declines. And I think it's really interesting, you know, when you think about different age groups, because certainly traditionally, and you know, in terms of media coverage, I think most people would have this idea that, that young people are, you know, the problem group, they're the ones going out every weekend and getting drunk and falling out of bars and having fights and all those kinds of elements. But actually, when you look at kind of trends in alcohol consumption, the increases in consumption, and the kind of heavy harmful consumption a lot of the time is, is happening in middle age groups. And it's not necessarily that people are going out all the time, but it's drinking at home. And we think a lot of that is because there's kind of increase in availability of cheap alcohol sold at all hours of the day, and you know, most shops that you go in, and it's just so available. So people kind of fall into these habitual drinking patterns where they have, you know, a bottle of wine a night or a few times a week. And that's actually, you know, really quite harmful over a period of time and is much higher than the guidelines suggest is, is a safe or at least low risk level.

James Morris: 33:18

Absolutely. And I think, again, in the previous episodes, I think that reflects the a lot of the discussion where many people sort of working in the alcohol field feel that that is practical, or pragmatic, or desirable to try and shift that balance so that more consumption, more drinking takes place in regulated environments and pubs and you know, away from the home home environment, which is so unregulated and a lot of people say that there's far less checks and boundaries on on the kind of drinking and and it's so easy to do just on a regular basis. So yeah, I think there is a lot of favour in the alcohol field on the whole or a lot of recognition for Yeah, just not labelling pubs as as bad places, but rather than a kind of an opportunity for less harmful drinking patterns to emerge as can much more easily occur in in kind of home context. Well, thanks so much for Yeah, it's been really, really good.

Dr Melissa Oldham: 34:16

Oh, thank you for having me. I really enjoyed it.