Annual data on number of deaths, age-standardised death rates and median registration delays for local authorities in England and Wales.

Data on the number of alcohol related deaths in England and Wales in 2019, by gender shows that during this period there were *** alcohol related deaths in total, with more male than female deaths of this kind.

This statistical report presents a range of information on alcohol use and misuse by adults and children drawn together from a variety of sources for England unless otherwise stated. More information can be found in the source publications which contain a wider range of data and analyses. Newly published data includes: Alcohol-related hospital admissions published by PHE in their Local Alcohol Profiles for England (LAPE) which uses data from NHS Digital’s Hospital Episode Statistics (HES). New analyses of data on affordability of alcohol using already published ONS data. The latest information from already published sources includes: Alcohol-specific deaths published by ONS. Information on the volume and cost of alcohol related prescriptions from NHS Digital. Adult drinking behaviours from the Health Survey for England (HSE). Child drinking behaviours from the Smoking, Drinking and Drug Use Survey (SDD). Road casualties involving illegal alcohol levels published by Department for Transport. Expenditure on alcohol from the Family Food report from the Living Costs and Food Survey (LCFS).

This statistic shows the total number of alcohol-specific deaths in the United Kingdom (UK) from 1994 to 2023, by gender. The number of alcohol-specific deaths among males peaked in 2023 at nearly seven thousand, roughly double the number of female deaths, which also peaked in the same year at 3,490 deaths.

Deaths from alcohol-related conditions, all ages, directly age-standardised rate per 100,000 population (standardised to the European standard population).

Rationale Alcohol consumption is a contributing factor to hospital admissions and deaths from a diverse range of conditions. Alcohol misuse is estimated to cost the NHS about £3.5 billion per year and society as a whole £21 billion annually.

The Government has said that everyone has a role to play in reducing the harmful use of alcohol - this indicator is one of the key contributions by the Government (and the Department of Health and Social Care) to promote measurable, evidence-based prevention activities at a local level, and supports the national ambitions to reduce harm set out in the Government's Alcohol Strategy. This ambition is part of the monitoring arrangements for the Responsibility Deal Alcohol Network. Alcohol-related deaths can be reduced through local interventions to reduce alcohol misuse and harm.

The proportion of disease attributable to alcohol (alcohol attributable fraction) is calculated using a relative risk (a fraction between 0 and 1) specific to each disease, age group, and sex combined with the prevalence of alcohol consumption in the population. All mortality records are extracted that contain an attributable disease and the age and sex-specific fraction applied. The results are summed into quinary age bands for the numerator and a directly standardised rate calculated using the European Standard Population. This revised indicator uses updated alcohol attributable fractions, based on new relative risks from ‘Alcohol-attributable fractions for England: an update’ (1) published by PHE in 2020. A detailed comparison between the 2013 and 2020 alcohol attributable fractions is available in Appendix 3 of the PHE report (2). A consultation was also undertaken with stakeholders where the impact of the new methodology on the LAPE indicators was quantified and explored (3).

The calculation that underlies all alcohol-related indicators has been updated to take account of the latest academic evidence and more recent alcohol-consumption figures. The result has been that the newly published mortality and admission rates are lower than those previously published. This is due to a change in methodology, mainly because alcohol consumption across the population has reduced since 2010. Therefore, the number of deaths and hospital admissions that we attribute to alcohol has reduced because in general people are drinking less today than they were when the original calculation was made.

Figures published previously did not misrepresent the burden of alcohol based on the previous evidence – the methodology used in this update is as close as sources and data allow to the original method. Though the number of deaths and admissions attributed to alcohol each year has reduced, the direction of trend and the key inequalities due to alcohol harm remain the same. Alcohol remains a significant burden on the health of the population and the harm alcohol causes to individuals remains unchanged.

References:

PHE (2020) Alcohol-attributable fractions for England: an update PHE (2020) Alcohol-attributable fractions for England: an update: Appendix 3 PHE (2021) Proposed changes for calculating alcohol-related mortality

Definition of numerator Deaths from alcohol-related conditions based on underlying cause of death, registered in the calendar year for all ages. Each alcohol-related death is assigned an alcohol attributable fraction based on underlying cause of death (and all cause of deaths fields for the conditions: ethanol poisoning, methanol poisoning, toxic effect of alcohol). Alcohol-attributable fractions were not available for children.

Mortality data includes all deaths registered in the calendar year where the local authority of usual residence of the deceased is one of the English geographies and an alcohol attributable diagnosis is given as the underlying cause of death. Counts of deaths for years up to and including 2019 have been adjusted where needed to take account of the MUSE ICD-10 coding change introduced in 2020. Detailed guidance on the MUSE implementation is available at: MUSE implementation guidance.

Counts of deaths for years up to and including 2013 have been double adjusted by applying comparability ratios from both the IRIS coding change and the MUSE coding change where needed to take account of both the MUSE ICD-10 coding change and the IRIS ICD-10 coding change introduced in 2014. The detailed guidance on the IRIS implementation is available at: IRIS implementation guidance.

Counts of deaths for years up to and including 2010 have been triple adjusted by applying comparability ratios from the 2011 coding change, the IRIS coding change, and the MUSE coding change where needed to take account of the MUSE ICD-10 coding change, the IRIS ICD-10 coding change, and the ICD-10 coding change introduced in 2011. The detailed guidance on the 2011 implementation is available at: 2011 implementation guidance.

Definition of denominator ONS mid-year population estimates aggregated into quinary age bands.

Caveats There is the potential for the underlying cause of death to be incorrectly attributed on the death certificate and the cause of death misclassified. Alcohol-attributable fractions were not available for children. Conditions where low levels of alcohol consumption are protective (have a negative alcohol-attributable fraction) are not included in the calculation of the indicator.

The confidence intervals do not take into account the uncertainty involved in the calculation of the AAFs – that is, the proportion of deaths that are caused by alcohol and the alcohol consumption prevalence that are included in the AAF formula are only an estimate and so include uncertainty. The confidence intervals published here are based only on the observed number of deaths and do not account for this uncertainty in the calculation of attributable fraction - as such the intervals may be too narrow.

Annual number of deaths registered related to drug poisoning, by local authority, England and Wales.

Public Health England (PHE) has published an update to Local Alcohol Profiles for England (LAPE).

The LAPE interactive tool presents a range of alcohol-related indicators and allows users to view and analyse data in a user-friendly format.

The aim of the profile is to provide information for local government, health organisations, commissioners and other agencies to monitor the impact of alcohol on local communities, and to monitor the services and initiatives that have been put in place to prevent and reduce the harmful impact of alcohol.

This release includes new data for the following indicators:

• alcohol-specific mortality
• mortality from chronic liver disease
• alcohol-related mortality

View previous Local Alcohol Profiles for England updates

Relevant information from LAPE to aid in the understanding of alcohol-related harm in a local population is available from the https://webarchive.nationalarchives.gov.uk/20171107173418/http://www.lape.org.uk/">UK Government Web Archive.

Objectives: To evaluate the associations of status, amount, and frequency of alcohol consumption across different alcoholic beverages with coronavirus disease 2019 (COVID-19) risk and associated mortality.Methods: This study included 473,957 subjects, 16,559 of whom tested positive for COVID-19. Multivariate logistic regression analyses were used to evaluate the associations of alcohol consumption with COVID-19 risk and associated mortality. The non-linearity association between the amount of alcohol consumption and COVID-19 risk was evaluated by a generalized additive model.Results: Subjects who consumed alcohol double above the guidelines had a higher risk of COVID-19 (1.12 [1.00, 1.25]). Consumption of red wine above or double above the guidelines played protective effects against the COVID-19. Consumption of beer and cider increased the COVID-19 risk, regardless of the frequency and amount of alcohol intake. Low-frequency of consumption of fortified wine (1–2 glasses/week) within guidelines had a protective effect against the COVID-19. High frequency of consumption of spirits (≥5 glasses/week) within guidelines increased the COVID-19 risk, whereas the high frequency of consumption of white wine and champagne above the guidelines decreased the COVID-19 risk. The generalized additive model showed an increased risk of COVID-19 with a greater number of alcohol consumption. Alcohol drinker status, frequency, amount, and subtypes of alcoholic beverages were not associated with COVID-19 associated mortality.Conclusions: The COVID-19 risk appears to vary across different alcoholic beverage subtypes, frequency, and amount. Red wine, white wine, and champagne have chances to reduce the risk of COVID-19. Consumption of beer and cider and spirits and heavy drinking are not recommended during the epidemics. Public health guidance should focus on reducing the risk of COVID-19 by advocating healthy lifestyle habits and preferential policies among consumers of beer and cider and spirits.

Age-standardised rate of mortality from oral cancer (ICD-10 codes C00-C14) in persons of all ages and sexes per 100,000 population.RationaleOver the last decade in the UK (between 2003-2005 and 2012-2014), oral cancer mortality rates have increased by 20% for males and 19% for females1Five year survival rates are 56%. Most oral cancers are triggered by tobacco and alcohol, which together account for 75% of cases2. Cigarette smoking is associated with an increased risk of the more common forms of oral cancer. The risk among cigarette smokers is estimated to be 10 times that for non-smokers. More intense use of tobacco increases the risk, while ceasing to smoke for 10 years or more reduces it to almost the same as that of non-smokers3. Oral cancer mortality rates can be used in conjunction with registration data to inform service planning as well as comparing survival rates across areas of England to assess the impact of public health prevention policies such as smoking cessation.References:(1) Cancer Research Campaign. Cancer Statistics: Oral – UK. London: CRC, 2000.(2) Blot WJ, McLaughlin JK, Winn DM et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 1988; 48: 3282-7. (3) La Vecchia C, Tavani A, Franceschi S et al. Epidemiology and prevention of oral cancer. Oral Oncology 1997; 33: 302-12.Definition of numeratorAll cancer mortality for lip, oral cavity and pharynx (ICD-10 C00-C14) in the respective calendar years aggregated into quinary age bands (0-4, 5-9,…, 85-89, 90+). This does not include secondary cancers or recurrences. Data are reported according to the calendar year in which the cancer was diagnosed.Counts of deaths for years up to and including 2019 have been adjusted where needed to take account of the MUSE ICD-10 coding change introduced in 2020. Detailed guidance on the MUSE implementation is available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/causeofdeathcodinginmortalitystatisticssoftwarechanges/january2020Counts of deaths for years up to and including 2013 have been double adjusted by applying comparability ratios from both the IRIS coding change and the MUSE coding change where needed to take account of both the MUSE ICD-10 coding change and the IRIS ICD-10 coding change introduced in 2014. The detailed guidance on the IRIS implementation is available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/impactoftheimplementationofirissoftwareforicd10causeofdeathcodingonmortalitystatisticsenglandandwales/2014-08-08Counts of deaths for years up to and including 2010 have been triple adjusted by applying comparability ratios from the 2011 coding change, the IRIS coding change and the MUSE coding change where needed to take account of the MUSE ICD-10 coding change, the IRIS ICD-10 coding change and the ICD-10 coding change introduced in 2011. The detailed guidance on the 2011 implementation is available at https://webarchive.nationalarchives.gov.uk/ukgwa/20160108084125/http://www.ons.gov.uk/ons/guide-method/classifications/international-standard-classifications/icd-10-for-mortality/comparability-ratios/index.htmlDefinition of denominatorPopulation-years (aggregated populations for the three years) for people of all ages, aggregated into quinary age bands (0-4, 5-9, …, 85-89, 90+)

Deaths related to cannabis use in England and Wales amounted to 32 in 2024. This marks a decrease compared to the previous year, when the countries recorded the highest annual amount in the past 30 years. The number of cannabis-related deaths was lowest in 2011, at seven deaths, and since 2014, the annual number of fatalities has remained above twenty. Use of cannabis According to a survey, over 30 percent of the English and Welsh public admitted they had consumed cannabis as of 2023. Prevalence of cannabis use in the previous twelve months, however, was at just under eight percent. Generally, cannabis was not regarded to be as dangerous as other illegal or even legal drugs by the public. Over a third of surveyed British individuals considered cannabis to be not harmful, compared to only four percent who thought tobacco is not harmful. Caught green handed In the period 2022 and 2023, cannabis was by far the most common drug seized by the police and border force in England and Wales. Cannabis was seized over 140,000 times, with the next highest number of seizures involving cocaine at 19,000. Although, the majority of the British public supports a policy change regarding the legal status of cannabis. As of 2024, a share of 56 percent of surveyed Brits believed cannabis and other soft drugs should be legalized or decriminalized.