S6E1
· 47:22
Hello, and welcome to season six of Public Health Disrupted with me, Xand van Tulleken.
Rochelle:And me, Rochelle Burgess. Zand is a doctor, writer, and TV presenter, and I am a community health psychologist and professor of global mental health and social justice at UCL's Institute for Global Health.
Xand:But this podcast is about public health. More importantly, it's about the systems that need disrupting to make public health better. As UCL celebrates its bicentenary two hundred years of challenging convention, we're continuing that spirit by asking the difficult questions. What needs to change? Why?
Xand:And how do we get there?
Rochelle:In this episode, first episode of season six, woo hoo, I really feel that this is kind of a huge deal.
Xand:No. It's a big deal.
Rochelle:In today's episode, we will dive into how our relationship with alcohol is changing and why so many younger people are choosing to drink less or not at all. As Gen z and Gen alpha rethink what socializing looks like, whole new communities and ways of connecting are emerging that don't revolve around alcohol.
Xand:Our guests are gonna help us unpack what this shift means for our health and our well-being. We'll find out what the research tells us about changing attitudes, the risk of drinking, and what all of this might mean in the long run for public health. Well, our first guest today is Millie Gooch. She is the founder of the Sober Girls Society. She's a leading voice in The UK sobriety movement.
Xand:She holds a master's degree in addiction and mental health. She's written for publications including Elle, the BBC, British Vogue. Her debut book, the Sober Girls Society Handbook, was released in 2021. And in 2022, she received the media award from the research society on alcoholism for her work disseminating research on alcohol and creating more accessible conversations around alcohol free living. Millie's a proud ambassador for Alcohol Change UK, and her second book, Booze Less, was released in November 2024.
Millie:I was getting redder and redder than all that was going on.
Xand:That's good. You should you should feel very you should feel very proud of it.
Rochelle:It's absolutely phenomenal. Like, British, Oh, thank nice. Spectacular. And from UCL, we are so delighted to have doctor Melissa Oldham. Melissa is a principal research fellow and Griffith Edwards academic fellow at UCL, And her amazing research focuses on understanding trends and drivers of alcohol consumption at population level alongside much needed development and intervention that think about how to reduce alcohol consumption.
Xand:Welcome both. Thank you so much for joining us. So, Melissa, can you, start us off with the patterns we're seeing in alcohol consumption today and how it's changed?
Melissa:Yes. Absolutely. So we've seen quite drastic changes in alcohol use amongst young people over the last, twenty, twenty five years, so from kind of '2 thousand onwards. So amongst underage drinkers, so in The UK this would be people who are 18, we see that young people are or underage drinkers are less likely to drink alcohol at all. And when they do drink alcohol, they tend to drink less frequently, less in terms of volume, and also start drinking later.
Melissa:There's also some evidence that this is carried forward into young adulthood, and these changes that we're seeing are quite drastic. So to give an example of that, we saw that ever drinking amongst underage drinkers was around sixty two percent in 2003, and this fell to thirty nine percent in 2021. So there was, you know, a really substantial drop, and that's also reflected when we look at drunkenness. So when we look at the proportion of people who were drunk in the last week, we see a halving in the portion who report drunkenness in the last week between two thousand and three and 2021. In terms of why this might be happening, there's been a huge amount of research in this area.
Melissa:So the first thing to say is that this seems to be quite a global pattern. So it's something that we're seeing across a number of high income countries. So, The US, Canada, Australia, lots of countries in in Europe. So the timing and the scale of the declines vary slightly, but it it seems that it's, you know, fairly fairly consistent across lots of different high income countries. So it's unlikely to be one thing that's driving the declines.
Melissa:It's more likely to be a kind of culmination of factors or something that's happening wider. So we did some research, and we spoke to young people and we asked them what they thought might be driving declines in your consumption. So one of the things that they talked about was that they felt that they had a better sense of alcohol harm than previous generations potentially through school, but also through social media. Also through kind of personal experience. So young people that we spoke to talked about having a family member or somebody in their kind of extended network or a parent, for example, who might have had problems themselves with alcohol.
Melissa:So they kind of would would would had seen that and had see and were more aware of the the damage that alcohol could do. But they also talked about broader shifts in the way that they lived and that they socialized that impacted on how alcohol fitted into that as well. So to give an example, when I was growing up, when I was an underage drinker, we tended to kind of drink in the park outside of of houses or kind of in whoever's, house where their parents were away that weekend. And alcohol was kind of central to those socialization opportunities that you had when you were young, you know, in terms of house parties and those kinds of things. But that seems to have shifted a little bit and young people nowadays, they they talk about socializing in a different way and part of that is due to social media, so they, can socialize more online.
Melissa:They don't necessarily kind of meet up so much in person. But also just kind of a broader shift away from the central focus in alcohol. So there has been an enormous amount of research that has looked at kind of one or two individual factors and looks at how they kind of contribute to this trend. But, obviously, because of the scale of the of the changes that we're seeing, it's quite difficult to kind of look at one factor in isolation, and it's unlikely to be one factor that's ex that's explaining the declines. So what the leading researchers in this field so there's Professor John Holmes at the University of Sheffield, there's, Professor Rainey Purnay in in Australia.
Melissa:And what they suggest is actually we need to kind of take a step back from thinking about it as alcohol per se or, you know, one factor per se and think more about kind of generational side of things. And they suggest that actually what we're seeing with this kind of cohort or generation of young people is just a bit of a shift in in how they think about and and interact with the world. So there's obviously been the kind of upheaval from economic instability, there's pressures around climate change, there's pressures through through COVID, that kind of impacted on how people live their life, and the generation that are kind of coming through are just thinking about risk in a different way. So they're trying to offset risks in different ways. They're trying to ensure that they get good grades at school so they kind of don't have this, economic pressure.
Melissa:They have you know, they can get a good job. They can be safe. They can be secure. So it's it's not just alcohol. It's kind of all part of of a wider picture as well.
Xand:Millie, you're you're one of the drivers of this, but you're also one of the participants in it. Can you can you talk about it from your point of view?
Millie:Yeah. Of course. I mean, I think Melissa sort of summed it up really well there. It is a perfect storm of factors almost. I think, like, the economic side of it is a big one.
Millie:I think a lot of people can't afford to drink or drink as much as previous generations used to drink. And not just that they can't afford to drink, but they're having to get very, you know, particular about their choices of what they spend their money on. So they are weighing up. Do I want to spend my money on something that potentially the next day is going make me feel rubbish, or do I want to spend it on this really cool thing that I've seen? I think social media, for better or worse, has had a huge impact on this.
Millie:I think the good side of it is, like Melissa said, people are more aware of the harms now, and there's also more people talking about sobriety and being role models for not drinking. I think as well people are seeing that, you know, there's so many amazing things out there that they could do that isn't just drinking. Travel feels more accessible. Building your own business feels more accessible. So I do think we have to think about the, like, negative side of social media as well.
Millie:I know, like, there is a bit of a fear of kind of instant documentation. Even when I went out at uni, smartphones were not a thing, and now they are. So I think there is a risk that, you know, you might do something and it might end up going viral on the Internet. You know, Gen Z, they're they're just much more conscious consumers. They're really thinking about what they're putting in their body, what they're spending their money on.
Millie:I think they have a little bit more of a pause and reflect because there's so much information out there now. They just have the luxury of choice. The only thing I would say is from anecdotally and what I am seeing, think we may actually end up seeing a bit of a swing back over the next few years because I think, you know, sobriety or, like, non alcoholic drinks, everything has seen this incredible boom that actually now we're seeing a little bit of a pushback against that sort of culture because in some ways it swung into slightly a bit of a perfectionist era. So I think we're seeing the swing back of that and, you know, people saying that the world is on fire. So why should we be doing anything but drinking?
Millie:So I think it'll be interesting to see how it pans out over the next few years.
Rochelle:I mean, there's there's so much fascinating stuff in that to unpack. You've both painted a really interesting picture about our relationships to society and changing society and how alcohol consumption feeds into that. I think thinking about society like that, it actually brings us to a space where we talk about public health, living and thinking about public health, because that's where most of public health is negotiated, this relationship between itself and the world. And I wonder, Millie, what would you think about these connections between this teetotal movement and how we think about alcohol consumption and maybe promote alcohol, reduce alcohol consumption in a sort of a public health landscape or in a mental health landscape landscape?
Millie:I mean, I think for public health it is a great thing if it's sort of the infrastructure's there and the support is there around it because I think otherwise, you know, some people might get sober completely, isolate themselves, not go out, and and that can be just as equally detrimental to your mental health. So I think I think if it's like people have the support around them, then I think it can be a fantastic thing. Mean, there is such a one of the kind of latest things I've been looking at as well is, you know, the links between sort of like alcohol and neurodivergence. And we have these like huge waiting lists at the moment for people trying to get a diagnosis for this sort of thing. So I think, you know, I think it could only be a positive thing if people could stop drinking or drink less and actually maybe tackle the root cause because what we see most of the time is that people are drinking for a reason, and a lot of that reason is because they might be struggling, whether that is with a mental health condition or an underlying neurodivergence that they don't know about.
Millie:I would say most of our girls would like identify in that camp, so I think it can be an incredible thing, but I just think we need to, like, not tip into this, like, hyper performative, hyper sort of, like, perfectionist thing when people stop drinking. And I think some of the messaging about, like, not drinking has just become really about, you know, striving to be the very best version of you, and actually, it can just be like a really lovely thing to age your mental health. So I think we just need to be really careful about the messaging around it.
Rochelle:Yeah. It's this idea that it's just a much nicer way to enjoy your life. Like Yeah. Going going through life without a hangover is nice. Like, it's actually a nice thing.
Rochelle:And a lot of times we have this debate in public health about whether we go for positive messaging or sort of negative messaging.
Millie:I think that's it. Every time I speak about anything negative about alcohol, people disengage. They don't they know it. People know that alcohol is not the healthiest thing for them. They're under no illusion that, like, they don't think it's kale.
Millie:They know. So there's only, like, so many times you can tell people the negative things. I think if you say, actually, it's really lovely over here and there's no hangovers and you're member your night and you've got more money. Actually, that sounds really cool. And I think that was one of the things that I wanted is because my experience of sobriety, yes, has been hard, but on the whole has been incredibly positive and it's brought so much to my life.
Millie:So I always go with the mantra of like, What are you gaining from this? Than what are you giving up? I think with public health messaging, that's really important.
Rochelle:Yeah, really, and across all kinds of public health messaging. Melissa, you're doing some deep nodding there, you want to jump in?
Melissa:Yeah, think Millie is absolutely right. One thing to be careful about is not just kind of framing it as sobriety is the only option because a lot of people, enjoy drinking. They don't want to stop drinking entirely. So I think if we're framing it as kind of sobriety or nothing, then I think that could potentially be quite alienating. I think for a lot of people, their goal might be to drink a bit less.
Melissa:And from a public health perspective, we know that there's this dose response relationship between alcohol and harm. So the more that somebody drinks, the more that they are to experience harm as a result of their drinking. So any kind of reduction, in alcohol consumption for for people drinking above, you know, low risk levels is is a really positive thing in in public health. I would also say from a more pessimistic, unfortunately, perspective, I think in terms of when we think about what this means for for public health more broadly, it really depends on whether the trend for lower consumption is maintained over the lifetime, and the evidence on that is quite mixed. So to give an example, so we know that there are kind of particular acute harms that are associated with young people drinking alcohol.
Melissa:So there's issues in terms of brain development, but there's also issues around kind of victimization, accidents, all all those kinds of more acute harms. So reductions in alcohol consumption amongst young people is is a brilliant thing in terms of that. But a lot of the harm that's caused by alcohol is related to more chronic harms, so things like cancer, like liver disease, coronary heart disease, and these are kind of conditions that take time to develop over life course. So it's really important for us to understand whether this is something that is kind of the trends that we're seeing amongst young people are delayed initiation of alcohol consumption that is maintained, or whether it's just that younger people start drinking a little bit later but then go on to drink at those previously higher levels. Because if the second is true, then the public health benefits are going to be much less.
Melissa:There has been a little bit of research in this area and it is quite mixed. There was some research in Australia which suggested that delayed initiation of alcohol consumption or low consumption amongst underage drinkers was carried through to around age 24. But there's also evidence from other countries. So I think in in Finland, they found that actually younger people started drinking later, but then around kind of 18, 19, they did catch up to to what previous generations had been drinking. So I think, not to be too pessimistic about it, but I think if we're talking about those really kind of big longer term public health benefits, then understanding how that shifts over the life course is really important.
Melissa:And because we're talking young people in particular, there's research in The UK which says well actually it's really dependent on life courses and life decisions as well. We've talked a little bit about universities and we know that university has been historically a stage where young people's alcohol consumption skyrockets and all their kind of substance use and risk behaviors as well because they're away from home for the first time, they're living in a different environment. So we know that amongst young people who are going to universities that who have kind of come through that that cohort who are drinking less as as underage drinkers, we do see that their, alcohol consumption then kind of goes up again at those times. So that's not to say that they're drinking as much as previous generations of university drinkers, but there there is increases there. So I just think that that's something that we kind of need to bear in mind when we're talking about those longer term public health benefits as well.
Xand:Both of you seem to be emphasizing this really interesting idea that, you know, if you work in public health, the idea that we've seen this dramatic drop in drinking in young people, even in the short term, there will be benefits. It just feels like such a win. And you both drawn attention to the fact that this may originate out of the fact that young people are under increasing financial pressure, not just short of money, but also they they have to live a kind of high performance life that you are now meant to be optimized. And, you know, it may be great to start your own business, but it may again reflect the kind of relentless pressure of social media. So I feel like that's such an interesting thing that I I have not heard anyone say before.
Xand:You know, we typically celebrate these things in the public health community, and you're sort of going, look. This could be a warning sign of the terrible difficulties that young people face. It's not saying, oh, everything's great, they've stopped drinking. Am am I understanding that right from from each of you? Is that is that a thing that you're you're genuinely concerned about?
Millie:Yeah. I think so because I think, I mean, I I am sort of seeing this pushback against this sort of, like, perfectionist culture. I remember even seeing, like, a post this week that was, like, clean girl is out, messy girl is in, and I think it is this, like, rejection of this kind of hyper performative, like, wellness kind of era. So I do think we could actually be seeing a bit of a a swing back. But, yeah, I do think a lot of this was driven in the first place by the fact that people don't really have the money to be drinking, and also so many people are struggling with, you know, mental health issues, whether that's anxiety, depression, which sometimes as a as well as a result of things like the cost of living crisis, but also just, you know, the political landscape.
Millie:And I think people are, like, not drinking because they know how much it interacts with their mental health because they have that information now. So I don't necessarily think this came from, like, the loveliest place. I think people it came from a kind of necessity for a lot of people, really.
Melissa:Yeah. I think I would agree with that. So I think that that, obviously, the declines in alcohol consumption that we're seeing is obviously a really positive story for public health, I don't want to kind of lose that or change it to something else, but it's more just about understanding the context in which that is happening. Like you were saying earlier, structure is there to support this shift. Because one thing that we see alongside these decreases in risky behaviours that I talked about were there have been increases in mental health conditions amongst younger people as well.
Melissa:So just making sure that the kind of support is there, the systems are there, so that people can can get support if if and when they need it, essentially.
Xand:Yeah. And I I suppose I wasn't. I I I definitely I definitely did didn't want to lose the sort of positive view of it, but it it strikes me even when we think of things like the smartphone free childhood campaign that the smartphones may be responsible for the reduction in alcohol. That's not to say you wanna you wanna keep the smart you know, keep the kids on the smartphone so they don't turn to booze, but rather to sort of go, there may be unanticipated consequences of these things that you'd want to watch out for. If you got rid of all the smartphones in childhood tomorrow, as you sort of described and I remember from my childhood, you know, you may end up with more kids in the park with with tins of cider.
Melissa:And it's it's interesting because that idea that if you kind of took smartphones away and things would kind of recede is a really interesting one in and of itself because I think there's also been a shift in terms of how parents think about alcohol and about underage use of alcohol. And often parents talk about almost engaging in damage limitation, so most young people who drink alcohol, most underage drinkers, get alcohol now from a parent, whether it's their own or whether it's one of their friends. Often that's because parents are engaged in this approach to damage limitation. Rather than them, their children kind of accessing, alcohol that might be spirits or stronger alcohol from someone who they've kind of persuaded to buy it for them outside of a shop, they now will provide kind of lower strength alcohol. But there's not great evidence on on that as an approach, really.
Melissa:I think there's often research, I think it was in the Northeast about parents who kind of were teaching their children to drink and teaching them how to drink, but that doesn't seem to be associated with kind of better better outcomes. And I think it just highlights how important it is to think about systems and structure and other behaviours and other kind of pressures and influences in young people's lives.
Millie:You can't really ignore the role that drugs are playing, especially again when people don't have that much money. A lot of them are finding that things like ketamine and a night of ketamine is cheaper than actually a night of drinking. So if, say, you're going to Ibiza, like, spoke to someone, they were like, I can get an ecstasy pill for £10, and a bottle of water in Oshawa is £10. So I think as well, you've got to think about things like that. And I think it's not necessarily say my generation who are maybe the ones that are actually sort of like maybe rethinking their drinking habits.
Millie:But in terms of like young young kids, this is a lot of like the thinking process, and vaping is huge as well.
Rochelle:Yeah. It sort of makes me think when you're getting to this point about how you build, like, supported environments, you're actually talking about social change. So how would you both say that social change and social justice sort of maps onto how we enable sort of alcohol reduction and reduced consumption? Is that something because in public health, I'm a hippie, I talk about it, but I'm not always the only one like, I'm lonely saying, like, we need social change and we need social movements.
Millie:Yeah. Well, I think we do because I I think alcohol has gone, at least in my opinion, for something that was largely used for farming connections, something that is now primarily being used to cope by a lot of people, whether that is with, you know, financial uncertainty, political uncertainty, all of these things. I think I think it's slowly being changed of the kind of use of it. So I think there are so many systems and and, you know, I think even things like our our mental health services and our neurodevelopmental services and our alcohol services are completely well to part. So I hear from, you know, girls all the time that are trying to access one service, and they're being told, actually, you can't get mental health service until you stop drinking.
Millie:And then they'll go to an alcohol service, and they say, well, you've got really complex trauma, so actually, you need to go to a mental health service. They get better between both, and then they fall through the middle. So there's some real big changes and things like that that I think need to happen.
Melissa:Yeah, I think they're really good points. I think in terms of this idea of resurgence of youth drinking, I think what we tend to see in the data is that it's kind of tapering off. So it's not necessarily going back up, but the decline is certainly slowing in the last few years kind of after the the COVID pandemic. But I think the point about taking a broader approach is a really good one because I think a lot of people underestimate the impact that their environment has on them. But in The UK, we live in such an alchogenic environment.
Melissa:So if we think about, supermarkets, if you walk into a supermarket in summer or Christmas, the first thing you see is these enormous displays of, like, alcohol on offer. It's very cheap, but it's it's kind of accessible, it's affordable. If we think about social rituals, so when a baby is born, we wet the baby's head. When somebody gets married, we do a toast. That when somebody dies, we have a wake.
Melissa:So it's like alcohol is really kind of embedded within all these social but also environmental rituals. So I think when we're talking about, okay, how do we how do we keep this going in the longer term? How do we really kind of capitalize on the benefits of of the trends that we have seen in recent years? We need to think about, like you were saying, Rochelle, like, definitely social kind of change, but also structural change. So rather than just kind of encouraging people through public health messaging to make choices within within the world that they live in and within the system that they live in, we also need to say, okay, well, what other things can we do to make alcohol less prominent in society?
Melissa:So things like policy would be would be a good place to start, I would argue. So things like minimum unit pricing, which we've seen have a huge impact in Scotland in terms of alcohol, related deaths and alcohol hospital related hospital admissions. Having, policy which impacts on the affordability of alcohol, the accessibility of alcohol, and all that kind of happening in tandem with this social change that we're seeing that seems to be coming from a more kind of grassroots place. I think that's this kind of culmination of factors that together could really impact on on those longer term trends and longer term public health benefits.
Xand:Just on policy, both of you, can I ask about the the marketing of alcohol? Because I would imagine that the alcohol industry has not sat back quietly and let everyone stop drinking.
Melissa:Yeah. So I think so when we look at alcohol policy, we know that there are kind of three broad approaches that are the best buys in terms of reducing alcohol harm. One is affordability of alcohol. One is around the accessibility of alcohol, but the the third one is around marketing. There's advertising of alcohol.
Melissa:So we know that there we live like I said before, we live in this very an alcoholic environment where we're kind of exposed to different forms of marketing, and that's actually grown in so in the age of this new social media as well because there's kind of traditional marketing on social media platforms, but there's also user generated content and sponsored posts and influencer posts and kind of all these different factors which are kind of bombarding people and often particularly younger people, with with alcohol advertising. So it so it is a it's a really kind of big issue, and it's a and it's a big contributor. So alcohol policy that would affect the and regulate better alcohol advertising, I think, would be a really positive shift.
Xand:And, Millie, what do you see about the kind of marketing? Because I I feel like maybe I just noticed this as I'm getting older, but I feel like the marketing does seem to target younger people.
Millie:Yeah. A 100%. I think it's gonna be interesting to see how it all changes, like, over the next few years, especially with social media. There are some kind of, like, loose rules of, like, alcohol advertising, safer influences on social media, but, you know, I have seen many get away with not sort of, like, abiding by the rules. And, you know, they have rules like, oh, the influencer has to be over 25, but who knows what audience they have got following them.
Millie:So they're still seeing these messages. But also the fact that now a lot of these alcohol brands have zero zero brands as well, so a lot of them are able to now actually advertise in places that they weren't necessarily advertised before. So the actual branding is, you know, getting airtime. And I think it's only gonna get worse because I think especially what we're seeing with, like, you know, AI and things like that, we're getting really hyper targeted adverts. And it's actually looking like we might get to a point where, you know, these companies can understand when you're most vulnerable or susceptible to wanting a drink, and then they might ping you at a certain time.
Millie:Like, one of the things I've really been looking into lately is, like, delivery apps that now deliver alcohol that can deliver at, you know, any time. You might end up getting a targeted advert ping at a time when it normally knows that you order alcohol. So I think the landscape is actually gonna get a bit scary, I think the alcohol industry are relentless. So they will keep going.
Melissa:Yeah. I completely agree, and I think Melanie makes really excellent points. There has been some research which has looked at the industry response to declining consumption amongst younger people and it tends to be in two broad areas. So one is with no low drinks, so lots of drinks companies and big drinks companies now own their own or kind of buy up smaller, no low brands. And like Millie says, they these are then kind of advertised in a way often alongside alcohol options, but often kind of creeping into spaces where they wouldn't have been previously.
Melissa:So I keep getting notifications saying that I can buy a Corona Zero as part of my meal deal. So there are these kind of sneak in influencers through the Nolo market. There was research done at the University of Stirling where they spoke to young people about Nolo drinks and they just see the brand. They don't see the zero. So it's basically just putting alcohol into these spaces and familiarizing younger people earlier with, alcohol options and kind of drawing that connection.
Melissa:And the other more worrying response in a way to the trends that we're seeing is that actually a lot of alcohol industry focus is going into lower economic countries where we're not seeing the same kind of declines in in youth consumption. So there's targeting of younger drinkers in some countries in Africa, for example. So that that that the industry will always kind of respond to changes, and they will always kind of try and ensure profits, I guess, at the end at the end of the day.
Rochelle:Yeah. I think those commercial determinants have been getting increased attention in some areas and not others, but it's very clear that they're basically just building up sort of like historical brand loyalty. Picking up on your point about engaging in low resource settings on low income countries and low income country, thinking about how alcohol works as a coping strategy in those settings will also be really important because the wider sociopolitical economy of what people are drinking to cope with and manage with is definitely one of those things that requires public health to engage with, like, a political economy and, like, social justice needs because the thing that you're drinking to escape is sort of indiscriminate violence or high levels of violence and crime in your community and inability to ensure safety or all these sorts of types of much higher risk issues. So when you wanna think about it globally, this system's interconnected. I just feel like are we actually really talking about this?
Rochelle:This is as Zen said, this is the first time I've actually heard it this way. A lot of the communications we get around alcohol consumption are drink less or not at all. It's not safe. Nothing safe. The safest amount of alcohol is no alcohol.
Rochelle:But it might be really interesting to be like, stick it to the alcohol companies, drink nothing, save your money.
Millie:That's my favourite that you Don't did not like give them your money.
Rochelle:Keep your money.
Millie:Because I think like what you were saying as well with the the risk things, you know, a lot of people might be, drinking because they're in a traumatic violence, that there's, you know, there's domestic violence in their relationship, which a lot of the time can be fueled by drinking. So, all of these things sort of like weave in, like there's a lot of stats around, you know, a large people, like when they're reporting their sexual assault or talking about their perpetrators being under the influence of alcohol. We don't we don't talk a lot about all of these things because then those people can often develop trauma from these incidents and then turn to drinking as a coping mechanism. So it's it's all in connected and there's such a huge social justice element that I think unfortunately is sometimes ruined or like dismissed because if you talk about that element, people already automatically label you as preachy or, you know, we're allowed to talk about so many other industries. People are happy to put those under the microscope.
Millie:Unfortunately, when you talk about alcohol, as I have learned over the years, the first thing you get is, oh, how boring. Oh, I bet you're fun at parties. And and it's just it's a really hard message to communicate.
Melissa:My, my husband's favorite game is when we're in the pub with new people, he'll he'll be like, tell them what you do. Yeah. And and immediately, as soon as I because I'm I was how I work in public health research, and then inevitably, they're like, oh, what in? And you say alcohol, and immediately, people is like people, like, look at their drink and look at you. Yeah.
Melissa:And they kinda say, oh, I don't normally drink on a Tuesday, but and it's like, I don't I I did there's no judge I'm also in the pub. Like, it but it's yeah. It's, it is very funny. It's become this kind of wider moral issue as well, and I think that's something that's lost sometimes in the messaging around, the public health messaging around alcohol because we kind of say that the the or the public health messaging has shifted definitely to this no safe level approach and that the best amount of alcohol to drink is is no alcohol. And I think sometimes the the way that that message can be carried across kind of just isn't really accepted by the public and isn't kind of seen in that same way.
Melissa:And you also risk moralizing around it a little bit as well and saying, well then anyone who does choose to drink, that's a that's a moral choice. And I don't think that any I don't think anyone I know who works in public health would would think that way. We would kind of think more about the structures that exist to encourage people to drink alcohol, and I think, yeah, I think if there is any moralizing to be done about around the alcohol, then I think that's that's where that would lie rather than with kind of individuals who make make decisions.
Rochelle:Yeah.
Xand:But I think, I've seen it a lot with with the work that my brother and my wife do on food and when I broadcast on the food system as well. But as soon as you as long as you're talking vaguely about unhealthy food, people sort of are okay. But as soon as there's some idea that you might take away their chocolate bars, which is not a thing I want to do at all, but that's that's where the food companies that's that's the press line, that's the the nanny status, and they're gonna confiscate your chocolate bars. That's the line. If if people think you're trying to take away a thing they're addicted to, that hugely threatens their coping strategies in their their entire life.
Xand:And so, the resistance to it is a very, very effective industry tactic to mobilize if you if they can say you're trying to they're trying to take your booze away rather than going, you know, not are trying alter the environment that kids the marketing is yeah.
Millie:But it's so interesting because we're so willing to add things. I remember when I was drinking really heavily and it was destroying my life. I was in therapy. I was getting crystals. I was at any anything I could think of, like, went on antidepressants.
Millie:I was so resistant to giving this thing up that I was just adding, you know, mindfulness apps, anything I could, yoga, but actually looking at the one thing that if I removed it might have, you know, really helped with everything. I was just so resistant to change. There's something about the idea of having something taken away from you that I think is really hard for a lot of us.
Xand:Yeah. I yeah. Yeah. Yeah. That's so nice.
Xand:So much easier to oh, that's such a nice point. Can I ask just as a a point? Can a child walk in and buy a zero zero beer at a supermarket? Can is there any age restriction?
Melissa:It's messy. Come listen. Thanks. I'll try my best.
Millie:I'll let you take this off.
Melissa:It's it's messy. So we were we were looking at, this recently on a project that I was working on with Alcohol Change UK, actually, looking at, no lay use amongst adolescents. And I think I think I'm right in saying, at the moment there's no regulation. So legally, a child could buy a zero alcohol drink, but what happens is that the retailers are kind of engaging voluntarily in a system of treating it the same as alcohol. So there should be kind of challenge 21, challenge 25.
Melissa:But I think at the moment, the the government are looking to to introduce some regulation to to close that loophole, essentially.
Xand:Okay. Okay. That's that that makes sense because I I but I I bought the I know there's point 5%, and then there's the actual zero zero, and I don't know which I bought. I've definitely been aged yet for some of it. Okay.
Xand:That that makes sense. So so there is possibly a loophole. So no one's really no one's really bringing a can of Guinness zero zero to school in their packed lunch, but, but there's a way of by the time you get sort of 16, 18, certainly parents, friends may think that this is an acceptable thing to do, and the advertising is much less regulated is is Yeah. Is the point you were drawing attention to.
Melissa:Yeah. The the advertising generally with alcohol is is very poorly regulated in this country because a lot of it relies on a self regulatory code whereby the industry check whether they're adhering to the rules that are set around advertising. So if someone raises a complaint and they kind of decide how well that whether that's a fair complaint or how well they've kind of kept to the to the, rules. There's an amazing report actually, I've got the name of the author now, that kind of looks at how well that system works, and spoiler, it doesn't seem to be working amazingly well. It's interesting with parents, so we, like I say, we were working on this project with Alcohol Change UK and part of that project was qualitative work was led by my colleague Laura Fenton at Sheffield and Lucy Burke, and they spoke to parents and children within home environments.
Melissa:They did a joint interview, then they spoke to the child, and spoke to the parents separately. And actually the message that they were getting from both parents and young people in the study was that it wasn't that parents thought that, no, or low alcohol drinks were unacceptable in any way. They just didn't really think of them as being relevant to younger people, so they weren't really frequently providing them. Sometimes they were in kind of settings of celebration, for example. So, you know, we we maybe would have had schleur when I was younger, and maybe that's changed slightly now.
Melissa:But both kind of parents and young people tended to think of no low drinks as being more, for people who needed to reduce their alcohol consumption for some reason. So maybe pregnancy or maybe they kind of were drinking at risky levels or something like that or in a particular context, for example, driving. So that was kind of the the perception in participants in that study at least anyway around, yeah, the applicability of nadirals for for adolescents.
Xand:That okay. That makes sense. That's a great answer.
Rochelle:I'd like to start with you, Millie. Could you talk us a little bit about the work that you're doing to build community around this and and how you know, what that work looks like, not just building community, but also how people are trying to navigate this new identity in social settings where not drinking isn't the norm.
Millie:I started Sober Girl Society, I always say quite selfishly, because I didn't know a single sober person, and I had all these questions of, like, how do I go on a date sober? How do I go to a party sober? And my friends are like, you'll be fine. I was like, yeah, you can say that because you're gonna be really drunk, so you'll be alright. Like and I kind of wanted to meet other people, and I, you know, thought this is maybe a great way to do this, and 10 of us will go for non alcoholic drinks on a Friday night.
Millie:And it just sort of, like, spiraled. It became this community, and people were firing the same questions at me that I didn't know for myself of, like, how do you go on a night out sober? Like, how do you dance sober? And so I kind of started thinking, maybe let's all try and learn together. So I started running sort of like events and meet ups where the, you know, the first ones were just we would just go and chat to each other and talk about the things that we were going through and and and then we we were actually like, okay, so what things we needed?
Millie:So, like, one of the girls said, oh, you know, I I have no idea how to go on a dance or sober. That's actually one thing that's holding me back from, like, giving up drinking. So we were like, okay, cool. Let's do some dance classes. So we ran some dance classes.
Millie:The same thing happened when someone said, I've got no idea how to be sexy without alcohol on dates and things like that. So we were like, let's do some burlesque classes. And it just sort of went from there and every problem that anyone had, we were like, let's tackle it. People said, I don't know what I like doing for fun. So we're like, okay, Let's try 5,000,000 different hobbies.
Millie:Let's go to karaoke. Let's let's do this. And, you know, we just that is still the ethos to this day. It is like nearly eight years later, and we are still just doing stuff to help people tackle those things that they find when they stop drinking. And I think it's it's just so lovely because people come to events and they look terrified.
Millie:Like, they've never socialized alcohol before. They've never met new people. And then they leave and they're like, I loved this so much. And just to see people like recognize sounds very cliche, but, like, recognize the power that they have within themselves, that they actually don't need to rely on missing and they can get to uncomfortable situations. So I just think so many of us don't we give all that credit to alcohol.
Millie:We don't know that we can be far than confident and do all of these things without it, and that is really all I've ever wanted to prove. We say that we're open to super curious girls or even if you just want a night off drinking, like some of the girls that come to us say, you know, all my friends ever do is wanna they just wanna go out and drink, and I wanna do something different. So they'll come to us for that and say, we just really want to help people know that alcohol doesn't have to be the central focus of their life and help them tackle all those things that people struggle to do without alcohol. And, yeah, we get new faces home, we get people coming back, and yeah, it's just been lovely for myself as well.
Xand:He's there. I'm very jealous of this. I mean, it it sounds it sounds absolutely brilliant. I and I really remember going and and dancing sober for the first time in my thirties probably and being like, oh my god. This is incredible.
Xand:I mean, I'm not a good I should have taken your approach of having a a dance
Millie:to be a good dancer. As long as you can move your limbs, you can dance.
Xand:Think my wife
Rochelle:I think my wife would
Xand:would prefer it. Not with my wife. Wife. It's not. She'd rather I was doing a better job.
Xand:But but I I was gonna ask just is is there a, I mean, I'm is there an equivalent for for men? Do you know? Or have you had that conversation?
Millie:Some there there are little pockets here and there. It's not to the scale of what we're doing, and it's really interesting because I've had so many men message me and say, I'd love to start something similar. And I'm like, do it. I'll help you. And it's been eight years, and it's set to launch.
Millie:But there's so many, like, more men talking about this now. And I think there are a lot men of men, I would say over the last maybe, like, four or five years, a lot more men are talking about this. Because I think when I first started talking about it, it was all women. And I think it's the same sort of, like, maybe with the mental health conversation of like because it also ties in. I don't know.
Millie:I I think it's now become more acceptable. I think men had a harder time at the beginning to say to their mates, I'm not coming to the pub. You know, a lot of them don't have any other ways of socializing with their friends unless they're drinking, but I do think over the last four or five years, a lot more men have started speaking about this. So I'm hoping there'll be a sober guy society at some point, and I'd I'd back it.
Xand:So the last question. Melissa, can I start with you? We're interested in disrupting thinking everywhere, not just in public health. So we ask all our guests what piece of art, music, poetry, anything you like from your life has disrupted your perspective?
Melissa:I'll start off by saying I have been so stressed about this question. I've changed my mind about 45 times in the last two weeks.
Xand:Yeah. That's great.
Melissa:So, yes, I I switched my mind a lot and then I started reading in the last couple of days this amazing book called, Wintering by Catherine May, and that made it very easy for me. So, it's kind of, self confessional but kind of mixed with different different things as well. So, it starts off by talking about difficult periods in life, so this might be things, marked by loss, illness, change in circumstances, and she refers to them as as winters. And she argues that these kind of changes or these periods of winter aren't failures to kind of cope or interruptions to life, but they're rather kind of part of life's natural cycles and part of being human. So it's not that we have this kind of linear path that between birth and death that kind of keeps going up.
Melissa:It's more that we kind of have these cycles or these seasons throughout the lifetime, and some of them are summer and they're periods of joy and happiness, and sometimes we have to kind of retreat a little bit and and go into something that go into our own winters. And part of the reason that I really liked it, so she it's it's, kind of a memoir, so she talks about her own experience of ill health and life pressures which lead her to kind of enter one of these wintering periods. So each chapter tracks a month in this winter that she's experiencing, but alongside kind of talking about her experiences and her life during that period, she also talks about winter more generally, and each chapter focuses on a different kind of element or part of winter. She gives this amazing example of trees in winter and how they kind of change their system, they stop producing as much chlorophyll and then these colors that were in the leaves anyway, the oranges and the reds, but they were kind of shadowed by the green, you see more of them and then the the trees kind of prepare for this period of leanness or winter by kind of dropping the leaves.
Melissa:But underneath the leaves that have dropped, there's these buds which are kind of ready to to go again in spring. And it's so it's just it's all about essentially taking a step back, the importance of rest and and the importance of kind of giving yourself time to recharge. And I think it's so lovely because I'm definitely the kind of person that has this really kind of awful habit of seeing any kind of anxiety or struggling to cope as a sign of personal weakness, and I get very frustrated with myself. And I think so reading it really just kind of blew my mind as actually okay. Sometimes this is this is life and these are the circumstances, and sometimes it's okay to retreat a little bit.
Melissa:And, yeah, I thought it was a really, really lovely, beautiful, book, which I would recommend.
Xand:I love that to bits. I love a book recommendation. Your description of it was really beautiful. I mean, I almost feel like I don't need to read the book. I'm like, wait.
Xand:Melissa told me. I'm just gonna say, Melissa Melissa told me this great thing. It's great. Don't worry about it. Got I've got been calling you this great.
Xand:It'll take me it'll take me ninety seconds to explain it. Thank you for such a thoughtful answer, because I I love that. Millie, what about you?
Millie:I actually wasn't stressed, and Melissa's answer was so good that now I'm stressed. Because I feel like mine's really low brow compared. Mine is actually a Bruce Springsteen song, which is Dancing in the Dark, which I absolutely love. There is a line in there, which is you can't start you can't start a fire without worrying about your little world falling apart. And I put this song on and pumped myself up before anything I did.
Millie:Like, when I did my TEDx talk, I literally had it in my ears like this because I do have throughout my life that I think it's got way better as I've got older, but struggled with anxiety and, you know, worrying about what people think. And especially with the work I do, you have to put your opinion forward a little bit. And I I think it's been one of the things that I play to always remind me that, like, it's it's bigger than me, and everything I do is bigger than me. And it sounds very silly, but it also just hypes me up for things. That that disrupts my thinking regularly.
Millie:If I get into a spiral of, like, overthinking about the work I'm doing, and nothing matters, I'll remember, I shouldn't say this because that I put it on, and I'm like, yes. It it it disrupts my spiral.
Xand:I love that, and it's such a Millie, that's such a I I that actually sort of gives me a lump in my throat. I I I love that song to bits. And when you said, oh, there's this line that starts, you can't start a fire, I'm like, yeah. Yeah. I know the line.
Xand:You can't start a fire without a spark. And it's like, no, no, no. That's not the line. That's not the line. It's not that line.
Xand:I love that song, and I will never listen to it the same way again. So that is Oh, thank you. That is fantastic. No. No.
Xand:I'm very we're both very grateful to both of you.
Millie:Thank you.
Xand:Thank you both so much. Aw. Aw.
Melissa:It's been a joy. Thanks.
Millie:Oh, you for having us.
Melissa:Yeah. Definitely. Thank you very much.
Rochelle:You've been listening to Public Health Disrupted. This episode was presented by me, Rochelle Burgitt, and Zan Van Tulleken. It was produced by UCL Health of the Public and edited by Annabel Buckland at Decibel Creative. Our thanks again to today's amazing guests, Millie Gooch and Melissa Olden.
Xand:And as UCL celebrates two hundred years of opening doors, challenging the status quo, and pushing ideas forward, we are proud to keep that tradition alive by imagining what public health could look like for the next two centuries. So if you'd like to hear more conversations from UCL Health of the Public, make sure you're subscribed wherever you get your podcasts. Search for UCL Health of the Public to discover the latest events, news, and research.
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