With its never-ending party scene, it is no surprise that Bristol has a significant problem with alcohol. In 2022, data from the House of Commons library revealed that Bristol was ranked as the eighth worst local authority area in England for alcohol-related hospital admissions, with death rates above the national average.
During the Covid-19 lockdowns, a study of 300,000 participants from the journal Addiction found that drinking habits in the UK had shifted towards at-home drinking. Each year, the Bristol Quality of Life survey (BQoL) takes place, sampling around 4,000 residents from across the city. The data from the survey is used to help the council understand the impact of alcohol-related issues and allocate resources to the areas with most need.
Before and during the lockdown, 15.5% of participants were “at a higher risk of alcohol-related health problems”. This has only recently begun to decline significantly to 12.6% in 2023. Initial reports from BQoL 2024/25 show that there has been no change.
The study reported that in 2023/24, Southville, Clifton Down, and Lockleaze had the highest percentage of participants identified as “at a higher risk of alcohol-related health problems”. All other wards fell within the Bristol average, except for Hengrove which was significantly better, with only 5.9% at a higher risk.
Situational and cultural differences
Consumption patterns across different demographics varied, probably due to cultural, social, and situational factors. In Bristol, men were more likely to have a “higher risk of alcohol-related health problems” (16.5%), than women (9%).
Studies by the Journal of College Student Development and Psychology and Health have shown that men may engage in risky drinking as “being able to hold your drink” is seen as a marker of masculinity. Risky drinking is associated with higher risk taking where the consumer is “signalling their indifference to both physical and social potential consequences” in an attempt to appear “tougher”. While direct comparisons between these studies and the BQoL are limited, this may explain the higher rate of risky drinking among men in Bristol.
Age is another factor that can influence drinking rates. In 2021, 16–24-year-olds had the highest drinking rate of any age group, at 21%, significantly above the Bristol average. The data also shows that in both 2020 and 2022, the rate for this age group was above average. In contrast, the drinking rates for those aged 50 and over and those aged 65 and older, have consistently remained well below the Bristol average. However, this data is limited as it does not include individuals aged 24–50, a large age group that warrants further investigation.
The BQoL indicated that full-time (13%) and part-time carers (16.6%) had alcohol-related health issues. The State of Caring report 2023, found that 79% of carers nationally reported feeling stress and anxiety out of a sample of over 11,000 which may explain the high percentage in Bristol; some carers turn to alcohol as a coping mechanism against stress and burn out
Lastly, the BQoL suggested that those with higher disposable income or financial security are more likely to have alcohol-related health issues, as some middle-aged homeowners (13.7%) engage in social drinking, as do some degree qualified individuals (13%) and non-degree qualified individuals who have higher paying jobs (11.9%).
While surveys are important in understanding the impact of alcohol-related issues in Bristol and help shape how the council allocates resources and support, they are not the whole story. Individuals may conceal or deny their drinking and associated health problems due to fear of shame. In the UK, alcoholism is rarely discussed due to social stigma, which frames it as a moral failing rather than a medical condition, which can prevent people seeking treatment.
Impact on families
Alcohol misuse in Bristol not only affects individuals but also families. The city reports there is a high level of need among individuals with co-occurring alcohol use and mental health issues. This has a significant impact on families within Bristol, especially the children of alcoholics as the level of need is above capacity.
Between 2018 and 2024, there were an average of 543 cases per year in Bristol where “Alcohol misuse: concerns about parent” was recorded at the end of a children and families assessment. This issue ranks among the top ten concerns identified during such assessments.
One service which supports children of alcoholics is the National Association of Children of Alcoholics (Nacoa). Nacoa’s 20-year helpline review, published in 2022, showed that over the past two decades Nacoa has been contacted over 370,000 times by individuals across the UK for advice in relation to a parent’s or loved one’s drinking. The highest number of contacts came from Bristol and the South West, unsurprising given the location of the charity in Bristol itself.
The review showed that one in five children live with an alcohol dependent parent and it can affect them profoundly. According to Nacoa, children of alcoholics are six times more likely to witness domestic violence, four times more likely to develop an eating disorder, three times more likely to consider suicide, and twice as likely to develop difficulties at school and get into trouble with the police.
Unfortunately, many will face these issues alone as the review revealed that over a quarter of callers kept their situation hidden throughout their childhood and even into adulthood, highlighting the lonely and frightening reality they face. This secrecy is a by-product of a dysfunctional family structure that teaches its members to deny their shared reality to appear ‘normal’ to the outside world through the mantra of “don’t talk, don’t trust, don’t feel”. Through fear of judgement and shame, this dynamic protects the alcohol user’s behaviour at the expense of the children’s mental health and, often, physical wellbeing and safety.
Shifting attitudes towards mental health and trauma have encouraged more children of alcoholics to open up. The report shows a decline in those telling no one – from nearly 40% (2001–2005) to 18% (2016–2020) – and an increase in confiding in partners, rising from 1–2% (2001–2015) to 9% (2016–2020). This progress stems from charities like Mind and Rethink Mental Illness, as well as Nacoa’s advocacy, awareness campaigns, and professional training.
Schools and colleges in Bristol, such as Snowdon Village and City of Bristol College, have also adopted trauma-informed approaches to support students’ wellbeing and academic success.
Generational drinking
Breaking the cycle of alcohol misuse remains challenging as children of alcoholics are three times more likely to develop alcohol dependency themselves, and wider trends in adolescent drinking suggest early exposure to alcohol remains a significant issue. The World Health Organization reports that England has the highest proportion of children at ages 11 and 13 who have ever drunk alcohol out of 44 countries (34% and 54%, respectively).
Research using data from the Avon Longitudinal Study of Parents and Children showed that children were more likely to drink at an earlier age if their parents were also moderate drinkers. Similarly, they were more likely to drink if their friends also drank and they are left unmonitored by their parents.
Another study in the West of England by BMC Public Health examined parental attitudes towards their children’s alcohol consumption. While not focused on Bristol, its findings likely reflect broader views across England, given the influence of societal drinking norms. The study showed many parents believed the wider community was more accepting of underage drinking and alcohol supply than they were themselves. They also felt that introducing alcohol at home acted as harm prevention, allowing them to monitor consumption and discourage excessive drinking outside the home.
However, this approach is risky. While well-intentioned, supplying alcohol to adolescents is linked to higher consumption and an increased risk of binge drinking and harm later. The risk is two-and-a-half times higher when alcohol is provided by parents, rising to fourfold when others also supply it.
Whilst more discussion is needed on the role of parents in underage drinking and how to shift these behaviours, proactive initiatives are already in place to reduce alcohol harm in the community by the council.
What is being done?
To fight rising alcohol-related health issues and deaths, Bristol City Council invests over £6.8mn per year in the Bristol Recovery Orientated Alcohol and Drugs Service, which has been providing advice on substance use, detox, rehab, and opioid substitutes since 2018.
Bristol received an additional £855,500 in 2022/23 to support those needing treatment who are at risk of rough sleeping through the Rough Sleepers Drug and Alcohol Treatment Grant. Young people are also supported, with Bristol Drugs Project (BDP) providing 1:1 support and group work sessions for those who use alcohol or other substances, or who have been affected by someone else’s substance abuse.
The council have also been working to shift the culture of drinking within communities by supporting alcohol-free events and spaces within the city. In March 2024, Bristol City Council, in partnership with the Tobacco and Alcohol Research Group of the University of Bristol, conducted a study which looked at the impact of making non-alcoholic beer available on draught in pubs. The eight-week study found that offering more non-alcoholic options can encourage healthier choices, as there was a significant shift away from alcoholic drinks when alcohol-free beers were readily available.
A recent study in Cambridge also found that reducing the size of glasses can have an impact on alcohol consumption. Removing pint-sized servings of beer, cider and lager led to a 9.7% decrease in sales of these drinks, suggesting that smaller serving sizes could lower alcohol intake for consumers.
Whilst further research is needed to assess the overall impact, the council could trial more non-alcoholic options or smaller serving sizes, such as capping draft alcohol at two-thirds per serving. Public health campaigns promoting smaller servings as a healthier choice could also be introduced.
Currently, Alcohol Change’s Dry January encourages people to reassess their relationship with alcohol, while independent events like those by Ravers2Runners offer similar challenges. The council could support or organise its own initiatives to further engage the public.
These practical measures are just one aspect of dealing with a complex problem.
The council has been working to change the drinking culture for the next generation through education. In 2020, they introduced a new health curriculum in schools to inform and empower students. They also launched the Bristol Healthy Awards scheme, which recognises students’ efforts in raising awareness and preventing alcohol and drug misuse. Students identified as ‘at risk’ will receive targeted support to ensure early intervention.
Bristol City Council says it is committed to tackling alcohol and drug misuse through policy, community support, and education. However, more targeted efforts may be necessary, as drinking is heavily normalised, and alcohol is readily available in shops and bars.
Those particularly at risk include higher-income groups, who experience higher rates of alcohol-related health issues due to their ability to afford it. Men, carers, young people, and children of alcoholics are also more likely to suffer from alcohol-related health problems.
While the reasons for this vary between groups, ranging from societal pressures to generational trauma, it is clear that open discussions and reducing the stigma surrounding alcoholism are vital in addressing the issue, as such conversations are empowering and allow people a space for reflection and change.
Ongoing campaigns to raise awareness of the associated health risks, as well as the promotion of low or alcohol-free drink options, are also crucial in creating a cultural shift. Further research is needed by the council, as the BQoL data excludes 24–50-year-olds, an age group that represents a significant portion of the population and must not ignored.
If you, or someone you know needs support with substance misuse, see Mind’s list of useful contacts for services near you.
For specific advice on how to talk to a child about their drinking, click here to access DrinkAware.
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