Alcohol-related collateral harm in the family and social circle: The unseen dimension of alcohol-related harm?

First published: 30 March 2019 | Last updated: 20 May 2019

Ms Briony Enser

Prior to commencing her PhD, Briony Enser was a Principal at the Department of Health.  Most recently, she was working in the field of Public Health (PH) for ten years and before that she worked in the area of ethics and genetics.

Her most recent PH work included preparation of evidence for The Government’s Alcohol Strategy (HO 2012), analysis of the UK-wide consultation on alcohol labelling and writing the Consultation Report (DH 2011).  She also prepared the DH input to the National Audit Office report Reducing Alcohol Harm (NAO 2008), the ensuing Health Select Committee report and the Government Response (HOC 2010).  Earlier PH work for DH included liaison with the National Institute for Health and Clinical Excellence (NICE) on effective interventions for alcohol misuse, incentives for GPs on interventions, through the Quality & Outcomes Framework, including the QOF Adult Obesity Indicator, and the policy to introduce smoke-free public places.

DH work on Ethics & Genetics focused on the Government response to the Royal Liverpool Children’s Inquiry on the taking and use of human tissue.  The work ranged from close liaison with bereaved families seeking redress, to preparation of the inquiry response and subsequent revisions to informed consent procedures for taking and using human tissue.  Prior to this she worked on pathology modernisation, hospital acquired infection and antibiotic resistance policy.  Before joining Central Government, she worked in Welfare on appeals tribunals, and undertook her MA on day release.

Work carried out: Oxford Brookes University

Funding: None

Clinical trial reg: N/A

Role: Student responsible for all aspects of the project thesis, design and implementation, including data collection methods, recruitment and subsequent quantitative and qualitative data analyses.

Abstract: Alcohol-Related Collateral Harm in the family and social circle: The unseen dimension of alcohol-related harm?


The study contends that there is a dimension within the totality of alcohol-related harm that remains largely unseen; the harm caused to people around the drinker, Alcohol-Related Collateral Harm (ARCH).  This thesis is pursued through an examination of the extent to which young adults’ health and wellbeing are affected by others who misuse alcohol in their family and social circle and through consideration of the significance of the findings as a neglected Public Health issue.



Phase 1: An electronic survey collected quantitative and qualitative data on participants’ knowledge and behaviours around alcohol, smoking, diet and exercise to assess their relative health and wellbeing and to appraise their experiences of ARCH.

Phase 2:  A purposive sample of survey participants was identified for semi-structured interviews to follow up experiences of ARCH.  Thematic analysis of this ongoing qualitative data collection will classify the experiences reported, explore their relevance and assess their wider significance.



A sample of 450 university and sixth-form college students aged 16-24 was recruited for the survey. Interviews with up to 50 of these are ongoing.


Findings and conclusions: Phase 1

•Almost half (47%) of survey participants reported having personal experience of ARCH.

•Participants’ parents’ drinking every day was predictive of reporting a personal experience of ARCH.

•Participants reported an extensive range of physical and psychological experiences of ARCH, from the relatively trivial to the impact of the alcohol-related death of a family member.

•Experiences of ARCH reported in Phase 1 proved susceptible to coding and categorisation for subsequent incorporation into the ongoing thematic analysis of the Phase 2 data.


Director of studies: Prof David Foxcroft, Professor of Community Psychology & Public Health, Faculty of Health & Life Sciences, Oxford Brookes University; Second supervisor: Dr Jane Appleton, Reader in Primary and Community Care, Faculty of Health and Life Sciences, Oxford Brookes University


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