At 3am on a Saturday night in Croydon High Street, the bars and clubs are kicking out. Hundreds of young people pack the street, shouting drunkenly and milling around, reluctant to go home. There is an aggressive edge to the crowd that makes the heavy police presence reassuring. "There's always a meat wagon and an ambulance parked here," says Dean Leahy, 24, who has been drinking in Croydon for years. "You get a lot of fights. It's a war zone; the bouncers don't care what happens on the street and you can't police it. There are just too many people.
It is one year since the licensing laws were changed and it's hard to imagine a scene more at odds with the continental café culture that ministers had hoped would flourish once drinking hours were extended. "Nothing has changed," says a barman working in Yates's, a busy night spot on the High Street. "It's the same story - except now everyone gets booted out between two and three in the morning."
The Home Office and the Department of Health say there is "no indication" that the change in licensing laws has had a negative impact on alcohol-related crime or public health. But that is not the point; Britain is in the grip of an alcohol epidemic that the Licensing Act has proved completely unable to arrest. It was supposed, at the very least, to stagger the flow of frustrated drunks on to the streets and, by ending the race to get tanked up before last orders, reduce crime and curb binge drinking.
Every Friday and Saturday night 70 per cent of all A&E admissions and 80 per cent of pedestrian road deaths are alcohol related, while the cost of alcohol abuse to the UK economy is estimated at £20bn a year. A report from Alcohol Concern earlier this month put the number of alcohol-related deaths at more than 22,000 a year, nearly three times the official figure of just over 8,000.
Most alarming is the discovery that those least able to handle their drink have taken to the bottle as never before. New figures reveal that the number of under-18s admitted to hospital with alcohol-related conditions is up by more than 20 per cent in the past five years.
Dr Nick Sherin, a member of the Royal Col- lege of Physicians Alcohol Committee, is concerned but not surprised. "Deaths from liver disease have doubled in the past ten years and the people I am seeing are getting younger. Evidence suggests that the earlier you start drinking the more likely you are to develop problems with alcohol dependency."
The implications for future public health are disastrous. Worse, the full health impact of excessive alcohol on the young is still unknown. "The adolescent brain is vulnerable and it remains a strong possibility that heavy drinking could cause lasting damage," says Sherin.
Carole Whittingham, the national secretary for the Campaign Against Drinking and Driving is deeply worried by the rising alcoholism among Britain's youth. "Young people go out with the deliberate intention of getting as drunk as possible," she says. "Seven years ago I would have said that young people were responsible and that drink-driving was primarily a problem of middle-aged men. That's no longer the case. We are seeing more young people and more young women convicted of drink-driving."
It is not just that young people are drinking more; there has been a huge shift in gender behaviour. Teenage girls in Britain are now drinking more than boys, according to a recent European survey. Almost a third (29 per cent) of female students admit drinking to excess at least three times a month, compared with 26 per cent of boys, while consumption among women of all ages has doubled over the past decade. Britain and Ireland are the only two countries in Europe where girls drink more than boys.
The causes for heavy drinking are complex but the British Medical Association identifies two key factors: price and availability. Alcohol is getting cheaper. In the past 40 years alcohol consumption per person (aged 15 plus) has doubled and the price of alcohol relative to income has halved. The number of shops selling alcohol has risen sharply and a third of all 24-hour lic- enses granted were given to supermarkets, where alcohol is cheapest. It is not surprising, then, that the consumption of alcohol outside licensed premises is on the rise.
Pressure group Action on Addiction (AOA) is one of a number of organisations campaigning for an increase in the price of alcohol. "Research shows that the higher the price of alcohol relative to income, the less the nation as a whole drinks," says Nicola Brian, a spokesperson at AOA. "We believe that raising the price would have a significant impact on young people who are more likely to have lower disposable incomes."
Sherin agrees: "I don't think anyone could argue against increasing the price of alcohol to pay for the damage it does. We need more nurses trained to spot and deal with alcohol problems and we need more counsellors and detox beds."
However, any price increases brought in by the government could be made largely redundant by the European Court of Justice, which is about to rule on the legality of Britons ordering alcohol from another country and having it delivered to their doors free of excise duty.
Within a few years, British drinkers could find it even easier to buy cheaper booze from countries such as Germany and Spain, which have zero duty and low VAT. The increased availability would reduce British prices further.
The government's only hope of combating a growing disaster is to change public attitudes. In October this year, the government launched its first national alcohol awareness campaign. The slick £4m "Know Your Limits" campaign is designed to shock. In one TV ad, a drunken man, fuelled by Dutch courage, attempts to impress a group of girls by rescuing balloons caught high in some scaffolding. He plunges to his death.
Frank Soodeen, a spokesperson for Alcohol Concern, welcomes the government's commitment, but adds: "It needs to be part of a sustained strategy. This campaign targets 18-24 year olds but we also need to target under-age drinkers. The problem is, you can't switch from one to the other. You need sustained campaigns targeting both. The obvious problem is funding."
The advertising drive does not ignore the responsibilities of the drinks industry. In October 2005, new Ofcom regulations came into force, which tightened the rules on alcohol advertising, to ensure that alcohol is portrayed in a sensible way and that advertisements do not appeal to the under-18s or associate alcohol with sex, or daring and aggressive behaviour.
A recent Young's Bitter billboard poster, which featured a man with a ram's head wearing a white suit surrounded by bikini-clad women, with the strap line "This is a ram's world", was found to breach the guidelines as it "linked the image of an alcohol brand with seduction".
But Frank Soodeen is not convinced that the regulations have gone far enough: "We find it odd that so much of the packaging on alcopops seems juvenile and the alcohol industry has yet to come up with a credible explanation."
The drinks industry is still doing what it has always done: trying to maximise its sales. "There's a lot of pressure to sell as much alcohol as you can," says Dean Terry, manager of The Ship in Croydon. "On the one hand you are told to encourage sensible drinking and not to serve drunk people, but on the other you are supposed to drive sales. So where is the line? It's difficult."
The reality is that no bar is going to extend its hours and stay open for a longer period of time, yet be content to sell exactly the same amount of alcohol as before.
In Croydon, a year on from licensing reform, "vertical drinking" - a marketing term - is the norm at the weekend. People drink more when they stand up. They drink even more if loud music makes talking difficult and if flat surfaces are taken away to prevent customers putting down their drinks.
It is difficult to see how café culture could be expected to thrive without tables, chairs or conversation.