Editor,—We were interested to read Dr Robson's leading article regarding alcohol misuse and the reference to acute alcohol admissions to Alder Hey in Liverpool, UK.1 ,2 We too are concerned by the increasing number of these problems that we see in hospital paediatric practice.

We carried out a retrospective case note review of all the children seen in the Paediatric Emergency department in Sunderland between November 1999 and October 2000. One hundred children (57 female) accounted for 106 attendances with acute alcohol intoxication (2 children attended twice and 2 three times). The notes of 97 attendances were available for review. Most children were aged 13 to 15 (77%), range 10–16 years. As might be expected, the majority presented during the weekend (66%) and in the evening or at night (84% between 19:00 and 01:00). Half had been drinking with friends in a public place, although precise details were not recorded in many cases. Sixty one children (63%) were brought in by emergency ambulance and 48 (49%) were admitted. Thirty (31%) were documented to have been drinking vodka, 21 cider (22%), 12 (12%) beer or lager, 11 (11%) other spirits, 8 (8%) wine, and 8 (8%) a combination of these. The type of alcohol was not recorded in 7 (7%) cases. In no cases were alcopops thought to be the beverage responsible for the acute attendance, and the beverages consumed are comparable with Alder Hey figures from 1996.2

Alcopops and designer drinks appeal to young people, particularly 14–16 year olds, and there has been criticism that marketing may be aimed at this age group.3 ,4 Consumption of alcopops has been associated with drinking in less controlled environments, heavier drinking, and greater self reported drunkenness.3 However, our data do not suggest that they are a problem in relation to acute intoxication presenting to Accident and Emergency. We support the statement that children will mimic adults in their use and misuse of alcohol, and consider that it is society's changing attitude to alcohol and not the type of alcohol available that is of concern.