24-hour licences: Coming soon to a pub near you...

Time will be called on last orders next week. Our guide to the changes in the law tells you all you need to know

Does this mean our local will be open all hours?

In practice, no. More than 500 licences to sell alcohol 24 hours a day have been granted by councils around the country. These are understood to include around 160 pubs, 75 clubs, 110 hotels and 200 supermarkets. However, many of the pubs that have obtained permission to sell alcohol round the clock will only operate all day on special occasions such as public holidays and festivals. The vast majority of drinking establishments will only be opening for one or two extra hours at weekends. In response to the overwhelming criticism it has received, the drinks industry has accused the supermarkets of exploiting the changes most.

Why the need for reform of the licensing laws?

The current 11pm curfew was imposed nearly 80 years ago by Lloyd George. Introduced during the First World War, it was aimed at reducing the number of munitions workers who staggered into work still drunk from the night before. In 2000, the Government carried out a study into how licensing laws could be brought up to date. This concluded that the 11pm and 2am chucking-out times for pubs and clubs were a major cause of alcohol-related disorder because drinkers spilled on to the street at the same time. Ministers also say that an overhaul of the closing times is long overdue and the current law is "undemocratic" and "restrictive".

Are extended opening hours a good idea?

Tessa Jowell, the Secretary of State for Culture, thinks they will curb crime, improve the quality of life for the British public and give people greater freedom of choice. Labour also argues that the changes will take the pressure off the police because staggered leaving times will prevent the closing-time surge of violence. But the changes have been controversial with professionals and the Opposition, who have condemned the plans. Theresa May, Conservative culture spokesperson, says that residents living near noisy pubs and clubs will suffer and that the Government must get a grip on yob behaviour before the changes are introduced.

What do the experts think?

The Royal College of Physicians is vehemently opposed to the reforms and say that the change will lead to an epidemic of alcohol-related health problems, especially in the young, and an increase in binge-drinking. Professor Ian Gilmore, chair of the RCP alcohol committee, has said: "An increase in the hours of sale is likely to be associated with a rise rather than a fall in alcohol consumption." The Association of Chief Police Officers (Acpo) has warned that resources will be so overstretched that policing the streets during the day will be put at risk. The organisation has called on the Government to delay the new laws. Earlier this year, Chris Fox, president of Acpo, warned that an explosion of disorder in city centres could result from 24-hour drinking, and said that dealing "with binge-drinking is beyond police capability".

Has it worked elsewhere?

Other places which have introduced 24-hour drinking include Western Australia, where, according to experts, bars that choose to open for one extra hour experienced a doubling of alcohol-related violence. In Iceland, the effect of extending licensing hours was so alarming that the laws had to be reversed. However, in Scotland, where flexible licensing laws have existed since the 1970s, the social impact has been more positive. After an initial rash of applications for late licences, most pubs in places such as Glasgow and Edinburgh now only remain open until midnight, with landlords exercising their power to open all day during special events such as the Edinburgh Festival.

Are we able to drink like civilised Continentals?

The Government thinks that we are, but others disagree. Tessa Jowell told this paper in August that the British should be trusted to drink sensibly. But social historians are quick to point out that we have a centuries-long history of excessive drinking. There are huge cultural differences between Britain and other European countries. In Spain and France, there is huge shame and social stigma attached to getting drunk in public and alcohol is an integral part of the family meal - not something to be knocked back after a stressful day.

What happens if it doesn't work?

In response to the huge objections to 24-hour drinking, the Government has promised to review the new licensing arrangements three months after the changes are brought in. If predictions of society descending into alcohol-related chaos prove true, then ministers say they are willing to listen to public opinion.

What can you do?

Residents who live near noisy pubs and clubs can try to block licence applications that come from drinking establishments which want to open for longer. It is not too late to make a formal complaint about a pub, bar or club which has already obtained an extended licence. Local authorities now have the power to close down pubs that are associated with rowdy behaviour, so residents who are fed up with yobs vomiting on their doorstep or fighting in the early hours can demand a review, at any time, of a licence that has already been approved. But critics are worried that the objections of ordinary people will be crushed by the might of the drinks industry and its lawyers.

The Question: How much is safe?

It is easy to be a killjoy about drinking. So it is worth noting its benefits. Going to the pub is the most popular social pastime in Britain. Even for those who never prop up a bar, alcohol is the most widely used social lubricant, enjoyed by adults of all ages and both sexes, which helps us relax, reduces inhibitions and enhances enjoyment.

In modest amounts it is good for us. People who drink up to the recommended limits of three units a day for men and two for women are likely to live longer than teetotallers - a unit being half a pint of beer, a small glass of wine or a single measure of spirits. The main reason is the protective effect against heart disease.

But there is a price and our livers are paying it. Deaths due to excessive drinking have doubled in the last 20 years, mostly due to chronic liver disease and cirrhosis. Drinking is responsible for 150,000 hospital admissions a year and up to a third of all accident and emergency cases.

Men have always been heavier drinkers than women and die from the effects of alcohol in greater numbers, but women are catching up. In another decade, on present trends, the death rate in both sexes will be the same.

At least a quarter of men and nearly a fifth of women drink above the recommended limits and a small number drink very heavily. Like smoking, this is a slow form of suicide. The damage to the liver is cumulative and can take decades to develop.

It takes an hour for the liver to metabolise a half pint of beer. After a heavy session, it could take 12 hours to return to normal. If it does not get a break, it suffers slow progressive damage. That is why doctors recommend "drink holidays" - alcohol-free days to allow the liver to recover.

Apart from liver damage - and an increased risk of mouth and oesophageal cancer - the damaging effects of binge-drinking are seen in drunken behaviour on the streets, the rise in crimes of violence, and in injuries treated in accident and emergency departments.

Doctors say efforts to target binge-drinkers are doomed. History shows that problem drinking is linked to the overall level of drinking. So the Government should be aiming to curtail consumption overall. To this end, the Academy of Medical Sciences called last year for a doubling of tax on alcohol. But governments are unlikely to welcome such a suggestion - for fear of being labelled killjoys.

Jeremy Laurance, Health Editor