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Farkouh EK, Vallance K, Wettlaufer A, Giesbrecht N, Asbridge M, Farrell-Low AM, Gagnon M, Price TR, Priore I, Shelley J, Sherk A, Shield KD, Solomon R, Stockwell TR, Thompson K, Vishnevsky N, Naimi TS. An assessment of federal alcohol policies in Canada and priority recommendations: Results from the 3rd Canadian Alcohol Policy Evaluation Project. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:640-653. [PMID: 38739320 PMCID: PMC11303602 DOI: 10.17269/s41997-024-00889-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/02/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To systematically assess the Canadian federal government's current alcohol policies in relation to public health best practices. METHODS The 2022 Canadian Alcohol Policy Evaluation (CAPE) Project assessed federal alcohol policies across 10 domains. Policy domains were weighted according to evidence for their relative impact, including effectiveness and scope. A detailed scoring rubric of best practices was developed and externally reviewed by international experts. Policy data were collected between June and December 2022, using official legislation, government websites, and data sources identified from previous iterations of CAPE as sources. Contacts within relevant government departments provided any additional data sources, reviewed the accuracy and completeness of the data, and provided amendments as needed. Data were scored independently by members of the research team. Final policy scores were tabulated and presented as a weighted overall average score and as unweighted domain-specific scores. RESULTS Compared to public health best practices, the federal government of Canada scored 37% overall. The three most impactful domains-(1) pricing and taxation, (2) marketing and advertising controls, and (3) impaired driving countermeasures-received some of the lowest scores (39%, 10%, and 40%, respectively). Domain-specific scores varied considerably from 0% for minimum legal age policies to 100% for controls on physical availability of alcohol. CONCLUSION Many evidence-informed alcohol policies have not been adopted, or been adopted only partially, by the Canadian federal government. Urgent adoption of the recommended policies is needed to prevent and reduce the enormous health, social, and economic costs of alcohol use in Canada.
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Affiliation(s)
- Elizabeth K Farkouh
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA.
| | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Ashley Wettlaufer
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
| | - Norman Giesbrecht
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Amanda M Farrell-Low
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Marilou Gagnon
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Tina R Price
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Isabella Priore
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Jacob Shelley
- Faculty of Law, University of Western Ontario, London, ON, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kevin D Shield
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Robert Solomon
- Faculty of Law, University of Western Ontario, London, ON, Canada
| | - Tim R Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kara Thompson
- St. Francis Xavier University, Antigonish, NS, Canada
| | - Nicole Vishnevsky
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Timothy S Naimi
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
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Jankhotkaew J, Casswell S, Huckle T, Chaiyasong S, Kalapat R, Waleewong O, Parker K. A composite index of provincial alcohol control policy implementation capacity in Thailand. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 130:104504. [PMID: 38936218 DOI: 10.1016/j.drugpo.2024.104504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 06/05/2024] [Accepted: 06/11/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND There is a well-published literature on the effectiveness and stringency of alcohol control policies, but not many studies focus on policy implementation, where policies transform into impact. The objective of this study is to create a composite index that measures the capacity for implementing effective alcohol control policies across all provinces in Thailand. METHODS Based on the international literature, we developed a list of key indicators for tracking the implementation of alcohol policies at the subnational level. To ensure these indicators were relevant to the Thai context, we obtained feedback from Thai experts. We collected primary data according to the developed indicators using questionnaires filled in by key informants at the implementing agencies and gathered secondary data at the provincial level. On this basis, we developed indices that reflect the status of alcohol control policy implementation. We then investigated the association between the indices and the prevalence and pattern of alcohol consumption and alcohol-related harms while adjusting for potential confounders using multiple linear regression and negative binomial regression, respectively. RESULTS Scores on the Provincial Alcohol Policy Implementation Capacity (PAPIC) Index ranged between 39 and 79. We found that each 1-point increase in PAPIC score was associated with a 1.98 % reduction in the quantity of alcohol consumed in grams per day (coefficient: -0.02; 95 %CI: -0.03, -0.00; p-value<0.05; e-0.02= 0.9802). We also found that for each 1-point increase in PAPIC score, the proportion of regular drinkers reduced by 0.30 per cent (coefficient: -0.30; 95 %CI: -0.55, -0.05; p-value<0.05). However, we did not find any association between the indices and alcohol-related harms. CONCLUSION The level of implementation of alcohol control policy at the sub-national level is associated with alcohol consumption levels. The findings suggest the value of allocating resources to the implementation of alcohol control policy.
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Affiliation(s)
- Jintana Jankhotkaew
- SHORE & Whariki Research Centre, Massey University, 90 Symonds Street, Grafton Auckland, 1010, New Zealand; International Health Policy Program, Ministry of Public Health, Tiwanond Road, Nonthaburi, 11000, Thailand.
| | - Sally Casswell
- SHORE & Whariki Research Centre, Massey University, 90 Symonds Street, Grafton Auckland, 1010, New Zealand
| | - Taisia Huckle
- SHORE & Whariki Research Centre, Massey University, 90 Symonds Street, Grafton Auckland, 1010, New Zealand
| | - Surasak Chaiyasong
- Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Khamriang Sub-District, Kantarawichai District, Maha Sarakham, 44150, Thailand
| | - Romtawan Kalapat
- Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Khamriang Sub-District, Kantarawichai District, Maha Sarakham, 44150, Thailand
| | - Orratai Waleewong
- International Health Policy Program, Ministry of Public Health, Tiwanond Road, Nonthaburi, 11000, Thailand
| | - Karl Parker
- SHORE & Whariki Research Centre, Massey University, 90 Symonds Street, Grafton Auckland, 1010, New Zealand
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Bartlett A, Lesch M, Golder S, McCambridge J. Alcohol policy framing in South Africa during the early stages of COVID-19: using extraordinary times to make an argument for a new normal. BMC Public Health 2023; 23:1877. [PMID: 37770857 PMCID: PMC10537160 DOI: 10.1186/s12889-023-16512-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/10/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION Public health and alcohol industry actors compete to frame alcohol policy problems and solutions. Little is known about how sudden shifts in the political context provide moments for policy actors to re-frame alcohol-related issues. South Africa's temporary bans on alcohol sales during the COVID-19 pandemic offered an opportunity to study this phenomenon. METHODS We identified Professor Charles Parry from the South African Medical Research Council as a key policy actor. Parry uses a Twitter account primarily to comment on alcohol-related issues in South Africa. We harvested his tweets posted from March 18 to August 31, 2020, coinciding with the first two alcohol sales bans. We conducted a thematic analysis of the tweets to understand how Parry framed alcohol policy evidence and issues during these 'extraordinary times.' RESULTS Parry underlined the extent of alcohol-related harm during 'normal times' with scientific evidence and contested industry actors' efforts to re-frame relevant evidence in a coherent and well-constructed argument. Parry used the temporary sales restrictions to highlight the magnitude of the health and social harms resulting from alcohol consumption, particularly trauma, rather than the COVID-19 transmission risks. Parry portrayed the sales ban as a policy learning opportunity (or 'experiment') for South Africa and beyond. CONCLUSIONS Crisis conditions can provide new openings for public health (and industry) actors to make salient particular features of alcohol and alcohol policy evidence.
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Affiliation(s)
- Andrew Bartlett
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, England.
| | - Matthew Lesch
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, England
| | - Su Golder
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, England
| | - Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, England
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Haley SJ, Peddireddy S, El-Harakeh A, Akasreku B, Riibe D. Qualitative study of states' capacity to support alcohol prevention policies during the COVID-19 pandemic in the USA. Drug Alcohol Rev 2023; 42:1358-1374. [PMID: 37452762 PMCID: PMC11002955 DOI: 10.1111/dar.13714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION The onset of the COVID-19 pandemic accelerated rates of alcohol purchasing and related harms in the USA. The increases followed governors' emergency orders that increased alcohol availability, including the allowance of alcohol home delivery, alcohol to-go from restaurants and bars, and curbside pickup from retailers. METHODS Semi-structured interviews were conducted with 53 participants involved in state-level alcohol prevention policy across 48 states. Interviewees' perspectives on changes to alcohol prevention policies during the COVID-19 pandemic, including capacity to respond to alcohol-focused executive and legislative changes to alcohol availability, were explored. Initial codes were developed collectively and refined through successive readings of transcripts using a phenomenological, action-oriented research approach. Themes were identified semantically after all transcripts were coded and reviewed. RESULTS Four themes were developed including: (i) alcohol prevention policies and capacity during COVID-19; (ii) industry-related challenges during COVID-19; (iii) limited pre-COVID-19 alcohol prevention capacity; and (iv) needs to strengthen alcohol prevention capacity. DISCUSSION AND CONCLUSIONS The pandemic exacerbated states' capacity limitations for alcohol prevention efforts and created additional impediments to public health messaging about alcohol health risks related to greater alcohol availability. Participants offered a myriad of strategies to improve alcohol prevention and to reduce alcohol-related harms. Recommendations included dedicated federal and state prioritisation, more funding for community organisations, greater coordination, consistent high-quality trainings, stronger surveillance and widespread prevention messaging. States' alcohol prevention efforts require dedicated leadership, additional funding and support to strengthen population-based strategies to reduce sustained alcohol-related harms associated with increases in alcohol availability.
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Affiliation(s)
- Sean J. Haley
- Department of Health Policy and Management, City University of New York’s Graduate School of Public Health and Health Policy, New York, USA
| | - Snigdha Peddireddy
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, USA
| | - Amena El-Harakeh
- Departments of Health Policy and Management and Community Health and Social Sciences, City University of New York’s Graduate School of Public Health and Health Policy, New York, USA
| | - Bridget Akasreku
- Departments of Health Policy and Management and Community Health and Social Sciences, City University of New York’s Graduate School of Public Health and Health Policy, New York, USA
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Subbaraman MS, Sesline K, Kerr WC, Roberts SC. Associations between state-level general population alcohol policies and drinking outcomes among women of reproductive age: Results from 1984 to 2020 National Alcohol Surveys. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1773-1782. [PMID: 38051149 PMCID: PMC10849058 DOI: 10.1111/acer.15156] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 07/13/2023] [Accepted: 07/16/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Policies specific to alcohol use during pregnancy have not been found to reduce risks related to alcohol use during pregnancy. In contrast, general population alcohol policies are protective for the general population. Here, we assessed whether US state-level general population alcohol policies are related to drinking outcomes among women of reproductive age. METHODS We conducted secondary analyses of 1984-2020 National Alcohol Survey data (N = 13,555 women ≤44 years old). State-level policy exposures were government control of liquor retail sales, heavy beer at gas stations, heavy beer at grocery stores, liquor at grocery stores, Sunday off-premise liquor sales, and blood alcohol concentration (BAC) driving limits (no law, 0.10 limit, 0.05-0.08 limit). Outcomes were past 12-month number of drinks, ≥5 drink days, ≥8 drink days, and any DSM-IV alcohol abuse/dependence symptoms. Regressions adjusted for individual and state-level controls, clustering by state, and included fixed effects for survey month and year. RESULTS Allowing Sunday off-premise liquor sales versus not was related to having 1.20 times as many drinks (95% CI: 1.01, 1.42), 1.41 times as many ≥5 drink days (95% CI: 1.08, 1.85), and 1.91 times as many ≥8 drink days (95% CI: 1.28, 2.83). BAC limits of 0.05-0.08 for driving versus no BAC limit was related to 0.51 times fewer drinks (95% CI: 0.27, 0.96), 0.28 times fewer days with ≥5 drinks (95% CI: 0.10, 0.75), and 0.20 times fewer days with ≥8 drinks (95% CI: 0.08, 0.47). CONCLUSIONS US state-level policies prohibiting Sunday off-premise liquor sales and BAC limits of 0.05-0.08 for driving are related to less past 12-month overall and heavy drinking among women 18-44 years old.
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Affiliation(s)
- Meenakshi S. Subbaraman
- Behavioral Health and Recovery Studies, Public Health Institute, 555 12th St, Oakland, CA 94607 USA
| | - Katrina Sesline
- Alcohol Research Group, 6001 Shellmound Ave, Suite 450, Emeryville, CA 94608, United States
| | - William C. Kerr
- Alcohol Research Group, 6001 Shellmound Ave, Suite 450, Emeryville, CA 94608, United States
| | - Sarah C.M. Roberts
- Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, University of California, San Francisco, Department of Obstetrics, Gynecology & Reproductive Sciences, Oakland, CA, USA
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Vinod Kumar TK. The Impact of Aggregate Level Alcohol Consumption on Homicide Rates: A Time Series Analysis. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023; 67:640-661. [PMID: 34189984 DOI: 10.1177/0306624x211028774] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Consumption of alcohol has an impact on violent crimes and homicides. The study examines the association between aggregate level consumption of spirit and homicide rates in the State of Kerala in India. Time-series analyses were conducted by building Autoregressive Moving Average with Exogenous Variables (ARMAX) models and OLS Regression models to explain the relationship between the monthly rate of consumption of alcoholic spirits and homicide rates. The study concludes that consumption of alcoholic spirits has a statistically significant impact on the total homicide rates and the male and female homicide rates. The study has significant policy implications being one of the first studies examining the relationship between alcohol consumption and homicide rates in India and suggesting methods to address challenges of adverse public health consequences associated with alcohol consumption.
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Gruenewald PJ, Sumetsky N, Mair C, Lee JP, Ponicki WR. Micro-temporal analyses of crime related to alcohol outlets: A comparison of outcomes over weekday, weekend, daytime and nighttime hours. Drug Alcohol Rev 2023; 42:902-911. [PMID: 36989160 PMCID: PMC10273326 DOI: 10.1111/dar.13644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION Causal relationships between alcohol outlets and crime are inferred from their statistical associations across neighbourhoods. However, many unobserved covariates may confound these effects. Recognising that outlet sales vary by time of day and day of week, we assess whether areas with more bars/pubs, restaurants or off-premise outlets have more crime during days and times when alcohol sales are greatest. METHODS Annual administrative crime counts, sociodemographic data and other area characteristics of 336 Census block groups in Oakland, California, USA, were related to outlet densities from 2000 to 2015. Bayesian space-time Poisson models were used to measure associations between outlet densities and crime during: (i) weekday daytime; (ii) weekday nighttime; (iii) weekend daytime; and (iv) weekend nighttime periods (four seemingly unrelated equations). Comparisons of parameter estimates across equations provided an assessment of outlet effects on crime across days and times within the same analysis units using the same constellation of confounding covariates. RESULTS Assault and driving under the influence crime incidents during weekend evening hours were more frequent in Census block group areas with greater numbers of bar/pubs. Burglaries were consistently greater in areas with greater densities of restaurants. DISCUSSION AND CONCLUSIONS The spatiotemporal signature relating densities of bars/pubs over weekend evening hours to assault and driving under the influence incidents suggests that these outlets are a critical source of these crimes across neighbourhoods. Prevention programs and policies that focus upon specific drinking establishments, days and times may be most effective in reducing assault and impaired driving incidents in neighbourhoods.
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Affiliation(s)
- Paul J. Gruenewald
- Prevention Research Center, Pacific Institute for Research
and Evaluation, Berkeley, USA
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences,
University of Pittsburgh School of Public Health, Pittsburgh, USA
- Department of Epidemiology, University of Pittsburgh School
of Public Health, Pittsburgh, USA
- Center for Social Dynamics and Community Health, University
of Pittsburgh School of Public Health, Pittsburgh, USA
| | - Christina Mair
- Department of Behavioral and Community Health Sciences,
University of Pittsburgh School of Public Health, Pittsburgh, USA
- Department of Epidemiology, University of Pittsburgh School
of Public Health, Pittsburgh, USA
- Center for Social Dynamics and Community Health, University
of Pittsburgh School of Public Health, Pittsburgh, USA
| | - Juliet P. Lee
- Prevention Research Center, Pacific Institute for Research
and Evaluation, Berkeley, USA
| | - William R. Ponicki
- Prevention Research Center, Pacific Institute for Research
and Evaluation, Berkeley, USA
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Mair C, Sumetsky N, Dougherty M, Thakar M. Do Changes to the Alcohol Retail Environment Reduce Interpersonal Violence? CURR EPIDEMIOL REP 2022; 9:282-289. [PMCID: PMC9672597 DOI: 10.1007/s40471-022-00315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Michelle Dougherty
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Maya Thakar
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
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Silver D, Bae JY, McNeill E, Macinko J. Do alcohol policies affect everyone equally? An assessment of the effects of state policies on education-related patterns of alcohol use, 2011-2019. Drug Alcohol Depend 2022; 239:109591. [PMID: 35947919 DOI: 10.1016/j.drugalcdep.2022.109591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Public policies are a powerful tool to change behaviors that may harm population health, but little is known about how state alcohol policies affect different population groups. This study assesses the effects of a comprehensive measure of the state alcohol regulatory environment (the State Alcohol Policy Score or SAPS) on heavy drinking-a risk factor for premature death-on different population groups, defined by levels of educational attainment, then by race/ethnicity, and sex. METHODS We pool each state's Behavioral Risk Factor Surveillance Survey (BRFSS) 2011-2019 and use robust Poisson regression analyses that control for individual-level factors, state-level factors (1 year lagged SAPS score for each state, state fixed effects), and year fixed effects to assess the relationship between SAPS and heavy drinking behaviors by education group. Interaction terms test whether education moderates the relationship by race/ethnicity and gender. RESULTS SAPS scores increased 2010-2018, but substantial gaps persist between states. A 10 % increase in a state's alcohol policy score is associated with a 2 % lower prevalence in current drinking (APR=0.97, 95 % CI=0.97-0.97, p < 0.0011) although not for those with a high school education or less. A 10 % increase in the SAPS was associated with a 3 % lower prevalence of heavy drinking; interaction terms in models reveal that a 10 % increase in the SAPS was associated with a lower prevalence of heavy drinking among those with less than a college education. CONCLUSION Narrowing gaps in alcohol policies between states may reduce heavy drinking among those with lower educational attainment.
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Affiliation(s)
- Diana Silver
- Department of Public Health Policy and Management, New York University School of Global Public Health, 708 Broadway, NY 10003, USA.
| | - Jin Yung Bae
- Department of Public Health Policy and Management, New York University School of Global Public Health, 708 Broadway, NY 10003, USA
| | - Elizabeth McNeill
- Department of Public Health Policy and Management, New York University School of Global Public Health, 708 Broadway, NY 10003, USA
| | - James Macinko
- Departments of Community Health Sciences and Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA 90095, USA
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Blanchette JG, Pacula RL, Smart R, Lira MC, Boustead AE, Caulkins JP, Kilmer B, Kerr WC, Treffers R, Naimi TS. Rating the comparative efficacy of state-level cannabis policies on recreational cannabis markets in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 106:103744. [DOI: 10.1016/j.drugpo.2022.103744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 10/18/2022]
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Livingston W, Holloway K, May T, Buhociu M, Madoc-Jones I, Perkins A. Adapting existing behaviour: Perceptions of substance switching and implementation of minimum pricing for alcohol in Wales. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 38:22-34. [PMID: 35309092 PMCID: PMC8899056 DOI: 10.1177/1455072520972304] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/20/2020] [Indexed: 11/15/2022] Open
Abstract
Aim Minimum Pricing for Alcohol (MPA) was enacted in Wales on March 2nd 2020. During the legislative process (i.e. consultation and parliamentary discussion), concern was expressed about the possibility of some drinkers switching to using other substances in response to any rise in the cost of alcohol. This paper reports on findings from a study which explored these pre-implementation concerns and how the policy was shaped. Method The research involved surveys (n=193) and interviews (n=87) with drinkers (predominantly harmful or treatment seeking) and providers of services. Survey responses were detailed, thus when combined with the interviews, provided a wealth of qualitative data, which are drawn upon in this paper. Results The findings highlight an expectation that most drinkers would respond to the new policy with adaptations of their coping mechanisms to maintain alcohol use at pre-legislative levels. This was either by switching alcohol products and adjusting their lifestyle to maintain an affordable drinking habit or developing new behaviours to manage additional costs. A small group of those with previous experience of drug use were identified as likely to switch from using alcohol to some other substances. Conclusions Prior to the legislation being implemented awareness of the detail of the policy was found to be low, and the perceptions of increased potential harm for certain groups, including switching, were linked to concern about a lack of treatment capacity.
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Affiliation(s)
- Wulf Livingston
- Wrexham Glyndwr University School of Social and Life Sciences, Wrexham, UK
| | - Katy Holloway
- University of South Wales School of Humanities and Social Sciences, Pontypridd, Rhondda Cynon Taff, UK
| | - Tom May
- University College London, London, UK
| | - Marian Buhociu
- University of South Wales School of Humanities and Social Sciences, Pontypridd, Rhondda Cynon Taff, UK
| | - Iolo Madoc-Jones
- Wrexham Glyndwr University School of Social and Life Sciences, Wrexham, UK
| | - Andy Perkins
- Consultancy c/o The Signpost Centre Lothian Crescent Dundee, UK
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Hébert-Dufresne L, Waring TM, St-Onge G, Niles MT, Kati Corlew L, Dube MP, Miller SJ, Gotelli NJ, McGill BJ. Source-sink behavioural dynamics limit institutional evolution in a group-structured society. ROYAL SOCIETY OPEN SCIENCE 2022; 9:211743. [PMID: 35345431 PMCID: PMC8941422 DOI: 10.1098/rsos.211743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/04/2022] [Indexed: 05/03/2023]
Abstract
Social change in any society entails changes in both behaviours and institutions. We model a group-structured society in which the transmission of individual behaviour occurs in parallel with the selection of group-level institutions. We consider a cooperative behaviour that generates collective benefits for groups but does not spread between individuals on its own. Groups exhibit institutions that increase the diffusion of the behaviour within the group, but also incur a group cost. Groups adopt institutions in proportion to their fitness. Finally, the behaviour may also spread globally. We find that behaviour and institutions can be mutually reinforcing. But the model also generates behavioural source-sink dynamics when behaviour generated in institutionalized groups spreads to non-institutionalized groups and boosts their fitness. Consequently, the global diffusion of group-beneficial behaviour creates a pattern of institutional free-riding that limits the evolution of group-beneficial institutions. Our model suggests that, in a group-structured society, large-scale beneficial social change can be best achieved when the relevant behaviour and institutions remain correlated.
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Affiliation(s)
- Laurent Hébert-Dufresne
- Department of Computer Science, University of Vermont, Burlington VT, USA
- Vermont Complex Systems Center, University of Vermont, Burlington VT, USA
- Department of Nutrition and Food Sciences, University of Vermont, Burlington VT, USA
| | - Timothy M. Waring
- School of Economics, University of Maine, Orono ME, USA
- Mitchell Center for Sustainability Solutions, University of Maine, Orono ME, USA
| | - Guillaume St-Onge
- Département de physique, de génie physique et d'optique, Université Laval, Québec (Québec), Canada G1V 0A6
- Centre interdisciplinaire en modélisation mathématique, Université Laval, Québec (Québec), Canada G1V 0A6
| | - Meredith T. Niles
- Department of Nutrition and Food Sciences, University of Vermont, Burlington VT, USA
| | - Laura Kati Corlew
- Department of Social Science, University of Maine at Augusta, Bangor ME, USA
| | - Matthew P. Dube
- Department of Computer Information Systems, University of Maine at Augusta, Bangor ME, USA
| | - Stephanie J. Miller
- Mitchell Center for Sustainability Solutions, University of Maine, Orono ME, USA
- Mitchell Center for Sustainability Solutions, University of Maine, Orono ME, USA
| | | | - Brian J. McGill
- Mitchell Center for Sustainability Solutions, University of Maine, Orono ME, USA
- Mitchell Center for Sustainability Solutions, University of Maine, Orono ME, USA
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13
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Frankeberger J, Gruenewald PJ, Sumetsky N, Lee JP, Ghanem L, Mair C. Dual Use of Off-Premise Outlets for Alcohol and Grocery Purchases: Results From the East Bay Neighborhoods Study. J Stud Alcohol Drugs 2021; 82:758-766. [PMID: 34762035 PMCID: PMC8819615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 05/28/2021] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE Alcohol privatization efforts have enabled consumers in many states in the United States to purchase alcohol in a variety of off-premise outlets, including grocery stores. This study examines the dual use of outlets to purchase both alcohol and groceries and the extent to which dual use is related to individual income, neighborhood income, and local physical availability of alcohol. METHOD The East Bay Neighborhoods Study surveyed residents from 72 microecological neighborhoods across six cities in Alameda County, California. Eligible respondents who purchased alcohol in the last year (n = 707) were asked about the off-premise outlet in which they most often purchase alcohol. Purchasing behaviors within this outlet, including purchasing groceries and frequency of visits to the outlet, were assessed. Multilevel logistic regression and negative binomial models assessed outcomes. RESULTS Seventy-three percent of participants reported dual use of their most used outlet for groceries and alcohol. In adjusted models, dual use of the outlet was not associated with individual income, alcohol use, or neighborhood outlet density but was positively associated with neighborhood income and the number of outlet visits. After adjustment, dual use of the most used outlet was associated with 0.77 more visits per 28 days. CONCLUSIONS Results suggest that convenience and reduced time costs for purchasing alcohol encourage the dual use of outlets, particularly in high-income neighborhoods. Differences in the dual use of outlets and frequency in outlet use by neighborhood environments highlight the importance of understanding the role of alcohol availability in distinct neighborhood income and outlet-level contexts.
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Affiliation(s)
- Jessica Frankeberger
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Paul J. Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Juliet P. Lee
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Lina Ghanem
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
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Matthay EC, Hagan E, Joshi S, Tan ML, Vlahov D, Adler N, Glymour MM. The Revolution Will Be Hard to Evaluate: How Co-Occurring Policy Changes Affect Research on the Health Effects of Social Policies. Epidemiol Rev 2021; 43:19-32. [PMID: 34622277 PMCID: PMC8763115 DOI: 10.1093/epirev/mxab009] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 08/20/2021] [Accepted: 10/04/2021] [Indexed: 12/25/2022] Open
Abstract
Extensive empirical health research leverages variation in the timing and location of policy changes as quasi-experiments. Multiple social policies may be adopted simultaneously in the same locations, creating co-occurrence that must be addressed analytically for valid inferences. The pervasiveness and consequences of co-occurring policies have received limited attention. We analyzed a systematic sample of 13 social policy databases covering diverse domains including poverty, paid family leave, and tobacco use. We quantified policy co-occurrence in each database as the fraction of variation in each policy measure across different jurisdictions and times that could be explained by covariation with other policies. We used simulations to estimate the ratio of the variance of effect estimates under the observed policy co-occurrence to variance if policies were independent. Policy co-occurrence ranged from very high for state-level cannabis policies to low for country-level sexual minority-rights policies. For 65% of policies, greater than 90% of the place-time variation was explained by other policies. Policy co-occurrence increased the variance of effect estimates by a median of 57-fold. Co-occurring policies are common and pose a major methodological challenge to rigorously evaluating health effects of individual social policies. When uncontrolled, co-occurring policies confound one another, and when controlled, resulting positivity violations may substantially inflate the variance of estimated effects. Tools to enhance validity and precision for evaluating co-occurring policies are needed.
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Affiliation(s)
- Ellicott C Matthay
- Correspondence to Dr. Ellicott C. Matthay, Center for Health and Community, School of Medicine, University of California San Francisco, 550 16th Street, 2nd Floor, Campus Box 0560, San Francisco, CA 94143 (e-mail: )
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15
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Greene N, Johnson RM, Rosen J, German D, Cohen JE. Exploring the relationship between the alcohol policy environment and nondiscrimination laws: Implications for binge drinking disparities among LGB adults in the United States. Drug Alcohol Depend 2021; 225:108749. [PMID: 34049096 PMCID: PMC8282708 DOI: 10.1016/j.drugalcdep.2021.108749] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/05/2021] [Accepted: 04/13/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Alcohol policies reduce population-level binge drinking; however, they may not reduce binge drinking disparities between different populations. We examined the association between the alcohol policy environment and binge drinking among Lesbian, Gay and Bisexual (LGB) and heterosexual adults in the presence and absence of state laws protecting LGB people from discrimination. METHODS The 2015-2018 Behavioral Risk Factor Surveillance System (BRFSS) provided information about individual-level binge drinking, sexual identity, and individual-level covariates. The Alcohol Policy Scale (APS) score measures the strength of the alcohol policy environment. Presence of state-level nondiscrimination protections based on sexual orientation came from the Movement Advancement Project. Logistic regression models were used to test whether nondiscrimination statutes modified the association between the alcohol policy environment and binge drinking and whether this interaction differed for LGB and heterosexual adults. RESULTS Among women, a 10 percentage-point increase in APS score was significantly associated with 7% lower odds of binge drinking in states with inclusive nondiscrimination laws (aOR: 0.93 [95% CI: 0.89-0.97; p = 0.0003]) but was not associated with binge drinking in states without inclusive laws (aOR: 0.98 [95% CI: 0.93-1.03] p = 0.4781). Moreover, binge drinking disparities comparing lesbian/bisexual women with heterosexual women were narrower in states with inclusive nondiscrimination laws. No significant association was found among men. CONCLUSIONS Binge drinking disparities between lesbian and heterosexual women are negligible in states with inclusive laws and strong alcohol policy environments. Inclusive nondiscrimination laws are an indicator of less structural stigma directed at lesbian and bisexual women.
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Affiliation(s)
- Naomi Greene
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Renee M. Johnson
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 624 N. Broadway Street, Baltimore, MD 21205
| | - Joanne Rosen
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Danielle German
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Joanna E. Cohen
- Department of Health, Behavior and Society; Bloomberg School of Public Health, Johns Hopkins University; 624 N. Broadway Street, Baltimore, MD 21205
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16
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Matthay EC, Gottlieb LM, Rehkopf D, Tan ML, Vlahov D, Glymour MM. What to Do When Everything Happens at Once: Analytic Approaches to Estimate the Health Effects of Co-Occurring Social Policies. Epidemiol Rev 2021; 43:33-47. [PMID: 34215873 PMCID: PMC8763089 DOI: 10.1093/epirev/mxab005] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 05/14/2021] [Accepted: 06/21/2021] [Indexed: 12/25/2022] Open
Abstract
Social policies have great potential to improve population health and reduce health disparities. Increasingly, those doing empirical research have sought to quantify the health effects of social policies by exploiting variation in the timing of policy changes across places. Multiple social policies are often adopted simultaneously or in close succession in the same locations, creating co-occurrence that must be handled analytically for valid inferences. Although this is a substantial methodological challenge for researchers aiming to isolate social policy effects, only in a limited number of studies have researchers systematically considered analytic solutions within a causal framework or assessed whether these solutions are being adopted. We designated 7 analytic solutions to policy co-occurrence, including efforts to disentangle individual policy effects and efforts to estimate the combined effects of co-occurring policies. We used an existing systematic review of social policies and health to evaluate how often policy co-occurrence is identified as a threat to validity and how often each analytic solution is applied in practice. Of the 55 studies, only in 17 (31%) did authors report checking for any co-occurring policies, although in 36 studies (67%), at least 1 approach was used that helps address policy co-occurrence. The most common approaches were adjusting for measures of co-occurring policies; defining the outcome on subpopulations likely to be affected by the policy of interest (but not other co-occurring policies); and selecting a less-correlated measure of policy exposure. As health research increasingly focuses on policy changes, we must systematically assess policy co-occurrence and apply analytic solutions to strengthen studies on the health effects of social policies.
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Affiliation(s)
- Ellicott C Matthay
- Correspondence to Dr. Ellicott C. Matthay, Center for Health and Community, School of Medicine, University of California, San Francisco, 550 16th Street, San Francisco, CA 94143 (e-mail: )
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17
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Vallance K, Stockwell T, Wettlaufer A, Giesbrecht N, Chow C, Card KG, Farrell-Low A. Strategies for engaging policy stakeholders to translate research knowledge into practice more effectively: Lessons learned from the Canadian Alcohol Policy Evaluation project. Drug Alcohol Rev 2021; 41:246-255. [PMID: 34046948 DOI: 10.1111/dar.13313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 04/19/2021] [Accepted: 04/30/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Evidence-based alcohol policies have the potential to reduce a wide range of related harms. Yet, barriers to adoption and implementation within governments often exist. Engaging relevant stakeholders may be an effective way to identify and address potential challenges thereby increasing reach and uptake of policy evaluation research and strengthening jurisdictional responses to alcohol harms. METHODS As part of the 2019 Canadian Alcohol Policy Evaluation project, we conducted interviews with government stakeholders across alcohol-related sectors prior to a second round of researcher-led policy assessments in Canada's 13 provinces and territories. Stakeholders were asked for feedback on the design and impact of an earlier policy assessment in 2013 and for recommendations to improve the design and dissemination strategy for the next iteration. Content analysis was used to identify ways of improving stakeholder engagement. RESULTS We interviewed 25 stakeholders across 12 of Canada's 13 jurisdictions, including representatives from government health ministries and from alcohol regulation, distribution and finance departments. In providing feedback on our stakeholder engagement strategy, participants highlighted the importance of maintaining ongoing contact; presenting results in accessible online formats; providing advance notice of results; and offering jurisdiction-specific webinars. DISCUSSION AND CONCLUSIONS This study offers important insight into the engagement preferences of government stakeholders involved in the health, regulation, distribution and financial aspects of alcohol control policy. Findings suggest that seeking input from stakeholders as part of conducting evaluation research is warranted; increasing the relevance, reach and uptake of results. Specific stakeholder engagement strategies are outlined.
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Affiliation(s)
- Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada.,Department of Psychology, University of Victoria, Victoria, Canada
| | - Ashley Wettlaufer
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Norman Giesbrecht
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Clifton Chow
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Kiffer G Card
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Amanda Farrell-Low
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
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18
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McKetta S, Morrison CN, Keyes KM. Trends in US Alcohol Consumption Frequency During the First Wave of the SARS-CoV-2 Pandemic. Alcohol Clin Exp Res 2021; 45:773-783. [PMID: 33587290 PMCID: PMC8014717 DOI: 10.1111/acer.14575] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/09/2021] [Indexed: 12/31/2022]
Abstract
Background The SARS‐CoV‐2 pandemic created disruptions and stressors which may have influenced alcohol consumption frequency trends. Varying COVID‐19 health burden and alcohol policies may have contributed to different consumption trends between states. The aim of this study is to assess trends in alcohol consumption and moderation by state of residence. Methods We examined trends in adult drinking days, during the first wave of the pandemic (March 10 to June 8) using longitudinal data from the Understanding America Study (N = 6,172 unique participants; N = 28,059 observations). Because state mandates were responsive to disease burden, we modeled the interaction of time by COVID‐19 burden, defined as whether the state had the median (or higher) daily incidence of COVID‐19 cases on the survey date, and state random effects. We controlled for individual sociodemographics, perceived personal/familial COVID‐19 burden, mental health symptomology, and risk avoidance. Results Drinking days increased throughout the duration (incidence risk ratio [IRR] for drinking per increase in one calendar day = 1.003, 95% CI 1.001, 1.004); trends were heterogeneous by disease burden, with individuals living in states with lower COVID‐19 burden increasing (IRR = 1.005, 95% CI 1.003, 1.007) faster than those living in states with higher COVID‐19 burden (IRR = 1.000, 95% CI 0.998, 1.002). Trends were heterogeneous between states, but there was no evidence of systematic geographic clustering of state trends. Conclusions Drinking days increased during the first months of the COVID‐19 pandemic, particularly among residents of states with lower disease burden.
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Affiliation(s)
- Sarah McKetta
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Christopher N Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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19
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Churchill S, Stockwell T, Sherk A. What proportion of the price of a typical alcoholic beverage is taxation in Canada and why does it matter? HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2021; 41:65-67. [PMID: 33599446 DOI: 10.24095/hpcdp.41.2.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Canadian distillers and brewers have claimed that between 50% and 80% of the price of alcoholic drinks are government taxes. These claims were made in campaigns to decrease alcohol taxation. METHODS We investigated these claims using publicly available Statistics Canada data and provincial-level product sales data and breakdowns of the prices of typical alcohol beverages in major market sectors. RESULTS In all cases, the rate of total sales tax and excise taxation are mostly between 20% and 30% of final retail prices, well below the industry claims.
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Affiliation(s)
- Samuel Churchill
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
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20
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Greene N, Johnson RM, German D, Rosen J, Cohen JE. State-Level Alcohol Environments and Sexual Identity Disparities in Binge Drinking in the Behavioral Risk Factor Surveillance System. LGBT Health 2021; 8:190-200. [PMID: 33538642 DOI: 10.1089/lgbt.2020.0182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Purpose: Binge drinking disparities by sexual identity are well documented. Stronger alcohol policy environments reduce binge drinking in the general population. We examined whether state-level alcohol policy environments have the same association with binge drinking among lesbian, gay, and bisexual (LGB) adults as among heterosexual adults. Methods: Binge drinking, sexual identity, and demographic characteristics were extracted from the 2015 to 2018 Behavioral Risk Factor Surveillance System. The strength of the alcohol policy environment was measured by using the Alcohol Policy Scale (APS) score. We estimated the association between APS score and binge drinking by using logistic regression and included an interaction term between APS score and sexual identity. Results: The interaction between APS score and sexual identity was not significant, and findings differed between women and men. Among women, a higher APS score was associated with lower odds of binge drinking (adjusted odds ratio [aOR]: 0.96, 95% confidence interval [CI]: 0.94-0.99). Differences in binge drinking by sexual identity remained after adjusting for individual and state-level factors (e.g., the percentage of LGB adults in the state). Compared with heterosexual women, the odds of binge drinking were 43% higher (aOR: 1.43, 95% CI: 1.17-1.75) among lesbian women and 58% higher (aOR: 1.58, 95% CI: 1.40-1.79) among bisexual women. A higher APS score was not associated with binge drinking among men. Conclusion: Stronger state-level alcohol policy environments were associated with lower binge drinking among women. Lesbian and bisexual women were still more likely to engage in binge drinking compared with heterosexual women even in states with stronger alcohol policy environments.
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Affiliation(s)
- Naomi Greene
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Renee M Johnson
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Danielle German
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Joanne Rosen
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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21
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Vallance K, Stockwell T, Wettlaufer A, Chow C, Giesbrecht N, April N, Asbridge M, Callaghan R, Cukier S, Hynes G, Mann R, Solomon R, Thomas G, Thompson K. The Canadian Alcohol Policy Evaluation project: Findings from a review of provincial and territorial alcohol policies. Drug Alcohol Rev 2021; 40:937-945. [DOI: 10.1111/dar.13251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/11/2020] [Accepted: 12/16/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria Victoria Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria Victoria Canada
| | - Ashley Wettlaufer
- Centre for Addiction and Mental Health Institute for Mental Health Policy Research Toronto Canada
| | - Clifton Chow
- Canadian Institute for Substance Use Research, University of Victoria Victoria Canada
| | - Norman Giesbrecht
- Centre for Addiction and Mental Health Institute for Mental Health Policy Research Toronto Canada
| | - Nicole April
- Direction du développement des individus et des communautés Institut national de santé publique du Québec Québec City Canada
| | - Mark Asbridge
- Departments of Community Health and Epidemiology and Emergency Medicine Dalhousie University Halifax Canada
| | - Russell Callaghan
- Northern Medical Program University of Northern British Columbia Prince George Canada
| | - Samantha Cukier
- Centre for Journalogy Ottawa Hospital Research Institute Ottawa Canada
| | - Geoff Hynes
- Population Health, Canadian Institute for Health Information Ottawa Canada
| | - Robert Mann
- Centre for Addiction and Mental Health Institute for Mental Health Policy Research Toronto Canada
| | | | - Gerald Thomas
- Canadian Institute for Substance Use Research, University of Victoria Victoria Canada
| | - Kara Thompson
- Department of Psychology St. Francis Xavier University Antigonish Canada
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22
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Giesbrecht N, Wettlaufer A, Stockwell T, Vallance K, Chow C, April N, Asbridge M, Callaghan R, Cukier S, Hynes G, Mann RE, Solomon R, Thomas G, Thompson K. Alcohol retail privatisation in Canadian provinces between 2012 and 2017. Is decision making oriented to harm reduction? Drug Alcohol Rev 2020; 40:459-467. [PMID: 33319402 DOI: 10.1111/dar.13229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Policy changes may contribute to increased alcohol-related risks to populations. These include privatisation of alcohol retailing, which influences density of alcohol outlets, location of outlets, hours of sale and prevention of alcohol sales to minors or intoxicated customers. Meta-analyses, reviews and original research indicate enhanced access to alcohol is associated with elevated risk of and actual harm. We assess the 10 Canadian provinces on two alcohol policy domains-type of alcohol control system and physical availability of alcohol-in order to track changes over time, and document shifting changes in alcohol policy. METHODS Our information was based on government documents and websites, archival statistics and key informant interviews. Policy domains were selected and weighted for their degree of effectiveness and population reach based on systematic reviews and epidemiological evidence. Government representatives were asked to validate all the information for their jurisdiction. RESULTS The province-specific reports based on the 2012 results showed that 9 of 10 provinces had mixed retail systems-a combination of government-run and privately owned alcohol outlets. Recommendations in each provincial report were to not increase privatisation. However, by 2017 the percentage of off-premise private outlets had increased in four of these nine provinces, with new private outlet systems introduced in several. DISCUSSION AND CONCLUSIONS Decision-making protocols are oriented to commercial interests and perceived consumer convenience. If public health and safety considerations are not meaningfully included in decision-making protocols on alcohol policy, then it will be challenging to curtail or reduce harms.
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Affiliation(s)
- Norman Giesbrecht
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Ashley Wettlaufer
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Clifton Chow
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Nicole April
- Direction du développement des individus et des communautés, Institut National de Santé Publique du Québec, Québec City, Canada
| | - Mark Asbridge
- Departments of Community Health and Epidemiology and Emergency Medicine, Dalhousie University, Halifax, Canada
| | - Russell Callaghan
- Northern Medical Program, University of Northern British Columbia, Prince George, Canada
| | - Samantha Cukier
- Centre for Journalogy, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Geoff Hynes
- Population Health, Canadian Institute for Health Information, Ottawa, Canada
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Gerald Thomas
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Kara Thompson
- Department of Psychology, St. Francis Xavier University, Antigonish, Canada
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23
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Blanchette JG, Lira MC, Heeren TC, Naimi TS. Alcohol Policies in U.S. States, 1999-2018. J Stud Alcohol Drugs 2020. [PMID: 32048602 DOI: 10.15288/jsad.2020.81.58] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE U.S. policymakers and public health practitioners lack composite indicators (indices) to assess and compare the restrictiveness of state-level alcohol policy environments, conceptualized as the presence of multiple policies in effect in a particular place and time. The purposes of this study were to characterize the alcohol policy environment in each U.S. state and Washington, DC, in 2018, and to examine changes during the past 20 years. METHOD State-specific Alcohol Policy Scale (APS) scores from 1999 to 2018 were based on 29 policies, after weighting each present policy by its efficacy and degree of implementation. Modified APS scores were also calculated on the basis of two sets of mutually exclusive policy subgroups. RESULTS APS scores in 2018 varied considerably between states, ranging from 25.6 to 67.9 on a theoretical scale of 0 to 100; the median score was 43.5 (based on a 0-100 range), and 43 states had scores less than 50. The median change in state APS scores from 1999 to 2018 was positive (+4.9, range: -7.4 to +10.3), indicating increases in the restrictiveness of policy environments, with decreases in only five states. The increases in APS scores were primarily attributable to the implementation of stronger impaired-driving laws, whereas policies to reduce excessive drinking were unchanged. There was no correlation between states' excessive drinking policy scores and their impaired-driving scores (r = .05, p = .74). CONCLUSIONS Based on this policy scale, few states have restrictive policy environments. Although states adopted policies targeting impaired driving during the study period, there was no change in policies to reduce excessive drinking.
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Affiliation(s)
- Jason G Blanchette
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, Massachusetts
| | - Marlene C Lira
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Timothy C Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Timothy S Naimi
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts.,Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
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24
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Stockwell T, Andreasson S, Cherpitel C, Chikritzhs T, Dangardt F, Holder H, Naimi T, Sherk A. The burden of alcohol on health care during COVID-19. Drug Alcohol Rev 2020; 40:3-7. [PMID: 32835427 PMCID: PMC7461236 DOI: 10.1111/dar.13143] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 01/07/2023]
Abstract
Alcohol's impact on global health is substantial and of a similar order of magnitude to that from COVID‐19. Alcohol now also poses specific concerns, such as increased risk of severe lung infections, domestic violence, child abuse, depression and suicide. Its use is unlikely to aid physical distancing or other preventative behavioural measures. Globally, alcohol contributes to 20% of injury and 11.5% of non‐injury emergency room presentations. We provide some broad comparisons between alcohol‐attributable and COVID‐19‐related hospitalisations and deaths in North America using most recent data. For example, for Canada in 2017 it was recently estimated there were 105 065 alcohol‐attributable hospitalisations which represent a substantially higher rate over time than the 10 521 COVID‐19 hospitalisations reported during the first 5 months of the pandemic. Despite the current importance of protecting health‐care services, most governments have deemed alcohol sales to be as essential as food, fuel and pharmaceuticals. In many countries, alcohol is now more readily available and affordable than ever before, a situation global alcohol producers benefit from and have helped engineer. We argue that to protect frontline health‐care services and public health more generally, it is essential that modest, evidence‐based restrictions on alcohol prices, availability and marketing are introduced. In particular, we recommend increases in excise taxation coupled with minimum unit pricing to both reduce impacts on health‐care services and provide much‐needed revenues for governments at this critical time.
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Affiliation(s)
- Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada.,Department of Psychology, University of Victoria, Victoria, Canada
| | - Sven Andreasson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Tanya Chikritzhs
- National Drug Research Institute, Health Sciences, Curtin University, Perth, Australia
| | - Frida Dangardt
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
| | - Harold Holder
- Pacific Institute for Research and Evaluation, Prevention Research Center, Calverton, USA
| | - Timothy Naimi
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
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Yellman MA, Bryan L, Sauber-Schatz EK, Brener N. Transportation Risk Behaviors Among High School Students - Youth Risk Behavior Survey, United States, 2019. MMWR Suppl 2020; 69:77-83. [PMID: 32817609 PMCID: PMC7440196 DOI: 10.15585/mmwr.su6901a9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Motor-vehicle crashes are a leading cause of death and nonfatal injury among U.S. adolescents, resulting in approximately 2,500 deaths and 300,000 nonfatal injuries each year. Risk for motor-vehicle crashes and resulting injuries and deaths varies, depending on such behaviors as seat belt use or impaired or distracted driving. Improved understanding of adolescents’ transportation risk behaviors can guide prevention efforts. Therefore, data from the 2019 Youth Risk Behavior Survey were analyzed to determine prevalence of transportation risk behaviors, including not always wearing a seat belt, riding with a driver who had been drinking alcohol (riding with a drinking driver), driving after drinking alcohol, and texting or e-mailing while driving. Differences by student characteristics (age, sex, race/ethnicity, academic grades in school, and sexual identity) were calculated. Multivariable analyses controlling for student characteristics examined associations between risk behaviors. Approximately 43.1% of U.S. high school students did not always wear a seat belt and 16.7% rode with a drinking driver during the 30 days before the survey. Approximately 59.9% of students had driven a car during the 30 days before the survey. Among students who drove, 5.4% had driven after drinking alcohol and 39.0% had texted or e-mailed while driving. Prevalence of not always wearing a seat belt was higher among students who were younger, black, or had lower grades. Riding with a drinking driver was higher among Hispanic students or students with lower grades. Driving after drinking alcohol was higher among students who were older, male, Hispanic, or had lower grades. Texting while driving was higher among older students or white students. Few differences existed by sexual identity. Multivariable analyses revealed that students engaging in one transportation risk behavior were more likely to engage in other transportation risk behaviors. Traffic safety and public health professionals can use these findings to reduce transportation risk behaviors by selecting, implementing, and contextualizing the most appropriate and effective strategies for specific populations and for the environment.
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Using Zoning as a Public Health Tool to Reduce Alcohol Outlet Oversaturation, Promote Compliance, and Guide Future Enforcement: a Preliminary Analysis of Transform Baltimore. J Urban Health 2020; 97:568-582. [PMID: 32632795 PMCID: PMC7392963 DOI: 10.1007/s11524-020-00453-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Alcohol outlet oversaturation often exacerbates negative public health outcomes. Recently, Baltimore City passed an extensive zoning rewrite ("TransForm Baltimore") that sought to give local government and residents a tool to reduce alcohol outlet oversaturation through land use regulation. The present investigation evaluated the outlet and neighborhood characteristics of stores impacted by two components of TransForm Baltimore: (1) a requirement that taverns licensed for on-premise consumption in addition to off-premise, carryout sales generate at least 50% of their business from on-premise sales, and (2) a requirement to close, repurpose, or relocate all package stores (i.e., off-premise alcohol outlets) that have been operating as "non-conforming" in residential zones since 1971. Research assistants visited every off-premise alcohol outlet in the city (n = 685) to complete an observational assessment. Approximately 77% (n = 530) of these off-premise alcohol outlets were open, including 292 taverns and 238 package stores. t tests and chi-square tests were used to compare neighborhood characteristics (neighborhood disadvantage, median household income, and racial segregation) of sham taverns (i.e., taverns with less than 50% space dedicated for on-premise sales that were primarily operating as a package store) and non-conforming package stores. Of the 292 taverns accessible during the study, the remainder were chronically closed (n = 130); 24 (8.2%) were deemed sham taverns. Sham taverns were more likely to be located in communities with more economic disadvantage and lower median household income (t test; p < 0.05). Compared to taverns, a lower proportion of sham taverns had visible dance floor space, patrons drinking, and menus available (chi-square test; p < 0.001). There were 80 residentially zoned, non-conforming alcohol outlets. These non-conforming alcohol outlets were disproportionately distributed in predominately poor and African American communities (t test; p < 0.05). As compared to conforming alcohol outlets, more non-conforming alcohol outlets sold sex paraphernalia and healthy foods (chi-square test; p < 0.05). With active enforcement, TransForm Baltimore offers the opportunity for local government and residents to improve public health and increase health equity in vulnerable and marginalized neighborhoods.
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Stockwell T, Churchill S, Sherk A, Sorge J, Gruenewald P. How many alcohol-attributable deaths and hospital admissions could be prevented by alternative pricing and taxation policies? Modelling impacts on alcohol consumption, revenues and related harms in Canada. Health Promot Chronic Dis Prev Can 2020; 40:153-164. [PMID: 32529975 PMCID: PMC7367427 DOI: 10.24095/hpcdp.40.5/6.04] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
INTRODUCTION In 2017, Canada increased alcohol excise taxes for the first time in over three decades. In this article, we describe a model to estimate various effects of additional tax and price policies that are predicted to improve health outcomes. METHODS We obtained alcohol sales and taxation data for 2016/17 for all Canadian jurisdictions from Statistics Canada and product-level sales data for British Columbia. We modelled effects of alternative price and tax policies - revenue-neutral taxes, inflation-adjusted taxes and minimum unit prices (MUPs) - on consumption, revenues and harms. We used published price elasticities to estimate impacts on consumption and revenue and the International Model for Alcohol Harms and Policies (InterMAHP) to estimate impacts on alcohol-attributable mortality and morbidity. RESULTS Other things being equal, revenue-neutral alcohol volumetric taxes (AVT) would have minimal influence on overall alcohol consumption and related harms. Inflation-adjusted AVT would result in 3.83% less consumption, 329 fewer deaths and 3762 fewer hospital admissions. A MUP of $1.75 per standard drink (equal to 17.05mL ethanol) would have reduced consumption by 8.68% in 2016, which in turn would have reduced the number of deaths by 732 and the number of hospitalizations by 8329 that year. Indexing alcohol excise taxes between 1991/92 and 2016/17 would have resulted in the federal government gaining approximately $10.97 billion. We estimated this could have prevented 4000-5400 deaths and 43 000-56 000 hospitalizations. CONCLUSION Improved public health outcomes would be made possible by (1) increasing alcohol excise tax rates across all beverages to compensate for past failures to index rates, and (2) setting a MUP of at least $1.75 per standard drink. While reducing alcohol-caused harms, these tax policies would have the added benefit of increasing federal government revenues.
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Affiliation(s)
- Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Samuel Churchill
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Justin Sorge
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Paul Gruenewald
- Prevention Research Center, Berkeley, California, United States of America
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Lira MC, Sarda V, Heeren TC, Miller M, Naimi TS. Alcohol Policies and Motor Vehicle Crash Deaths Involving Blood Alcohol Concentrations Below 0.08. Am J Prev Med 2020; 58:622-629. [PMID: 32192802 PMCID: PMC7174083 DOI: 10.1016/j.amepre.2019.12.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/14/2019] [Accepted: 12/15/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Motor vehicle crashes are a leading cause of injury death in the U.S. Restrictive alcohol policies protect against crashes involving alcohol above the legal blood alcohol concentration of 0.08%. Characteristics of motor vehicle crash fatalities involving blood alcohol concentrations below the limit and their relationships to alcohol control policies have not been well characterized. METHODS Motor vehicle crash fatality data and crash and decedent characteristics from 2000 to 2015 came from the Fatality Analysis Reporting System and were analyzed in 2018-2019. Alcohol Policy Scale scores characterized alcohol policy environments by state-year. Generalized estimating equation alternating logistic regression models assessed these scores and the odds that a fatality involved alcohol below the legal threshold. RESULTS Of 612,030 motor vehicle crash fatalities, 223,471 (37%) died in alcohol-involved crashes, of which 33,965 (15% of alcohol-involved fatalities or 6% of all fatalities) had a blood alcohol concentration <0.08%. A 10 percentage point increase in Alcohol Policy Scale score, approximating the interquartile range among states, was associated with reduced odds of fatalities involving alcohol <0.08% vs 0.00% (AOR=0.91, 95% CI=0.89, 0.93). These findings held across multiple subgroup analyses by decedent and crash characteristics. Similar results were found for odds of alcohol involvement <0.05% vs 0.00% (AOR=0.90, 95% CI=0.88, 0.93), and ≥0.05% but <0.08% vs <0.05% (AOR=0.93, 95% CI=0.89, 0.96). CONCLUSIONS The number of lower blood alcohol concentration fatalities is substantial. States with more restrictive alcohol policies tend to have reduced odds of lower blood alcohol concentration motor vehicle crashes than states with weaker policies.
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Affiliation(s)
- Marlene C Lira
- Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Vishnudas Sarda
- Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts
| | - Timothy C Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Matthew Miller
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Timothy S Naimi
- Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts; Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
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Blanchette JG, Lira MC, Heeren TC, Naimi TS. Alcohol Policies in U.S. States, 1999-2018. J Stud Alcohol Drugs 2020; 81:58-67. [PMID: 32048602 PMCID: PMC7024811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/05/2019] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVE U.S. policymakers and public health practitioners lack composite indicators (indices) to assess and compare the restrictiveness of state-level alcohol policy environments, conceptualized as the presence of multiple policies in effect in a particular place and time. The purposes of this study were to characterize the alcohol policy environment in each U.S. state and Washington, DC, in 2018, and to examine changes during the past 20 years. METHOD State-specific Alcohol Policy Scale (APS) scores from 1999 to 2018 were based on 29 policies, after weighting each present policy by its efficacy and degree of implementation. Modified APS scores were also calculated on the basis of two sets of mutually exclusive policy subgroups. RESULTS APS scores in 2018 varied considerably between states, ranging from 25.6 to 67.9 on a theoretical scale of 0 to 100; the median score was 43.5 (based on a 0-100 range), and 43 states had scores less than 50. The median change in state APS scores from 1999 to 2018 was positive (+4.9, range: -7.4 to +10.3), indicating increases in the restrictiveness of policy environments, with decreases in only five states. The increases in APS scores were primarily attributable to the implementation of stronger impaired-driving laws, whereas policies to reduce excessive drinking were unchanged. There was no correlation between states' excessive drinking policy scores and their impaired-driving scores (r = .05, p = .74). CONCLUSIONS Based on this policy scale, few states have restrictive policy environments. Although states adopted policies targeting impaired driving during the study period, there was no change in policies to reduce excessive drinking.
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Affiliation(s)
- Jason G. Blanchette
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, Massachusetts
| | - Marlene C. Lira
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Timothy C. Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Timothy S. Naimi
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
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Associations Between Alcohol Policies and Adolescent Alcohol Use: A Pooled Analysis of GSHS and ESPAD Data. Alcohol Alcohol 2019; 54:639-646. [DOI: 10.1093/alcalc/agz068] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/08/2019] [Accepted: 07/13/2019] [Indexed: 12/23/2022] Open
Abstract
Abstract
Aims
Alcohol-attributable harm remains high worldwide, and alcohol use among adolescents is particularly concerning. The purpose of this study is to determine the effect of national alcohol control policies on adolescent alcohol use in low-, middle- and high-income countries and improve on previous cross-national attempts to estimate the impact of alcohol policy on this population.
Methods
Data on adolescent (n = 277,110) alcohol consumption from 84 countries were pooled from the Global School-based Health Survey and the European School Survey Project on Alcohol and Other Drugs. Alcohol use measures included lifetime alcohol use, current (past 30 days) alcohol use and current (past 30 days) binge drinking. Information on national alcohol control policies was obtained from the World Health Organization’s Global Information System on Alcohol and Health and scored for effectiveness. Main effects were estimated using two-level, random intercept hierarchical linear models, and the models were adjusted for sex and age of the participants, and pattern of drinking score, gross domestic product based on purchasing power parity and study at the country level.
Results
Availability (OR [95% CI] = 0.991 [0.983, 0.999]), marketing (OR [95% CI] = 0.994 [0.988, 1.000]) and pricing (OR [95% CI] = 0.955 [0.918, 0.993]) policies were inversely associated with lifetime drinking status. Pricing policies were also inversely associated with current binge drinking status among current drinkers (OR [95% CI] = 0.939 [0.894, 0.986]). There were no associations between the included alcohol policies and current drinking status.
Conclusions
Strong availability, marketing and pricing policies can significantly and practically impact adolescent alcohol consumption.
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Giesbrecht N, Bosma LM, Reisdorfer E. Reducing Harm Through Evidence-Based Alcohol Policies: Challenges and Options. WORLD MEDICAL & HEALTH POLICY 2019. [DOI: 10.1002/wmh3.314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Karriker-Jaffe KJ, Room R, Giesbrecht N, Greenfield TK. Alcohol's Harm to Others: Opportunities and Challenges in a Public Health Framework. J Stud Alcohol Drugs 2019; 79:239-243. [PMID: 29553351 DOI: 10.15288/jsad.2018.79.239] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The emergent and growing body of research on alcohol's harm to others (AHTO), or secondhand effects of drinking, has important implications for prevention, intervention, and policy. Those victimized by other drinkers tend to favor effective alcohol policies more than their nonvictimized peers, but often a community's impulse will be to combat AHTO by targeting and stigmatizing individual heavy drinkers, rather than taking a public health approach to reducing harm. Here we discuss opportunities and challenges in selecting ways of reducing AHTO. We make a case for adopting joint public health and individual approaches to reduce AHTO.
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Affiliation(s)
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Lira MC, Xuan Z, Coleman SM, Swahn MH, Heeren TC, Naimi TS. Alcohol Policies and Alcohol Involvement in Intimate Partner Homicide in the U.S. Am J Prev Med 2019; 57:172-179. [PMID: 31239088 PMCID: PMC6642831 DOI: 10.1016/j.amepre.2019.02.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Intimate partner violence (IPV) results in deaths of both primary and corollary (i.e., nonintimate partner) victims. Alcohol use is a known risk factor for IPV, yet the relationship between alcohol policies and IPV homicides is unclear. This repeated cross-sectional study characterizes alcohol involvement, and the relationship between alcohol policies and alcohol involvement, among victims of IPV homicides in the U.S. METHODS Homicide victim data from 17 states in the National Violent Death Reporting System from 2003 to 2012 were analyzed in 2017-2018. Alcohol Policy Scale scores characterized alcohol policies by state year and were used in generalized estimating equation logistic regression models to predict the odds of alcohol involvement among victims of IPV homicide. RESULTS Among victims of IPV homicide, 36.5% of primary and 41.1% of corollary victims had a blood alcohol concentration (BAC) >0.00%. Of the victims with a positive BAC, 67.6% had a BAC ≥0.08%. In adjusted models, a 10-percentage point increase in Alcohol Policy Scale score was associated with reduced odds of having a positive BAC (AOR=0.77, 95% CI=0.64, 0.93) and having a BAC ≥0.08% (AOR=0.82, 95% CI=0.68, 0.99) among all victims, primary victims (AOR=0.78, 95% CI=0.63, 0.98; AOR=0.82, 95% CI=0.65, 1.04), and corollary victims (AOR=0.61, 95% CI=0.42, 0.89; AOR=0.68, 95% CI=0.48, 0.97). CONCLUSIONS Alcohol use was prevalent among victims of IPV homicide, and more-restrictive alcohol policies were associated with reduced odds of alcohol involvement. Strengthening alcohol policies is a promising strategy to reduce alcohol-involved IPV homicide victimization.
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Affiliation(s)
- Marlene C Lira
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Ziming Xuan
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Sharon M Coleman
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts
| | - Monica H Swahn
- Department of Epidemiology & Biostatistics, Georgia State University School of Public Health, Atlanta, Georgia
| | - Timothy C Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Timothy S Naimi
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts; Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
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Greenfield TK, Cook WK, Karriker-Jaffe KJ, Patterson D, Kerr WC, Xuan Z, Naimi TS. The Relationship Between the U.S. State Alcohol Policy Environment and Individuals' Experience of Secondhand Effects: Alcohol Harms Due to Others' Drinking. Alcohol Clin Exp Res 2019; 43:1234-1243. [PMID: 31166048 PMCID: PMC6553486 DOI: 10.1111/acer.14054] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 04/05/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although restrictive state alcohol policy environments are protective for individuals' binge drinking, research is sparse on the effect of alcohol policies on alcohol's harms to others (AHTO). We examined the lagged associations between efficacy of U.S. state alcohol policies and number of harms from others' drinking 1 year later. METHODS Individuals with AHTO data in a nationally representative sample of U.S. adults (analytic sample n = 26,744) that pooled the 2000, 2005, 2010, and 2015 National Alcohol Surveys and a 2015 National Alcohol's Harm to Others Survey were linked with prior-year state policy measures. We used 2 measures from the Alcohol Policy Scale (APS)-effectiveness in reducing (i) binge drinking and (ii) impaired driving, based on experts' efficacy judgments regarding 29 state alcohol policies. Three 12-month AHTO measures (due to another drinker) were experiencing: (i) either family/marriage difficulties or financial troubles; (ii) being assaulted or vandalized; and (iii) passenger with drunk driver or traffic accident. Multilevel models accounting for clustering within states and stratified by age-groups (<40 vs. ≥40) examined associations between the APS and AHTO measures, controlling for individual covariates (gender, race, education, employment and marital status, family problem-drinking history) of the victim. RESULTS Only for those aged <40, the lagged APS-Binge drinking and APS-Impaired driving scores were each inversely associated with aggression-related harms and, separately, with drunk driving-related harm from someone else's drinking (ps < 0.05 to < 0.01). Family/financial harms were not associated with APS scores for either age-group. Composite AHTO measures (any of 3 harm-types) also were inversely associated with stronger state alcohol policy environments (ps < 0.05 to <0.01). CONCLUSIONS State alcohol policies may be effective in reducing, to a meaningful degree, aggression-related harms and vehicular hazards due to other drinkers, but mainly in those under 40.
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Affiliation(s)
| | - Won K. Cook
- Public Health Institute, Alcohol Research Group, Emeryville California USA
| | | | - Deidre Patterson
- Public Health Institute, Alcohol Research Group, Emeryville California USA
| | - William C. Kerr
- Public Health Institute, Alcohol Research Group, Emeryville California USA
| | - Ziming Xuan
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Timothy S. Naimi
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
- Clinical Addiction Research & Education Unit, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts, USA
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Slutske WS, Deutsch AR, Piasecki TM. Neighborhood density of alcohol outlets moderates genetic and environmental influences on alcohol problems. Addiction 2019; 114:815-822. [PMID: 30561109 DOI: 10.1111/add.14534] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/15/2018] [Accepted: 12/07/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND AIMS Geographic differences in rates of alcohol use disorder suggest that environmental factors and gene-environment interactions are likely to play an important role in its genesis. We aimed to examine whether living in a community with more alcohol outlets would facilitate the expression of the genetic propensity to develop alcohol problems. DESIGN Cross-sectional twin/sibling study. SETTING United States. PARTICIPANTS The participants were 18-26-year-old twin, full- and half-sibling pairs from Wave III of the National Longitudinal Study of Adolescent to Adult Health. MEASUREMENTS Participants completed in-home interviews in which past year alcohol problems were assessed. Alcohol outlet densities were extracted from state-level liquor license databases aggregated at the census tract level. FINDINGS There was evidence that estimates of genetic and environmental influences on alcohol problems varied as a function of the density of alcohol outlets in the community. The heritability of alcohol problems for those residing in a neighborhood with more than 10 on-premises outlets was 78% (95% confidence limits = 52-100%), compared with 11% (95% confidence limits = 0-29%) for those in a neighborhood with no on-premises outlets. This moderating effect of alcohol outlet density was not explained by state of residence, population density or neighborhood socio-demographic characteristics. CONCLUSIONS Individuals who are genetically predisposed to develop alcohol problems may be especially sensitive to the influence of many alcohol outlets in their community.
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Affiliation(s)
- Wendy S Slutske
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Arielle R Deutsch
- Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA
| | - Thomas M Piasecki
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
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Van Vleck VNL. Detecting DUI (Non) deterrence: A macro-methodology to uncover "restrictive v permissive" county jurisdictions in California. ACCIDENT; ANALYSIS AND PREVENTION 2019; 125:241-248. [PMID: 30798149 DOI: 10.1016/j.aap.2019.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/21/2018] [Accepted: 02/08/2019] [Indexed: 06/09/2023]
Abstract
This paper builds a method to detect the apparent restrictiveness or permissiveness of communities towards drunk-driving. A framework of three mutually interacting community domains is used to motivate a minimum set of DUI patterns to be expected from an appropriately deterrent environment. Based on the (simplified) system dynamics model, an empirical estimation strategy and scoring methodology is outlined. This "macroscopic" approach is demonstrated using results from time-series panel analyses of California's 58 counties for the years 1990 to 2010 (Van Vleck et al., 2017). The process successfully classified three-quarters of California counties, encompassing almost 90% of the state population. The paper demonstrates a potential tool to classify communities' systemic behavior toward drinking-and-driving and other enforcement-sensitive subjects.
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Affiliation(s)
- Va Nee L Van Vleck
- California State University, Fresno, 5245 N Backer Ave, 93740-8001, Fresno, California, United States.
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Pliakas T, Lock K, Jones A, Aalders S, Egan M. Getting shops to voluntarily stop selling cheap, strong beers and ciders: a time-series analysis evaluating impacts on alcohol availability and purchasing. J Public Health (Oxf) 2019; 41:110-118. [PMID: 29447371 DOI: 10.1093/pubmed/fdy003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 12/13/2017] [Accepted: 01/09/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND 'Reducing the Strength' (RtS) is a public health initiative encouraging retailers to voluntarily stop selling cheap, strong beers/ciders (≥6.5% alcohol by volume). This study evaluates the impact of RtS initiatives on alcohol availability and purchasing in three English counties with a combined population of 3.62 million people. METHODS We used a multiple baseline time-series design to examine retail data over 29 months from a supermarket chain that experienced a two-wave, area-based role out of RtS: initially 54 stores (W1), then another 77 stores (W2). We measured impacts on units of alcohol sold (primary outcome: beers/ciders; secondary outcome: all alcoholic products), economic impacts on alcohol sales and substitution effects. RESULTS We observed a non-significant W1 increase (+3.7%, 95% CI: -11.2, 21.0) and W2 decrease (-6.8%, 95% CI: -20.5, 9.4) in the primary outcome. We observed a significant W2 decrease in units sold across all alcohol products (-10.5%, 95% CI: -19.2, -0.9). The direction of effect between waves was inconsistent for all outcomes, including alcohol sales, with no evidence of substitution effects. CONCLUSIONS In the UK, voluntary RtS initiatives appear to have little or no impact on reducing alcohol availability and purchase from the broader population of supermarket customers.
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Affiliation(s)
- T Pliakas
- National Institute for Health Research School for Public Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, UK
| | - K Lock
- National Institute for Health Research School for Public Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, UK
| | - A Jones
- Suffolk County Council, Ipswich, UK
| | | | - M Egan
- National Institute for Health Research School for Public Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, UK
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Setting Policy Priorities for Front-of-Pack Health Claims and Symbols in the European Union: Expert Consensus Built by Using a Delphi Method. Nutrients 2019; 11:nu11020403. [PMID: 30769879 PMCID: PMC6412322 DOI: 10.3390/nu11020403] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 01/29/2019] [Accepted: 02/04/2019] [Indexed: 11/17/2022] Open
Abstract
Despite the fact that front-of-pack nutrition labels such as health claims and symbols have received growing attention in consumer behavior research, comprehensive conclusions could not yet be drawn to develop concrete policy actions, owing to the complexity of the subject and a constantly changing market environment. In this study, evidence-based policy recommendations and communication guidelines have been derived from the findings of the EU FP7 project CLYMBOL ("Role of health-related CLaims and sYMBOLs in consumer behavior", Grant Agreement 311963), and have been evaluated and prioritized by European stakeholders using a three-round Delphi method. A moderate level of consensus was achieved and results suggest that policy priority should focus on ways to improve consumer motivation and interest in healthy eating. Consumers' interest in healthy eating could be increased by adopting appropriate communication strategies such as using innovative ways to communicate the importance of healthy eating, which may aim to change the possible negative association between healthiness and tastiness. The highest-rated finding was related to consumers' favorable attitude towards health claims with shorter and less complex messages and health symbols with a visible endorsement. Meanwhile, there was a clear consensus that health claims need to be scientifically substantiated and credible but phrased without using overly complex scientific wordings, in order to be meaningful for consumers. Furthermore, stakeholders from academia and industry believe that consumer awareness about existing health claims should be increased. The identified policy recommendations and communication guidelines stem from recent empirical evidence and provide useful insights that guide future policy development aligning consumer protection issues as well as public health and food marketing communication interests.
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Keyes KM, Shev A, Tracy M, Cerdá M. Assessing the impact of alcohol taxation on rates of violent victimization in a large urban area: an agent-based modeling approach. Addiction 2019; 114:236-247. [PMID: 30315599 PMCID: PMC6314891 DOI: 10.1111/add.14470] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/22/2018] [Accepted: 10/05/2018] [Indexed: 02/03/2023]
Abstract
AIMS To use simulation to estimate the impact of alcohol taxation on drinking, non-fatal violent victimization and homicide in New York City (NYC). We simulate the heterogeneous effects of alcohol price elasticities by income, level of consumption and beverage preferences, and examine whether taxation can reduce income inequalities in alcohol-related violence. DESIGN Agent-based modeling simulation. SETTING NYC, USA. PARTICIPANTS Adult population aged 18-64 years in the year 2000 in the 59 community districts of NYC. The population of 256 500 agents approximates a 5% sample of the NYC population. MEASUREMENTS Agents were parameterized through a series of rules that governed alcohol consumption and engagement in violence. Six taxation interventions were implemented based on extensive reviews and meta-analyses, increasing universal alcohol tax by 1, 5 and 10%, and beer tax by 1, 5 and 10%. FINDINGS Under no tax increase, approximately 12.2% [95% credible interval (prediction interval, PI) = 12.1-12.3%] were heavy drinkers. Taxation decreased the proportion of heavy drinkers; a 10% tax decreased heavy drinking to 9.6% (95% PI = 9.4-9.8). Beer taxes had the strongest effect on population consumption. Taxation influenced those in the lowest income groups more than the highest income groups. Alcohol-related homicide decreased from 3.22 per 100 000 (95% PI = 2.50-3.73) to 2.40 per 100 000 under a 10% universal tax (95% PI = 1.92-2.94). This translates into an anticipated benefit of ~1200 lives/year. CONCLUSION Reductions in alcohol consumption in a large urban environment such as New York City can be sustained with modest increases in universal taxation. Alcohol tax increases also have a modest effect on alcohol-related violent victimization. Taxation policies reduce income inequalities in alcohol-related violence.
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Affiliation(s)
- Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Aaron Shev
- Department of Emergency Medicine, School of Medicine, University of California at Davis, Sacramento, CA
| | - Melissa Tracy
- Department of Epidemiology and Biostatistics, State University of New York at Albany, Albany, NY
| | - Magdalena Cerdá
- Department of Emergency Medicine, School of Medicine, University of California at Davis, Sacramento, CA
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Jones-Webb R, McKee P, Joshi S, Erickson D, Toomey T, Nelson T. Is Restricting Sales of Malt Liquor Beverages Effective in Reducing Crime in Urban Areas? J Stud Alcohol Drugs 2018; 79:826-834. [PMID: 30573012 PMCID: PMC6308175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVE We evaluated the effects of outlet and small area level malt liquor policies on crime in 10 U.S. cities and hypothesized that more restrictive malt liquor policies would be associated with greater reductions in crime. METHOD We used a pooled time-series study design (i.e., panel regression) with comparison areas to test our hypothesis. Quarterly crime rates in targeted areas were compared 3 years before and after policy adoption. Four crime outcomes were analyzed: Selected Part II crimes, assaults, vandalism/property damage, and disorderly conduct. Both the presence and absence of a malt liquor policy (yes, no) and degree of restrictiveness of the malt liquor policy were assessed using a newly created measure of malt liquor policy restrictiveness developed by the investigators. Results were analyzed using a series of linear mixed models. RESULTS Adoption of malt liquor policies was not associated with Part II selected crimes. For individual crimes (e.g., assaults, vandalism, disorderly conduct), we found mixed results as more restrictive malt liquor policies were significantly associated with decreases as well as increases in crime. In general, the evaluated policies were considered to be not highly restrictive. CONCLUSIONS Our findings suggest that malt liquor policies at the outlet or small area level alone may not be sufficient to reduce crime associated with malt liquor use. Policies that are more restrictive or cover larger areas than assessed in the current study may be required to have an independent effect on crime outcomes.
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Affiliation(s)
- Rhonda Jones-Webb
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Patricia McKee
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Spruha Joshi
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Darin Erickson
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Traci Toomey
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Toben Nelson
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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Babor TF, Robaina K, Brown K, Noel J, Cremonte M, Pantani D, Peltzer RI, Pinsky I. Is the alcohol industry doing well by 'doing good'? Findings from a content analysis of the alcohol industry's actions to reduce harmful drinking. BMJ Open 2018; 8:e024325. [PMID: 30361407 PMCID: PMC6224758 DOI: 10.1136/bmjopen-2018-024325] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/07/2018] [Accepted: 09/18/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The aims of this study were to: (1) describe alcohol industry corporate social responsibility (CSR) actions conducted across six global geographic regions; (2) identify the benefits accruing to the industry ('doing well'); and (3) estimate the public health impact of the actions ('doing good'). SETTING Actions from six global geographic regions. PARTICIPANTS A web-based compendium of 3551 industry actions, representing the efforts of the alcohol industry to reduce harmful alcohol use, was issued in 2012. The compendium consisted of short descriptions of each action, plus other information about the sponsorship, content and evaluation of the activities. Public health professionals (n=19) rated a sample (n=1046) of the actions using a reliable content rating procedure. OUTCOME MEASURES WHO Global strategy target area, estimated population reach, risk of harm, advertising potential, policy impact potential and other aspects of the activity. RESULTS The industry actions were conducted disproportionately in regions with high-income countries (Europe and North America), with lower proportions in Latin America, Africa and Asia. Only 27% conformed to recommended WHO target areas for global action to reduce the harmful use of alcohol. The overwhelming majority (96.8%) of industry actions lacked scientific support (p<0.01) and 11.0% had the potential for doing harm. The benefits accruing to the industry ('doing well') included brand marketing and the use of CSR to manage risk and achieve strategic goals. CONCLUSION Alcohol industry CSR activities are unlikely to reduce harmful alcohol use but they do provide commercial strategic advantage while at the same time appearing to have a public health purpose.
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Affiliation(s)
- Thomas F Babor
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Katherine Robaina
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | | | - Jonathan Noel
- Department of Health Science, Johnson and Wales University, Providence, Rhode Island, USA
| | - Mariana Cremonte
- CONICET, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
| | - Daniela Pantani
- Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Raquel I Peltzer
- CONICET, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
| | - Ilana Pinsky
- Psychiatry Institute, Columbia University, New York, USA
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Cheng WJ, Pien LC. A Comparison of International Drunk-Driving Policies and the Role of Drinking Patterns. Am J Prev Med 2018; 55:263-270. [PMID: 29606527 DOI: 10.1016/j.amepre.2018.01.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 01/31/2018] [Accepted: 01/31/2018] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Effective drunk-driving policies are not adopted consistently in many countries. To understand how drinking behaviors influence national drunk-driving policymaking, the associations between drunk-driving policies and country-level drinking volumes and patterns were examined. METHODS Data for 194 countries were obtained from the WHO 2012 Global Information System on Alcohol and Health. Country-level drinking behaviors were measured using average drinking volumes and patterns of drinking scores based on six attributes of risky drinking. Drunk-driving policies were categorized into preemptive measures (random breath testing, breath alcohol concentration limits for driving a vehicle, and sobriety checkpoints), penalties (community service, short- or long-term detention, fines, suspension or revocation of license, and vehicle impoundment), mandatory treatment, and ignition interlock. Data analysis was conducted in 2017. The percentages of each policy adoption were examined in countries with different drinking behaviors. The internal consistencies of preemptive measures were calculated using Cronbach's α. A structural equation model was established to examine the associations between drinking behaviors and drunk-driving policy categories, after adjusting for national income levels and general alcohol policies. RESULTS Mandatory treatment and preemptive measures were less commonly adopted than penalties were. The adoption of preemptive measures had a low consistency level, and the consistency level decreased with drinking pattern riskiness. Risky drinking patterns were negatively associated with mandatory treatment policy. CONCLUSIONS Drinking patterns are associated with national drunk-driving policymaking. Accessible medical treatment and comprehensive preemptive measures should be advocated in countries with risky drinking patterns.
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Affiliation(s)
- Wan-Ju Cheng
- Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.
| | - Li-Chung Pien
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Sindian District, New Taipei City, Taiwan
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Naimi TS, Xuan Z, Sarda V, Hadland SE, Lira MC, Swahn MH, Voas RB, Heeren TC. Association of State Alcohol Policies With Alcohol-Related Motor Vehicle Crash Fatalities Among US Adults. JAMA Intern Med 2018; 178:894-901. [PMID: 29813162 PMCID: PMC6145714 DOI: 10.1001/jamainternmed.2018.1406] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Motor vehicle crashes are a leading cause of mortality. However, the association between the restrictiveness of the alcohol policy environment (ie, based on multiple existing policies) and alcohol-related crash fatalities has not been characterized previously to date. OBJECTIVE To examine the association between the restrictiveness of state alcohol policy environments and the likelihood of alcohol involvement among those dying in motor vehicle crashes in the United States. DESIGN, SETTING, AND PARTICIPANTS This investigation was a repeated cross-sectional study in which state alcohol policies (operationalized by the Alcohol Policy Scale [APS]) from 1999 to 2014 were related to motor vehicle crash fatalities from 2000 to 2015 using data from the Fatality Analysis Reporting System (1-year lag). Alternating logistic regression models and generalized estimating equations were used to account for clustering of multiple deaths within a crash and of multiple crashes occurring within states. The study also examined independent associations of mutually exclusive subgroups of policies, including consumption-oriented policies vs driving-oriented policies. The study setting was the 50 US states. Participants were 505 614 decedents aged at least 21 years from motor vehicle crashes from 2000 to 2015. MAIN OUTCOMES AND MEASURES Odds that a crash fatality was alcohol related (fatality stemmed from a crash in which ≥1 driver had a blood alcohol concentration [BAC] ≥0.08%). RESULTS From 2000 to 2015, there were 505 614 adult motor vehicle crash fatalities in the United States, of which 178 795 (35.4%) were alcohol related. Each 10-percentage point increase in the APS score (corresponding to more restrictive state policies) was associated with reduced individual-level odds of alcohol involvement in a crash fatality (adjusted odds ratio [aOR], 0.90; 95% CI, 0.89-0.91); results were consistent among most demographic and crash-type strata. More restrictive policies also had protective associations with alcohol involvement among crash fatalities associated with BACs from greater than 0.00% to less than 0.08%. After accounting for driving-oriented policies, consumption-oriented policies were independently protective for alcohol-related crash fatalities (aOR, 0.97; 95% CI, 0.96-0.98 based on a 10-percentage point increased APS score). CONCLUSIONS AND RELEVANCE Strengthening alcohol policies, including those that do not specifically target impaired driving, could reduce alcohol-related crash fatalities. Policies may also protect against crash fatalities involving BAC levels below the current legal limit for driving in the United States.
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Affiliation(s)
- Timothy S Naimi
- Section of General Internal Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts.,Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Ziming Xuan
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Vishnudas Sarda
- Section of General Internal Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Scott E Hadland
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Marlene C Lira
- Section of General Internal Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Monica H Swahn
- Division of Epidemiology and Biostatistics, Georgia State University School of Public Health, Atlanta
| | - Robert B Voas
- Pacific Institute for Research and Evaluation, Calverton, Maryland
| | - Timothy C Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
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Roberts SCM, Thomas S, Treffers R, Drabble L. Forty Years of State Alcohol and Pregnancy Policies in the USA: Best Practices for Public Health or Efforts to Restrict Women's Reproductive Rights? Alcohol Alcohol 2018; 52:715-721. [PMID: 29016712 DOI: 10.1093/alcalc/agx047] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/05/2017] [Indexed: 11/14/2022] Open
Abstract
Aims Alcohol consumption during pregnancy remains a public health problem despite >40 years of attention. Little is known about how state policies have evolved and whether policies represent public health goals or efforts to restrict women's reproductive rights. Methods Our data set includes US state policies from 1970 through 2013 obtained through original legal research and from the National Institute for Alcohol Abuse and Alcoholism's (NIAAA)'s Alcohol Policy Information System. Policies were classified as punitive to women or supportive of them. The association between numbers of punitive policies and supportive policies in 2013 with a measure of state restrictions on reproductive rights and Alcohol Policy Effectiveness Scores (APS) was estimated using a Pearson's correlation. Results The number of states with alcohol and pregnancy policies has increased from 1 in 1974 to 43 in 2013. Through the 1980s, state policy environments were either punitive or supportive. In the 1990s, mixed punitive and supportive policy environments began to be the norm, with punitive policies added to supportive ones. No association was found between the number of supportive policies in 2013 and a measure of reproductive rights policies or the APS, nor was there an association between the number of punitive policies and the APS. The number of punitive policies was positively associated, however, with restrictions on reproductive rights. Conclusion Punitive alcohol and pregnancy policies are associated with efforts to restrict women's reproductive rights rather than effective efforts to curb public health harms due to alcohol use in the general population. Future research should explore the effects of alcohol and pregnancy policies. Short Summary The number of states with alcohol and pregnancy policies has increased since 1970 (1 in 1974 and 43 in 2013). Alcohol and pregnancy policies are becoming increasingly punitive. These punitive policies are associated with efforts to restrict women's reproductive rights rather than policies that effectively curb alcohol-related public health harms.
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Affiliation(s)
- Sarah C M Roberts
- Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94706, USA
| | - Sue Thomas
- Pacific Institute for Research and Evaluation (PIRE), P.O. Box 7042, Santa Cruz, CA 96061, USA
| | - Ryan Treffers
- Pacific Institute for Research and Evaluation (PIRE), P.O. Box 7042, Santa Cruz, CA 96061, USA
| | - Laurie Drabble
- San Jose State University School of Social Work, One Washington Square, San Jose, CA 95192-0124, USA
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McFadyen T, Tindall J, Wiggers J, Kingsland M, Sherker S, Gillham K, Rowland B, Heaton R, Lecathelinais C, Wolfenden L. Alcohol management practices in community sporting clubs: Validation of an online self-report tool. Drug Alcohol Rev 2018; 37:580-587. [PMID: 29876978 DOI: 10.1111/dar.12816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/30/2018] [Accepted: 04/20/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Those involved in organised sport have a high risk of excessive alcohol consumption and alcohol-related harm, the implementation of alcohol management practices have been proven to reduce these risks. Measuring alcohol management practice implementation by sporting clubs is impeded by a lack of valid tools. The aim of this study was to determine the validity of online self-report of alcohol-management practices by community football clubs via comparison with observational methods. DESIGN AND METHODS A cross-sectional study was undertaken with a sample of community football clubs within Australia. The implementation of 12 alcohol management practices was collected via: (i) an online survey; and (ii) observational audit at a clubs home ground. The prevalence of implementation of alcohol management practices for both data collection methods was calculated as was percent agreement and Kappa/Prevalence Adjusted and Bias Adjusted Kappa (PABAK) statistics. RESULTS Data were collected from 58 football clubs. For both assessment methods, implementation prevalence was greater than 80% for 6 of the 12 alcohol management practices. A total of 75% (n = 9) of practices had at least 70% agreement between the online and observation methods of assessment. Kappa/PABAK scores ranged from -0.08 (poor agreement) to 0.97 (almost perfect agreement). DISCUSSION AND CONCLUSION The online survey provided valid measure of assessing some but not all alcohol management practices in community sporting clubs. The validity of the measure may be improved by enhancements to the manner in which the self-report data are collected.
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Affiliation(s)
- Tameka McFadyen
- Hunter New England Population Health, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | | | - John Wiggers
- Hunter New England Population Health, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | - Melanie Kingsland
- Hunter New England Population Health, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | | | - Karen Gillham
- Hunter New England Population Health, Newcastle, Australia
| | - Bosco Rowland
- School of Psychology, Deakin University, Melbourne, Australia
| | | | | | - Luke Wolfenden
- Hunter New England Population Health, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
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McFadyen T, Wolfenden L, Kingsland M, Tindall J, Rowland B, Sherker S, Gillham K, Heaton R, Clinton-McHarg T, Lecathelinais C, Brooke D, Wiggers J. Randomised controlled trial of a web-based programme in sustaining best practice alcohol management practices at community sports clubs: a study protocol. BMJ Open 2018; 8:e017796. [PMID: 29362250 PMCID: PMC5786140 DOI: 10.1136/bmjopen-2017-017796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Community-based interventions have been found to effectively increase the implementation of alcohol management practices and reduce excessive alcohol use and alcohol-related harm at sports clubs. However, once implementation support ceases there may be a reduction in such intervention effects. Thus, ongoing contribution to improving the health of the community is diminished; sustaining practice implementation is a key determinant to address this. One possible solution to the strategic and logistical challenges of sustainability involves the use of the web. The primary aim of this study is to assess the effectiveness of a web-based programme in sustaining the implementation of alcohol management practices by community football clubs. The secondary aim is to assess the effectiveness of the programme in preventing excessive alcohol consumption and alcohol-related harm among members of community football clubs. METHODS AND ANALYSIS The study will employ a repeat randomised controlled trial design and be conducted in regional and metropolitan areas within two states of Australia. Community level football clubs who are currently accredited with an existing alcohol management programme ('Good Sports') and implementing at least 10 of the 13 core alcohol management practices (eg, not serving alcohol to <18-year-olds) required by the programme will be recruited and randomised to either a web-based sustainability programme or a 'minimal contact' programme. The primary outcome measures are the proportion of football clubs implementing ≥10 of the 13 required alcohol management practices and the mean number of those practices being implemented at 3-year follow-up. Secondary outcomes include: the proportion of club members who report risky drinking at their club, the Alcohol Use Disorder Identification Test (AUDIT) score and mean AUDIT score of club members. Outcome data will be collected via observation at the club during a 1-day visit to a home game, conducted by trained research assistants at baseline and follow-up. ETHICS AND DISSEMINATION The study was approved by The University of Newcastle Human Research Ethics Committee (reference: H-2013-0429). Study findings will be disseminated widely through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12614000746639; Pre-results.
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Affiliation(s)
- Tameka McFadyen
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Population Health, Hunter New England Health, Wallsend, New South Wales, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Population Health, Hunter New England Health, Wallsend, New South Wales, Australia
| | - Melanie Kingsland
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Jennifer Tindall
- Population Health, Hunter New England Health, Wallsend, New South Wales, Australia
| | - Bosco Rowland
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Shauna Sherker
- Good Sports, Alcohol and Drug Foundation, Melbourne, Victoria, Australia
| | - Karen Gillham
- Population Health, Hunter New England Health, Wallsend, New South Wales, Australia
| | - Rachael Heaton
- Good Sports, Alcohol and Drug Foundation, Melbourne, Victoria, Australia
| | - Tara Clinton-McHarg
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | | | - Daisy Brooke
- Good Sports, Alcohol and Drug Foundation, Melbourne, Victoria, Australia
| | - John Wiggers
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Population Health, Hunter New England Health, Wallsend, New South Wales, Australia
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Stockwell T. Minimum unit pricing for alcohol: the most cost-effective of cancer prevention strategies? Expert Rev Anticancer Ther 2017; 17:981-983. [PMID: 28929817 DOI: 10.1080/14737140.2017.1381565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Timothy Stockwell
- a Centre for Addictions Research of British Columbia , University of Victoria , Victoria , BC , Canada
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Naimi TS, Xuan Z, Coleman SM, Lira MC, Hadland SE, Cooper SE, Heeren TC, Swahn MH. Alcohol Policies and Alcohol-Involved Homicide Victimization in the United States. J Stud Alcohol Drugs 2017; 78:781-788. [PMID: 28930066 PMCID: PMC5675429 DOI: 10.15288/jsad.2017.78.781] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the associations between the alcohol policy environment and alcohol involvement in homicide victims in the United States, overall and by sociodemographic groups. METHOD To characterize the alcohol policy environment, the presence, efficacy, and degree of implementation of 29 alcohol policies were used to determine Alcohol Policy Scale (APS) scores by state and year. Data about homicide victims from 17 states from 2003 to 2012 were obtained from the National Violent Death Reporting System. APS scores were used as lagged exposure variables in generalized estimating equation logistic regression models to predict the individual-level odds of alcohol involvement (i.e., blood alcohol concentration [BAC] > 0.00% vs. = 0.00% and BAC ≥ 0.08% vs. ≤ 0.079%) among homicide victims. RESULTS A 10 percentage point increase in APS score (representing a more restrictive policy environment) was associated with reduced odds of alcohol-involved homicide with BAC greater than 0.00% (adjusted odds ratio [AOR] = 0.89, 95% CI [0.82, 0.99]) and BAC of 0.08% or more (AOR = 0.91, 95% CI [0.82, 1.02]). In stratified analyses of homicide victims, more restrictive policy environments were significantly protective of alcohol involvement at both BAC levels among those who were female, ages 21-29 years, Hispanic, unmarried, victims of firearm homicides, and victims of homicides related to intimate partner violence. CONCLUSIONS More restrictive alcohol policy environments were associated with reduced odds of alcohol-involved homicide victimization overall and among groups at high risk of homicide. Strengthening alcohol policies is a promising homicide prevention strategy.
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Affiliation(s)
- Timothy S. Naimi
- Section of General Internal Medicine, Boston
Medical Center, Boston, Massachusetts,Department of Community Health Sciences,
Boston University School of Public Health, Boston, Massachusetts,Correspondence may be sent to Timothy S. Naimi
at the Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts
Ave., 2nd Floor, Boston, MA 02118, or via email at:
| | - Ziming Xuan
- Department of Community Health Sciences,
Boston University School of Public Health, Boston, Massachusetts
| | - Sharon M. Coleman
- Data Coordinating Center, Boston University
School of Public Health, Boston, Massachusetts
| | - Marlene C. Lira
- Section of General Internal Medicine, Boston
Medical Center, Boston, Massachusetts
| | - Scott E. Hadland
- Department of Pediatrics, Boston University
School of Medicine, Boston, Massachusetts
| | - Susanna E. Cooper
- Section of General Internal Medicine, Boston
Medical Center, Boston, Massachusetts
| | - Timothy C. Heeren
- Department of Biostatistics, Boston University
School of Public Health, Boston, Massachusetts
| | - Monica H. Swahn
- Department of Epidemiology and Biostatistics,
Georgia State University School of Public Health, Atlanta, Georgia
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49
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Is there an association between trends in alcohol consumption and cancer mortality? Findings from a multicountry analysis. Eur J Cancer Prev 2017; 28:45-53. [PMID: 28683009 DOI: 10.1097/cej.0000000000000403] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aim of this analysis is to examine long-term trends in alcohol consumption and associations with lagged data on specific types of cancer mortality, and indicate policy implications. Data on per capita annual sales of pure alcohol; mortality for three alcohol-related cancers - larynx, esophageal, and lip, oral cavity, and pharynx; and per capita consumption of tobacco products were extracted at the country level. The Unobservable Components Model was used for this time-series analysis to examine the temporal association between alcohol consumption and cancer mortality, using lagged data, from 17 countries. Statistically significant associations were observed between alcohol sales and cancer mortality, in the majority of countries examined, which remained after controlling for tobacco use (P<0.05). Significant associations were observed in countries with increasing, decreasing, or stable trends in alcohol consumption and corresponding lagged trends in alcohol-related cancer mortality. Curtailing overall consumption has potential benefits in reducing a number of harms from alcohol, including cancer mortality. Future research and surveillance are needed to investigate, monitor, and quantify the impact of alcohol control policies on trends in cancer mortality.
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McKee P, Erickson DJ, Toomey T, Nelson T, Less EL, Joshi S, Jones-Webb R. The Impact of Single-Container Malt Liquor Sales Restrictions on Urban Crime. J Urban Health 2017; 94:289-300. [PMID: 28271236 PMCID: PMC5391327 DOI: 10.1007/s11524-016-0124-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Many US cities have adopted legal restrictions on high-alcohol malt liquor sales in response to reports of crime and nuisance behaviors around retail alcohol outlets. We assessed whether these policies are effective in reducing crime in urban areas. We used a rigorous interrupted time-series design with comparison groups to examine monthly crime rates in areas surrounding alcohol outlets in the 3 years before and after adoption of malt liquor sales restrictions in two US cities. Crime rates in matched comparison areas not subject to restrictions served as covariates. Novel methods for matching target and comparison areas using virtual neighborhood audits conducted in Google Street View are described. In Minneapolis, Minnesota, sales of single containers of 16 oz or less were prohibited in individual liquor stores (n = 6). In Washington, D.C., the sale of single containers of any size were prohibited in all retail alcohol outlets within full or partial wards (n = 6). Policy adoption was associated with modest reductions in crime, particularly assaults and vandalism, in both cities. All significant outcomes were in the hypothesized direction. Our results provide evidence that retail malt liquor sales restrictions, even relatively weak ones, can have modest effects on a range of crimes. Policy success may depend on community support and concurrent restrictions on malt liquor substitutes.
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Affiliation(s)
- Patricia McKee
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St, Suite 300, Minneapolis, MN, 55454, USA.
| | - Darin J Erickson
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St, Suite 300, Minneapolis, MN, 55454, USA
| | - Traci Toomey
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St, Suite 300, Minneapolis, MN, 55454, USA
| | - Toben Nelson
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St, Suite 300, Minneapolis, MN, 55454, USA
| | - Elyse Levine Less
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St, Suite 300, Minneapolis, MN, 55454, USA
| | - Spruha Joshi
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St, Suite 300, Minneapolis, MN, 55454, USA
| | - Rhonda Jones-Webb
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St, Suite 300, Minneapolis, MN, 55454, USA
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