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Hollett RC, Fairclough J, Butt J, Mills B. Exposure to preference-matched alcohol advertisements from national sports broadcasts increases short-term alcohol consumption inclinations in risky drinkers. Health Promot J Austr 2024. [PMID: 38951019 DOI: 10.1002/hpja.894] [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: 01/11/2024] [Revised: 04/17/2024] [Accepted: 06/12/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND In Australia, sports broadcasting is afforded special alcohol advertising rights during daytime hours, which raises public health concerns, including short-term increases in alcohol consumption among the broad viewership of national sporting codes. METHODS We conducted a content analysis across a sample of nationally televised finals matches (N = 16) from the Australian Football League (AFL) and the National Rugby League (NRL) to determine the prevalence of alcohol advertising video clips during these broadcasts. We also conducted an online experiment exposing participants (N = 345) to a randomly selected alcohol advertisement and measured the immediate effects on self-reported alcohol craving and drinking intentions. RESULTS The prevalence of alcohol advertising video clips during AFL broadcasts was 3.9% and 1.8% for NRL. While, overall, alcohol advertisement video clip exposure did not impact craving or drinking intentions, a modest increase in craving was found for a subsample of risky drinking participants (N = 107) who also reported a preference for the specific alcoholic beverage being advertised. CONCLUSIONS Video alcohol advertisements occurred less than 1 in 20 advertisements on average and exposure to alcohol advertising elicited a low, yet measurable, short-term increase in alcohol inclinations, among vulnerable adult drinkers when a desirable alcoholic beverage advertisement is viewed. SO WHAT?: Given that alcohol advertisements are most likely to increase consumption among risky drinkers, health messaging during sports broadcasts needs to specifically target these individuals.
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Affiliation(s)
- Ross C Hollett
- Psychology and Criminology, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Jesse Fairclough
- Psychology and Criminology, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Julia Butt
- Psychology and Criminology, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Brennen Mills
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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2
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Sersli S, Shareck M. Is alcohol outlet availability associated with binge drinking in Canadian young adults? Findings from British Columbia and Quebec. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024:10.17269/s41997-024-00905-6. [PMID: 38918359 DOI: 10.17269/s41997-024-00905-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024]
Abstract
OBJECTIVES Alcohol availability is associated with alcohol consumption and related harms, but there is less evidence on associations with heavy episodic drinking (HED), a drinking pattern prevalent among young adults. This study aimed to assess the associations between alcohol availability and HED among young Canadians. METHODS We used a population-based sample of Canadian urban-dwelling young adult drinkers (18‒29 years) from the cross-sectional Canadian Community Health Survey (CCHS; cycles 2015‒2019). We linked data from CCHS respondents in British Columbia and Quebec with two measures of alcohol availability for both offsite and onsite outlets: density (AOD) and accessibility (SAI) within dissemination areas (N = 1,067,747). We used logistic regression to estimate the associations between alcohol availability and monthly HED, adjusting for covariates. RESULTS The associations between availability and HED differed by province, and availability measure. In British Columbia, offsite and onsite accessibility using SAI was inversely associated with HED. For example, living in neighbourhoods with medium alcohol accessibility (as compared to low) was significantly associated with reduced odds of HED (offsite OR = 0.33, 95% CI 0.17‒0.64; onsite OR = 0.49, 95% CI 0.27‒0.89). In Quebec, offsite availability was positively associated with HED using SAI (although not statistically significant) while no clear trend was seen for onsite availability. CONCLUSION Results were consistent with previous evidence. Restricting spatial availability of alcohol remains an important public health strategy for decreasing the ease/convenience of access. Understanding why patterns of availability and drinking differ across regions could inform regionally tailored policies.
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Affiliation(s)
- Stephanie Sersli
- Faculté de médecine et des sciences de la santé, Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Québec, Canada
| | - Martine Shareck
- Faculté de médecine et des sciences de la santé, Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Québec, Canada.
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Québec, Canada.
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3
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Forbes SM, Schwartz N, Fu SH, Hobin E, Smith BT. The association between off- and on-premise alcohol outlet density and 100% alcohol-attributable emergency department visits by neighbourhood-level socioeconomic status in Ontario, Canada. Health Place 2024; 89:103284. [PMID: 38875963 DOI: 10.1016/j.healthplace.2024.103284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 06/16/2024]
Abstract
Alcohol availability is positively associated with alcohol use and harms, but the influence of socioeconomic status (SES) on these associations is not well established. This population-based cross-sectional study examined neighbourhood-level associations between physical alcohol availability (measured as off- and on-premise alcohol outlet density) and 100% alcohol-attributable emergency department (ED) visits by neighbourhood SES in Ontario, Canada from 2017 to 2019 (n = 19,740). A Bayesian spatial modelling approach was used to assess associations and account for spatial autocorrelation, which produced risk ratios (RRs) and 95% credible intervals (95% CrI). Each additional off-premise alcohol outlet in a neighbourhood was associated with a 3% increased risk of alcohol-attributable ED visits in both men (RR = 1.03, 95%CrI: 1.02-1.04) and women (RR = 1.03, 95% CrI: 1.02-1.04). Positive associations were also observed between on-premise alcohol outlet density and alcohol-attributable ED visits, although effect sizes were small. A disproportionately greater association with ED visits was observed with increasing alcohol outlet density in the lowest compared to higher SES neighbourhoods. Reducing physical alcohol availability may be an important policy lever for reducing alcohol harm and alcohol-attributable health inequities.
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Affiliation(s)
- Samantha M Forbes
- Public Health Ontario, 661 University Ave, Toronto, Ontario, Canada, M5G 1M1.
| | - Naomi Schwartz
- Public Health Ontario, 661 University Ave, Toronto, Ontario, Canada, M5G 1M1.
| | - Sze Hang Fu
- Public Health Ontario, 661 University Ave, Toronto, Ontario, Canada, M5G 1M1.
| | - Erin Hobin
- Public Health Ontario, 661 University Ave, Toronto, Ontario, Canada, M5G 1M1; Dalla Lana School of Public Health, University of Toronto, 1 55 College St, Toronto, Canada, M5T 3M7.
| | - Brendan T Smith
- Public Health Ontario, 661 University Ave, Toronto, Ontario, Canada, M5G 1M1; Dalla Lana School of Public Health, University of Toronto, 1 55 College St, Toronto, Canada, M5T 3M7.
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Giesbrecht N, Reisdorfer E, Shield K. The impacts of alcohol marketing and advertising, and the alcohol industry's views on marketing regulations: Systematic reviews of systematic reviews. Drug Alcohol Rev 2024. [PMID: 38803126 DOI: 10.1111/dar.13881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024]
Abstract
ISSUES Advertising and marketing affect alcohol use; however, no single systematic review has covered all aspects of how they affect alcohol use, and how the alcohol industry views alcohol marketing restrictions. APPROACH Two systematic reviews of reviews were performed according to the Preferred Reporting Items on 2 February 2023. Results were analysed using a narrative synthesis approach. KEY FINDINGS Twenty-three reviews were included in the systematic reviews. The first systematic review examined youth and adolescents (11 reviews), digital or internet marketing (3 reviews), alcohol marketing's impact on cognition (3 reviews), and alcohol marketing and policy options (2 reviews). The second systematic review focused on alcohol industry (i.e., importers, producers, distributors, retailers and advertising firms) response to advertising restrictions (four reviews). The reviews indicated that there is evidence that alcohol marketing (including digital marketing) is associated with increased intentions to drink, levels of consumption and harmful drinking among youth and young adults. Studies on cognition indicate that advertisements focusing on appealing contexts and outcomes may be more readily accepted by adolescents, and may be less easily extinguished in this population. The review of the alcohol industry found a strong desire to self-regulate alcohol advertising. IMPLICATIONS We found alcohol advertising and marketing is associated with increased drinking intentions, consumption and harmful drinking. Thus, policies which restrict advertising may be an effective way to reduce alcohol use. CONCLUSION More research is needed to assess all aspects of the observed associations, especially as to how marketing policies impact women and people with alcohol dependence.
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Affiliation(s)
- Norman Giesbrecht
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Kevin Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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5
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Düring SW, Austin SF, Mårtensson S, Johansen KS. Perceived advantages and disadvantages of substance use in a dual diagnosis population with severe mental disorders and severe substance use disorder. Considering the self-medication hypothesis. Nord J Psychiatry 2024; 78:281-289. [PMID: 38380582 DOI: 10.1080/08039488.2024.2318649] [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: 08/11/2023] [Accepted: 02/09/2024] [Indexed: 02/22/2024]
Abstract
AIM Based on a large cohort of dual diagnosis patients, the aim of this study was to quantify the patient-perceived problems and advantages of their substance use and relate the quantity of problems to the substance type and psychiatric diagnosis. MATERIAL Data comes from a naturalistic cohort admitted to an in-patient facility in Denmark specialized in integrated dual diagnosis treatment. We included 1076 patients at their first admission to the facility from 2010 to 2017. Participants completed 607 DrugCheck and 130 DUDIT-E questionnaires. METHOD we analyzed the questionnaires and included admission diagnosis by use of t-test and ANOVA to depict the patterns in substance use in relation to psychiatric diagnosis. RESULTS The three most common substance related problems according to the DrugCheck questionnaire were: feeling depressed, financial problems, and losing interest in daily activities. From DUDIT-E, the highest-ranking negative substance related effects were financial ruin, deterioration of health, and problems at work. Effects on social life relationships were also evident with more than 40% of participants. The top three positive substance related effects reported were relaxation, improved sleep, and control over negative emotions. The number of problems listed varied significantly with the type of preferred substance. Patients using pain medication, sedatives, central stimulants, and alcohol reported most problems. Diagnosis did not differentiate the problems experienced. Results partially support the broad self-medication hypothesis for patients with severe mental illness, but also points out that patients are well aware of negative effects.
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Affiliation(s)
- Signe Wegmann Düring
- Competence Centre of Dual Diagnosis, Mental Health Services of the Capital Region, Mental Health Centre Sct. Hans, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Mental Health Services of the Capital Region, Mental Health Centre Sct. Hans, Roskilde, Denmark
- Mental Health Services of the Capital Region, Mental Health Centre Amager, Copenhagen, Denmark
| | | | - Solvej Mårtensson
- Competence Centre of Dual Diagnosis, Mental Health Services of the Capital Region, Mental Health Centre Sct. Hans, Roskilde, Denmark
| | - Katrine Schepelern Johansen
- Competence Centre of Dual Diagnosis, Mental Health Services of the Capital Region, Mental Health Centre Sct. Hans, Roskilde, Denmark
- National Institute of Public Health, University of Southern, Odense, Denmark
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Doyle A, Foley R, Houghton F. A spatial examination of alcohol availability and the level of disadvantage of schools in Ireland. BMC Public Health 2024; 24:795. [PMID: 38481175 PMCID: PMC10938707 DOI: 10.1186/s12889-024-18261-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/03/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND The availability of alcohol is a major factor in underage drinking and according to the alcohol harm paradox, those living in more deprived communities are more susceptible to the negative consequences of alcohol use, despite drinking the same or less than those from more affluent areas. Alcohol availability within the vicinity of the home or school normalises alcohol for schoolchildren. For the first time in the Republic of Ireland, this study examines the number of premises licensed to sell alcohol within 300 m of all schools in Ireland and differences in this number between disadvantaged and non-disadvantaged schools. METHODS Using publicly available data from the Department of Education and Revenue, the addresses of all schools (n = 3,958) and all premises with at least one liquor licence (n = 14,840) were geocoded and analysed using the Geographic Information System software, Quantum GIS (QGIS). Schools were identified by their disadvantaged classification using the HP Pobal Deprivation Index and the number of liquor licences within 300 m of each school type was examined. To test for significant differences between schools' level of disadvantage, a combination of Mann-Whitney U tests, Kruskal-Wallis tests and Dunn-Bonferroni tests were used. RESULTS There was a mean of two licenced premises within 300 m of all schools in Ireland, but when disadvantaged schools were compared to non-disadvantaged schools, there was a significantly higher number of licenced premises around disadvantaged schools (p < .001). Primary schools are further classified according to their level of disadvantage and the results indicated that those schools classified as the most disadvantaged had a significantly greater number of liquor licences within 300 meters (p < .001). There was no significant difference in density of licenced premises when comparing disadvantaged secondary schools with non-disadvantaged secondary schools (p = .705). CONCLUSION Ireland is considering increasing alcohol availability through the Sale of Alcohol Bill, 2022. However, this analysis indicates already problematic numbers of licenced premises within close proximity of schools in Ireland. It is essential that the harms associated with alcohol availability are considered, especially for those living and attending school in disadvantaged communities, where higher numbers of licenced premises were identified.
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Affiliation(s)
- Anne Doyle
- Health Research Board, Grattan House 67-72 Lower Mount Street, Dublin, Ireland.
| | - Ronan Foley
- Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Frank Houghton
- Technological University of the Shannon, Limerick, Ireland
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Klingemann H, Lesch M. The confluence of legacy, corporate social responsibility, and public health: The case of Migros and alcohol-free retailing in Switzerland. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 125:104333. [PMID: 38350167 DOI: 10.1016/j.drugpo.2024.104333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/10/2024] [Accepted: 01/17/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Alcohol policy studies have traditionally focused on formal policymaking processes. Retail cooperatives, however, have rarely been studied as sites of public health interventions. Migros, a cooperatively owned chain of supermarkets in Switzerland, has long forbidden alcohol sales in its supermarkets. Focusing on processes of framing, this study explores a recent unsuccessful attempt to reverse the long-standing ban via membership vote in 2022. METHODS The study draws on a range of data sources, including company documents, a televised debate, and the results of a large online survey among the general population conducted ahead of the referendum. Using thematic analysis, it investigates various campaign-related arguments, including those made by Migros management, NGOs, and other key campaign participants. RESULTS Proponents and opponents used a combination of public health, economic/market-oriented, and corporate social responsibility (CSR) frames. Migros's longstanding dedication to CSR, its participatory governance structure, and the regional political dynamics in the Swiss context are essential in understanding the nature and impact of framing. CONCLUSIONS Alcohol-related harm arises from a complex interaction between different social, political, and economic factors. Reducing harm requires approaches that consider the range of contexts and measures that can shape alcohol availability.
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Affiliation(s)
- Harald Klingemann
- Bern University of Applied Sciences, Bern Academy of the Arts (HKB), Institute of Design Research (IDR) Bern Switzerland, Fellerstrasse 11, Bern, CH-3027, Switzerland.
| | - Matthew Lesch
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, United Kingdom
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Fitzgerald N, Egan M, O'Donnell R, Nicholls J, Mahon L, de Vocht F, McQuire C, Angus C, Purves R, Henney M, Mohan A, Maani N, Shortt N, Bauld L. Public health engagement in alcohol licensing in England and Scotland: the ExILEnS mixed-method, natural experiment evaluation. PUBLIC HEALTH RESEARCH 2024:1-76. [PMID: 38345369 DOI: 10.3310/fsrt4135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
Background International systematic reviews suggest an association between alcohol availability and increased alcohol-related harms. Alcohol availability is regulated through separate locally administered licensing systems in England and Scotland, in which local public health teams have a statutory role. The system in Scotland includes a public health objective for licensing. Public health teams engage to varying degrees in licensing matters but no previous study has sought to objectively characterise and measure their activity, examine their effectiveness, or compare practices between Scotland and England. Aim To critically assess the impact and mechanisms of impact of public health team engagement in alcohol premises licensing on alcohol-related harms in England and Scotland. Methods We recruited 39 diverse public health teams in England (n = 27) and Scotland (n = 12). Public health teams more active in licensing were recruited first and then matched to lower-activity public health teams. Using structured interviews (n = 66), documentation analysis, and expert consultation, we developed and applied the Public Health Engagement In Alcohol Licensing (PHIAL) measure to quantify six-monthly activity levels from 2012 to 2019. Time series of PHIAL scores, and health and crime outcomes for each area, were analysed using multivariable negative binomial mixed-effects models to assess correlations between outcome and exposure, with 18-month average PHIAL score as the primary exposure metric. In-depth interviews (n = 53) and a workshop (n = 10) explored public health team approaches and potential mechanisms of impact of alcohol availability interventions with public health team members and licensing stakeholders (local authority licensing officers, managers and lawyers/clerks, police staff with a licensing remit, local elected representatives). Findings Nineteen public health team activity types were assessed in six categories: (1) staffing; (2) reviewing and (3) responding to licence applications; (4) data usage; (5) influencing licensing stakeholders/policy; and (6) public involvement. Usage and intensity of activities and overall approaches varied within and between areas over time, including between Scotland and England. The latter variation could be explained by legal, structural and philosophical differences, including Scotland's public health objective. This objective was felt to legitimise public health considerations and the use of public health data within licensing. Quantitative analysis showed no clear evidence of association between level of public health team activity and the health or crime outcomes examined, using the primary exposure or other metrics (neither change in, nor cumulative, PHIAL scores). Qualitative data suggested that public health team input was valued by many licensing stakeholders, and that alcohol availability may lead to harms by affecting the accessibility, visibility and norms of alcohol consumption, but that the licensing systems have limited power to act in the interests of public health. Conclusions This study provides no evidence that public health team engagement in local licensing matters was associated with measurable downstream reductions in crime or health harms, in the short term, or over a 7-year follow-up period. The extensive qualitative data suggest that public health team engagement is valued and appears to be slowly reorienting the licensing system to better address health (and other) harms, especially in Scotland, but this will take time. A rise in home drinking, alcohol deliveries, and the inherent inability of the licensing system to reduce - or in the case of online sales, to contain - availability, may explain the null findings and will continue to limit the potential of these licensing systems to address alcohol-related harms. Future work Further analysis could consider the relative success of different public health team approaches in terms of changing alcohol availability and retailing. A key gap relates to the nature and impact of online availability on alcohol consumption, harms and inequalities, alongside development and study of relevant policy options. A national approach to licensing data and oversight would greatly facilitate future studies and public health input to licensing. Limitations Our interview data and therefore PHIAL scores may be limited by recall bias where documentary evidence of public health activity was not available, and by possible variability in grading of such activity, though steps were taken to minimise both. The analyses would have benefited from additional data on licensing policies and environmental changes that might have affected availability or harms in the study areas. Study registration The study was registered with the Research Registry (researchregistry6162) on 26 October 2020. The study protocol was published in BMC Medical Research Methodology on 6 November 2018. Funding This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number 15/129/11.
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Affiliation(s)
- Niamh Fitzgerald
- Institute for Social Marketing and Health, University of Stirling, Scotland, UK
- SPECTRUM Consortium, UK
| | - Matt Egan
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- NIHR School for Public Health Research, Tyne and Wear, UK
| | - Rachel O'Donnell
- Institute for Social Marketing and Health, University of Stirling, Scotland, UK
| | - James Nicholls
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK
| | - Laura Mahon
- Alcohol Focus Scotland, Glasgow, Scotland, UK
| | - Frank de Vocht
- NIHR School for Public Health Research, Tyne and Wear, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West, Bristol, UK
| | - Cheryl McQuire
- NIHR School for Public Health Research, Tyne and Wear, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Colin Angus
- SPECTRUM Consortium, UK
- School of Health and Related Research, University of Sheffield, UK
| | - Richard Purves
- Institute for Social Marketing and Health, University of Stirling, Scotland, UK
| | - Madeleine Henney
- School of Health and Related Research, University of Sheffield, UK
| | - Andrea Mohan
- School of Health Sciences, University of Dundee, Scotland, UK
| | - Nason Maani
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Niamh Shortt
- SPECTRUM Consortium, UK
- School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Linda Bauld
- SPECTRUM Consortium, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
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Booth L, Miller M, Pettigrew S. The potential adverse effects of minors' exposure to alcohol-related stimuli via licenced venues: A narrative review. Drug Alcohol Rev 2024; 43:141-155. [PMID: 37934620 DOI: 10.1111/dar.13769] [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: 02/27/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 11/09/2023]
Abstract
ISSUES Young people are particularly impressionable when it comes to forming expectations and attitudes around alcohol consumption. Any stimuli that normalise and foster positive expectations around alcohol use may increase the risk of underage alcohol consumption. Alcohol venues that market themselves as being appropriate 'family friendly' establishments for children risk exposing minors to environments that are saturated with alcohol-related stimuli. However, research examining how exposure to licenced venues affects underage people is very limited. The aim of this narrative review was to identify and synthesise relevant evidence to better understand how attending these venues might affect minors. APPROACH A narrative review of research published between January 2016 and November 2022 was conducted to investigate the potential effects on underage people of exposure to licenced venues and stimuli encountered in/around these venues. Examined stimuli included alcohol advertising, people consuming alcohol and alcohol outlets. KEY FINDINGS The reviewed literature indicates that the risk of alcohol-related harm among minors is likely to increase with greater exposure to alcohol venues due to the associated exposure to alcohol advertising, exposure to others consuming alcohol and higher outlet density. In combination, these factors are likely to normalise alcohol consumption for minors and create positive alcohol expectancies. IMPLICATIONS AND CONCLUSION Venues serving alcohol should be discouraged from targeting families and parents should be warned about the risks associated with taking minors to venues where alcohol is sold and consumed.
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Affiliation(s)
- Leon Booth
- The George Institute for Global Health, UNSW Sydney, Sydney, Australia
| | - Mia Miller
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, UNSW Sydney, Sydney, Australia
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Chambers T, Mizdrak A, Herbert S, Davies A, Jones A. The estimated health impact of alcohol interventions in New Zealand: A modelling study. Addiction 2024; 119:125-136. [PMID: 37649140 DOI: 10.1111/add.16331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 07/24/2023] [Indexed: 09/01/2023]
Abstract
AIMS To estimate the health impacts of key modelled alcohol interventions among Māori (indigenous peoples) and non-Māori in New Zealand (NZ). DESIGN Multi-stage life-table intervention modelling study. We modelled two scenarios: (1) business-as-usual (BAU); and (2) an intervention package scenario that included a 50% alcohol tax increase, outlet density reduction from 63 to five outlets per 100 000 people, outlet hours reduction from 112 to 50 per week and a complete ban on all forms of alcohol marketing. SETTING AND PARTICIPANTS The model's population replicates the 2018 NZ population by ethnicity (Māori/non-Māori), age and sex. MEASUREMENTS Alcohol consumption was estimated using nationally representative survey data combined with sales data and corrected for tourist and unrecorded consumption. Disease incidence, prevalence and mortality were calculated using Ministry of Health data. We used dose-response relationships between alcohol and illness from the 2016 Global Burden of Disease study and calculated disability rates for each illness. Changes in consumption were based on the following effect sizes: total intervention package [-30.3%, standard deviation (SD) = 0.02); tax (-7.60%, SD = 0.01); outlet density (-8.64%, SD = 0.01); outlet hours (-9.24%, SD = 0.01); and marketing (-8.98%, SD = 0.02). We measured health gain using health-adjusted life years (HALYs) and life expectancy. FINDINGS Compared with the BAU scenario, the total alcohol intervention package resulted in 726 000 [95% uncertainty interval (UI) = 492 000-913 000] HALYs gained during the life-time of the modelled population. Māori experienced greater HALY gains compared with non-Māori (0.21, 95% UI = 0.14-0.26 and 0.16, 95% UI = 0.11-0.20, respectively). When modelled individually, each alcohol intervention within the intervention package produced similar health gains (~200 000 HALYs per intervention) owing to the similar effect sizes. CONCLUSIONS Modelled interventions for increased alcohol tax, reduced availability of alcohol and a ban on alcohol marketing among Māori and non-Māori in New Zealand (NZ) suggest substantial population-wide health gains and reduced health inequities between Māori and non-Māori.
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Affiliation(s)
- Tim Chambers
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Anja Mizdrak
- Department of Public Health, University of Otago, Wellington, New Zealand
| | | | - Anna Davies
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Amanda Jones
- Department of Public Health, University of Otago, Wellington, New Zealand
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11
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Zhen-Duan J, Banks DE, Ferreira C, Zhang L, Valentino K, Alegría M. Mexican-origin parent and child reported neighborhood factors and youth substance use. Front Psychiatry 2023; 14:1241002. [PMID: 38107000 PMCID: PMC10722282 DOI: 10.3389/fpsyt.2023.1241002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/08/2023] [Indexed: 12/19/2023] Open
Abstract
Background Structural oppression affects health behaviors through residence in suboptimal neighborhoods and exposure to community violence. Youth and parents report perceptions of neighborhood factors that can affect youth substance use behaviors. Given that Latinx youth report higher levels of perceived community violence than other racial and ethnic groups, it is imperative to examine how youth- and parent-perceived neighborhood-level factors may relate to youth substance use. Methods Data were collected using clinical interviews with family triads (fathers, mothers, and youth) and parent-child dyads (father or mother and youth) enrolled in the Seguimos Avanzando study of 344 Mexican-origin families in Indiana. Neighborhood measures, including perceptions of exposure to violence, neighborhood characteristics, and neighborhood collective efficacy, were included in parent and youth surveys. Self-report measures for past year alcohol and drug use were included in the youth survey only. T-tests were conducted to estimate differences in neighborhood reports among the sample triads. A series of linear regression models were used to estimate the associations between youth-, mother-, and father-reported perceptions of neighborhood factors and youth substance use. Results Preliminary results indicate that fathers reported higher levels of exposure to violence than mothers [t(163) = 2.33, p = 0.02] and youth [t(173) = 3.61, p < 0.001]. Youth reported lower negative neighborhood characteristics than mothers [t(329) = 6.43, p < 0.001] and fathers [t(169) = 3.73, p < 0.001]. Youth reported significantly better neighborhood collective efficacy than mothers [t(296) = 3.14, p = 0.002], but not statistically different from fathers. Results from the primary analysis showed that youth exposure to violence was positively associated with youth substance use (b = 0.24, SE = 0.06, p < 0.0001), but the youth's neighborhood characteristics and collective efficacy were not significantly associated with youth substance use. None of the parent-reported neighborhood variables were associated with youth substance use. Conclusion The discrepant findings between parent and youth reports of perceived neighborhood characteristics and substance use have important implications for researchers and community stakeholders, and for developing targeted interventions and prevention strategies. Our study highlights the need to address youth experience of community violence and to prioritize creating safe and inclusive neighborhood environments. Potential strategies include improving community resources, strengthening social support networks, promoting open communication about neighborhood risks, and fostering collaborative efforts to address substance use behaviors.
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Affiliation(s)
- Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Devin E. Banks
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, United States
| | - Caroline Ferreira
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Lulu Zhang
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, United States
| | - Kristin Valentino
- Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
| | - Margarita Alegría
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MO, United States
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12
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Rasouli MA, Zareie B, Gouya MM, Hadavandsiri F, Mahboobi M, Moradi Y, Moradi R, Moradi G. Lifetime and past-month alcohol use and related factors among female sex workers in Iran. Brain Behav 2023; 13:e3288. [PMID: 37872677 PMCID: PMC10726872 DOI: 10.1002/brb3.3288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/07/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE Alcohol use is more common among female sex workers (FSWs). This study assessed the prevalence of lifetime and past-month alcohol use and related factors among FSWs in Iran. METHODS We conducted a cross-sectional survey among 1464 women from 8 major cities in Iran. Behavioral data were collected by trained interviewers and conducted face-to-face in a private room. Weighted analysis was used to determine the lifetime and past-month alcohol use prevalence. Univariate and multivariate logistic regression was used to investigate the association between alcohol use and independent variables. RESULTS The most alcohol used in lifetime and past-month (weekly, less than once a week, and daily) in FSWs was 52.7% (12.25%, 12.94%, and 1.83%), respectively. In the final model, factors that were independently associated with alcohol use included the 31-40 years (AOR = 2.41, 95% CI: 1.13-5.15), education level of diploma (AOR = 2.43, 95% CI: 1.31-4.51), history of lifetime drug use (AOR = 2.79, 95% CI: 2.01-3.89), history of lifetime group sex (AOR = 2.07, 95% CI: 1.41-3.03), history of intentional abortion (AOR = 1.42, 95% CI: 1.06-1.92), six or more sexual clients in the last month (AOR = 3.25, 95% CI: 1.80-5.87), history of lifetime anal sex (AOR = 2.47, 95% CI: 1.82-3.35), and FSWs the married, temporarily married, and living with partner were positively associated with lifetime alcohol use. CONCLUSION Alcohol use is prevalent among FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with alcohol use among this vulnerable population in Iran. Designing intervention programs, it is suggested to consider other variables affecting alcohol use in FSWs.
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Affiliation(s)
- Mohammad Aziz Rasouli
- Department of Epidemiology and BiostatisticsFaculty of Medicine, Kurdistan University of Medical SciencesSanandajIran
| | - Bushra Zareie
- Department of Epidemiology, School of Public HealthHamadan University of Medical SciencesHamadanIran
| | - Mohammad Mehdi Gouya
- Iranian Center for Communicable Disease ControlMinistry of Health and Medical EducationTehranIran
| | - Fatemeh Hadavandsiri
- School of Public Health and SafteyShahid Beheshti University of Medical SciencesTehranIran
| | - Marzieh Mahboobi
- Iranian Center for Communicable Disease ControlMinistry of Health and Medical EducationTehranIran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Rozhin Moradi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
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13
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Kong AY, Herbert L, Feldman JM, Trangenstein PJ, Fakunle DO, Lee JGL. Tobacco and Alcohol Retailer Availability and Neighborhood Racialized, Economic, and Racialized Economic Segregation in North Carolina. J Racial Ethn Health Disparities 2023; 10:2861-2871. [PMID: 36469288 DOI: 10.1007/s40615-022-01463-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Despite evidence of racialized and socioeconomic inequities in tobacco and alcohol outlet availability, few studies have investigated spatial inequities in areas experiencing both concentrated residential racialized segregation and socioeconomic disadvantage. This study examined whether segregation-racialized, economic or both-was associated with alcohol and tobacco retailer counts in North Carolina (NC). METHODS The NC Alcoholic Beverage Control Commission provided lists of 2021 off-premise alcohol retailers. We created a list of 2018 probable tobacco retailers using ReferenceUSA. We calculated three census tract-level measures of the Index of Concentrations at the Extremes (ICE), indicating racialized segregation between non-Hispanic White and Black residents and economic segregation based on household income. We used negative binomial regression to test associations between quintiles of each ICE measure and tobacco and, separately, alcohol retailer counts. RESULTS Tracts with the greatest racialized disadvantage had 38% (IRR, 1.38; 95% CI, 1.15-1.66) and 65% (IRR, 1.65; 95% CI, 1.34-2.04) more tobacco and alcohol outlets, respectively, as tracts with the lowest. Tracts with the highest racialized economic disadvantage had a predicted count of 1.51 tobacco outlets per 1000 people while those in the lowest had nearly one fewer predicted outlet. Similar inequities existed in the predicted count of alcohol outlets. DISCUSSION Tobacco and alcohol outlet availability are higher in NC places experiencing concentrated racialized and economic segregation. A centralized agency overseeing tobacco and alcohol outlet permits and strategies to reduce the retail availability of these harmful products (e.g., capping the number of permits) are needed to intervene upon these inequities.
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Affiliation(s)
- Amanda Y Kong
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Lily Herbert
- Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - David O Fakunle
- Public Health Program, Morgan State University School of Community Health & Policy, Baltimore, MD, USA
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Berasaluce M, Martín-Turrero I, Valiente R, Martínez-Manrique L, Sandín-Vázquez M, Sureda X. Urban and social determinants of alcohol and tobacco consumption among adolescents in Madrid. GACETA SANITARIA 2023; 37:102336. [PMID: 38006663 DOI: 10.1016/j.gaceta.2023.102336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/10/2023] [Accepted: 09/25/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVE This study aims to describe the accessibility to and promotion of alcohol and tobacco around secondary schools in Madrid and its distribution in relation with area-level socioeconomic deprivation; analyze the relationship between this exposure and individual consumption characteristics of students between 14 and 18 years old; and explore other facilitators of this consumption. METHOD Mixed-methods study conducted in three phases: 1) we collected data on accessibility to and promotion of alcohol and tobacco in the environment using systematic social observation around 55 secondary schools; 2) we administered 2287 questionnaires among the students in these centers to gather information about characteristics and determinants of consumption; and 3) we conducted 20 semi-structured interviews and one discussion group to deepen in the results obtained in surveys and systematic social observation. We will use Geographic Information Systems to integrate and analyze the data from a spatial perspective.
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Affiliation(s)
- Maitane Berasaluce
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Irene Martín-Turrero
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Roberto Valiente
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom; SPECTRUM Consortium, United Kingdom
| | - Lucía Martínez-Manrique
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Preventive Medicine, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
| | - María Sandín-Vázquez
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Community Health and Social Sciences, Graduate School of Public Health & Health Policy, City University of New York, New York, United States of America
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, United States of America; Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Spain.
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15
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Sandín Vázquez M, Pastor A, Molina de la Fuente I, Conde Espejo P, Sureda Llul F. Using photovoice to generate policy recommendations to improve the alcohol urban environment: A participatory action research project. Health Place 2023; 84:103131. [PMID: 37847983 DOI: 10.1016/j.healthplace.2023.103131] [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: 04/17/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023]
Abstract
The place where we live, work and play may influence our alcohol drinking behaviours. This study aimed to present local policy recommendations on urban determinants for alcohol consumption prevention in a low-income and a high-income area of Madrid (Spain) using a participatory action research method, with photovoice and nominal group techniques. Participants (n = 26) engaged in a photovoice project initiated a process of critical reflection by discussing and analysing their alcohol environment based on photographs they took themselves. At the end of six week group discussion sessions, participants identified 33 themes related to their alcohol environment. They later met to translate the final categories into urban policy recommendations using a logical framework approach. Then, with a nominal group, they prioritized these recommendations based on time, impact, feasibility, and cost. Finally, participants produced a total of 61 policy recommendations for the improvement of the alcohol environment, highlighting the need for researcher-community collaborations when designing public health interventions.
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Affiliation(s)
- María Sandín Vázquez
- Surgery, Medical and Social Science Department, School of Medicine, University of Alcalá, Madrid, Spain; Public Health and Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain; Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, 10027, United States.
| | - Andrea Pastor
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain
| | - Irene Molina de la Fuente
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain
| | - Paloma Conde Espejo
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain
| | - Francisca Sureda Llul
- Surgery, Medical and Social Science Department, School of Medicine, University of Alcalá, Madrid, Spain; Public Health and Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain; Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, 10027, United States; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; Respiratory Diseases Networking Biomedical Research Centre (CIBERES), Madrid, Spain
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Pedroso CF, Pereira CC, Cavalcante AMRZ, Guimarães RA. Magnitude of risk factors for chronic noncommunicable diseases in adolescents and young adults in Brazil: A population-based study. PLoS One 2023; 18:e0292612. [PMID: 37856487 PMCID: PMC10586685 DOI: 10.1371/journal.pone.0292612] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/25/2023] [Indexed: 10/21/2023] Open
Abstract
AIM OF THE STUDY Estimate the magnitude and factors associated with risk factors for chronic noncommunicable diseases in adolescents and young adults in Brazil. METHODS Cross-sectional study that analyzed data from the 2019 National Health Survey. The population of interest was adolescents and young adults aged 15 to 24 years. Data were collected through individual interviews during home visits. Dependent variables included major risk factors for chronic noncommunicable diseases. Demographic and socioeconomic characteristics were used as independent variables. Multiple Poisson regression models were used to assess the relationship between independent variables and risk factors. RESULTS A total of 10,460 individuals (5,001 men and 5,459 women) were included. Regardless of sex, the most prevalent risk factors were insufficient fruit and vegetable consumption (92.6%) and leisure-time physical inactivity (43.3%). The prevalence rates of tobacco smokers, alcohol consumption once a month or more, and alcohol abuse were 8.9%, 28.7%, and 18.5%, respectively. Regular consumption of soft drinks and/or artificial juices was described by 17.2%. The prevalence of overweight was 32.5%. Young adults, males, and individuals with lower educational levels, of black race/skin color, with lower household income, and residents of urban areas had a higher prevalence for most risk factors. Differences in the determinants were found for some factors. Inequalities between Brazilian regions were recorded for seven of the nine factors analyzed. The most socioeconomically developed regions had the highest prevalence of most risk factors. The high magnitude of risk factors indicates a potential increase in the burden of chronic noncommunicable diseases in a future scenario for Brazil.
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Affiliation(s)
- Charlise Fortunato Pedroso
- Federal Institute of Education, Science and Technology of Goiás, Goiânia Oeste Campus, Goiânia, Goiás, Brazil
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Cristina Camargo Pereira
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Rafael Alves Guimarães
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
- Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás, Brazil
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Wu M, Qin S, Tan C, Li S, Xie O, Wan X. Estimated projection of incidence and mortality of alcohol-related liver disease in China from 2022 to 2040: a modeling study. BMC Med 2023; 21:277. [PMID: 37501074 PMCID: PMC10375628 DOI: 10.1186/s12916-023-02984-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND China has one of the highest numbers of liver disease cases in the world, including 6.4 million cirrhosis associated with alcohol-related liver disease (ALD) cases. However, there is still a lack of urgent awareness about the growth of alcohol consumption and the increased burden of ALD in China. Therefore, we aimed to project the potential impact of changes in alcohol consumption on the burden of ALD in China up to 2040 under different scenarios. METHODS We developed a Markov model to simulate the natural history of ALD until 2040 in China. We estimated the incidence and mortality of alcohol-related cirrhosis and hepatocellular carcinoma between 2022 and 2040 under four projected scenarios: status quo scenario and scenarios with a 2%, 4%, and 8% annual decrease in excessive alcohol consumption, respectively. RESULTS Under the status quo scenario, the cumulative new cases of cirrhosis from 2022 to 2040 was projected to be 3.61 million (95% UI 3.03-4.44 million), resulting in a cumulative 1.96 million (1.66-2.32 million) deaths from alcohol-related cirrhosis and hepatocellular carcinoma. However, a 2% annual reduction in excessive alcohol consumption was expected to avert 0.3 million deaths associated with ALD, and a 4% annual reduction was projected to prevent about 1.36 million new cases of cirrhosis and prevent 0.5 million ALD-related deaths. Moreover, an 8% annual reduction would prevent about 2 million new cases of cirrhosis and 0.82 million deaths. CONCLUSIONS Without any substantial change in alcohol attitudes and policies to regulate excessive drinking, the disease burden of ALD in China will increase enormously. Strengthening the implementation of alcohol restriction interventions is critical and urgent to reduce the impact of ALD on the Chinese population.
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Affiliation(s)
- Meiyu Wu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- Institute of Clinical Pharmacy, Central South University, Changsha, 410011, Hunan, China
| | - Shuxia Qin
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- Institute of Clinical Pharmacy, Central South University, Changsha, 410011, Hunan, China
| | - Chongqing Tan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- Institute of Clinical Pharmacy, Central South University, Changsha, 410011, Hunan, China
| | - Sini Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ouyang Xie
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- Institute of Clinical Pharmacy, Central South University, Changsha, 410011, Hunan, China
| | - Xiaomin Wan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
- Institute of Clinical Pharmacy, Central South University, Changsha, 410011, Hunan, China.
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Beksinska A, Karlsen O, Gafos M, Beattie TS. Alcohol use and associated risk factors among female sex workers in low- and middle-income countries: A systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001216. [PMID: 37310993 DOI: 10.1371/journal.pgph.0001216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/08/2022] [Indexed: 06/15/2023]
Abstract
Due to its widespread use in the sex work industry, female sex workers (FSWs) in low- and middle-income countries (LMICs) are at high risk of harmful alcohol use and associated adverse health outcomes. Factors associated with harmful alcohol use include violence, mental health problems, drug use, sexual risk behaviors and HIV/STIs. To our knowledge, there has been no quantitative synthesis of FSW alcohol use data to date. This systematic review and meta-analysis aims to provide an estimate of the prevalence of harmful alcohol use among FSWs in LMICs and to examine associations with common health and social concerns. The review protocol was registered with PROSPERO, number CRD42021237438. We searched three electronic databases for peer-reviewed, quantitative studies from inception to 24th February 2021. Studies were selected for inclusion that reported any measure of prevalence or incidence of alcohol use among FSWs aged 18 or older from countries defined as LMIC in accordance with the World Bank income groups 2019. The following study designs were included: cross-sectional survey, case-control study, cohort study, case series analysis, or experimental study with baseline measures for alcohol use. Study quality was assessed with the Center for Evidence-Based Management (CEBMa) Critical Appraisal Tool. Pooled prevalence estimates were calculated for (i) any hazardous/harmful/dependent alcohol use, (ii) harmful/dependent alcohol use only, both overall and by region and (iii) daily alcohol use. Meta-analyses examined associations between harmful alcohol use and violence, condom use, HIV/STIs, mental health problems and other drug use. In total, 435 papers were identified. After screening, 99 papers reporting on 87 unique studies with 51,904 participants from 32 LMICs met the inclusion criteria. Study designs included cross-sectional (n = 89), cohort (n = 6) and experimental (n = 4). Overall, 5 scored as high quality, 79 studies scored as moderate and 15 scored as weak quality. Twenty-nine papers reporting on 22 unique studies used validated alcohol use tools including AUDIT, CAGE and WHO CIDI. The pooled prevalence of any hazardous/harmful/dependent alcohol use was 41% (95% CI: 31-51%), and of daily alcohol use was 26% (95% CI: 17-36%). There was variation in harmful alcohol use by global region (Sub-Saharan Africa: 38%; South Asia/Central Asia/ East Asia and Pacific: 47% and Latin America and the Caribbean:44%). Harmful alcohol use was significantly associated with inconsistent condom use (pooled unadjusted RR: 1.65; 95% CI: 1.01-2.67), STIs (pooled unadjusted OR: 1.29; 95% CI 1.15-1.46); and other drug use (pooled unadjusted OR of 2.44; 95% CI 1.24-4.80), but not with HIV, violence or mental health problems. We found a high prevalence of problem alcohol use and daily alcohol use among FSWs in LMICs. Harmful drinking was associated with important HIV risk factors such as inconsistent condom use, STIs and other drug use. Major limitations included heterogeneity in tools and cut-off scores to measure alcohol use and other common risk factors, and a paucity of longitudinal studies. There is an urgent need for tailored interventions for FSWs in LMICs that address alcohol use as well as the associated sex work risk environment.
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Affiliation(s)
- Alicja Beksinska
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Oda Karlsen
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mitzy Gafos
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tara S Beattie
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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O’Donnell R, Mohan A, Purves R, Maani N, Angus C, Egan M, Fitzgerald N. Mechanisms of impact of alcohol availability interventions from the perspective of 63 diverse alcohol licensing stakeholders: a qualitative interview study. DRUGS (ABINGDON, ENGLAND) 2023; 31:338-347. [PMID: 38835541 PMCID: PMC11147450 DOI: 10.1080/09687637.2023.2205991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/06/2023] [Indexed: 06/06/2024]
Abstract
Aims Interventions restricting temporal and spatial availability of alcohol are associated with reduced harm, but the pathways by which specific interventions have impact are poorly understood. We examined mechanisms of impact from the perspective of diverse licensing stakeholders. Methods Fifty-three in-depth interviews were conducted with licensing stakeholders (from public health teams [PHTs], police, local authority licensing teams and lawyers, and alcohol premises licensing committees) from 20 local government areas. Interviewees were recruited as part of the Exploring the impact of alcohol licensing in England and Scotland (ExILEnS) study. Data were analyzed thematically and preliminary themes/subthemes were discussed during online groups with a different sample of public health and licensing professionals (n = 10). Findings Most interviewees struggled to articulate how availability interventions might lead to changes in alcohol consumption or harms. Five overarching mechanisms were identified: access, visibility, premises and area-level norms, affordability, and management of the night-time economy, with specific pathways identified for certain subgroups/premises types. The mechanisms by which alcohol availability interventions may impact on alcohol consumption and harms are diverse, but were poorly understood. Conclusions These findings will inform licensing and availability policy and advocacy, highlighting the need for further scrutiny of the evidence underpinning identified mechanisms, and primary research to address knowledge gaps.
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Affiliation(s)
- R. O’Donnell
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - A. Mohan
- School of Health Sciences, University of Dundee, Dundee, UK
| | - R. Purves
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - N. Maani
- School of Social and Political Science, The University of Edinburgh, Edinburgh, UK
| | - C. Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - M. Egan
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - N. Fitzgerald
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
- SPECTRUM Consortium, Edinburgh, UK
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Bennett E, Topp SM, Moodie AR. National Public Health Surveillance of Corporations in Key Unhealthy Commodity Industries - A Scoping Review and Framework Synthesis. Int J Health Policy Manag 2023; 12:6876. [PMID: 37579395 PMCID: PMC10425693 DOI: 10.34172/ijhpm.2023.6876] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/02/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Corporations in unhealthy commodity industries (UCIs) have growing influence on the health of national populations through practices that lead to increased consumption of unhealthy products. The use of government-led public health surveillance is best practice to better understand any emerging public health threat. However, there is minimal systematic evidence, generated and monitored by national governments, regarding the scope of UCI corporate practices and their impacts. This study aims to synthesise current frameworks that exist to identify and monitor UCI influence on health to highlight the range of practices deployed by corporations and inform future surveillance efforts in key UCIs. METHODS Seven biomedical, business and scientific databases were searched to identify literature focused on corporate practices that impact human health and frameworks for monitoring or assessment of the way UCIs impact health. Content analysis occurred in three phases, involving (1) the identification of framework documents in the literature and extraction of all corporate practices from the frameworks; (2) initial inductive grouping and synthesis followed by deductive synthesis using Lima and Galea's 'vehicles of power' as a heuristic; and (3) scoping for potential indicators linked to each corporate practice and development of an integrated framework. RESULTS Fourteen frameworks were identified with 37 individual corporate practices which were coded into five different themes according the Lima and Galea 'Corporate Practices and Health' framework. We proposed a summary framework to inform the public health surveillance of UCIs which outlines key actors, corporate practices and outcomes that should be considered. The proposed framework draws from the health policy triangle framework and synthesises key features of existing frameworks. CONCLUSION Systematic monitoring of the practices of UCIs is likely to enable governments to mitigate the negative health impacts of corporate practices. The proposed synthesised framework highlights the range of practices deployed by corporations for public health surveillance at a national government level. We argue there is significant precedent and great need for monitoring of these practices and the operationalisation of a UCI monitoring system should be the object of future research.
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Affiliation(s)
- Elizabeth Bennett
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, VIC, Australia
| | - Stephanie M. Topp
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, VIC, Australia
| | - Alan Rob Moodie
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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21
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Fernandez-Alvarez MDM, Zabaleta-Del-Olmo E, Cachero-Rodríguez J, Martin-Payo R. Nutritional content and quality of processed foods and beverages advertised near schools in three cities in the north of Spain. NUTR BULL 2023; 48:66-73. [PMID: 36377713 DOI: 10.1111/nbu.12597] [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: 07/22/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022]
Abstract
The advertisement of food and beverages on television and social media has been widely assessed, evidencing its powerful influence on children's dietary patterns and the development of childhood obesity. However, there is a gap in the evidence about advertisements near schools. The aim of this study was to describe and classify the nutritional quality and information of processed foods and alcoholic and non-alcoholic beverages advertised near schools in three cities in the north of Spain. A descriptive analysis was performed from September to December 2021 in the cities of Oviedo, Gijón and Avilés in the Principality of Asturias (Spain). The nutritional quality and information of processed foods or beverages advertised within a 500 m radius of schools were assessed. The Nutri-Score system was used for the classification of the nutritional quality of products and nutritional information, calories, fat, saturated fat, carbohydrates, sugars, protein and salt in 100 g or ml of each product was calculated. A total of 73.5% of the products were classified as "foods to eat less often and in small amounts," and 22.6% and 46.3% were classified as D or E, respectively, according to the Nutri-Score system. Finally, 57.5%, 56.4% and 78.5% of the products showed a medium to high content of fat, saturated fat and sugar, respectively. In conclusion, the food and drink advertisements surrounding schools in the assessed cities promote many products of low nutritional value, rich in fat, saturated fat and sugars, which have high obesogenic potential.
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Affiliation(s)
- Maria Del Mar Fernandez-Alvarez
- Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, Spain.,PRECAM Research Team, Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - Edurne Zabaleta-Del-Olmo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Nursing Department, Faculty of Nursing, Universitat de Girona, Girona, Spain.,Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain
| | - Judit Cachero-Rodríguez
- Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, Spain.,PRECAM Research Team, Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - Rubén Martin-Payo
- Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, Spain.,PRECAM Research Team, Health Research Institute of the Principality of Asturias, Oviedo, Spain
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22
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Dimova ED, Lekkas P, Maxwell K, Clemens TL, Pearce JR, Mitchell R, Emslie C, Shortt NK. Exploring the influence of local alcohol availability on drinking norms and practices: A qualitative scoping review. Drug Alcohol Rev 2023; 42:691-703. [PMID: 36657792 PMCID: PMC10946767 DOI: 10.1111/dar.13596] [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: 10/21/2022] [Revised: 12/08/2022] [Accepted: 12/08/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION High alcohol availability is related to increased alcohol consumption and harms. Existing quantitative research provides potential explanations for this relationship but there is little understanding of how people experience local alcohol availability. This is the first review to synthesise qualitative research exploring the relationship between alcohol availability and other factors in local alcohol environments. METHODS The scoping review includes qualitative studies exploring community-level alcohol availability and other factors, facilitating the purchase and consumption of alcohol. We included studies focusing on children and adolescents as well as adults. Study findings were brought together using thematic analysis and the socio-environmental context model, which explains how certain environments may facilitate drinking. RESULTS The review includes 34 articles. The majority of studies were conducted since 2012. Most studies were conducted in the United Kingdom, Australia and South Africa. The physical availability of alcohol and proximity to local amenities and temporal aspects, like late night opening hours, may be linked to social factors, such as normalisation of drinking and permissive drinking environments. The review highlights the importance of social and cultural factors in shaping interactions with local alcohol environments. DISCUSSION AND CONCLUSION This qualitative scoping review advances understanding of the pathways linking alcohol availability and alcohol harms by showing that availability, accessibility and visibility of alcohol may contribute towards permissive drinking environments. Further research is needed to better understand how people experience alcohol availability in their local environment and how this can inform alcohol control policies.
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Affiliation(s)
| | - Peter Lekkas
- Centre for Research on Environment, Society and HealthSchool of Geosciences, University of EdinburghEdinburghUK
| | | | - Tom L. Clemens
- Centre for Research on Environment, Society and HealthSchool of Geosciences, University of EdinburghEdinburghUK
| | - Jamie R. Pearce
- Centre for Research on Environment, Society and HealthSchool of Geosciences, University of EdinburghEdinburghUK
| | - Richard Mitchell
- MRC/CSO Social and Public Health Sciences UnitInstitute for Health and Wellbeing, University of GlasgowGlasgowUK
| | | | - Niamh K. Shortt
- Centre for Research on Environment, Society and HealthSchool of Geosciences, University of EdinburghEdinburghUK
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23
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Public perceptions of responsibility for alcohol control actions by actor type in seven countries. Addict Behav 2023; 136:107486. [PMID: 36084414 DOI: 10.1016/j.addbeh.2022.107486] [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: 04/20/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 02/03/2023]
Abstract
Many governments are failing to systematically introduce evidence-based alcohol control policies, and debate continues around issues of market freedom and personal responsibility. The aim of this international study was to assess the extent to which the public considers a range of alcohol control policies to be the responsibility of three different categories of actors: government, the private sector, and individuals. Around 1000 respondents from seven countries (Australia, Canada, China, India, New Zealand, the UK, and the US; n = 7559) completed an online survey assessing demographic characteristics, alcohol consumption status, and perceived responsibility for four alcohol harm-reduction actions relating to alcohol availability, advertising, and public education campaigns. Across the total sample and all assessed actions, governments were selected as an appropriate actor in 66 % of instances, the private sector in 39 %, and individuals in 28 %. Respondents from New Zealand were most likely to consider the actions to be government responsibility and respondents from the US the least. In relatively few instances (8 %), respondents considered the actions unworthy of attention by any actor. Across all seven countries, governments were considered to be the most appropriate actors to undertake actions relating to restricting alcohol availability, regulating alcohol advertising, and disseminating campaigns to educate the public about alcohol-related harm. The results indicate that the public may be receptive to greater intervention in these areas.
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24
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Caryl FM, Pearce J, Mitchell R, Shortt NK. Inequalities in children's exposure to alcohol outlets in Scotland: a GPS study. BMC Public Health 2022; 22:1749. [PMID: 36109778 PMCID: PMC9479265 DOI: 10.1186/s12889-022-14151-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Alcohol use is a leading cause of harm in young people and increases the risk of alcohol dependence in adulthood. Alcohol use is also a key driver of rising health inequalities. Quantifying inequalities in exposure to alcohol outlets within the activity spaces of pre-adolescent children-a vulnerable, formative development stage-may help understand alcohol use in later life. METHODS GPS data were collected from a nationally representative sample of 10-and-11-year-old children (n = 688, 55% female). The proportion of children, and the proportion of each child's GPS, exposed to alcohol outlets was compared across area-level income-deprivation quintiles, along with the relative proportion of exposure occurring within 500 m of each child's home and school. RESULTS Off-sales alcohol outlets accounted for 47% of children's exposure, which was higher than expected given their availability (31% of alcohol outlets). The proportion of children exposed to alcohol outlets did not differ by area deprivation. However, the proportion of time children were exposed showed stark inequalities. Children living in the most deprived areas were almost five times more likely to be exposed to off-sales alcohol outlets than children in the least deprived areas (OR 4.83, 3.04-7.66; P < 0.001), and almost three times more likely to be exposed to on-sales alcohol outlets (OR 2.86, 1.11-7.43; P = 0.03). Children in deprived areas experienced 31% of their exposure to off-sales outlets within 500 m of their homes compared to 7% for children from less deprived areas. Children from all areas received 22-32% of their exposure within 500 m of schools, but the proportion of this from off-sales outlets increased with area deprivation. CONCLUSIONS Children have little control over what they are exposed to, so policies that reduce inequities in alcohol availability should be prioritised to ensure that all children have the opportunity to lead healthy lives.
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Affiliation(s)
- Fiona M. Caryl
- grid.8756.c0000 0001 2193 314XMRC/CSO Social and Public Health Sciences Unit, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Jamie Pearce
- grid.4305.20000 0004 1936 7988Centre for Research On Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Rich Mitchell
- grid.8756.c0000 0001 2193 314XMRC/CSO Social and Public Health Sciences Unit, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Niamh K. Shortt
- grid.4305.20000 0004 1936 7988Centre for Research On Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
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25
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O’Donnell R, Mohan A, Purves R, Maani N, Egan M, Fitzgerald N. How public health teams navigate their different roles in alcohol premises licensing: ExILEnS multistakeholder interview findings. PUBLIC HEALTH RESEARCH 2022. [DOI: 10.3310/xcuw1239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
In England and Scotland, local governments regulate the sale of alcohol by awarding licences to premises to permit the sale of alcohol for consumption on or off the premises, under certain conditions; without such a licence, alcohol cannot be legally sold. In recent years, many local public health teams have become proactive in engaging with alcohol licensing, encouraging licensing authorities to act in ways intended to improve population health.
Objective
This research aimed to explore and understand the approaches and activities of public health stakeholders (i.e. NHS staff and other public health professionals) in seeking to influence local alcohol licensing policy and decisions, and the views of licensing stakeholders (i.e. licensing officers/managers, police staff with a licensing remit, elected members and licensing lawyers/clerks) on the acceptability and effectiveness of these approaches.
Participants
Local public health teams in England and Scotland were directly informed about this multisite study. Scoping calls were conducted with interested teams to explore their level of activity in alcohol licensing from 2012 across several categories. Twenty local authority areas with public health teams active in licensing matters were recruited purposively in England (n = 14) and Scotland (n = 6) to vary by region and rurality. Fifty-three in-depth telephone interviews (28 with public health stakeholders and 25 with licensing stakeholders outside health, such as local authority licensing teams/lawyers or police) were conducted. Interview transcripts were analysed thematically in NVivo 12 (QSR International, Warrington, UK) using inductive and deductive approaches.
Results
Public health stakeholders’ approaches to engagement varied, falling into three main (and sometimes overlapping) types. (1) Many public health stakeholders in England and all public health stakeholders in Scotland took a ‘challenging’ approach to influencing licensing decisions and policies. Reducing health harms was felt to necessitate a focus on reducing availability and generating longer-term culture change, citing international evidence on the links between availability and alcohol-related harms. Some of these stakeholders viewed this as being a narrow, ‘nanny state’ approach, whereas others welcomed public health expertise and its evidence-based approach and input. (2) Some public health stakeholders favoured a more passive, ‘supportive’ approach, with some reporting that reducing availability was unachievable. They reported that, within the constraints of current licensing systems, alcohol availability may be contained (at least in theory) but cannot be reduced, because existing businesses cannot be closed on availability grounds. In this ‘supportive’ approach, public health stakeholders supplied licensing teams with data on request or waited for guidance from licensing teams on when and how to get involved. Therefore, public health action supported the licensing team in their aim of promoting ‘safe’ and ‘responsible’ retailing of alcohol and/or focused on short-term outcomes other than health, such as crime. (3) Some public health stakeholders favoured a ‘collaborative’ approach in which they worked in close partnership with licensing teams; this could include a focus on containing availability or responsible retail of alcohol, or both.
Conclusions
In engaging with alcohol licensing, public health stakeholders adapted their approaches, sometimes resulting in a diminished focus on public health goals. Sampling did not include lower-activity areas, in which experiences might differ. The extent to which current licensing systems enable achievement of public health goals is questionable and the effectiveness of public health efforts merits quantitative evaluation.
Study registration
The study is registered with the Research Registry as researchregistry6162.
Funding
This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme and will be published in Public Health Research. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Rachel O’Donnell
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Andrea Mohan
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Richard Purves
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Nason Maani
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Matt Egan
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Niamh Fitzgerald
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
- SPECTRUM Consortium, Edinburgh, UK
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26
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Bostean G, Sánchez LA, Douglas JA. Spatial Disparities: The Role of Nativity in Neighborhood Exposure to Alcohol and Tobacco Retailers. J Immigr Minor Health 2022; 24:945-955. [PMID: 34591231 DOI: 10.1007/s10903-021-01277-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 01/25/2023]
Abstract
Studies of retail environment, one of the social determinants of health, document racial/ethnic disparities in exposure to alcohol and tobacco (A and T) retailers, but have largely overlooked nativity. We examined associations between A and T retailer density and rates of foreign-born Latinx and foreign-born Asian residents in California census tracts (N = 7888), using spatial regressions and controlling for population and ecological confounders (e.g., population density, zoning, residential instability, urbanicity). Socio-demographic data came from the American Community Survey (2012-2016); census tract density of A and T retailers came from geocoded addresses from state license data for off-sale alcohol distributors and purchased data on tobacco retailers from a commercial provider. Models predicting A and T tract retailer density showed that the rate of foreign-born Latinx residents was associated with higher tobacco retailer density but lower alcohol retailer density, and demonstrate no significant associations between rate of foreign-born Asian residents tobacco and alcohol retail density. Retail environment could contribute to observed declines in immigrant health over time in the US and across generations.
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Affiliation(s)
- Georgiana Bostean
- Department of Sociology and Environmental Science and Policy Program, Chapman University, One University Drive, Orange, CA, 92866, USA.
| | - Luis A Sánchez
- Department of Sociology, California State University, Channel Islands, One University Drive, Camarillo, CA, 93012, USA
| | - Jason A Douglas
- Department of Health Sciences, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA
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Pastor A, Sureda X, Valiente R, Badland H, García-Dorado M, Escobar F. Using Geovisualization Tools to Examine Attitudes towards Alcohol Exposure in Urban Environments: A Pilot Study in Madrid, Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159192. [PMID: 35954557 PMCID: PMC9368102 DOI: 10.3390/ijerph19159192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 02/01/2023]
Abstract
Pervasiveness of alcohol products and their promotion in the urban landscape may normalize alcohol consumption. This study aims to utilize geovisualization-based methods to assess attitudes towards different levels of alcohol exposure in the urban environment. We selected a typical downtown location, Lavapiés Square in Madrid, Spain, to conduct our study. First, we designed and created realistic 3D models simulating three different urban scenes with varying degrees of exposure to alcohol in the environment. Second, we used a survey on 159 adults to explore the level of acceptance of, attitudes towards, and perceptions of alcohol exposure in each scene. Participants reported a higher level of comfort in the scene with null alcohol exposure compared with the other scenes (p < 0.001). Acceptance towards alcohol exposure decreased as the level of alcohol elements increased in the scenes (p < 0.01). Acceptance also decreased when children were present in the scenes (p < 0.01). This study demonstrated that geovisualization tools provide a useful and well-suited approach to analyze perceptions of the alcohol environment. The use of geovisualization can help understand attitudes and perceptions towards the alcohol environment and may offer a way to simulate different scenarios prior to development or retrofitting.
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Affiliation(s)
- Andrea Pastor
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Campus Universitario-Ctra. de Madrid-Barcelona, Km. 33,600, 28871 Madrid, Spain;
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Campus Universitario-Ctra. de Madrid-Barcelona, Km. 33,600, 28871 Madrid, Spain;
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, 205 E 42nd St., New York, NY 10017, USA
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, l’Hospitalet de Llobregat Avinguda de la Granvia de l’Hospitalet, 199, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-918-222-351
| | - Roberto Valiente
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, University of Edinburgh, Edinburgh EH8 9XP, UK;
- SPECTRUM Consortium, UK
| | - Hannah Badland
- Health, Place and Society Group, Centre for Urban Research, RMIT University, Melbourne, VIC 3000, Australia;
| | - Macarena García-Dorado
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, 28801 Madrid, Spain; (M.G.-D.); (F.E.)
| | - Francisco Escobar
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, 28801 Madrid, Spain; (M.G.-D.); (F.E.)
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28
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Skylstad V, Engebretsen IMS, Nalugya SJ, Opesen C, Ndeezi G, Okello ES, Moland KM, Tumwine JK, Skar AMS. 'There is nowhere to take the child': a qualitative study of community members' views on managing early childhood substance use in Mbale, Uganda. BMC Public Health 2022; 22:1192. [PMID: 35705928 PMCID: PMC9198618 DOI: 10.1186/s12889-022-13548-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/26/2022] [Indexed: 11/20/2022] Open
Abstract
Background Harmful alcohol use by 5–8-year-old children has been identified in Mbale District, Uganda. To further examine this finding, the present study explores the experiences and perceptions of community members regarding how childhood substance use (before age 10) is managed in this area. Methods We conducted eight focus group discussions with 48 parents of children aged < 10 years and 26 key informant interviews with teachers, health workers, child protection workers, police, local stakeholders, brewers, and others. Thematic content analysis was performed. Results Three main themes were identified: ‘We don’t talk about it’: Despite concern, childhood substance use was not addressed in the community. Participants attributed this to three main factors related to a lack of leadership in addressing it, changing acceptability for peer parental interference, and uncertainty about repercussions related to children’s rights. ‘There is nowhere to take the child’: Schools, police, and remand homes were intuitively considered appropriate arenas for managing childhood substance use but were considered inaccessible, unresponsive, and inadequate due to insufficient resources, competence, and training. Since substance use was not considered a medical problem, help from the health sector was only sought for adverse consequences, such as injury. This left the participants with the experience that there was in effect nowhere to take the child. ‘The government has not done so much’: The participants called for government action and clear laws that would regulate the availability of alcohol and other substances to children, but they had limited trust in the capacity and commitment of the government to act. Conclusions The participants were concerned about childhood alcohol and substance use, but the complexity and magnitude of the problem left them feeling incapacitated in responding. Relevant factors were identified on the community, institutional, and the government level, such as a lack of leadership in addressing it, a loss of mandate to interfere in child-rearing, inadequate services, weak legal structures, and missing government action. A strengthening of collective agency and public policy is necessary to prevent and address childhood alcohol and substance use. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13548-4.
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Affiliation(s)
- V Skylstad
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - I M S Engebretsen
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - S J Nalugya
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Department of Psychiatry, Mulago National Referral and Teaching Hospital, Ministry of Health, Kampala, Uganda
| | - C Opesen
- Department of Sociology and Anthropology, School of Social Sciences, Makerere University, Kampala, Uganda
| | - G Ndeezi
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - E S Okello
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza Campus, Mwanza, Tanzania
| | - K M Moland
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - J K Tumwine
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.,Department of Paediatrics and Child Health, Kabale University School of Medicine, Kabale, Uganda
| | - A M S Skar
- Global Health Cluster, Norwegian Institute of Public Health, Oslo, Norway.,Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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29
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Beksinska A, Nyariki E, Kabuti R, Kungu M, Babu H, Shah P, Nyabuto C, Okumu M, Mahero A, Ngurukiri P, Jama Z, Irungu E, Adhiambo W, Muthoga P, Kaul R, Seeley J, Weiss HA, Kimani J, Beattie TS. Harmful Alcohol and Drug Use Is Associated with Syndemic Risk Factors among Female Sex Workers in Nairobi, Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7294. [PMID: 35742558 PMCID: PMC9223659 DOI: 10.3390/ijerph19127294] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Abstract
Background: Female Sex Workers (FSWs) are at high risk of harmful alcohol and other drug use. We use quantitative data to describe the prevalence of alcohol and other drug use and identify associated occupational and socio-economic risk factors, and aim to elucidate patterns of alcohol and drug use through information drawn from qualitative data. Methods: Maisha Fiti was a mixed-method longitudinal study conducted in 2019 among a random sample of FSWs in Nairobi, Kenya. We used baseline date from the behavioural−biological survey, which included the WHO Alcohol, Smoking and Substance Involvement Screening Test that measures harmful alcohol and other drug use in the past three months (moderate/high risk score: >11 for alcohol; >4 for other drugs). In-depth interviews were conducted with 40 randomly selected FSWs. Findings: Of 1003 participants, 29.9% (95%CI 27.0−32.6%) reported harmful (moderate/high risk) alcohol use, 21.5% harmful amphetamine use (95%CI 19.1−24.1%) and 16.9% harmful cannabis use (95%CI 14.7−19.2%). Quantitative analysis found that harmful alcohol, cannabis and amphetamine use were associated with differing risk factors including higher Adverse Childhood Experience (ACE) scores, street homelessness, food insecurity (recent hunger), recent violence from clients, reduced condom use, depression/anxiety and police arrest. Qualitative interviews found that childhood neglect and violence were drivers of entry into sex work and alcohol use, and that alcohol and cannabis helped women cope with sex work. Conclusions: There is a need for individual and structural-level interventions, tailored for FSWs, to address harmful alcohol and other drug use and associated syndemic risks including ACEs, violence and sexual risk behaviours.
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Affiliation(s)
- Alicja Beksinska
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK; (P.S.); (J.S.); (T.S.B.)
| | - Emily Nyariki
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Rhoda Kabuti
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Mary Kungu
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Hellen Babu
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Pooja Shah
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK; (P.S.); (J.S.); (T.S.B.)
| | - The Maisha Fiti Study Champions
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Chrispo Nyabuto
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Monica Okumu
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Anne Mahero
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Pauline Ngurukiri
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Zaina Jama
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Erastus Irungu
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Wendy Adhiambo
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Peter Muthoga
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Rupert Kaul
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada;
| | - Janet Seeley
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK; (P.S.); (J.S.); (T.S.B.)
| | - Helen A. Weiss
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Joshua Kimani
- Partners for Health and Development in Africa (PHDA), UNITID, College of Health Sciences, Nairobi P.O. Box 30197-00100, Kenya; (E.N.); (R.K.); (M.K.); (H.B.); (C.N.); (M.O.); (A.M.); (P.N.); (Z.J.); (E.I.); (W.A.); (P.M.); (J.K.)
| | - Tara S. Beattie
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK; (P.S.); (J.S.); (T.S.B.)
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The transition of alcohol control in China 1990-2019: Impacts and recommendations. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 105:103698. [PMID: 35483250 PMCID: PMC9247746 DOI: 10.1016/j.drugpo.2022.103698] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 11/23/2022]
Abstract
The harmful use of alcohol is a severe public health issue globally. Chinese per-capita alcohol consumption has increased sharply in recent decades, which has contributed to a rise in alcohol-related problems. In this article we present an analysis of Chinese alcohol policy, beginning with a characterization of alcohol consumption in China followed by an examination of how the nation's alcohol control policy has evolved over the past 30 years, identifying shortcomings and obstacles to improvement. Finally, we present several recommendations informed by the Global Strategy to Reduce the Harmful Use of Alcohol and the SAFER Technical Package-Five Areas of Intervention at National and Subnational Levels (SAFER initiative), to the areas of taxation, alcohol availability, alcohol marketing regulation, and treatment.
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Skylstad V, Nalugya JS, Skar A, Opesen C, Ndeezi G, Okello ES, Moland KM, Engebretsen I, Tumwine JK. 'As soon as they can hold a glass, they begin taking alcohol': a qualitative study on early childhood substance use in Mbale District, Uganda. BMC Public Health 2022; 22:812. [PMID: 35459136 PMCID: PMC9033416 DOI: 10.1186/s12889-022-13140-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 03/31/2022] [Indexed: 11/14/2022] Open
Abstract
Background Globally, substance use is a leading contributor to the burden of disease among young people, with far reaching social, economic and health effects. Following a finding of harmful alcohol use among 5-8-year-old children in Mbale District, Uganda, this study aims to investigate community members’ views on early childhood substance use among children below the age of 10 years. Methods In 2016, we conducted eight focus group discussions with 48 parents and 26 key informant interviews with teachers, health workers, alcohol distributors, traditional healers, religious leaders, community leaders and youth workers. We used thematic content analysis. Four participants and two research assistants reviewed and confirmed the findings. Results Alcohol in everyday life: ‘Even children on laps taste alcohol’: Almost all participants confirmed the existence of and concern for substance use before age 10. They described a context where substance use was widespread in the community, especially intake of local alcoholic brews. Children would access substances in the home or buy it themselves. Those living in poor neighbourhoods or slums and children of brewers were described as particularly exposed. Using substances to cope: ‘We don’t want them to drink’: Participants explained that some used substances to cope with a lack of food and resources for childcare, as well as traumatic experiences. This made children in deprived families and street-connected children especially vulnerable to substance use. Participants believed this was a result of seeing no alternative solution. Conclusions To our knowledge, this is the first study to describe the context and conditions of childhood substance use before age 10 in Mbale District, Uganda. The study shows that community members attributed early childhood substance use to a social context of widespread use in the community, which was exacerbated by conditions of material and emotional deprivation. These social determinants for this practice deserve public health attention and intervention.
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Affiliation(s)
- V Skylstad
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - J S Nalugya
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Department of Psychiatry, Mulago National Referral and Teaching Hospital, Kampala, Uganda
| | - Ams Skar
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.,Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - C Opesen
- Department of Sociology and Anthropology, School of Social Sciences, Makerere University, Kampala, Uganda
| | - G Ndeezi
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - E S Okello
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza Campus, Mwanza, Tanzania
| | - K M Moland
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ims Engebretsen
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - J K Tumwine
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.,Kabale University School of Medicine, Kabale, Uganda
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Bingham AL, De Silva AP, Vaisey AM, Temple-Smith MJ, Spark SY, Hocking JS. Alcohol availability and prevalent Chlamydia trachomatis in young Australians: a multi-level analysis. Sex Health 2021; 18:460-465. [PMID: 34844665 DOI: 10.1071/sh21098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022]
Abstract
Background Prevalence of sexually transmissible infections (STIs) has been associated with availability of alcohol. This paper investigates potential associations between prevalent cases of chlamydia in young people in Australia and the availability of alcohol within their local area, defined as postcode of residence. Methods Alcohol availability was determined at the postcode level using liquor licensing data, classified as total number of licences, number of 'take-away' licences and number of licenses by population. Participant data were drawn from a survey targeting Australians aged 16-29years in rural and regional Australia, capturing demographic details including postcode of residence, indicators of sexual behaviour including condom use and chlamydia test results. Mixed-effects logistic regression was used to examine potential associations between first, alcohol availability and chlamydia, and second, between condom use and chlamydia. Results We found little evidence of associations between alcohol availability and chlamydia in either unadjusted or adjusted models. After adjusting for alcohol availability, we observed significant associations between inconsistent condom use and chlamydia prevalence, whether alcohol availability was measured as total number (adjusted odds ratio (AOR) 2.20; 95% confidence interval (CI) 1.20, 3.70), number of take-away licenses (AOR 2.19; 95% CI1.30, 3.69) or licenses per 1000 population (AOR 2.19; 95% CI 1.30, 3.68). Conclusion Little evidence of association between alcohol availability and chlamydia at the postcode level was found. Further research is required to determine appropriate measures of 'local area' and how characteristics thereof may impact on sexual health.
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Affiliation(s)
- Amie L Bingham
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Anurika P De Silva
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Alaina M Vaisey
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | | | - Simone Y Spark
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
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Bozorgi P, Porter DE, Eberth JM, Eidson JP, Karami A. The leading neighborhood-level predictors of drug overdose: A mixed machine learning and spatial approach. Drug Alcohol Depend 2021; 229:109143. [PMID: 34794060 DOI: 10.1016/j.drugalcdep.2021.109143] [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: 06/11/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Drug overdose is a leading cause of unintentional death in the United States and has contributed significantly to a decline in life expectancy during recent years. To combat this health issue, this study aims to identify the leading neighborhood-level predictors of drug overdose and develop a model to predict areas at the highest risk of drug overdose using geographic information systems and machine learning (ML) techniques. METHOD Neighborhood-level (block group) predictors were grouped into three domains: socio-demographic factors, drug use variables, and protective resources. We explored different ML algorithms, accounting for spatial dependency, to identify leading predictors in each domain. Using geographically weighted regression and the best-performing ML algorithm, we combined the output prediction of three domains to produce a final ensemble model. The model performance was validated using classification evaluation metrics, spatial cross-validation, and spatial autocorrelation testing. RESULTS The variables contributing most to the predictive model included the proportion of households with food stamps, households with an annual income below $35,000, opioid prescription rate, smoking accessories expenditures, and accessibility to opioid treatment programs and hospitals. Compared to the error estimated from normal cross-validation, the generalized error of the model did not increase considerably in spatial cross-validation. The ensemble model using ML outperformed the GWR method. CONCLUSION This study identified strong neighborhood-level predictors that place a community at risk of experiencing drug overdoses, as well as protective factors. Our findings may shed light on several specific avenues for targeted intervention in neighborhoods at risk for high drug overdose burdens.
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Affiliation(s)
- Parisa Bozorgi
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; South Carolina Department of Health and Environmental Control (SCDHEC), Columbia, SC 29201, USA.
| | - Dwayne E Porter
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | - Jan M Eberth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC 29210, USA.
| | - Jeannie P Eidson
- South Carolina Department of Health and Environmental Control (SCDHEC), Columbia, SC 29201, USA.
| | - Amir Karami
- School of Information Science, University of South Carolina, Columbia, SC 29208, USA.
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Cardoza LMS, Santos DSD, Hofelmann DA. [Classification of alcohol outlets in the area surrounding state schools]. CIENCIA & SAUDE COLETIVA 2021; 26:4813-4822. [PMID: 34787177 DOI: 10.1590/1413-812320212611.3.35402018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 09/16/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to characterize the environments of Curitiba's state schools in relation to commercialization of alcoholic beverages and investigate the association with local socio-economic indicators. A cross-sectional study in commercial establishments was carried out around 30 state-owned schools. We applied a survey to characterize the locations in relation to the availability of alcoholic beverages. Differentiation between school environments regarding income was estimated by multilevel mixed-effects model. We evaluated 200 commercial establishments, 66.0% commercialized alcohol. Of them, 52 (39.4%) were off-premise alcohol outlets and 80 (60.6%) on-premise. In on-premise category, neighborhood markets (16.5%) and gas stations (10.1%) had higher presence and half of schools had this type of this establishment in their environment. These establishment had more variety of alcoholic beverages and lower prices. In school's environments located in lower income's neighborhoods, the number of neighborhood market and bars were higher. It was observed the presence of establishments that commercialized alcoholic beverages and with attendance to the public during the classes period, near the evaluated schools.
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Affiliation(s)
- Loren Milagros Salazar Cardoza
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Paraná. R. Padre Camargo 280, 3º andar, Alto da Glória. 80060-240 Curitiba PR Brasil.
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Salagay OO, Soshkina KV, Brun EA, Kekelidze Z I, Klimenko T V, Kobyakova OS, Khalturina DA, Zykov V A. Scientifc assessment of the degree of implementation of the state policy to reduce abuse of alcoholic products and prevent alcoholism among the population of the Russian Federation until 2020. Public Health 2021. [DOI: 10.21045/2782-1676-2021-1-2-5-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Goal. The goal of this study was to assess the scale of the implementation of the measures of the Concept to Reduce Alcohol Abuse Alcohol Dependence among the Population of the Russian Federation for the Period up to 2020.Methods. Research methods included legal analysis, as well as epidemiological and sociological data analysis.Results. The goals and the indicators of the Concept were achieved generally. According to our assessment, 15 (71%) out of 21 of the Concept’s measures have been implemented, among them 12 were fully, and 3 were partially (14%) implemented. Out of the 17 evidence-based measures of the Concept, 15 (88%) were implemented in full or in part.Alcohol consumption decreased from 15,7 to 9,1 liters of ethanol per capita (or by 42%) in 2008–2019. Mortality from accidental alcohol poisoning decreased by 60% (from 16,9 to 7 per 100.000) between 2008 and 2020. There was a signifcant decrease in the indicators of alcoholism in Russia during the period of the implementation of the Concept.Conclusions. The study shows that the goals, the objectives, the measures and the indicators of the Concept have been largely achieved. This was accompanied by the decrease in morbidity and mortality associated with alcohol consumption in Russia.
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Affiliation(s)
| | | | - E. A. Brun
- Moscow Research and PracticalCentre for Narcology of the Department of Public Health of Moscow
| | - Z. I. Kekelidze
- V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology
| | - T. V. Klimenko
- V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology
| | - O. S. Kobyakova
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
| | - D. A. Khalturina
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
| | - V. A. Zykov
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
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Wadsworth E, Driezen P, Hammond D. Retail availability and legal purchases of dried flower in Canada post-legalization. Drug Alcohol Depend 2021; 225:108794. [PMID: 34098382 DOI: 10.1016/j.drugalcdep.2021.108794] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Retail availability of cannabis has the potential to influence demand for both legal and illegal cannabis. The aims of the study were to: 1) estimate the percentage of consumers who report purchasing dried flower legally; and 2) examine the association between purchasing dried flower legally and retail availability, where retail availability was represented as: a) Canadian province; b) 'objective' retail proximity; and c) self-reported retail proximity. METHODS Data come from Canadian respondents in Wave 2 of the International Cannabis Policy Study (ICPS) conducted one year after non-medical cannabis legalization in September-October 2019. Respondents were 18+ years in Alberta/Quebec and 19+ years elsewhere and had purchased any dried flower in the past year (n = 2506). Respondents were recruited through commercial online panels. Weighted binary logistic regression models examined likelihood of purchasing dried flower legally. RESULTS Overall, 47.7 % of past-year dried flower purchasers reported last purchasing dried flower legally, with variation across provinces (range = 40.5 %-81.2 %). Likelihood of purchasing dried flower legally was greater among those who lived closer to a legal retail store based on Euclidean distance (<3 km vs. > 10 km: AOR = 1.56, 95 % CI: 1.20,2.02), and who had shorter self-reported travel time to a retail store (<5 min. vs. > 15 min.: AOR = 2.24, 95 % CI: 1.56,3.21). CONCLUSION One year after legalization, retail availability was associated with last purchasing dried flower legally among past-year dried flower purchasers. To our knowledge, the current study is among the first to examine the legality of purchase source used for dried flower and retail availability of cannabis in Canada post-legalization.
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Affiliation(s)
- Elle Wadsworth
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada.
| | - Pete Driezen
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada; Department of Psychology, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
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Cambron C, Kosterman R, Rhew IC, Catalano RF, Guttmannova K, Hawkins JD. Neighborhood Structural Factors and Proximal Risk for Youth Substance Use. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 21:508-518. [PMID: 31853720 DOI: 10.1007/s11121-019-01072-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study examined associations of neighborhood structural factors (census-based measures, socioeconomic disadvantage, and residential stability); self-reported measures of general and substance use-specific risk factors across neighborhood, school, peer, and family domains; and sociodemographic factors with substance use among 9th grade students. Data drawn from the Seattle Social Development Project, a theory-driven longitudinal study originating in Seattle, WA, were used to estimate associations between risk factors and past month cigarette smoking, binge drinking, marijuana use, and polysubstance use among students (N = 766). Results of logistic regression models adjusting for neighborhood clustering and including all domains of risk factors simultaneously indicated that neighborhood socioeconomic disadvantage was associated with a significantly higher likelihood of cigarette smoking, binge drinking, and polysubstance use, but not marijuana use. In fully controlled models, substance use-specific risk factors across neighborhood, school, peer, and family domains were also associated with increased likelihood of substance use and results differed by the outcome considered. Results highlight substance-specific risk factors as an intervention target for reducing youth substance use and suggest that further research is needed examining mechanisms linking neighborhood socioeconomic disadvantage and youth substance use.
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Affiliation(s)
- Christopher Cambron
- College of Social Work, University of Utah, 395 South 1500 East, Salt Lake City, UT, 84112, USA. .,Center for Health Outcomes and Population Equity, Huntsman Cancer Institute, Salt Lake City, UT, USA.
| | - Rick Kosterman
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA, USA
| | - Isaac C Rhew
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Richard F Catalano
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA, USA
| | - Katarina Guttmannova
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - J David Hawkins
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA, USA
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Cardoza LS, Machado CO, Santos CTD, Höfelmann DA. Alcohol outlets availability in school neighborhoods and alcohol use among adolescents. CAD SAUDE PUBLICA 2021; 36:e00062919. [PMID: 33146263 DOI: 10.1590/0102-311x00062919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 03/12/2020] [Indexed: 11/22/2022] Open
Abstract
This cross-sectional study investigated the association between alcohol use by adolescents and the availability of alcohol outlets in the neighborhood of public schools. We collected primary data including variables at individual and school neighborhood level. Multilevel logistic regression was used to estimate odds ratio (OR) with a 95% confidence interval (95%CI) for alcohol use with the exposure variables. A total of 18.4% (95%CI: 13.2; 24.1) of adolescents reported using alcohol, which was associated with variables on the individual level such as being 18 years or older, working, and having previously smoked. Lower alcohol use was observed among adolescents from schools that were located 250m or more from alcohol outlets (OR = 0.29; 95%CI: 0.17; 0.48). Actions to reduce the use of alcohol among adolescents should take student's and school neighborhood's characteristics into account.
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Sileo KM, Miller AP, Wagman JA, Kiene SM. Psychosocial interventions for reducing alcohol consumption in sub-Saharan African settings: a systematic review and meta-analysis. Addiction 2021; 116:457-473. [PMID: 33463834 PMCID: PMC8543382 DOI: 10.1111/add.15227] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/04/2020] [Accepted: 08/12/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Harmful alcohol use is a leading cause of morbidity and mortality in sub-Saharan Africa (sSA); however, the effects of non-pharmacological alcohol interventions in this region are unknown. DESIGN A systematic review and meta-analysis of the available literature through 14 March 2019 was undertaken. Two authors extracted and reconciled relevant data and assessed risk of bias. Meta-analyses were conducted. The review protocol is registered on International Prospective Register of Systematic Reviews (PROSPERO) (CRD42019094509). SETTING Studies conducted in sSA were eligible for inclusion. PARTICIPANTS Individuals participating in interventions aimed at reducing alcohol use. INTERVENTIONS Randomized and non-randomized controlled trials testing non-pharmacological interventions (psychosocial and structural) on alcohol consumption in sSA. MEASUREMENTS Eligible outcomes included the Alcohol Use Disorders Identification Test (AUDIT) scores; alcohol abstinence; measures of drinking quantity and frequency; and biomarkers of alcohol consumption. FINDINGS Nineteen intervention trials (18 reports) testing psychosocial interventions (no structural interventions included), judged of moderate quality, were included in meta-analyses. A beneficial effect was identified for psychosocial interventions on alcohol abstinence at 3-6 months [odds ratio (OR) = 2.05, 95% confidence interval (CI) = 1.20-3.48, k = 5, n = 2312, I2 = 79%] and 12-60 months (OR = 1.91, 95% CI = 1.40-2.61, k = 6, n = 2737, I2 = 63%) follow-up. There were no statistically significant effects found for AUDIT score [2-3 months: mean differences (MD) = -1.13, 95% CI = -2.60 to 0.34, k = 6, n = 992, I2 = 85%; 6 months: MD = -0.83, 95% CI = -1.92 to 0.26, k = 6, n = 1081, I2 = 69%; 12 months: MD = -0.15, 95% CI = -1.66 to 1.36, k = 4; n = 677; I2 = 75%], drinks per drinking day (3 months: MD = -0.22, 95% CI = -2.51 to 2.07, k = 2, n = 359, I2 = 82%; 6-36 months: MD = -0.09, 95% CI = -0.49 to 0.30, k = 3, n = 1450, I2 = 60%) or percentage of drinking days (3 months: MD = -4.60, 95% = -21.14 to 11.94; k = 2; n = 361; I2 = 90%; 6-9 months: MD = 1.96, 95% CI = -6.54 to 10.46; k = 2; n = 818; I2 = 88%). CONCLUSION Psychosocial interventions show promise at increasing self-reported alcohol abstinence in sSA, but clinical, methodological and statistical heterogeneity across meta-analytical outcomes suggests that results should be interpreted with caution.
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Affiliation(s)
- Katelyn M. Sileo
- The Department of Public Health, The University of Texas at
San Antonio, One UTSA Circle, San Antonio, TX, USA,Division of Epidemiology and Biostatistics, School of
Public Health, San Diego State University, 5500 Campanile Drive San Diego, CA
92182,The Center for Interdisciplinary Research on AIDS (CIRA),
Yale University, 135 College Street, Suite 200, New Haven, CT 06510-2483
| | - Amanda P. Miller
- Division of Infectious Diseases and Global Public Health,
Department of Medicine, The University of California, San Diego, 9500 Gilman Drive,
La Jolla, CA 92093
| | - Jennifer A. Wagman
- Division of Infectious Diseases and Global Public Health,
Department of Medicine, The University of California, San Diego, 9500 Gilman Drive,
La Jolla, CA 92093,The Department of Community Health Sciences, The University
of California, Los Angeles, 650 Charles E. Young Drive South, 46-071B CHS, Box
951772, Los Angeles, CA, 90095-1772
| | - Susan M. Kiene
- Division of Epidemiology and Biostatistics, School of
Public Health, San Diego State University, 5500 Campanile Drive San Diego, CA
92182
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Sileo KM, Miller AP, Huynh TA, Kiene SM. A systematic review of interventions for reducing heavy episodic drinking in sub-Saharan African settings. PLoS One 2020; 15:e0242678. [PMID: 33259549 PMCID: PMC7707537 DOI: 10.1371/journal.pone.0242678] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 11/08/2020] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Assess the effect of non-pharmacological alcohol interventions on reducing heavy episodic drinking (HED) outcomes in sub-Saharan Africa. METHODS A systematic review of the available literature through August 19, 2020 was conducted. Randomized and non-randomized controlled trials testing non-pharmacological interventions on alcohol consumption in sub-Saharan Africa were eligible for inclusion. Eligible outcomes included measures of HED/binge drinking, and measures indicative of this pattern of drinking, such as high blood alcohol concentration or frequency of intoxication. Three authors extracted and reconciled relevant data and assessed risk of bias. The review protocol is available on PROSPERO (registration number: CRD42019094509). The Cochrane Handbook recommendations for the review of interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines guided all methodology. RESULTS Thirteen intervention trials were identified that met our inclusion criteria and measured change in HED. Studies were judged of moderate quality. A beneficial effect of non-pharmacological interventions on HED was reported in six studies, three of which were deemed clinically significant by the review authors; no statistically significant effects were identified in the other seven studies. Interventions achieving statistical and/or clinical significance had an intervention dose of two hours or greater, used an array of psychosocial approaches, including Motivational Interviewing integrated in Brief Intervention, cognitive behavioral therapy and integrated risk reduction interventions, and were delivered both individually and in groups. CONCLUSIONS Evidence for the effectiveness of non-pharmacological interventions to reduce HED in sub-Saharan African settings was limited, demonstrating the need for more research. To strengthen the literature, future research should employ more rigorous study designs, improve consistency of HED measurement, test interventions developed specifically to address HED, and explore structural approaches to HED reduction.
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Affiliation(s)
- Katelyn M. Sileo
- Department of Public Health, University of Texas at San Antonio, San Antonio, Texas, United States of America
- Division of Epidemiology and Biostatistics, San Diego State University School of Public Health, San Diego, California, United States of America
- Center for Interdisciplinary Research on AIDS (CIRA), Yale University, New Haven, Connecticut, United States of America
| | - Amanda P. Miller
- Division of Infectious Disease and Global Public Health, Department of Medicine, The University of California, San Diego, La Jolla, California, United States of America
| | - Tina A. Huynh
- Department of Public Health, University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Susan M. Kiene
- Division of Epidemiology and Biostatistics, San Diego State University School of Public Health, San Diego, California, United States of America
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Siegler AJ, Komro KA, Wagenaar AC. Law Everywhere: A Causal Framework for Law and Infectious Disease. Public Health Rep 2020; 135:25S-31S. [PMID: 32735203 PMCID: PMC7407060 DOI: 10.1177/0033354920912991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Aaron J Siegler
- 25798 Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kelli A Komro
- 25798 Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Alexander C Wagenaar
- 25798 Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Foster S, Hooper P, Divitini M, Knuiman M, Trapp G. Over the limit? Testing non-linear associations between alcohol outlets and young adults' alcohol consumption. Drug Alcohol Rev 2020; 39:664-670. [PMID: 32567116 DOI: 10.1111/dar.13115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS By specifying a threshold at which the number of liquor licences has the most impact on local populations, authorities can work to restrict licence approvals and help prevent alcohol-related harm. DESIGN AND METHODS Raine Study Generation 2 participants reported their alcohol intake at 22 years (n = 843) and liquor licences within 1600 m of participants' homes were mapped. Analyses examined associations between licences (all licences, on-premise licences, liquor stores) and alcohol intake (g ethanol per day). Two models were fitted: (i) forced a straight-line relationship; and (ii) allowed a curved relationship via restricted cubic splines. RESULTS The straight-line and curved models showed significant relationships with all licences (P = 0.002 and P = 0.002 respectively) and on-premise licences (P = 0.006 and P = 0.01 respectively), but not liquor stores (P = 0.065 and P = 0.13 respectively). The straight-line model indicated that alcohol consumption increased, on average, by 0.15 g per day for each additional licence and 0.17 g per day for each additional on-premise licence. The curved model indicated that consumption increased by around 0.4 g per day for each additional licence from 0 to 10, but increases were negligible for additional licences beyond 10. The curved model provided a better overall fit to the data than the straight-line model (R2 9.52% vs. 9.18%), but the improvement in fit did not quite reach statistical significance (P = 0.08). The curvature was similar, but less pronounced for on-premise licences (R2 9.11% vs. 8.95%; P = 0.23). DISCUSSION AND CONCLUSIONS Results suggest a possible saturation point at which additional licences have a smaller effect on the alcohol intake of 22-year-olds living in metropolitan Perth.
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Affiliation(s)
- Sarah Foster
- Centre for Urban Research, School of Global, Urban and Social Studies, RMIT University, Melbourne, Australia.,School of Agriculture and Environment, The University of Western Australia, Perth, Australia
| | - Paula Hooper
- Australian Urban Design Research Centre, School of Design, The University of Western Australia, Perth, Australia
| | - Mark Divitini
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Matthew Knuiman
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Georgina Trapp
- School of Population and Global Health, The University of Western Australia, Perth, Australia.,Telethon Kids Institute, Perth, Australia
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Fairman BJ, Goldstein RB, Simons-Morton BG, Haynie DL, Liu D, Hingson RW, Gilman SE. Neighbourhood context and binge drinking from adolescence into early adulthood in a US national cohort. Int J Epidemiol 2020; 49:103-112. [PMID: 31263877 DOI: 10.1093/ije/dyz133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Underage binge drinking is a serious health concern that is likely influenced by the neighbourhood environment. However, longitudinal evidence has been limited and few studies have examined time-varying neighbourhood factors and demographic subgroup variation. METHODS We investigated neighbourhood influences and binge drinking in a national cohort of US 10th grade students at four times (2010-2014; n = 2745). We estimated odds ratios (OR) for past 30-day binge drinking associated with neighbourhood disadvantage, personal and property crime (quartiles), and number of liquor, beer and wine stores within 5 km, and then evaluated whether neighbourhood associations differ by age, sex and race/ethnicity. RESULTS Neighbourhood disadvantage was associated with binge drinking before 18 [OR = 1.54; 95% confidence interval (1.14, 2.08)], but not after 18 years of age. Property crime in neighbourhoods was associated with a higher odds of binge drinking [OR = 1.54 (0.96, 2.45)], an association that was stronger in early adulthood [4th vs 1st quartile: OR = 1.77 (1.04, 3.03)] and among Whites [4th vs 1st quartile: OR = 2.46 (1.03, 5.90)]. Higher density of liquor stores predicted binge drinking among Blacks [1-10 stores vs none: OR = 4.31 (1.50, 12.36)] whereas higher density of beer/wine stores predicted binge drinking among Whites [one vs none for beer: OR = 2.21 (1.06, 4.60); for wine: OR = 2.04 (1.04, 4.03)]. CONCLUSIONS Neighbourhood conditions, particularly those related to economic circumstances, crime and alcohol outlet density, were related to binge drinking among young adults, but associations varied across age and individual characteristics.
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Affiliation(s)
- Brian J Fairman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Risë B Goldstein
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Bruce G Simons-Morton
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Denise L Haynie
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Danping Liu
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health
| | - Ralph W Hingson
- Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Assanangkornchai S, Saingam D, Jitpiboon W, Geater AF. Comparison of drinking prevalence among Thai youth before and after implementation of the Alcoholic Beverage Control Act. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:325-332. [PMID: 31990584 DOI: 10.1080/00952990.2019.1692213] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Underage drinking contributes to numerous health and social problems among adolescents. The Alcoholic Beverage Control Act, issued in Thailand in 2008, contains several clauses aiming at preventing underage and novice drinking, such as raising the minimum legal purchasing age from 18 to 20, banning alcohol sale and consumption in places frequented by youth, and banning alcohol advertisements. OBJECTIVES To estimate the changes in the prevalence of alcohol consumption and perceptions of drinking norms among high-school students 8 years after the Act was implemented. METHODS Data from the Thai national high-school surveys in 2007 (N = 50,033; 49.9% female) and 2016 (N = 38,535; 49.8% female), using similar questionnaires, were analyzed. Prevalence rates and group norms toward drinking were compared between the two surveys, using weighted Poisson regression and prevalence ratios. RESULTS Drinking prevalence significantly increased in females, with prevalence ratios ranging from 1.2 for 30-day intoxication to 2.1 for 30-day binging. In males, the 12-month drinking prevalence increased in 2016, but a non-significant change for binge drinking and a 40% decrease for intoxication was seen. Higher proportions of students in 2016 perceived that most of their friends also drank alcohol compared to students in 2007 (16.8% vs. 11.2%; 49.8% increase). A significant effect of the year of survey on drinking patterns was seen across all school levels. CONCLUSION Drinking rates decreased among males, but increased in females. These changes may be somewhat due to the Act, or to changes in the social environment in Thailand over this 8-year period.
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Affiliation(s)
| | - Darika Saingam
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University , Hat Yai, Thailand
| | - Walailuk Jitpiboon
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University , Hat Yai, Thailand
| | - Alan F Geater
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University , Hat Yai, Thailand
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Walls H, Cook S, Matzopoulos R, London L. Advancing alcohol research in low-income and middle-income countries: a global alcohol environment framework. BMJ Glob Health 2020; 5:e001958. [PMID: 32377401 PMCID: PMC7199708 DOI: 10.1136/bmjgh-2019-001958] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 03/03/2020] [Accepted: 03/27/2020] [Indexed: 11/12/2022] Open
Abstract
Alcohol-related harm has gained increased attention in high-income countries (HICs) in recent years which, alongside government regulation, has effected a reduction in alcohol consumption. The alcohol industry has turned its attention to low-income and middle-income country (LMIC) markets as a new source of growth and profit, prompting increased consumption in LMICS. Alcohol use in LMICs is also increasing. There is a need to understand particularly in LMICs the impact of industry strategy in shaping local contexts of alcohol use. We draw on conceptualisations from food systems research, and research on the commercial determinants of health, to develop a new approach for framing alcohol research and discuss implications for alcohol research, particularly in LMICs, focusing on South Africa as an illustrative example. We propose a conceptualisation of the ‘alcohol environment’ as the system of alcohol provision, acquisition and consumption—including, critically, industry advertising and marketing—along with the political, economic and regulatory context of the alcohol industry that mediates people’s alcohol drinking patterns and behaviours. While each country and region is different in terms of its context of alcohol use, we contrast several broadly distinct features of alcohol environments in LMICs and HICs. Improving understanding of the full spectrum of influences on drinking behaviour, particularly in LMICs, is vital to inform the design of interventions and policies to facilitate healthier environments and reduce the harms associated with alcohol consumption. Our framework for undertaking alcohol research may be used to structure mixed methods empirical research examining the role of the alcohol environment particularly in LMICs.
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Affiliation(s)
- Helen Walls
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah Cook
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Richard Matzopoulos
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Leslie London
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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A systematic review, and meta-analysis, examining the prevalence of price promotions on foods and whether they are more likely to be found on less-healthy foods. Public Health Nutr 2020; 23:1281-1296. [PMID: 32209142 PMCID: PMC7196736 DOI: 10.1017/s1368980019004129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective: There are concerns that price promotions encourage unhealthy dietary choices. This review aims to answer the following research questions (RQ1) what is the prevalence of price promotions on foods in high-income settings, and (RQ2) are price promotions more likely to be found on unhealthy foods? Design: Systematic review of articles published in English, in peer-review journals, after 1 January 2000. Setting: Included studies measured the prevalence of price promotions (i.e. percentage of foods carrying a price promotion out of the total number of foods available to purchase) in retail settings, in upper-mid to high-income countries. Participants: ‘Price promotion’ was defined as a consumer-facing temporary price reduction or discount available to all customers. The control group/comparator was the equivalent products without promotions. The primary outcome for this review was the prevalence of price promotions, and the secondary outcome was the difference between the proportions of price promotions on healthy and unhealthy foods. Results: Nine studies (239 344 observations) were included for the meta-analysis for RQ1, the prevalence of price promotions ranged from 6 % (95 % CI 2 %, 15 %) for energy-dense nutrient-poor foods to 15 % (95 % CI 9 %, 25 %) for cereals, grains, breads and other starchy carbohydrates. However, the I-squared statistic was 99 % suggesting a very high level of heterogeneity. Four studies were included for the analysis of RQ2, of which two supported the hypothesis that price promotions were more likely to be found on unhealthy foods. Conclusions: The prevalence of price promotions is very context specific, and any proposed regulations should be supported by studies conducted within the proposed setting(s).
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Goldstick JE, Walton MA, Bohnert ASB, Heinze JE, Cunningham RM. Predictors of alcohol use transitions among drug-using youth presenting to an urban emergency department. PLoS One 2019; 14:e0227140. [PMID: 31891632 PMCID: PMC6938309 DOI: 10.1371/journal.pone.0227140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/12/2019] [Indexed: 11/19/2022] Open
Abstract
Background Precipitants of alcohol use transitions can differ from generalized risk factors. We extend prior research by predicting transitions in alcohol use disorder (AUD) during adolescence and emerging adulthood. Methods From 12/2009-9/2011, research assistants recruited 599 drug-using youth age 14–24 from Level-1 Emergency Department in Flint, Michigan. Youth were assessed at baseline and four biannual follow-ups, including a MINI Neuropsychiatric interview to diagnose AUD (abuse/dependence). We modeled AUD transitions using continuous time Markov Chains with transition probabilities modulated by validated measures of demographics, anxiety/depression symptoms, cannabis use, peer drinking, parental drinking, and violence exposure. Separate models were fit for underage (<21) and those of legal drinking age. Results We observed 2,024 pairs of consecutive AUD states, including 264 transitions (119 No-AUD→AUD; 145 AUD→No-AUD); 194 (32.4%) individuals were diagnosed with AUD at ≥1 assessment. Among age 14–20, peer drinking increased AUD onset (No-AUD→AUD transition) rates (Hazard ratio—HR = 1.70; 95%CI: [1.13,2.54]), parental drinking lowered AUD remission (AUD→No-AUD transition) rates (HR = 0.53; 95%CI: [0.29,0.97]), and cannabis use severity both hastened AUD onset (HR = 1.18; 95%CI: [1.06,1.32]) and slowed AUD remission (HR = 0.85; 95%CI: [0.76,0.95]). Among age 21–24, anxiety/depression symptoms both increased AUD onset rates (HR = 1.35; 95%CI: [1.13,1.60]) and decreased AUD remission rates (HR = 0.74; 95%CI: [0.63,0.88]). Friend drinking hastened AUD onset (HR = 1.18, 95%CI: [1.05,1.33]), and slowed AUD remission (HR = 0.84; 95%CI: [0.75,0.95]). Community violence exposure slowed AUD remission (HR = 0.69, 95%CI: [0.48,0.99]). In both age groups, males had >2x the AUD onset rate of females, but there were no sex differences in AUD remission rates. Limitations, most notably that this study occurred at a single site, are discussed. Conclusions Social influences broadly predicted AUD transitions in both age groups. Transitions among younger youth were predicted by cannabis use, while those among older youth were predicted more by internalizing symptoms and stress exposure (e.g., community violence). Our results suggest age-specific AUD etiology, and contrasts between prevention and treatment strategies.
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Affiliation(s)
- Jason E. Goldstick
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States of America
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States of America
- * E-mail:
| | - Maureen A. Walton
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States of America
- Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI, United States of America
| | - Amy S. B. Bohnert
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States of America
- Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI, United States of America
| | - Justin E. Heinze
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States of America
- Youth Violence Prevention Center, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - Rebecca M. Cunningham
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States of America
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States of America
- Youth Violence Prevention Center, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
- Hurley Medical Center, Department of Emergency Medicine, Flint, MI, United States of America
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Li J, Wu B, Tevik K, Krokstad S, Helvik AS. Factors associated with elevated consumption of alcohol in older adults-comparison between China and Norway: the CLHLS and the HUNT Study. BMJ Open 2019; 9:e028646. [PMID: 31377703 PMCID: PMC6687031 DOI: 10.1136/bmjopen-2018-028646] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The primary objective was to investigate the prevalence and factors associated with elevated alcohol consumption among older adults 65 years and above in China and Norway. The secondary objective was to compare the prevalence and factors in the two countries. DESIGN A secondary data analysis was conducted using two large cross-sectional studies (Chinese Longitudinal Healthy Longevity Survey data in 2008-2009 and Nord-Trøndelag Health Study data in 2006-2008). PARTICIPANTS A total of 3223 (weighted) Chinese older adults and 6210 Norwegian older adults who responded drinking alcohol were included in the analysis. OUTCOME MEASURES The dependent variable was elevated alcohol consumption, which was calculated as a ratio of those with elevated drinking among current drinkers. Multivariable logistic regression was used to test the dependent variable. RESULTS The prevalence of elevated alcohol consumption among current drinkers for the Chinese and Norwegian samples were 78.3% (weighted) and 5.1%, respectively. Being male was related to a higher likelihood of elevated alcohol consumption in both Chinese and Norwegian samples (OR=2.729, 95% CI 2.124 to 3.506, OR=2.638, 95% CI 1.942 to 3.585). Being older, with higher levels of education and a living spouse or partner were less likely to have elevated drinking in the Chinese sample (OR=0.497, 95% CI 0.312 to 0.794, OR=0.411, 95% CI 0.260 to 0.649, OR=0.533, 95% CI 0.417 to 0.682, respectively). Among Norwegian older adults, a higher level of education was related to higher likelihood of elevated drinking (OR=1.503, 95% CI 1.092 to 2.069, OR=3.020, 95% CI 2.185 to 4.175). Living in rural areas and higher life satisfaction were related to lower likelihood of elevated drinking in the Norwegian sample (OR=0.739, 95% CI 0.554 to 0.984, OR=0.844, 95% CI 0.729 to 0.977, respectively). CONCLUSIONS The elevated alcohol consumption patterns were strikingly different between China and Norway in regards to prevalence and socioeconomic distribution. To develop and implement culturally appropriate public health policies regarding alcohol in the future, public health policy makers and professionals need to be aware of the cultural differences and consider the demographic, social and economic characteristics of their intended population.
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Affiliation(s)
- Juan Li
- School of Nursing, Clinic Nursing Department, Second Military Medical University, Shanghai, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York City, New York, USA
| | - Kjerstin Tevik
- Norwegian Advisory unit on Ageing and Health, Sykehuset i Vestfold HF, Tonsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
| | - Steinar Krokstad
- General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Levanger, Norway
| | - A S Helvik
- Norwegian Advisory unit on Ageing and Health, Sykehuset i Vestfold HF, Tonsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
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Fairman BJ, Simons-Morton B, Haynie DL, Liu D, Goldstein RB, Hingson RW, Gilman SE. State alcohol policies, taxes, and availability as predictors of adolescent binge drinking trajectories into early adulthood. Addiction 2019; 114:1173-1182. [PMID: 30830991 PMCID: PMC6548657 DOI: 10.1111/add.14600] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 08/22/2018] [Accepted: 02/25/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS A number of alcohol policies in the United States have been presumed to reduce underage youth drinking. This study characterized underage youth binge-drinking trajectories into early adulthood and tested associations with the strength of the alcohol policy environment, beer excise taxes and number of liquor stores. DESIGN Longitudinal cohort study. SETTING United States. PARTICIPANTS A national cohort of 10th graders in 2010 (n = 2753), assessed annually from 2010 to 2015. MEASUREMENTS Participants reported on their 30-day binge drinking [defined as consuming five or more+ (for boys) or four or more (for girls) drinks within 2 hours]. We scored the strength of 19 state-level policies at baseline and summarized them into an overall score and two subdomain scores. We also assessed state beer excise taxes (dollars/gallon) and linked the number of liquor stores in 1 km to the participants' geocoded address. FINDINGS We identified five binge-drinking trajectories: low-risk (32.9%), escalating (26.1%), late-onset (13.8%), chronic (15.1%) and decreasing (12.0%). Lower overall alcohol policy strength was associated with increased risk of being in the escalating versus low-risk binge-drinking class [relative risk ratio (RRR) = 1.44 per 1 standard deviation (SD) in policy score; 95% confidence interval (CI) = 1.17, 1.77)]. Higher beer excise taxes were associated with a reduced risk of being in the escalating class (RRR = 0.22 per 1-dollar increase; 95% CI = 0.09, 0.50). The number of liquor stores was not significantly associated with any binge-drinking trajectory. CONCLUSIONS In the United States, stronger state alcohol policies and higher beer excise taxes appear to be associated with lower risk of escalating alcohol consumption trajectories among underage youth.
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Affiliation(s)
- Brian J. Fairman
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH
| | - Bruce Simons-Morton
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH
| | - Denise L. Haynie
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH
| | | | - Risë B. Goldstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH
| | | | - Stephen E. Gilman
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
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Ayano G, Yohannis K, Abraha M, Duko B. The epidemiology of alcohol consumption in Ethiopia: a systematic review and meta-analysis. Subst Abuse Treat Prev Policy 2019; 14:26. [PMID: 31186050 PMCID: PMC6558840 DOI: 10.1186/s13011-019-0214-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 05/28/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Globally, excessive alcohol consumption is a major public health problem and is associated with social, mental, physical and legal consequences. However, no systematic review and meta-analysis has been performed to report the consolidated magnitude of alcohol consumption in Ethiopia. METHODS PubMed, EMBASE, and SCOPUS were systematically searched to identify pertinent studies. Subgroup and sensitivity analysis was conducted and Cochran's Q- and the I2 test were used to assess heterogeneity. Publication bias was evaluated by using Egger's test and visual inspection of the symmetry in funnel plots. RESULTS We included 26 articles with a total of 42,811 participants. The pooled current and lifetime prevalence of alcohol consumption was 23.86% (95%CI; 17.53-31.60) and 44.16% (95%CI; 34.20-54.62), respectively. The pooled prevalence of hazardous alcohol consumption was 8.94% (95%CI; 3.40-21.50). The prevalence of hazardous alcohol consumption was remarkably higher in men (11.58%) than in women (1.21%). The prevalence of current and lifetime alcohol consumptions among university students were 22.08% & 38.88% respectively. The pooled data revealed that male sex was found to be a significant predictor of hazardous alcohol consumption (OR 10.38; 95%CI 3.86 to 27.88) as well as current (OR 2.45; 95%CI 1.78 to 3.38) and lifetime (OR 2.14; 95%CI 1.39 to 3.29) consumption. The magnitude of alcohol consumption among university students was apparently lower than the magnitude in other population of the country. The current study suggested a remarkable recent increment in the magnitude of hazardous alcohol consumption in Ethiopia. CONCLUSION The current study revealed that the prevalence of alcohol consumption in Ethiopia is comparable with the global estimates of alcohol consumption from the World Health Organization (WHO). The prevalence of hazardous alcohol consumption was remarkably higher in men (11.58%) than in women (1.21%). Male sex was found to be a significant predictor of alcohol consumption. The present study also suggested considerable recent increment in the magnitude of hazardous alcohol consumption in Ethiopia.
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Affiliation(s)
- Getinet Ayano
- Research and Training Department, Amanuel Mental Specialized Hospital, PO BOX: 1971 Addis Ababa, Ethiopia
| | | | - Mebratu Abraha
- Department of Psychiatry, Paulo’s Millennium Medical College, Addis Ababa, Ethiopia
| | - Bereket Duko
- Department of Psychiatry, Hawassa University, Hawassa, Ethiopia
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