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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; 43:1402-1425. [PMID: 38803126 DOI: 10.1111/dar.13881] [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: 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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Burns EJ, de Vocht F, Siqueira N, Ure C, Audrey S, Coffey M, Hare S, Hargreaves SC, Hidajat M, Parrott S, Scott L, Cook PA. An 'alcohol health champions' intervention to reduce alcohol harm in local communities: a mixed-methods evaluation of a natural experiment. PUBLIC HEALTH RESEARCH 2024; 12:1-135. [PMID: 39268883 DOI: 10.3310/htmn2101] [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] [Indexed: 09/15/2024] Open
Abstract
Background Globally alcohol consumption is a leading risk factor for premature death and disability and is associated with crime, social and economic consequences. Local communities may be able to play a role in addressing alcohol-related issues in their area. Objectives To evaluate the effectiveness and cost-benefit of an asset-based community development approach to reducing alcohol-related harm and understand the context and factors that enable or hinder its implementation. Design A mixed-methods evaluation. Area-level quasi-experimental trial analysed using four different evaluation methods (a stepped-wedge design where each area was a control until it entered the intervention, comparison to matched local/national controls and comparison to synthetic controls), alongside process and economic evaluations. Setting Ten local authorities in Greater Manchester, England. Participants The outcomes evaluation was analysed at an area level. Ninety-three lay persons representing nineareas completed questionnaires, with 12 follow-up interviews in five areas; 20 stakeholders representing ten areas were interviewed at baseline, with 17 follow-up interviews in eight areas and 26 members of the public from two areas attended focus groups. Interventions Professionals in a co-ordinator role recruited and supported lay volunteers who were trained to become alcohol health champions. The champion's role was to provide informal, brief alcohol advice to the local population and take action to strengthen restrictions on alcohol availability. Main outcome measures Numbers of alcohol-related hospital admissions, accident and emergency attendances, ambulance call-outs, street-level crime and antisocial behaviour in the intervention areas (area size: 1600-5500 residents). Set-up and running costs were collected alongside process evaluation data exploring barriers and facilitators. Data sources Routinely collected quantitative data on outcome measures aggregated at the intervention area and matched control and synthetic control areas. Data from policy documents, licensing registers, meeting notes, invoices, time/cost diaries, training registers, questionnaires, interviews, reflective diaries and focus groups. Results The intervention rolled out in nine out of ten areas, seven of which ran for a full 12 months. Areas with better-established infrastructure at baseline were able to train more champions. In total, 123 alcohol health champions were trained (95 lay volunteers and 28 professionals): lay volunteers self-reported positive impact. Champions engaged in brief advice conversations more readily than taking action on alcohol availability. There were no consistent differences in the health and crime area-level indicators between intervention areas and controls, as confirmed by using three different analysis methods for evaluating natural experiments. The intervention was not found to be cost-beneficial. Limitations Although the sequential roll-out order of the intervention was randomised, the selection of the intervention areas was not. Self-reported impact may have been subject to social desirability bias due to the project's high profile. Conclusions There was no measurable impact on health and crime outcomes. Possible explanations include too few volunteers trained, volunteers being unwilling to get involved in licensing decisions, or that the intervention has no direct impact on the selected outcomes. Future work Future similar interventions should use a coproduced community outcomes framework. Other natural experiment evaluations should use methodological triangulation to strengthen inferences about effectiveness. Trial registration This trial is registered as ISRCTN81942890. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/129/03) and is published in full in Public Health Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Elizabeth J Burns
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Cathy Ure
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Suzanne Audrey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Margaret Coffey
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Susan Hare
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Suzy C Hargreaves
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Steve Parrott
- School of Health Sciences, University of York, York, UK
| | - Lauren Scott
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Penny A Cook
- School of Health and Society, University of Salford, Greater Manchester, UK
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Walker FC, de Visser RO. Messages focused on the effect of alcohol on the immune system boosted intention to adhere to alcohol intake guidelines during Covid-19 lockdown. Psychol Health 2024; 39:1321-1336. [PMID: 36412106 DOI: 10.1080/08870446.2022.2145606] [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: 12/26/2021] [Revised: 10/30/2022] [Accepted: 11/04/2022] [Indexed: 11/23/2022]
Abstract
Objective: Research shows that personal relevance may affect the impact of alcohol-related health information. This study explored alcohol consumption during the UK Covid-19 lockdown, and whether a message emphasising the effect of alcohol on the immune system was more effective in altering intentions to follow low-risk drinking guidelines than other messages about the effects of alcohol on health. Methods & Measures: From April to June 2020, 953 drinkers completed an online questionnaire, and were randomly allocated to exposure to a control condition or one of three messages emphasising the impact of alcohol on: the immune system; mental health; or physical health. Outcome variables were: concern about alcohol intake, and intention to adhere to low-risk drinking guidelines. Results: Pre-post ANCOVAs revealed that participants in the immunity message group had significantly stronger intention to adhere to low-risk guidelines than the control group (after controlling for initial intention). Concern for the effect of alcohol on health was not significantly affected. Conclusion: During Covid-19 lockdown, a message emphasising the impact of alcohol on the immune-system had a greater effect on intention to observe low-risk drinking guidelines than other messages. Contextually relevant messages could be used for alcohol health campaigns and for improving alcohol labelling.
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Affiliation(s)
| | - Richard O de Visser
- School of Psychology, University of Sussex
- Department of Primary Care & Public Health, Brighton & Sussex Medical School
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Rostami M, Babashahi M, Ramezani S, Dastgerdizad H. A scoping review of policies related to reducing energy drink consumption in children. BMC Public Health 2024; 24:2308. [PMID: 39187818 PMCID: PMC11346296 DOI: 10.1186/s12889-024-19724-y] [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: 11/29/2023] [Accepted: 08/08/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Frequent consumption of Energy Drinks (EDs) is associated with numerous health problems, including overweight and obesity, particularly among children and adolescents. The extensive promotion, wide accessibility, and relatively low cost of EDs have significantly increased their popularity among this age group. This paper examines policies/programs that, directly and indirectly, contribute to reducing ED consumption in children and adolescents and shares global experiences to help policymakers adopt evidence-based policies. METHODS A systematic search was performed using PubMed, Scopus, and Web of Science databases from January 2000 to June 2024, along with reputable international organization websites, to find literature on policies aimed at reducing ED consumption among children and adolescents. All sources meeting the inclusion criteria were included without restrictions. Titles and abstracts were initially screened, followed by a full-text review. After evaluating the quality of the selected studies, data were extracted and, along with information from the selected documents, compiled into a table, detailing the country, policy type, and the effectiveness and weaknesses of each policy. RESULTS Out of 12166 reviewed studies and documents, 84 studies and 70 documents met the inclusion criteria. 73 countries and territories have implemented policies like taxation, sales bans, school bans, labeling, and marketing restrictions on EDs. Most employ fiscal measures, reducing consumption despite enforcement challenges. Labeling, access restrictions, and marketing bans are common but face issues like black markets. CONCLUSION This scoping review outlines diverse strategies adopted by countries to reduce ED consumption among children and teenagers, such as taxation, school bans, sales restrictions, and labeling requirements. While heightened awareness of ED harms has reinforced policy efforts, many Asian and African nations lack such measures, some policies remain outdated for over a decade, and existing policies face several challenges. These challenges encompass industry resistance, governmental disagreements, public opposition, economic considerations, and the intricacies of policy design. Considering this, countries should tailor policies to their cultural and social contexts, taking into account each policy's strengths and weaknesses to avoid loopholes. Inter-sectoral cooperation, ongoing policy monitoring, updates, and public education campaigns are essential to raise awareness and ensure effective implementation.
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Affiliation(s)
- Mohammadhassan Rostami
- Student Research Committee, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mina Babashahi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Shaghayegh Ramezani
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadis Dastgerdizad
- Department of Public Health, University of South Carolina, Bluffton, SC, 29909, USA
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5
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Farkouh EK, Vallance K, Wettlaufer A, Giesbrecht N, Asbridge M, Farrell-Low AM, Gagnon M, Price TR, Priore I, Shelley J, Sherk A, Shield KD, Solomon R, Stockwell TR, Thompson K, Vishnevsky N, Naimi TS. An assessment of federal alcohol policies in Canada and priority recommendations: Results from the 3rd Canadian Alcohol Policy Evaluation Project. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:640-653. [PMID: 38739320 PMCID: PMC11303602 DOI: 10.17269/s41997-024-00889-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/02/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To systematically assess the Canadian federal government's current alcohol policies in relation to public health best practices. METHODS The 2022 Canadian Alcohol Policy Evaluation (CAPE) Project assessed federal alcohol policies across 10 domains. Policy domains were weighted according to evidence for their relative impact, including effectiveness and scope. A detailed scoring rubric of best practices was developed and externally reviewed by international experts. Policy data were collected between June and December 2022, using official legislation, government websites, and data sources identified from previous iterations of CAPE as sources. Contacts within relevant government departments provided any additional data sources, reviewed the accuracy and completeness of the data, and provided amendments as needed. Data were scored independently by members of the research team. Final policy scores were tabulated and presented as a weighted overall average score and as unweighted domain-specific scores. RESULTS Compared to public health best practices, the federal government of Canada scored 37% overall. The three most impactful domains-(1) pricing and taxation, (2) marketing and advertising controls, and (3) impaired driving countermeasures-received some of the lowest scores (39%, 10%, and 40%, respectively). Domain-specific scores varied considerably from 0% for minimum legal age policies to 100% for controls on physical availability of alcohol. CONCLUSION Many evidence-informed alcohol policies have not been adopted, or been adopted only partially, by the Canadian federal government. Urgent adoption of the recommended policies is needed to prevent and reduce the enormous health, social, and economic costs of alcohol use in Canada.
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Affiliation(s)
- Elizabeth K Farkouh
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA.
| | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Ashley Wettlaufer
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
| | - Norman Giesbrecht
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Amanda M Farrell-Low
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Marilou Gagnon
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Tina R Price
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Isabella Priore
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Jacob Shelley
- Faculty of Law, University of Western Ontario, London, ON, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kevin D Shield
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Robert Solomon
- Faculty of Law, University of Western Ontario, London, ON, Canada
| | - Tim R Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kara Thompson
- St. Francis Xavier University, Antigonish, NS, Canada
| | - Nicole Vishnevsky
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Timothy S Naimi
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
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Cohen DA, Preciado M, Voorhees A, Castillo A, Montes M, Labisi T, Lopez K, Economos C, Story M. Feasibility and Acceptability of Standardizing Portions in Restaurants. J Urban Health 2024; 101:775-781. [PMID: 38720143 PMCID: PMC11329444 DOI: 10.1007/s11524-024-00867-7] [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] [Accepted: 03/27/2024] [Indexed: 08/17/2024]
Abstract
Most restaurants serve customers excess calories which significantly contributes to the obesity epidemic. This pilot study tested the feasibility and acceptability of offering customers standardized portions to reduce caloric consumption when dining out in three restaurants. Portions were developed to limit quantity of food served, with lunches and dinners ≤ 700 cal and breakfast ≤ 500 cal. Participating restaurants developed an alternative "Balanced Portions Menu." Training and instructions were provided with respect to the volume and weight of food to be plated following the standardized guidelines and providing at least one cup of vegetables per lunch/dinner. We invited local residents to help us evaluate the new menu. We monitored restaurant adherence to guidelines, obtained feedback from customers, and incentivized customers to complete dietary recalls to determine how the new menus might have impacted their daily caloric consumption. Of the three participating restaurants, all had a positive experience after creating the new menus and received more foot traffic. One restaurant that did not want to change portion sizes simply plated the appropriate amount and packed up the rest to-go, marketing the meals as "Dinner today, lunch tomorrow." Two of the restaurants followed the guidelines precisely, while one sometimes plated more rice than the three-fourths cup that was recommended. A significant number of customers ordered from the Balanced Portions menus. Two of the three restaurants have decided to keep offering the Balanced Portions menus indefinitely. Following standardized portions guidelines is both feasible for restaurants and acceptable to customers.
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Affiliation(s)
- Deborah A Cohen
- Kaiser Permanente Research and Evaluation, Southern California, 100 S Los Robles Ave, Pasadena, CA, 91101, USA.
| | - Melissa Preciado
- Kaiser Permanente Research and Evaluation, Southern California, 100 S Los Robles Ave, Pasadena, CA, 91101, USA
| | - Allison Voorhees
- Kaiser Permanente Research and Evaluation, Southern California, 100 S Los Robles Ave, Pasadena, CA, 91101, USA
| | - Amorette Castillo
- Kaiser Permanente Research and Evaluation, Southern California, 100 S Los Robles Ave, Pasadena, CA, 91101, USA
| | | | - Titilola Labisi
- Kaiser Permanente Research and Evaluation, Southern California, 100 S Los Robles Ave, Pasadena, CA, 91101, USA
| | - Kelly Lopez
- Kaiser Permanente Research and Evaluation, Southern California, 100 S Los Robles Ave, Pasadena, CA, 91101, USA
| | - Christina Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Medford, MA, USA
| | - Mary Story
- Duke Global Health Institute, Duke University, Durham, NC, USA
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7
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Liu S, Kazonda P, Leyna GH, Rohr JK, Fawzi WW, Shinde S, Abioye AI, Francis JM, Probst C, Sando D, Mwanyka-Sando M, Killewo J, Bärnighausen T. Emotional and cognitive influences on alcohol consumption in middle-aged and elderly Tanzanians: a population-based study. Sci Rep 2024; 14:17520. [PMID: 39079984 PMCID: PMC11289436 DOI: 10.1038/s41598-024-64694-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 06/12/2024] [Indexed: 08/02/2024] Open
Abstract
Alcohol consumption in Tanzania exceeds the global average. While sociodemographic difference in alcohol consumption in Tanzania have been studied, the relationship between psycho-cognitive phenomena and alcohol consumption has garnered little attention. Our study examines how depressive symptoms and cognitive performance affect alcohol consumption, considering sociodemographic variations. We interviewed 2299 Tanzanian adults, with an average age of 53 years, to assess their alcohol consumption, depressive symptoms, cognitive performance, and sociodemographic characteristics using a zero-inflated negative binomial regression model. The logistic portion of our model revealed that the likelihood alcohol consumption increased by 8.4% (95% confidence interval [CI] 3.6%, 13.1%, p < 0.001) as depressive symptom severity increased. Conversely, the count portion of the model indicated that with each one-unit increase in the severity of depressive symptoms, the estimated number of drinks decreased by 2.3% (95% CI [0.4%, 4.0%], p = .016). Additionally, the number of drinks consumed decreased by 4.7% (95% CI [1.2%, 8.1%], p = .010) for each increased cognitive score. Men exhibited higher alcohol consumption than women, and Christians tended to consume more than Muslims. These findings suggest that middle-aged and elderly adults in Tanzania tend to consume alcohol when they feel depressed but moderate their drinking habits by leveraging their cognitive abilities.
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Affiliation(s)
- Shuyan Liu
- Department of Psychiatry and Psychotherapy (Campus Charité Mitte), Charité - Universitätsmedizin Berlin, Berlin, Germany.
- German Center for Mental Health (DZPG), Berlin and Heidelberg, Germany.
| | | | - Germana H Leyna
- Department of Epidemiology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Julia K Rohr
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sachin Shinde
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ajibola Ibraheem Abioye
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Joel M Francis
- Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Charlotte Probst
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - David Sando
- Management and Development for Health, Dar Es Salaam, Tanzania
| | | | - Japhet Killewo
- Department of Epidemiology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Till Bärnighausen
- German Center for Mental Health (DZPG), Berlin and Heidelberg, Germany.
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany.
- Africa Health Research Institute, Somkhele and Durban, South Africa.
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Lübker C, Murtin F. Educational inequalities in deaths of despair in 14 OECD countries: a cross-sectional observational study. J Epidemiol Community Health 2024:jech-2024-222089. [PMID: 39019490 DOI: 10.1136/jech-2024-222089] [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: 02/21/2024] [Accepted: 06/25/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Deaths of despair are a key contributor to stagnating life expectancy in the USA, especially among those without a university-level education, but these findings have not been compared internationally. METHODS Mortality and person-year population exposure data were collected in 14 Organisation for Economic Co-operation and Development member countries and stratified by age, sex, educational attainment and cause of death. The sample included 1.4 billion person-year observations from persons aged ≥25 years between 2013 and 2019. Country-specific and sex-specific contributions of deaths of despair to: (a) the life expectancy gap at age 25 and (b) rate differences in age-standardised mortality rates between high and low educational attainment groups were calculated. RESULTS Eliminating deaths of despair could reduce the life expectancy gap in the USA by 1.1 years for men and 0.6 years for women was second only to Korea, where it would reduce the gap by 3.4 years for men and 2.2 years for women. In Italy, Spain and Türkiye, eliminating deaths of despair would improve life expectancy gains by less than 0.1 years for women and 0.3 years for men, closing the educational gap by <1%. Findings were robust to controls for differences in population structures. CONCLUSIONS Deaths of despair are a major determinant of educational inequalities in longevity in Korea and the USA, while having limited impact in Southern European countries, indicating substantial international variation and scope for improvement in high burden high-income countries.
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Affiliation(s)
- Christopher Lübker
- Department of Health Sciences, University of York, York, UK
- Centre for Health Economics, University of York, York, UK
| | - Fabrice Murtin
- Centre for Wellbeing, Inclusion, Sustainability, and Equal Opportunity, Organisation for Economic Co-operation and Development, Paris, France
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Suddle A, Reeves H, Hubner R, Marshall A, Rowe I, Tiniakos D, Hubscher S, Callaway M, Sharma D, See TC, Hawkins M, Ford-Dunn S, Selemani S, Meyer T. British Society of Gastroenterology guidelines for the management of hepatocellular carcinoma in adults. Gut 2024; 73:1235-1268. [PMID: 38627031 PMCID: PMC11287576 DOI: 10.1136/gutjnl-2023-331695] [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: 12/06/2023] [Accepted: 03/19/2024] [Indexed: 05/01/2024]
Abstract
Deaths from the majority of cancers are falling globally, but the incidence and mortality from hepatocellular carcinoma (HCC) is increasing in the United Kingdom and in other Western countries. HCC is a highly fatal cancer, often diagnosed late, with an incidence to mortality ratio that approaches 1. Despite there being a number of treatment options, including those associated with good medium to long-term survival, 5-year survival from HCC in the UK remains below 20%. Sex, ethnicity and deprivation are important demographics for the incidence of, and/or survival from, HCC. These clinical practice guidelines will provide evidence-based advice for the assessment and management of patients with HCC. The clinical and scientific data underpinning the recommendations we make are summarised in detail. Much of the content will have broad relevance, but the treatment algorithms are based on therapies that are available in the UK and have regulatory approval for use in the National Health Service.
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Affiliation(s)
- Abid Suddle
- King's College Hospital NHS Foundation Trust, London, UK
| | - Helen Reeves
- Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK
| | - Richard Hubner
- Department of Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | | | - Ian Rowe
- University of Leeds, Leeds, UK
- St James's University Hospital, Leeds, UK
| | - Dina Tiniakos
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Stefan Hubscher
- Department of Pathology, University of Birmingham, Birmingham, UK
| | - Mark Callaway
- Division of Diagnostics and Therapies, University Hospitals Bristol NHS Trust, Bristol, UK
| | | | - Teik Choon See
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Maria Hawkins
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | | | - Sarah Selemani
- King's College Hospital NHS Foundation Trust, London, UK
| | - Tim Meyer
- Department of Oncology, University College, London, UK
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10
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Vichitkunakorn P, Khampang R, Leelahavarong P, Nontarak J, Assanangkornchai S. Cost-utility analysis of an alcohol policy in Thailand: a case study of a random breath testing intervention. BMC Health Serv Res 2024; 24:739. [PMID: 38886718 PMCID: PMC11181527 DOI: 10.1186/s12913-024-11189-4] [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: 09/24/2023] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Road traffic injuries are a major concern worldwide, with Thailand facing high accident mortality rates. Drunk driving is a key factor that requires countermeasures. Random breath testing (RBT) and mass media campaigns recommended by the World Health Organisation intend to deter such behaviour. This study aimed to evaluate the cost-effectiveness of implementing RBT in combination with mass media campaigns in Thailand. METHODS A Markov simulation model estimated the lifetime cost and health benefits of RBT with mass media campaigns compared to mass media campaigns only. Direct medical and non-medical care costs were evaluated from a societal perspective. The health outcomes were quality-adjusted life years (QALY). Costs and outcomes were discounted by 3% per year. Subgroup analyses were conducted for both sexes, different age groups, and different drinking levels. Probabilistic sensitivity analyses were conducted over 5,000 independent iterations using a predetermined distribution for each parameter. RESULTS This study suggested that RBT with mass media campaigns compared with mass media campaigns increases the lifetime cost by 24,486 THB per male binge drinker and 10,475 THB per female binge drinker (1 USD = 35 THB) and results in a QALY gain of 0.43 years per male binge drinker and 0.10 years per female binge drinker. The intervention yielded incremental cost-effectiveness ratios (ICERs) of 57,391 and 103,850 THB per QALY for male and female drinkers, respectively. Moreover, the intervention was cost-effective for all age groups and drinking levels. The intervention yielded the lowest ICER among male-dependent drinkers. Sensitivity analyses showed that at a willingness-to-pay (WTP) threshold of 160,000 per QALY gained, the RBT combined with mass media campaigns had a 99% probability of being optimal for male drinkers, whereas the probability for females was 91%. CONCLUSIONS RBT and mass media campaigns in Thailand are cost-effective for all ages and drinking levels in both sexes. The intervention yielded the lowest ICER among male-dependent drinkers. Given the current Thai WTP threshold, sensitivity analyses showed that the intervention was more cost-effective for males than females.
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Affiliation(s)
- Polathep Vichitkunakorn
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Centre of Alcohol Studies, Thai Health Promotion Foundation, Bangkok, Thailand
| | - Roongnapa Khampang
- Siriraj Health Policy Unit (SiHP), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Pattara Leelahavarong
- Siriraj Health Policy Unit (SiHP), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jiraluck Nontarak
- Centre of Alcohol Studies, Thai Health Promotion Foundation, Bangkok, Thailand
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Sawitri Assanangkornchai
- Centre of Alcohol Studies, Thai Health Promotion Foundation, Bangkok, Thailand
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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11
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Lesch M, McCambridge J. Continuities and change in alcohol policy at the global level: a documentary analysis of the 2010 Global Strategy for Reducing the Harmful Use of Alcohol and the Global Alcohol Action Plan 2022-2030. Global Health 2024; 20:47. [PMID: 38877515 PMCID: PMC11179290 DOI: 10.1186/s12992-024-01034-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/23/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND There are only two major statements which define alcohol policy development at the global level. There has not been any comparative analysis of the details of these key texts, published in 2010 and 2022 respectively, including how far they constitute similar or evolving approaches to alcohol harm. METHODS Preparatory data collection involved examination of documents associated with the final policy statements. A thematic analysis across the two policy documents was performed to generate understanding of continuity and change based on comparative study. Study findings are interpreted in the contexts of the evolving conceptual and empirical literatures. RESULTS Both documents exhibit shared guiding principles and identify similar governance challenges, albeit with varying priority levels. There is more emphasis on the high-impact interventions on price, availability and marketing in 2022, and more stringent targets have been set for 2030 in declaring alcohol as a public health priority therein, reflecting the action-oriented nature of the Plan. The identified roles of policy actors have largely remained unchanged, albeit with greater specificity in the more recent statement, appropriately so because it is concerned with implementation. The major exception, and the key difference in the documents, regards the alcohol industry, which is perceived primarily as a threat to public health in 2022 due to commercial activities harmful to health and because policy interference has slowed progress. CONCLUSIONS The adoption of the Global Alcohol Action Plan 2022-30 potentially marks a pivotal moment in global alcohol policy development, though it is unclear how fully it may be implemented. Perhaps, the key advances lie in advancing the ambitions of alcohol policy and clearly identifying that the alcohol industry should not be seen as any kind of partner in public health policymaking, which will permit progress to the extent that this influences what actually happens in alcohol policy at the national level.
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Affiliation(s)
- Matthew Lesch
- Department of Politics and International Relations, Derwent College, University of York, D/N/126, Heslington, York, YO10 5DD, UK.
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12
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Reile R, Rehm J. Does higher alcohol consumption affect attitudes towards alcohol control measures in Estonia? PUBLIC HEALTH IN PRACTICE 2024; 7:100455. [PMID: 38405229 PMCID: PMC10885783 DOI: 10.1016/j.puhip.2023.100455] [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: 09/07/2023] [Revised: 10/24/2023] [Accepted: 11/15/2023] [Indexed: 02/27/2024] Open
Abstract
Objectives To analyze whether higher alcohol consumption is associated with negative attitudes towards stricter alcohol control policy measures in Estonia. Study design Cross-sectional analysis of nationally representative data from 2022 (n = 2059). Methods Attitudes towards seven alcohol control measures and their association with high-risk alcohol consumption (>140 g absolute alcohol for men and >70 g for women per week) were analyzed using used descriptive statistics and binary logistic regression using nationally representative data on Estonian 15-74-year-old population. Results In general, high-risk consumption associated with lower acceptance for alcohol control policies. Although men had higher prevalence of opposing alcohol control measure for every item considered, both men and women with high-risk alcohol consumption were significantly more likely to be against alcohol control measures in general even after accounting for the variation by demographic characteristics. Conclusions As public opinion is detrimental to the successful implementation of alcohol policies, these findings emphasize the need to communicate alcohol-related harms to the public in order to increase awareness and support for alcohol control policies.
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Affiliation(s)
- Rainer Reile
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Jürgen Rehm
- Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario, M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 1P8, Canada
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse & WHO CC, 81-95 Roc Boronat St., 08005, Barcelona, Spain
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13
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Nazif-Munoz JI, Pereira CCM, Martinez PA, Najafi Moghaddam V, Domínguez-Cancino K. Analyzing 14-years of suicide rates in Chile: Impact of alcohol policy, domestic violence, and a suicide prevention program. Psychiatry Res 2024; 333:115729. [PMID: 38244283 DOI: 10.1016/j.psychres.2024.115729] [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: 06/12/2023] [Revised: 01/06/2024] [Accepted: 01/10/2024] [Indexed: 01/22/2024]
Abstract
Suicide is a major public health problem worldwide with far-reaching effects on families, communities, and societies. Influencing factors range from macro-level interventions like alcohol control policies and suicide prevention programs to individual contributors such as alcohol abuse and domestic violence. This study aimed to examine the relationship between Chile's suicide rate changes from 2002 to 2015 and the Alcohol Act of 2004, a national suicide prevention program implemented in 2007, alcohol abuse, and domestic violence. Assembling a unique longitudinal dataset from Chilean public institutions, the study employed an instrumental variable time-series cross-regional design. Results indicated that the Alcohol Act was not associated with suicide rates, domestic violence exhibited a significant association with increased suicide rates, and the national suicide prevention program was linked to reductions in suicide rates, especially among males. These findings align with research from neighbouring countries, showcasing the efficacy of suicide prevention programs in decreasing suicide rates in Chile. Results highlight the importance of integrating protocols to early-detect domestic violence in suicide prevention programs, as well as the need to further improving alcohol control policies to complement suicide prevention programs.
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Affiliation(s)
- José Ignacio Nazif-Munoz
- Service sur les Dépendances, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 150, Place Charles-Le Moyne, Bureau 200, Longueuil, QC J4K 0A8, Canada.
| | - Camila Corrêa Matias Pereira
- Service sur les Dépendances, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 150, Place Charles-Le Moyne, Bureau 200, Longueuil, QC J4K 0A8, Canada
| | - Pablo Alberto Martinez
- Service sur les Dépendances, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 150, Place Charles-Le Moyne, Bureau 200, Longueuil, QC J4K 0A8, Canada
| | - Vahid Najafi Moghaddam
- Service sur les Dépendances, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 150, Place Charles-Le Moyne, Bureau 200, Longueuil, QC J4K 0A8, Canada
| | - Karen Domínguez-Cancino
- Service sur les Dépendances, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 150, Place Charles-Le Moyne, Bureau 200, Longueuil, QC J4K 0A8, Canada
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14
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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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15
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Lau G, Mitra B, Gabbe BJ, Dietze PM, Reeder S, Cameron PA, Smit DV, Schneider HG, Symons E, Koolstra C, Stewart C, Beck B. Prevalence of alcohol and other drug detections in non-transport injury events. Emerg Med Australas 2024; 36:78-87. [PMID: 37717234 PMCID: PMC10952644 DOI: 10.1111/1742-6723.14312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE To measure the prevalence of alcohol and/or other drug (AOD) detections in suspected major trauma patients with non-transport injuries who presented to an adult major trauma centre. METHODS This registry-based cohort study examined the prevalence of AOD detections in patients aged ≥18 years who: (i) sustained non-transport injuries; and (ii) met predefined trauma call-out criteria and were therefore managed by an interdisciplinary trauma team between 1 July 2021 and 31 December 2022. Prevalence was measured using routine in-hospital blood alcohol and urine drug screens. RESULTS A total of 1469 cases met the inclusion criteria. Of cases with a valid blood test (n = 1248, 85.0%), alcohol was detected in 313 (25.1%) patients. Of the 733 (49.9%) cases with urine drug screen results, cannabinoids were most commonly detected (n = 103, 14.1%), followed by benzodiazepines (n = 98, 13.4%), amphetamine-type substances (n = 80, 10.9%), opioids (n = 28, 3.8%) and cocaine (n = 17, 2.3%). Alcohol and/or at least one other drug was detected in 37.4% (n = 472) of cases with either a blood alcohol or urine drug test completed (n = 1263, 86.0%). Multiple substances were detected in 16.6% (n = 119) of cases with both blood alcohol and urine drug screens (n = 718, 48.9%). Detections were prevalent in cases of interpersonal violence (n = 123/179, 68.7%) and intentional self-harm (n = 50/106, 47.2%), and in those occurring on Friday and Saturday nights (n = 118/191, 61.8%). CONCLUSION AOD detections were common in trauma patients with non-transport injury causes. Population-level surveillance is needed to inform prevention strategies that address AOD use as a significant risk factor for serious injury.
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Affiliation(s)
- Georgina Lau
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Biswadev Mitra
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Emergency and Trauma CentreThe Alfred HospitalMelbourneVictoriaAustralia
| | - Belinda J Gabbe
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Health Data Research UK, Swansea University Medical SchoolSwansea UniversitySwanseaUK
| | - Paul M Dietze
- Disease Elimination Program, Burnet InstituteMelbourneVictoriaAustralia
- National Drug Research InstituteCurtin UniversityPerthWestern AustraliaAustralia
| | - Sandra Reeder
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Peter A Cameron
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Emergency and Trauma CentreThe Alfred HospitalMelbourneVictoriaAustralia
| | - De Villiers Smit
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Emergency and Trauma CentreThe Alfred HospitalMelbourneVictoriaAustralia
- National Trauma Research InstituteThe Alfred HospitalMelbourneVictoriaAustralia
| | - Hans G Schneider
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Department of PathologyThe Alfred HospitalMelbourneVictoriaAustralia
| | - Evan Symons
- Alfred Mental and Addiction HealthThe Alfred HospitalMelbourneVictoriaAustralia
| | - Christine Koolstra
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Emergency and Trauma CentreThe Alfred HospitalMelbourneVictoriaAustralia
| | - Cara Stewart
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Emergency and Trauma CentreThe Alfred HospitalMelbourneVictoriaAustralia
| | - Ben Beck
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
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16
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Gage R, Connor J, Jackson N, McKerchar C, Signal L. Generating political priority for alcohol policy reform: A framework to guide advocacy and research. Drug Alcohol Rev 2024; 43:381-392. [PMID: 38017702 DOI: 10.1111/dar.13782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/30/2023]
Abstract
INTRODUCTION While effective policies exist to reduce alcohol-related harm, political will to enact them is low in many jurisdictions. We aimed to identify key barriers and strategies for strengthening political priority for alcohol policy reform. METHODS A framework synthesis was conducted, incorporating relevant theory, key informant interviews (n = 37) and a scoping review. Thematic analysis informed the development of a framework for understanding and influencing political priority for alcohol policy. RESULTS Twelve barriers and 14 strategies were identified at multiple levels (global, national and local). Major barriers included neoliberal or free trade ideology, the globalised alcohol industry, limited advocate capacity and the normalisation of alcohol harms. Strategies fell into two categories: sector-specific and system change initiatives. Sector-specific strategies primarily focus on influencing policymakers and mobilising civil society. Examples include developing a clear, unified solution, coalition building and effective framing. System change initiatives target structural change to reduce the power imbalance between industry and civil society, such as restricting industry involvement in policymaking and securing sustainable funding for advocacy. A key example is establishing an international treaty, similar to the Framework Convention on Tobacco Control, to support domestic policymaking. DISCUSSION AND CONCLUSIONS Our findings provide a framework for understanding and advancing political priority for alcohol policy. The framework highlights that progress can be achieved at various levels and through diverse groups of actors. The importance of upstream drivers of policymaking was a key finding, presenting challenges for time-poor advocates, but offering potential facilitation through effective global leadership.
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Affiliation(s)
- Ryan Gage
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Jennie Connor
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Christina McKerchar
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Louise Signal
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
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Veldhuis CB, Kreski NT, Usseglio J, Keyes KM. Are Cisgender Women and Transgender and Nonbinary People Drinking More During the COVID-19 Pandemic? It Depends. Alcohol Res 2023; 43:05. [PMID: 38170029 PMCID: PMC10760999 DOI: 10.35946/arcr.v43.1.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
PURPOSE This narrative review of research conducted during the first 2 years of the COVID-19 pandemic examines whether alcohol use among cisgender women and transgender and nonbinary people increased during the pandemic. The overarching goal of the review is to inform intervention and prevention efforts to halt the narrowing of gender-related differences in alcohol use. SEARCH METHODS Eight databases (PubMed, APA PsycInfo, CINAHL, Embase, Scopus, Gender Studies Database, GenderWatch, and Web of Science) were searched for peer-reviewed literature, published between March 2020 and July 2022, that reported gender differences or findings specific to women, transgender or nonbinary people, and alcohol use during the pandemic. The search focused on studies conducted in the United States and excluded qualitative research. SEARCH RESULTS A total 4,132 records were identified, including 400 duplicates. Of the remaining 3,732 unique records for consideration in the review, 51 were ultimately included. Overall, most studies found increases in alcohol use as well as gender differences in alcohol use, with cisgender women experiencing the most serious consequences. The findings for transgender and nonbinary people were equivocal due to the dearth of research and because many studies aggregated across gender. DISCUSSION AND CONCLUSIONS Alcohol use by cisgender women seems to have increased during the pandemic; however, sizable limitations need to be considered, particularly the low number of studies on alcohol use during the pandemic that analyzed gender differences. This is of concern as gender differences in alcohol use had been narrowing before the pandemic; and this review suggests the gap has narrowed even further. Cisgender women and transgender and nonbinary people have experienced sizable stressors during the pandemic; thus, understanding the health and health behavior impacts of these stressors is critical to preventing the worsening of problematic alcohol use.
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Affiliation(s)
- Cindy B Veldhuis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Noah T Kreski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia Irving Medical Center, Columbia University, New York, New York
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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18
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Jaguga F, Ott MA, Kwobah EK, Apondi E, Giusto A, Barasa J, Kosgei G, Rono W, Korir M, Puffer ES. Adapting a substance use screening and brief intervention for peer-delivery and for youth in Kenya. SSM - MENTAL HEALTH 2023; 4:100254. [PMID: 38047062 PMCID: PMC10688596 DOI: 10.1016/j.ssmmh.2023.100254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Background Substance use is a major problem among youth in sub-Saharan Africa, yet interventions that address this problem are scarce within the region. Screening and brief intervention is a cost-effective, efficacious, and easy to scale public health approach to addressing substance use problems. We conducted a pilot study to evaluate the feasibility of implementing a peer delivered screening and brief intervention program for youth in Kenya. The goal of this paper is to report on the process of adapting the Alcohol Smoking and Substance Involvement Screening Test for Youth- linked Brief Intervention (ASSIST-Y-linked BI) program for peer delivery and for the Kenyan context prior to the pilot. Methods The adaptation process was led by a multi-disciplinary team comprised of psychiatrists, pediatricians, and psychologists. We utilized the ADAPT-ITT framework to adapt the ASSIST-Y-linked BI. The ADAPT-ITT framework consists of 8 phases including Assessment, Decision making, Adaptation, Production, Topical Experts, Integration, Training, and Testing the evidence-based intervention. Here, we report on phases 1-7 of the framework. The results of the pilot testing have been published elsewhere. Results Overall, we made surface level adaptations to the ASSIST-Y-linked BI program such as simplifying the language to enhance understandability. We maintained the core components of the program i.e., Feedback, Responsibility, Advice, Menu of Options, Empathy, Self-efficacy (FRAMES). Conclusions Our paper provides information which other stakeholders planning to implement the ASSIST-Y-linked BI for youth in sub-Saharan Africa, could use to adapt the intervention.
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Affiliation(s)
- Florence Jaguga
- Moi Teaching & Referral Hospital Department of Mental Health, PO BOX 3-30100, Eldoret Kenya
| | - Mary A. Ott
- Division of Adolescent Medicine, Department of Pediatrics, Indiana University, Indiana, USA
| | - Edith Kamaru Kwobah
- Moi Teaching & Referral Hospital Department of Mental Health, PO BOX 3-30100, Eldoret Kenya
| | - Edith Apondi
- Moi Teaching & Referral Hospital Department of Mental Health, PO BOX 3-30100, Eldoret Kenya
| | - Ali Giusto
- Columbia University Medical Center/New York State Psychiatric Institute, New York, 40 Haven Ave., #171. New York, NY 10032. USA
| | - Julius Barasa
- Academic Model Providing Access to Healthcare. PO BOX 4606-30100, Eldoret, Kenya
| | - Gilliane Kosgei
- Academic Model Providing Access to Healthcare. PO BOX 4606-30100, Eldoret, Kenya
| | - Wilter Rono
- Academic Model Providing Access to Healthcare. PO BOX 4606-30100, Eldoret, Kenya
| | - Mercy Korir
- Academic Model Providing Access to Healthcare. PO BOX 4606-30100, Eldoret, Kenya
| | - Eve S. Puffer
- Department of Psychology & Neuroscience, Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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Aby ES, Vogel AS, Winters AC. Intersection of Coronavirus Disease 2019 and Alcohol-associated Liver Disease: A Review of Emerging Trends and Implications. Clin Ther 2023; 45:1164-1170. [PMID: 37758533 DOI: 10.1016/j.clinthera.2023.08.019] [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: 05/11/2023] [Revised: 08/04/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE This review will provide an overview of alcohol use and alcohol associated liver disease (ALD) prior to the coronavirus disease 2019 (COVID-19) pandemic and the impact of the pandemic on alcohol use and ALD. Furthermore, this review will explore strategies to mitigate the growing disease burden of AUD and ALD. METHODS A search using PubMed was performed for articles on topics related to alcohol use, ALD, and COVID-19. The literature was reviewed and pertinent sources were used for this narrative review. FINDINGS In the United States (US), excessive alcohol use is the third leading cause of preventable death. Prior to the COVID-19 pandemic, the increasing prevalence of alcohol use disorder (AUD) and ALD in the US had already constituted a public health crisis given the association between alcohol misuse, AUD, and ALD with significant medical, economic, and societal burdens. The COVID-19 pandemic led to increased alcohol consumption and downstream consequences, including increased prevalence of AUD, ALD, ALD-related hospitalization and death, and liver transplantation for ALD. IMPLICATIONS There is a critical need for additional, multi-pronged interventions to mitigate the mortality and morbidity linked to ALD.
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Affiliation(s)
- Elizabeth S Aby
- Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota.
| | - Alexander S Vogel
- Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Adam C Winters
- Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York
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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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Huang X, Zhang J, Zheng Y, Liu X, Xu Y, Fang Y, Lin Z, Lin L, Zhang H, Wang Z. Alcoholic drink produced by pea is a risk factor for incident knee surgery in patients with knee osteoarthritis. Front Nutr 2023; 10:1264338. [PMID: 37915622 PMCID: PMC10616467 DOI: 10.3389/fnut.2023.1264338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/21/2023] [Indexed: 11/03/2023] Open
Abstract
Objective The objective of this study is to investigate whether alcohol exposure and specific alcoholic drinks are independent risk factors for incident knee surgery in knee osteoarthritis (KOA) patients. Methods We identified all patients who were clinically diagnosed as KOA between January 2010 and January 2018 in our outpatient department. Demographic, clinical, and radiographic data were collected from the database of our hospital. Next, we analyzed the association between alcohol consumption and incident knee surgery. Results A total of 4,341 KOA patients completed the current study and were included in the final analysis. Incident knee surgery for the purpose of treating osteoarthritis was observed in 242 patients. Incident knee surgery was significantly associated with age (OR [95%CI], 1.023 [1.009-1.039], P = 0.002), BMI (OR [95%CI], 1.086 [1.049-1.123], P < 0.001), baseline K-L grade 3 (OR [95%CI], 1.960 [1.331-2.886], P = 0.001), baseline K-L grade 4 (OR [95%CI], 1.966 [1.230-3.143], P = 0.005), 7.1-14 drinks per week (OR [95%CI], 2.013 [1.282-3.159], P = 0.002), >14 standard drinks per week (OR [95%CI], 2.556 [1.504-4.344], P = 0.001), and the most common alcoholic drink produced by pea (OR [95%CI], 3.133 [1.715-5.723], P < 0.001). Conclusion KOA patients who consumed more than seven standard drinks per week were at substantial risk of incident knee surgery. In addition, alcoholic drink produced by pea is also an independent risk factor.
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Affiliation(s)
| | - Jinshan Zhang
- Orthopedics Department, Jinjiang Municipal Hospital, Fujian, China
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22
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Capurro G, Maier R, Tustin J, Jardine CG, Driedger SM. 'Stay home and stay safe … but maybe you can have somebody over': public perceptions of official COVID-19 messages during the 2020 holiday season in Canada. JOURNAL OF COMMUNICATION IN HEALTHCARE 2023; 16:279-286. [PMID: 37859463 DOI: 10.1080/17538068.2022.2138243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
BACKGROUND The COVID-19 pandemic triggered extreme preventive measures, including economic and social lockdowns. Many experts and commentators, however, have argued in favor of a harm reduction approach, giving individuals the liberty to assess their risk and potentially engage in risky behavior more safely. Drawing on concepts from harm reduction literature we examine how Canadians interpreted messages intended to mitigate harm during the 2020 end-of-year holiday season. METHODS We conducted 12 focus groups in four Canadian cities to discuss public health guidance to reduce the spread of COVID-19, how these messages influenced their holiday celebration plans, and how they interpreted harm mitigation messages. RESULTS Focus group participants (n = 82) described COVID-19 public health guidance as confusing and difficult to follow. Participants considered that messages intended to mitigate harm from official sources would contribute to deepening confusion and uncertainty, allow for personal interpretation of guidelines, and discourage those who follow guidelines diligently. CONCLUSION Official public health messaging intended to mitigate harm in rapidly evolving crisis situations can be ineffective in reducing risky behaviors because it may instead encourage people to not abide the recommended guidelines. In these situations, harm reduction messaging should be limited to specific groups who cannot otherwise avoid risk exposure.
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Affiliation(s)
- Gabriela Capurro
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Ryan Maier
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Jordan Tustin
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Canada
| | - Cynthia G Jardine
- Faculty of Health Sciences, University of Fraser Valley, Chilliwack, Canada
| | - S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
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23
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Myran DT, Pugliese M, Roberts RL, Solmi M, Perlman CM, Fiedorowicz J, Tanuseputro P, Anderson KK. Association between non-medical cannabis legalization and emergency department visits for cannabis-induced psychosis. Mol Psychiatry 2023; 28:4251-4260. [PMID: 37500826 DOI: 10.1038/s41380-023-02185-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/29/2023]
Abstract
A major public health concern of cannabis legalization is that it may result in an increase in psychotic disorders. We examined changes in emergency department (ED) visits for cannabis-induced psychosis following the legalization and subsequent commercialization (removal of restrictions on retail stores and product types) of non-medical cannabis in Ontario, Canada (population of 14.3 million). We used health administrative data containing the cause of all ED visits to examine changes over three periods; 1) pre-legalization (January 2014-September 2018); 2) legalization with restrictions (October 2018 - February 2020); and 3) commercialization (March 2020 - September 2021). We considered subgroups stratified by age and sex and examined cocaine- and methamphetamine-induced psychosis ED visits as controls. During our study, there were 6300 ED visits for cannabis-induced psychosis. The restricted legalization period was not associated with changes in rates of ED visits for cannabis-induced psychosis relative to pre-legalization. The commercialization period was associated with an immediate increase in rates of ED visits for cannabis-induced psychosis (IRR 1.30, 95% CI 1.02-1.66) and no gradual monthly change; immediate increases were seen only for youth above (IRR 1.63, 1.27-2.08, ages 19-24) but not below (IRR 0.73 95%CI 0.42-1.28 ages, 15-18) the legal age of purchase, and similar for men and women. Commercialization was not associated with changes in rates of ED visits for cocaine- or methamphetamine-induced psychosis. This suggests that legalization with store and product restrictions does not increase ED visits for cannabis-induced psychosis. In contrast, cannabis commercialization may increase cannabis-induced psychosis presentations highlighting the importance of preventive measures in regions considering legalization.
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Affiliation(s)
- Daniel T Myran
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- Bruyère Research Institute, Ottawa, ON, Canada.
| | - Michael Pugliese
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Rhiannon L Roberts
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Marco Solmi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | | | - Jess Fiedorowicz
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Neurosciences, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Peter Tanuseputro
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Kelly K Anderson
- Departments of Epidemiology & Biostatistics and Psychiatry, Western University, London, ON, Canada
- ICES Western, London, ON, Canada
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Kruckow S, Santini ZI, Hjarnaa L, Becker U, Andersen O, Tolstrup JS. Associations between alcohol intake and hospital contacts due to alcohol and unintentional injuries in 71,025 Danish adolescents - a prospective cohort study. EClinicalMedicine 2023; 64:102187. [PMID: 37936661 PMCID: PMC10626163 DOI: 10.1016/j.eclinm.2023.102187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 11/09/2023] Open
Abstract
Background Alcohol is a leading risk factor to adolescent health. However, it is unclear how associations between alcohol intake and injuries are shaped. We investigated the dose-response relationship between alcohol intake and risk of hospital contacts due to alcohol and unintentional injuries in adolescents. Methods We conducted a prospective cohort study including 71,025 Danish students aged 15-24 years, followed up for five years from 2014 to 2019. The main outcome measures were hospital contacts due to alcohol and unintentional injuries (all injuries and head injuries), obtained from hospital registers. Findings Approximately 90% of males and females reported drinking alcohol, and the median intake among those was 11 drinks/week in males and 8 drinks/week in females. During five years of follow-up, 1.3% had an alcohol-attributable hospital contact, the majority of which were due to acute intoxication (70%). Alcohol-attributable hospital contacts were equally frequent in males and females and between age groups (15-17-year-olds vs 18-24-year-olds). Compared with never drinking, the adjusted incidence rate ratios for weekly intake of <7, 7-13, 14-20, 21-27, and >27 drinks/week were 1.70 (95% confidence interval 1.23-2.34), 1.77 (1.27-2.46), 1.91 (1.35-2.70), 2.34 (1.59-3.46), and 3.25 (2.27-4.64) for having an alcohol-attributable hospital contact within five years of follow-up. Restricting follow-up to one year more than doubled risk estimates. During the five years of follow-up, 27% incurred an unintentional injury. The most frequent types of injury were to the wrist or hand (27.6%), ankle or foot (25.2%), or head (12.4%). Injuries were more frequent among males (first-time incidence rate 110 per 1000 person-years) compared to females (82 per 1000 person-years), with no differences between age groups. Compared with never drinking, the adjusted incidence rate ratios for weekly intake of <7, 7-13, 14-20, 21-27, and >27 drinks were 1.09 (1.03-1.15), 1.14 (1.07-1.20), 1.25 (1.17-1.33), 1.38 (1.28-1.49), and 1.58 (1.47-1.69) for having a hospital contact for any type of unintentional injury within five years of follow-up. Results for the one-year follow-up period were comparable. Separate analysis for head injuries showed similar results as the analysis on all injuries. Results were generally similar in males and females. Interpretation Adolescents' drinking is associated with a higher risk of acute harm in terms of hospital contacts due to alcohol and unintentional injuries in a dose-response relationship. Thus, increased risk was apparent in those with low alcohol intake, suggesting a need for awareness of and initiatives to prevent youth drinking. Furthermore, initiatives should include a strengthened focus on people younger than 18 years. Funding This study was funded by the Tryg Foundation (ID: 153539) and The Helse Foundation (21-B-0359).
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Affiliation(s)
- Sofie Kruckow
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ziggi Ivan Santini
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Louise Hjarnaa
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ove Andersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Janne S. Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Solovei A, Mercken L, Jané-Llopis E, Bustamante I, Evers S, Gual A, Medina P, Mejía-Trujillo J, Natera-Rey G, O’Donnell A, Pérez-Gómez A, Piazza M, de Vries H, Anderson P. Development of community strategies supporting brief alcohol advice in three Latin American countries: a protocol. Health Promot Int 2023; 38:daab192. [PMID: 34849866 PMCID: PMC10439512 DOI: 10.1093/heapro/daab192] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Brief alcohol advice offered to patients was shown to be a clinically- and cost-effective intervention to prevent and manage alcohol-related health harm. However, this intervention is not yet optimally implemented in practice. A suggested strategy to improve the implementation of brief alcohol advice is through community actions which would enhance the environment in which primary healthcare providers must deliver the intervention. However, there has been scarce research conducted to date regarding which community actions have most influence on the adoption and implementation of brief alcohol advice. The current protocol presents the development of a package of community actions to be implemented in three Latin American municipalities, in Colombia, Mexico and Peru. The community actions were based on the Institute for Health Care Improvement's framework for going to full scale, and include: (i) involvement of a Community Advisory Board, (ii) involvement of a project champion, (iii) adoption mechanisms, (iv) support systems and (v) a communication campaign. By presenting a protocol for developing community actions with input from local stakeholders, this article contributes to advancing the public health field of alcohol prevention by potentially stimulating the sustainable adoption and implementation of brief alcohol advice in routine practice.
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Affiliation(s)
- Adriana Solovei
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Liesbeth Mercken
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Eva Jané-Llopis
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Univ. Ramon Llull, ESADE, Barcelona, Spain
- Institute for Mental Health Policy Research, CAMH, Toronto, Canada
| | - Inés Bustamante
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Silvia Evers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Antoni Gual
- Addictions Unit. Psychiatry Dept. Hospital Clínic, Barcelona, Spain
- Red de Trastornos Adictivos. Instituto Carlos III, Madrid, Spain
- Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Perla Medina
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | | | | | - Amy O’Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Marina Piazza
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Peter Anderson
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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26
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Elling DL, Almquist YB, Wennberg P, Sundqvist K. Effects of a multi-component alcohol prevention program in the workplace on hazardous alcohol use among employees. BMC Public Health 2023; 23:1420. [PMID: 37488547 PMCID: PMC10367231 DOI: 10.1186/s12889-023-16150-4] [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: 04/27/2022] [Accepted: 06/19/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND The workplace can be affected negatively by hazardous alcohol use, and intervening at an early stage remains a challenge. Recently, a multi-component alcohol prevention program, Alcohol Policy and Managers' skills Training (hereafter, 'APMaT'), was delivered at the organizational level. In a previous outcome evaluation, APMaT appeared to be effective at the managerial level. The current study takes a step further by aiming to evaluate the effectiveness of APMaT in decreasing the alcohol risk level among employees. METHODS Data from 853 employees (control: n = 586; intervention: n = 267) were gathered through a cluster-randomized study. To analyze changes in the odds of hazardous alcohol use among employees, multilevel logistic regression was applied using group (control vs. intervention), time (baseline vs. 12-month follow-up), and the multiplicative interaction term (group × time) as the main predictors. The intervention effect was further adjusted for sociodemographic characteristics and policy awareness. RESULTS No statistically significant difference was observed in the odds of hazardous alcohol use, although employees in the intervention group showed a larger decrease compared to the control group. This remained even after adjusting for several factors, including the sociodemographic factors and policy awareness. CONCLUSIONS The findings are insufficient to determine the effectiveness of APMaT at the employee level at the current stage of the evaluation. Future studies should strive to identify issues with implementation processes in workplace-based alcohol interventions. TRIAL REGISTRATION The trial was retrospectively registered on 11/10/2019; ISCRTN ID: ISRCTN17250048.
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Affiliation(s)
- Devy L Elling
- Department of Public Health Sciences, Stockholm University, Stockholm, SE-106 91, Sweden.
| | - Ylva B Almquist
- Department of Public Health Sciences, Stockholm University, Stockholm, SE-106 91, Sweden
| | - Peter Wennberg
- Department of Public Health Sciences, Stockholm University, Stockholm, SE-106 91, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, SE-171 77, Sweden
| | - Kristina Sundqvist
- Department of Psychology, Stockholm University, Stockholm, SE-106 91, Sweden
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27
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Le LKD, Faller J, Chatterton ML, Perez JK, Chiotelis O, Tran HNQ, Sultana M, Hall N, Lee YY, Chapman C, Newton N, Slade T, Sunderland M, Teesson M, Mihalopoulos C. Interventions to prevent alcohol use: systematic review of economic evaluations. BJPsych Open 2023; 9:e117. [PMID: 37365798 DOI: 10.1192/bjo.2023.81] [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] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Alcohol use is a leading risk factor for death and disability worldwide. AIMS We conducted a systematic review on the cost-effectiveness evidence for interventions to prevent alcohol use across the lifespan. METHOD Electronic databases (EMBASE, Medline, PsycINFO, CINAHL and EconLit) were searched for full economic evaluations and return-on-investment studies of alcohol prevention interventions published up to May 2021. The methods and results of included studies were evaluated with narrative synthesis, and study quality was assessed by the Drummond ten-point checklist. RESULTS A total of 69 studies met the inclusion criteria for a full economic evaluation or return-on-investment study. Most studies targeted adults or a combination of age groups, seven studies comprised children/adolescents and one involved older adults. Half of the studies found that alcohol prevention interventions are cost-saving (i.e. more effective and less costly than the comparator). This was especially true for universal prevention interventions designed to restrict exposure to alcohol through taxation or advertising bans; and selective/indicated prevention interventions, which involve screening with or without brief intervention for at-risk adults. School-based interventions combined with parent/carer interventions were cost-effective in preventing alcohol use among those aged under 18 years. No interventions were cost-effective for preventing alcohol use in older adults. CONCLUSIONS Alcohol prevention interventions show promising evidence of cost-effectiveness. Further economic analyses are needed to facilitate policy-making in low- and middle-income countries, and among child, adolescent and older adult populations.
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Affiliation(s)
- Long Khanh-Dao Le
- PhD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Jan Faller
- MHE, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Mary Lou Chatterton
- PharmD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Joahna Kevin Perez
- MHE, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Oxana Chiotelis
- MHE, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Huong Ngoc Quynh Tran
- MHE, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Marufa Sultana
- PhD, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Natasha Hall
- MHE, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Yong Yi Lee
- PhD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia; School of Public Health, The University of Queensland, Australia; and Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia
| | - Cath Chapman
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Nicola Newton
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Tim Slade
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Matt Sunderland
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Maree Teesson
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Cathrine Mihalopoulos
- PhD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
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Ghamarpoor R, Fallah A, Jamshidi M. Investigating the use of titanium dioxide (TiO 2) nanoparticles on the amount of protection against UV irradiation. Sci Rep 2023; 13:9793. [PMID: 37328531 DOI: 10.1038/s41598-023-37057-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/15/2023] [Indexed: 06/18/2023] Open
Abstract
In this study, three samples of commercial titanium dioxide nanoparticles (TiO2) in different sizes were used to investigate their effect on the formulation of sunscreen creams. The aim was to evaluate their role in the performance of sunscreens (i.e. SPF, UVAPF, and critical wavelength). Then the particle size of these samples was determined by photon correlation spectroscopy methods. As a result, the size of primary particles was reduced by using milling and homogenization methods at different times. The results showed that the particle size of samples TA, TB, and TC in the ultrasonic homogenizer decreased from 966.4, 2745.8, and 2471.6 nm to 142.6, 254.8, and 262.8 nm, respectively. These particles were used in the pristine formulation. Then the functional characteristics of each formulation were determined by standard methods. TA had the best dispersion in cream compared to other samples due to its smaller size (i.e. 142.6 nm). For each formulation, two important parameters, including pH and TiO2 dosage, were investigated in different states. The results showed that the formulations prepared with TA had the lowest viscosity compared to formulations containing TB and TC. SPSS 17 statistical software analysis of variance showed that the performance of SPF, UVAPF and λc in formulations containing TA had the highest levels. Also, the sample containing TAU with the lowest particle size values had the highest protection against UV rays (SPF). According to the photocatalytic functionality of TiO2, the photodegradation of methylene blue in the presence of each nanoparticle of TiO2 was studied. The results showed that smaller nanoparticles (i.e. TA) had more photocatalytic activity under UV-Vis irradiation during 4 h (TA (22%) > TB (16%) > TC (15%)). The results showed that titanium dioxide can be used as a suitable filter against all types of UVA and UVB rays.
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Affiliation(s)
- Reza Ghamarpoor
- School of Chemical, Petroleum and Gas Engineering, Iran University of Science and Technology (IUST), Tehran, Iran.
- Constructional Polymers and Composites Research Laboratory, School of Chemical, Petroleum and Gas Engineering, Iran University of Science and Technology (IUST), Tehran, Iran.
| | - Akram Fallah
- Department of Chemical Technologies, Iranian Research Organization for Science and Technology (IROST), Tehran, Iran
| | - Masoud Jamshidi
- Constructional Polymers and Composites Research Laboratory, School of Chemical, Petroleum and Gas Engineering, Iran University of Science and Technology (IUST), Tehran, Iran
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29
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Pearson M, Dawson A, Raubenheimer J, Senerathna L, Conigrave K, Lee KSK, Rajapakse T, Pushpakumara PHGJ, Siribaddana S, Soerensen JB, Konradsen F, Jan S, Dawson AJ, Buckley N, Abeysinghe R, Siriwardhana P, Priyadarshana C, Haber PS, Dzidowska M, Abeykoon P, Glozier N. Community-based alcohol education intervention (THEATRE) study to reduce harmful effects of alcohol in rural Sri Lanka: design and adaptation of a mixed-methods stepped wedge cluster randomised control trial. BMJ Open 2023; 13:e064722. [PMID: 37321807 PMCID: PMC10276966 DOI: 10.1136/bmjopen-2022-064722] [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: 05/19/2022] [Accepted: 04/19/2023] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION Alcohol consumption is a leading cause of mortality, morbidity and adverse social sequelae in Sri Lanka. Effective community-based, culturally adapted or context-specific interventions are required to minimise these harms. We designed a mixed-methods stepped wedge cluster randomised control trial of a complex alcohol intervention. This paper describes the initial trial protocol and subsequent modifications following COVID-19. METHODS AND ANALYSIS We aimed to recruit 20 villages (approximately n=4000) in rural Sri Lanka. The proposed intervention consisted of health screening clinics, alcohol brief intervention, participatory drama, film, and public health promotion materials to be delivered over 12 weeks.Following disruptions to the trial resulting from the Easter bombings in 2019, COVID-19 and a national financial crisis, we adapted the study in two main ways. First, the interventions were reconfigured for hybrid delivery. Second, a rolling pre-post study evaluating changes in alcohol use, mental health, social capital and financial stress as the primary outcome and implementation and ex-ante economic analysis as secondary outcomes. ETHICS AND DISSEMINATION The original study and amendments have been reviewed and granted ethical approval by Rajarata University of Sri Lanka (ERC/2018/21-July 2018 and February 2022) and the University of Sydney (2019/006). Findings will be disseminated locally in collaboration with the community and stakeholders.The new hybrid approach may be more adaptable, scalable and generalisable than the planned intervention. The changes will allow a closer assessment of individual interventions while enabling the evaluation of this discontinuous event through a naturalistic trial design. This may assist other researchers facing similar disruptions to community-based studies. TRIAL REGISTRATION The trial is registered with the Sri Lanka Clinical Trials Registry; https://slctr.lk/trials/slctr-2018-037.
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Affiliation(s)
- Melissa Pearson
- Centre for Pesticide Suicide Prevention, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Andrew Dawson
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Jacques Raubenheimer
- Biomedical Informatics and Digital Health, University of Sydney, Sydney, New South Wales, Australia
| | - Lalith Senerathna
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Health Promotion, Faculty of Applied Sciences, Rajarata University of Sri Lanka, Mihintale, Sri Lanka
| | - Katherine Conigrave
- Sydney Medical School, Royal Prince Albert Hospital, Camperdown, New South Wales, Australia
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Camperdown, New South Wales, Australia
| | - K S Kylie Lee
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Thilini Rajapakse
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Pahala Hangidi Gedara Janaka Pushpakumara
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Family Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Peradeniya, Sri Lanka
| | - Sisira Siribaddana
- Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Jane Brandt Soerensen
- Global Health Section, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Konradsen
- Global Health Section, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stephen Jan
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Angela J Dawson
- Faculty of Health, World Health Collaborating Centre, University of Technology, Sydney, Sydney, New South Wales, Australia
| | - Nicholas Buckley
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Biomedical Informatics and Digital Health, University of Sydney, Sydney, New South Wales, Australia
| | - Ranil Abeysinghe
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Prabash Siriwardhana
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Health Promotion, Faculty of Applied Sciences, Rajarata University of Sri Lanka, Mihintale, Sri Lanka
| | - Chamil Priyadarshana
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Paul S Haber
- Sydney Medical School, Royal Prince Albert Hospital, Camperdown, New South Wales, Australia
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Monika Dzidowska
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Nick Glozier
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
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Udesen CH, Hviid SS, Becker U, Tolstrup JS. Alcohol-related mortality in 15–24-year-olds in Denmark (2010–2019): a nationwide exploratory study of circumstances and socioeconomic predictors. Lancet Reg Health Eur 2023; 29:100620. [PMID: 37025107 PMCID: PMC10070885 DOI: 10.1016/j.lanepe.2023.100620] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
Background Adolescents and young adults aged 15-24 years are disproportionately affected by unnatural deaths, including accidents, suicide and interpersonal violence for which alcohol is a leading risk factor. We aimed to explore the extent of and circumstances surrounding alcohol-related deaths in young people aged 15-24 years and whether socioeconomic background and ethnicity differ in those who died due to alcohol-related causes as compared to the background population. Methods All deaths of 15-24-year-olds occurring in Denmark from 2010 to 2019 were investigated. We manually reviewed death certificates containing information on circumstances, results from autopsies and blood tests, and statements from witnesses. Relevant information published in the media (most often newspaper articles) was included. Our main outcome measures were alcohol-related death and manner of death (accidents (transport accidents, drownings, falls, poisonings), suicide and violence). Further, we designed a population-based case-control study including 10 age- and sex-matched controls per case to test whether there was a socioeconomic gradient in alcohol-related deaths. We used parents' educational level and employment status to define socioeconomic position. Immigration status was used to assess ethnicity. Findings Over the 10-year period, 1783 deaths occurred among 15-24-year-olds. Of those, 1067 (60%) were due to unnatural causes, corresponding to a mortality rate of 14.8 (95% confidence interval: 13.9-15.7) per 100,000. Twelve percent of unnatural deaths (n = 125) were alcohol related, corresponding to a rate of 1.7 (1.4-2.0) per 100,000, and were higher in males (2.9 [2.3-3.4]) than in females (0.6 [0.3-0.8]); thus, males accounted for 105 (84%) of alcohol-related deaths. The majority of alcohol-related deaths occurred on Fridays, Saturdays and Sundays (n = 77, 62%). Accidents accounted for 82% (n = 102) of alcohol-related deaths, followed by suicide (n = 19, 15%) and interpersonal violence (n = 4, 3%). Of all fatal accidents, 102 of 636 (16%) were alcohol related. Of all deaths caused by drownings and falls, 14 of 26 (54%) and 10 of 25 (40%), respectively, were alcohol related. Alcohol-related drownings most often occurred while the deceased was alone, whereas alcohol-related falls most often occurred in relation to parties, involving falls from a window or balcony. Those who died from alcohol-related causes more often had parents with a short education or who were unemployed, as compared to the general population. For example, odds ratios were 3.9 (2.2-7.0) and 1.8 (1.2-2.9) for having parents with short and medium as compared to long educations. The odds ratio for being of Danish origin was 4.0 (1.7-9.5) compared to being first- or second-generation immigrants. Interpretation In 15-24-year-olds, alcohol-related deaths accounted for a substantial proportion of all unnatural deaths. There was substantial socioeconomic inequality in alcohol-related deaths, as has repeatedly been shown for chronic alcohol-related mortality in older adults. Funding Trygfonden.
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Maurice JB, Tribich S, Zamani A, Ryan J. How to manage alcohol-related liver disease: A case-based review. Frontline Gastroenterol 2023; 14:435-441. [PMID: 37581189 PMCID: PMC10423597 DOI: 10.1136/flgastro-2022-102270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 05/02/2023] [Indexed: 08/16/2023] Open
Affiliation(s)
- James B Maurice
- Department of Gastroenterology and Hepatology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Samuel Tribich
- Department of Hepatology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Ava Zamani
- Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Jennifer Ryan
- Department of Hepatology and Liver Transplantation, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
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Probst C, Buckley C, Lasserre AM, Kerr WC, Mulia N, Puka K, Purshouse RC, Ye Y, Rehm J. Simulation of Alcohol Control Policies for Health Equity (SIMAH) Project: Study Design and First Results. Am J Epidemiol 2023; 192:690-702. [PMID: 36702471 PMCID: PMC10423629 DOI: 10.1093/aje/kwad018] [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: 01/21/2022] [Revised: 09/15/2022] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
Since about 2010, life expectancy at birth in the United States has stagnated and begun to decline, with concurrent increases in the socioeconomic divide in life expectancy. The Simulation of Alcohol Control Policies for Health Equity (SIMAH) Project uses a novel microsimulation approach to investigate the extent to which alcohol use, socioeconomic status (SES), and race/ethnicity contribute to unequal developments in US life expectancy and how alcohol control interventions could reduce such inequalities. Representative, secondary data from several sources will be integrated into one coherent, dynamic microsimulation to model life-course changes in SES and alcohol use and cause-specific mortality attributable to alcohol use by SES, race/ethnicity, age, and sex. Markov models will be used to inform transition intensities between levels of SES and drinking patterns. The model will be used to compare a baseline scenario with multiple counterfactual intervention scenarios. The preliminary results indicate that the crucial microsimulation component provides a good fit to observed demographic changes in the population, providing a robust baseline model for further simulation work. By demonstrating the feasibility of this novel approach, the SIMAH Project promises to offer superior integration of relevant empirical evidence to inform public health policy for a more equitable future.
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Affiliation(s)
- Charlotte Probst
- Correspondence to Dr. Charlotte Probst, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula-Franklin Street, Toronto, ON M5S 2S1, Canada (e-mail: )
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Gobiņa I, Isajeva L, Spriņģe L, Vrobļevska E, Pelne A, Mārtiņsone U, Lange S. A narrative review of alcohol control policies in Latvia between 1990 and 2020. Drug Alcohol Rev 2023; 42:946-959. [PMID: 36974381 PMCID: PMC10897783 DOI: 10.1111/dar.13647] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/29/2023]
Abstract
ISSUES Latvia has one of the highest alcohol per capita consumption in Europe. This study provides a narrative review of all evidence-based population-level alcohol control policies implemented in Latvia during the past 30 years. APPROACH A review of country-level alcohol control policies implemented in Latvia between 1990 and 2020 was conducted. The World Health Organization's "best buys" and other recommended interventions for alcohol control were used to guide the search. KEY FINDINGS Alcohol control policies in Latvia have evolved significantly over the last three decades. The most changes to alcohol control policy occurred in the transitional period between regaining independence in 1991 and joining the European Union in 2004. A number of significant alcohol control policies have been implemented to reduce alcohol availability and affordability, to restrict alcohol marketing and to counter drunk-driving. However, since 2010, when an increasing trend of alcohol consumption was observed, there has been a reluctance to pursue national public health policy actions to reduce alcohol consumption, and few adjustments to legislation to increase alcohol control have been made. IMPLICATIONS Despite the progress in alcohol control, Latvia still has considerable potential for strengthening alcohol control to reduce the high levels of alcohol consumption. CONCLUSION Although several alcohol control policies have been established in Latvia, many of the planned activities to limit alcohol intake and related harm have not been executed. Public health goals rather than political and economic incentives should be prioritised to reduce high levels of alcohol consumption in Latvia.
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Affiliation(s)
- Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Laura Isajeva
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
| | - Lauma Spriņģe
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
| | - Elīna Vrobļevska
- Department of Political Science, Riga Stradiņš University, Riga, Latvia
| | - Aija Pelne
- Addiction Monitoring Unit, Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | - Una Mārtiņsone
- Addiction Monitoring Unit, Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Wyper GMA, Mackay DF, Fraser C, Lewsey J, Robinson M, Beeston C, Giles L. Evaluating the impact of alcohol minimum unit pricing on deaths and hospitalisations in Scotland: a controlled interrupted time series study. Lancet 2023; 401:1361-1370. [PMID: 36963415 PMCID: PMC10154457 DOI: 10.1016/s0140-6736(23)00497-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Since May 1, 2018, every alcoholic drink sold in Scotland has had minimum unit pricing (MUP) of £0·50 per unit. Previous studies have indicated that the introduction of this policy reduced alcohol sales by 3%. We aimed to assess whether this has led to reductions in alcohol-attributable deaths and hospitalisations. METHODS Study outcomes, wholly attributable to alcohol consumption, were defined using routinely collected data on deaths and hospitalisations. Controlled interrupted time series regression was used to assess the legislation's impact in Scotland, and any effect modification across demographic and socioeconomic deprivation groups. The pre-intervention time series ran from Jan 1, 2012, to April 30, 2018, and for 32 months after the policy was implemented (until Dec 31, 2020). Data from England, a part of the UK where the intervention was not implemented, were used to form a control group. FINDINGS MUP in Scotland was associated with a significant 13·4% reduction (95% CI -18·4 to -8·3; p=0·0004) in deaths wholly attributable to alcohol consumption. Hospitalisations wholly attributable to alcohol consumption decreased by 4·1% (-8·3 to 0·3; p=0·064). Effects were driven by significant improvements in chronic outcomes, particularly alcoholic liver disease. Furthermore, MUP legislation was associated with a reduction in deaths and hospitalisations wholly attributable to alcohol consumption in the four most socioeconomically deprived deciles in Scotland. INTERPRETATION The implementation of MUP legislation was associated with significant reductions in deaths, and reductions in hospitalisations, wholly attributable to alcohol consumption. The greatest improvements were in the four most socioeconomically deprived deciles, indicating that the policy is positively tackling deprivation-based inequalities in alcohol-attributable health harm. FUNDING Scottish Government.
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Affiliation(s)
- Grant M A Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK; School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Daniel F Mackay
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Catriona Fraser
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
| | - Jim Lewsey
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mark Robinson
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK; Institute for Social Science Research, University of Queensland, Brisbane, QLD, Australia
| | - Clare Beeston
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
| | - Lucie Giles
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
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Vaitkevičiūtė J, Gobiņa I, Janik-Koncewicz K, Lange S, Miščikienė L, Petkevičienė J, Radišauskas R, Reile R, Štelemėkas M, Stoppel R, Telksnys T, Tran A, Rehm J, Zatoński WA, Jiang H. Alcohol control policies reduce all-cause mortality in Baltic Countries and Poland between 2001 and 2020. Sci Rep 2023; 13:6326. [PMID: 37072446 PMCID: PMC10112307 DOI: 10.1038/s41598-023-32926-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023] Open
Abstract
Alcohol consumption in the Baltic countries and Poland is among the highest globally, causing high all-cause mortality rates. Contrary to Poland, the Baltic countries have adopted many alcohol control policies, including the World Health Organization (WHO) "best buys". The aim of this study was to evaluate the impact of these policies, which were implemented between 2001 and 2020, on all-cause mortality. Monthly mortality data for men and women aged 20+ years of age in Estonia, Latvia, Lithuania, and Poland were analysed for 2001 to 2020. A total of 19 alcohol control policies, fulfilling an a-priori defined definition, were implemented between 2001 and 2020 in the countries of interest, and 18 of them could be tested. Interrupted time-series analyses were conducted by employing a generalized additive mixed model (GAMM) for men and women separately. The age-standardized all-cause mortality rate was lowest in Poland and highest in Latvia and had decreased in all countries over the time period. Taxation increases and availability restrictions had short-term effects in all countries, on average reducing the age-standardized all-cause mortality rate among men significantly (a reduction of 2.31% (95% CI 0.71%, 3.93%; p = 0.0045)). All-cause mortality rates among women were not significantly reduced (a reduction of 1.09% (95% CI - 0.02%, 2.20%; p = 0.0554)). In conclusion, the alcohol control policies implemented between 2001 and 2020 reduced all-cause mortality among men 20+ years of age in Baltic countries and Poland, and thus, the practice should be continued.
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Affiliation(s)
- Justina Vaitkevičiūtė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania.
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Kronvalda Boulevard 9, Riga, 1010, Latvia
- Institute of Public Health, Riga Stradiņš University, Kronvalda Boulevard 9, Riga, 1010, Latvia
| | - Kinga Janik-Koncewicz
- European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, 62-800, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska 51, 05-830, Nadarzyn, Poland
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada
| | - Laura Miščikienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių av. 15, 50162, Kaunas, Lithuania
| | - Rainer Reile
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Department for Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
| | - Relika Stoppel
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
- Department of Economics, University of Potsdam, August-Bebel-Straße 89, 14482, Potsdam, Germany
| | - Tadas Telksnys
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Institute of Clinical Psychology and Psychotherapy, Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, ON, M5S 1A8, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse & designated WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St., 08005, Barcelona, Spain
| | - Witold A Zatoński
- European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, 62-800, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska 51, 05-830, Nadarzyn, Poland
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
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Lahtinen H, Moustgaard H, Ripatti S, Martikainen P. Association between genetic risk of alcohol consumption and alcohol-related morbidity and mortality under different alcohol policy conditions: Evidence from the Finnish alcohol price reduction of 2004. Addiction 2023; 118:678-685. [PMID: 36564914 DOI: 10.1111/add.16118] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/05/2022] [Indexed: 12/25/2022]
Abstract
AIMS Harmful alcohol consumption is influenced by both genetic susceptibility and the price of alcohol. Many previous studies have observed that genetic susceptibility to consumption of alcohol is more predictive in less restrictive drinking conditions. We assess whether such a pattern applies when the prices of alcoholic beverages are decreased. DESIGN Data consist of genetically informed population-representative surveys (FINRISK 1992, 1997, 2002 and Health 2000) linked to administrative registers. We analysed the interaction between a polygenic score (PGS) for alcoholic drinks per week consumed and price reduction in predicting the incidence of alcohol-related hospitalizations and deaths in difference-in-difference and interrupted time-series frameworks. SETTING Individuals in Finland were followed quarter-yearly from 1 March 2000 to 31 May 2008. PARTICIPANTS A total of 22 152 individuals (607 132-person quarter-years, 1399 outcome events) aged 30-79 years. INTERVENTION A natural experiment stemming from the alcohol tax reduction in March 2004 and import deregulation in May 2004. MEASUREMENTS Outcome was quarter-yearly-measured alcohol-related death or hospitalization. The independent variables of main interest were PGS and a price reform indicator. We adjusted for gender, age, age squared, season, 10 first principal components of the genome, data collection round and genotyping batch. FINDINGS Both alcohol price reduction and one standard deviation change in PGS were associated with alcohol-related health outcomes; odds ratios (ORs) were 1.32, 95% confidence interval (CI) = 1.13, 1.53 and 1.26, 95% CI = 1.12, 1.42 in the 8-year follow-up, respectively. The association between PGS and alcohol-related morbidity was similar before and after the alcohol price reform (PGS × price reform interaction OR = 0.96, 95% CI = 0.81, 1.14). These results were robust across different follow-up periods and measurement and analysis strategies. CONCLUSIONS Although the decrease of alcohol price in Finland in 2004 substantially increased overall alcohol-related morbidity and mortality, the genetic susceptibility to alcohol consumption did not become more manifest in predicting them.
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Affiliation(s)
- Hannu Lahtinen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Heta Moustgaard
- Helsinki Institute for Social Sciences and Humanities, University of Helsinki, Helsinki, Finland
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, University of Helsinki, Helsinki, Finland.,Max Planck Institute for Demographic Research, Rostock, Germany
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Ng CS, Au M, Tian L, Quan J. Impact of alcohol taxes on violence in Hong Kong: a population-based interrupted time series analysis. J Epidemiol Community Health 2023; 77:391-397. [PMID: 36927519 DOI: 10.1136/jech-2022-219996] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Interpersonal violence is a major public health concern with alcohol use a known risk factor. Despite alcohol taxation being an effective policy to reduce consumption; Hong Kong, contrary to most developed economies, embarked on an alcohol tax reduction and elimination policy. METHODS To assess the impact of the alcohol tax reductions, we analysed population-based hospitalisation data for assault from the Hong Kong Hospital Authority, and violent and sexual crimes recorded by the Hong Kong Police Force (2004-2018). We conducted an interrupted time series using seasonal autoregressive integrated moving average models on monthly rates. Breakpoints in March 2007 and March 2008 were applied separately. RESULTS The 2007 tax cut was associated with sustained increases in violence-related hospitalisation rates for 35-49 age group (female: 0.19%, p=0.007; male: 0.22%, p<0.001; overall: 0.16%, p=0.007); and an immediate increase of 51.3% (p=0.005) in the rate of sexual crimes reported. Results for the 35-49 age group after the 2008 tax cut were similar with sustained increases in hospitalisation rates (female: 0.21%, p=0.010; male: 0.23%, p<0.001; overall: 0.17%, p<0.001). The 2008 tax cut was also associated with immediate increases in hospitalisation rates in children (female: 33.1%, p=0.011; male: 49.2%, p<0.001, overall: 31.5%, p=0.007). For both tax cuts, results were insignificant in males and females for other age groups (15-34 and 50+ years). CONCLUSIONS Both alcohol tax reductions in 2007 and 2008 were in some age groups associated with increases in violence-related hospitalisations and reports of sexual assault even in an environment of low crime.
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Affiliation(s)
- Carmen S Ng
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Minnie Au
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Linwei Tian
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Jianchao Quan
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
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Keyes KM. Alcohol use in the older adult US population: Trends, causes, and consequences. Alcohol 2023; 107:28-31. [PMID: 35661693 DOI: 10.1016/j.alcohol.2022.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 01/25/2023]
Abstract
Alcohol use, binge drinking, and alcohol use disorders have been increasing among older adults in the US population, including adults over 50 as well as adults over 65. Increases in consumption are sharper among women, and among those who use additional substances such as cannabis, and those who are relatively healthy in older adulthood (i.e. those without multimorbidites). This commentary describes these trends as well as provides hypotheses, and the data underlying them, for both supply-side (alcohol marketing and messaging) and demand-side (healthier aging, increased financial stress) potential drivers of these increases. The need for additional resources and focus on older adult drinking is increasingly urgent, as alcohol-attributable deaths escalate among older adults in the United States.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.
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Duthie C, Pocock T, Curl A, Clark E, Norriss D, Bidwell S, McKerchar C, Crossin R. Online on-demand delivery services of food and alcohol: A scoping review of public health impacts. SSM Popul Health 2023; 21:101349. [PMID: 36845670 PMCID: PMC9950721 DOI: 10.1016/j.ssmph.2023.101349] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/19/2023] [Accepted: 01/22/2023] [Indexed: 01/25/2023] Open
Abstract
The increase in availability of online on-demand food and alcohol delivery services has changed the way unhealthy commodities are accessed and understood. We conducted a systematic scoping review of academic and grey literature to map the current knowledge of public health and regulatory/policy outcomes arising from on-demand food and alcohol delivery (defined as delivery within 2 h). We systematically searched three electronic databases and completed supplementary forward citation searches and Google Scholar searches. In total, we screened 761 records (de-duplicated) and synthesised findings from 40 studies by commodity types (on-demand food or alcohol) and outcome focus (outlet, consumer, environmental, labour). Outlet-focused outcomes were most common (n = 16 studies), followed by consumer (n = 11), environmental (n = 7), and labour-focused (n = 6) outcomes. Despite geographical and methodological diversity of studies, results indicate that on-demand delivery services market unhealthy and discretionary foods, with disadvantaged communities having reduced access to healthy commodities. Services that deliver alcohol on-demand can also subvert current alcohol access restrictions, particularly through poor age verification processes. Underpinning these public health impacts is the multi-layered nature of on-demand services and context of the COVID-19 pandemic, which creates ongoing complications as to how populations access food and alcohol. Changing access to unhealthy commodities is an emerging issue in public health. Our scoping review considers priority areas for future research to better inform policy decisions. Current regulation of food and alcohol may not appropriately cover emerging on-demand technologies, necessitating a review of policy.
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Affiliation(s)
- Cassian Duthie
- University of Otago Medical School, Christchurch, New Zealand
| | - Tessa Pocock
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Angela Curl
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Elinor Clark
- University of Otago Medical School, Christchurch, New Zealand
| | - Dru Norriss
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Susan Bidwell
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Christina McKerchar
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Rose Crossin
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
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Belay GM, Lam KKW, Liu Q, Wu CST, Mak YW, Ho KY. Magnitude and determinants of alcohol use disorder among adult population in East Asian countries: A systematic review and meta-analysis. Front Public Health 2023; 11:1144012. [PMID: 36926176 PMCID: PMC10011711 DOI: 10.3389/fpubh.2023.1144012] [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: 01/13/2023] [Accepted: 02/08/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Alcohol use disorder is a medical condition characterized by an impaired ability to control or stop alcohol use despite adverse health outcomes. Despite several studies that have analyzed the prevalence and determinants, their results have been equivocal, and the reasons for the differences in prevalence rates and determinants of AUD across nationalities are unknown. Hence, this study estimated the pooled prevalence of alcohol use disorder and its determinant among adults in East Asian countries. Methods Articles were searched from PubMed, Web of Science, EMBASE, PsycINFO, and Scopus. All observational study designs that fulfilled the predefined criteria were included in the study. The findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The quality and heterogeneity of articles were assessed using the new castle-Ottawa scale (NOS) and I2, respectively. Additionally, publication bias was checked through funnel plot and Egger's regression test. Results A total of 14 articles with 93, 161 study participants were considered in the study. Of which 9 studies were included in the meta-analysis of the 1-year prevalence of alcohol use disorder, 6 in the lifetime, 9 in alcohol abuse, and 8 in alcohol dependency. Consequently, the overall pooled prevalence of one-year alcohol use disorder was 8.88% (95% CI: 6.32, 11.44), lifetime 13.41% (95%CI: 8.48, 18.34), alcohol abuse 5.4% (95% CI: 2.66, 8.13), and alcohol dependency 4.47% (95% CI: 2.66, 6.27). In the subgroup analysis by country, the highest 1-year and lifetime pooled prevalence of alcohol use disorder was observed in Korea at 9.78% (95% CI:4.40, 15.15) and 16.73% (95% CI: 15.31, 18.16), respectively. Besides, smoking (OR: 3.99; 95% CI: 1.65, 6.33) and male gender (OR: 5.9; 95% CI: 3.3, 8.51) were significant determinants of alcohol use disorder. Conclusions The magnitude of alcohol use disorder was high among adults in East Asian countries. Smoking and male gender were the key determinants of alcohol use disorders.
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Affiliation(s)
| | | | | | | | | | - Ka Yan Ho
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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Scully M, Dixon H, Brennan E, Niederdeppe J, O'Brien K, Pettigrew S, Vandenberg B, Wakefield M. Can counter-advertising exposing alcohol sponsorship and harms influence sport spectators' support for alcohol policies? An experimental study. BMC Public Health 2023; 23:396. [PMID: 36849894 PMCID: PMC9969365 DOI: 10.1186/s12889-023-15250-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/09/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Exposure to alcohol advertising and sponsorship through elite sport is associated with harmful use of alcohol. Owing to strong financial and cultural ties between alcohol and sport in Australia, policy action to restrict alcohol sport sponsorship is unlikely to occur without strong public support for change. This study tested whether exposure to counter-advertising exposing industry marketing of harmful products-a technique shown to be effective in tobacco control-promotes higher support for policy change and less favourable beliefs about the alcohol industry among sport spectators. METHODS A sample of 1,075 Australian adults aged 18-49 years who planned to watch an National Rugby League (NRL) State of Origin series game, featuring prominent alcohol sponsorship, was recruited through an online panel and randomly assigned to one of three conditions: control (neutral advertisement); counter-advertisement exposing alcohol harms; counter-advertisement exposing alcohol sponsorship and harms. Participants completed a pre-test questionnaire and viewed their assigned counter-advertisement multiple times in the 5-7 days before the NRL game. Within four days of watching the game, participants completed post-test measures. RESULTS Compared to both the control advertisement and the counter-advertisement exposing alcohol harms, participants who viewed the counter-advertisement exposing alcohol sponsorship and harms were significantly more likely to indicate support for each of four policies aimed at restricting sports-related alcohol marketing, including the complete removal of alcohol sponsorship from sport (51% vs. 32% and 37%). They were also significantly less likely to agree with statements such as "alcohol companies should be allowed to sponsor sport since their products are legal" (39% vs. 63% and 60%) and significantly less likely to report liking alcohol companies in general (38% vs. 59% and 54%). There were no significant differences in policy support or industry beliefs between participants who saw the counter-advertisement exposing alcohol harms and those who saw the control advertisement. CONCLUSION Counter-advertising employing messages that expose and critique the intent and impact of pervasive alcohol sponsorship in sport has potential to bolster public support for policies targeting alcohol sport sponsorship, diminish beliefs supportive of alcohol industry marketing strategies and enhance negative views of alcohol companies and their marketing practices.
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Affiliation(s)
- Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia. .,Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia. .,Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.
| | - Emily Brennan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Jeff Niederdeppe
- Department of Communication, Cornell University, Ithaca, New York, USA
| | - Kerry O'Brien
- School of Social Sciences, Monash University, Clayton, Victoria, Australia
| | - Simone Pettigrew
- The George Institute of Global Health, Newtown, New South Wales, Australia
| | - Brian Vandenberg
- Department of Communication, Cornell University, Ithaca, New York, USA.,Australian Institute of Family Studies, Southbank, Victoria, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
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Luukkonen J, Junna L, Remes H, Martikainen P. The association of lowered alcohol prices with birth outcomes and abortions: A population-based natural experiment. Addiction 2023; 118:836-844. [PMID: 36791778 DOI: 10.1111/add.16119] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 12/05/2022] [Indexed: 02/17/2023]
Abstract
BACKGROUND AND AIMS Alcohol use during pregnancy remains an important risk factor for adverse birth outcomes, but little is known regarding how alcohol prices affect pregnancy outcomes on the population level. We assess the associations between decreased alcohol prices with birth outcomes and abortions. DESIGN Using national registers, we used interrupted time-series modelling to compare outcomes of pregnancies conceived before and after a tax cut, resulting in 33% mean decrease of off-premise alcohol prices on 1 March 2004. We also addressed possible heterogeneity of the associations by maternal age and household income. SETTING Finland. PARTICIPANTS All registered pregnancies starting 2 years before and 1 year after the alcohol price cut (analysis sample consisted of 169 735 live births and 32 441 abortions). MEASUREMENTS The outcomes were birth weight, gestational age, the probability of low birth weight (< 2500 g at birth), preterm birth (< 37 weeks of gestation), any congenital malformations and share of registered abortions of pregnancies. FINDINGS On the population level, lowered alcohol prices were associated with an increase in abortions immediately after the price cut [+0.84 percentage points; 95% confidence interval (CI) = 0.2, 1.4]. For birth outcomes, negative associations were observed among women in the lowest income quintile; for example, increased probabilities of low birth weight (+1.5 percentage points; 95% CI = 0.4, 2.6) and preterm birth (+1.98 percentage points; 95% CI = 0.8, 3.2). All changes were strongest immediately after the price cut and attenuated during the course of the following year. CONCLUSIONS Lowered alcohol prices in Finland were associated with a short-term increase in adverse birth outcomes among low-income mothers and an overall increase in abortions.
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Affiliation(s)
- Juha Luukkonen
- Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Liina Junna
- Population Research Unit, University of Helsinki, Helsinki, Finland.,Max Planck Institute for Demographic Research, Rostock, Germany
| | - Hanna Remes
- Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, University of Helsinki, Helsinki, Finland.,Max Planck Institute for Demographic Research, Rostock, Germany.,Department of Public Health Sciences, University of Stockholm, Stockholm, Sweden
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Yoshioka T, So R, Takayama A, Okubo R, Funada S, Takada M, Wakabayashi M, Tabuchi T. Strong chū-hai, a Japanese ready-to-drink high-alcohol-content beverage, and hazardous alcohol use: A nationwide cross-sectional study. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:285-295. [PMID: 36478596 DOI: 10.1111/acer.14991] [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: 07/18/2022] [Revised: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND A new ready-to-drink premixed high-alcohol-content beverage, called strong chū-hai, was launched in Japan, and more recently, in Taiwan and Australia. We aimed to examine the popularity and association of strong chū-hai with individual alcohol use, both of which remained unclear. METHODS We conducted a cross-sectional study using data from the Japan "Society and New Tobacco" Internet Survey conducted from February 1 to 28, 2022, in Japan. We enrolled 27,993 respondents (aged 15 to 81 years; male 48.5%), including 15,083 current alcohol users. Using inverse probability weighting of data from the 2016 Comprehensive Survey of Living Conditions on Health and Welfare, we estimated the weighted proportions of strong chū-hai users among all respondents and constructed multivariable logistic regression models to estimate the weighted odds ratios (OR) and 95% confidence intervals (CI) of strong chū-hai use for hazardous and harmful alcohol use, defined as a score ≥8 of the Alcohol Use Disorder Identification Test, among current alcohol users. RESULTS Among all respondents, 56.2% (weighted proportions: past, 35.9%; and current, 20.3%) drank strong chū-hai. Among drinkers, both past and current strong chū-hai use, compared to never use, were associated with hazardous and harmful alcohol use (past, OR 1.73, 95% CI 1.42 to 2.12; current, OR 2.19, 95% CI 1.79 to 2.69). CONCLUSIONS Our study found that more than half of the respondents experienced strong chū-hai consumption, suggesting that it is widely used in Japan. In addition, both past and current strong chū-hai use were associated with hazardous and harmful alcohol use among current alcohol users.
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Affiliation(s)
- Takashi Yoshioka
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Ryuhei So
- Department of Psychiatry, Okayama Psychiatric Medical Center, Okayama, Japan
| | - Atsushi Takayama
- Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan
| | - Ryo Okubo
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoshi Funada
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Midori Takada
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Mami Wakabayashi
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
- The Tokyo Foundation for Policy Research, Tokyo, Japan
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Pisinger VSC, Hoffmann SH, Krølner R, Tolstrup J. A natural experiment: Assessment of Danish high-school students' alcohol drinking patterns from 2014 and 2019 after the introduction of a common alcohol policy. Scand J Public Health 2023; 51:67-74. [PMID: 36474361 DOI: 10.1177/14034948221140189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM In this study, using national survey data from 2014 and 2019, we tested the hypothesis that students at schools who introduced a common alcohol policy in 2017 drank less than students at schools without a common policy. METHODS We used survey data from 41 high schools that participated in the Danish National Youth Study in 2014 and 2019. We perceived the introduction of a common high-school alcohol policy in 2017 among local groups of high schools as a natural experiment and assessed it using difference-in-difference analyses. We assessed drinking patterns from 2014 and 2019 among students at schools with and without a common alcohol policy combined and stratified by sex in negative binominal regression and logistic regression models. Drinking patterns were measured as average weekly alcohol use, average alcohol intake at last school party, proportion of non-drinkers and frequent binge drinkers. RESULTS Drinking patterns were similar among students in schools with and without a common alcohol policy. For example, among students at schools with a common alcohol policy, the average alcohol intake at the last school party among drinkers was 8.7 units in 2014 and 8.5 units in 2019, whereas average alcohol intake among students at schools without a common alcohol policy was 8.8 units in 2014 and 8.9 units in 2019 (p=0.413). CONCLUSIONS
No statistically significant effects were observed following the introduction of a common alcohol policy on students' drinking patterns, and alcohol consumption among high-school students was stable and remained high in 2014 and in 2019.
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Affiliation(s)
| | - Sofie Have Hoffmann
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Rikke Krølner
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Janne Tolstrup
- National Institute of Public Health, University of Southern Denmark, Denmark
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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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Sureshkumar K, Rajendran N, Kailash S, Chitravelu S, Rumaisa N. Does a ban on liquor sales benefit alcohol dependence patients? A study on usage and procurement of alcohol during the COVID-19 lockdown. INDIAN JOURNAL OF HEALTH SCIENCES AND BIOMEDICAL RESEARCH (KLEU) 2023. [DOI: 10.4103/kleuhsj.kleuhsj_489_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Guindon GE, Zhao K, Fatima T, Garasia S, Quinn N, Baskerville NB, Paraje G. Prices, taxes and alcohol use: a systematic umbrella review. Addiction 2022; 117:3004-3023. [PMID: 35661298 PMCID: PMC9796894 DOI: 10.1111/add.15966] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/09/2022] [Indexed: 01/07/2023]
Abstract
AIM To measure the impact of taxes and prices on alcohol use with particular attention to the different context of rising alcohol consumption in low- and middle-income countries. METHODS Systematic review: we searched MEDLINE, Embase, EconLit and LILACS, grey literature, hand-searched five specialty journals and examined references of relevant studies. We considered all reviews that included studies that quantitatively examined the relationship between alcohol prices or taxes and alcohol use. At least two reviewers independently screened the articles and extracted the characteristics, methods and main results and assessed the quality of each included study. We identified 30 reviews. RESULTS There was overwhelming evidence that higher alcohol prices and taxes were associated with lower total alcohol consumption and that price responsiveness varied by beverage type. Total own-price elasticities of alcohol demand were consistently negative and substantial enough to be policy meaningful; total own-price elasticities for beer, wine and spirits were found to be approximately -0.3, -0.6 and -0.65. Reviews generally concluded that higher taxes and prices were associated with lower heavy episodic drinking and heavy drinking, although the magnitude of these associations was generally unclear. Reviews provided no evidence that alcohol price responsiveness differed by socioeconomic status, mixed and contradictory evidence with respect to age and sex and limited evidence that price responsiveness in low- and middle-income countries was approximately the same as in high-income countries. CONCLUSIONS Taxes are effective in reducing alcohol use. Moreover, increasing the price of alcohol by increasing taxes can also be expected to increase tax revenue, because the demand for alcohol is most certainly inelastic.
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Affiliation(s)
- G. Emmanuel Guindon
- Centre for Health Economics and Policy AnalysisMcMaster UniversityHamiltonONCanada,Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonONCanada,Department of EconomicsMcMaster UniversityHamiltonONCanada
| | - Kevin Zhao
- Centre for Health Economics and Policy AnalysisMcMaster UniversityHamiltonONCanada
| | - Tooba Fatima
- Centre for Health Economics and Policy AnalysisMcMaster UniversityHamiltonONCanada
| | - Sophiya Garasia
- Centre for Health Economics and Policy AnalysisMcMaster UniversityHamiltonONCanada,Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonONCanada
| | | | | | - Guillermo Paraje
- Escuela de Negocios, Universidad Adolfo IbáñezSantiagoChile,Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP)Santiago de ChileChile
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48
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Uusitalo L, Nevalainen J, Rahkonen O, Erkkola M, Saarijärvi H, Fogelholm M, Lintonen T. Changes in alcohol purchases from grocery stores after authorising the sale of stronger beverages: The case of the Finnish alcohol legislation reform in 2018. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 39:589-604. [PMID: 36452445 PMCID: PMC9703366 DOI: 10.1177/14550725221082364] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/07/2022] [Indexed: 08/17/2023] Open
Abstract
Aims: The Finnish alcohol law was reformed in January 2018. The availability of alcoholic beverages in grocery stores increased as the legal limit for retail sales of alcoholic drinks was raised from 4.7% to 5.5% alcohol, and the requirement of production by fermentation was abolished. We analysed how the inclusion of strong beers, ciders, and ready-to-drink beverages in grocery stores was reflected in alcohol purchases, and how these changes differed by age, sex, level of education and household income. Design: The study sample included 47,066 loyalty card holders from the largest food retailer in Finland. The data consisted of longitudinal, individual-level information on alcohol purchases from grocery stores, covering the time period between 1 January 2017 and 31 December 2018. The volumes of absolute alcohol during a calendar year from beers, ciders, ready-to-drink beverages, and in total, were calculated. Alcohol purchases in 2017 and 2018 were compared. Results: There was no overall change in the total alcohol (0.04 [95% CI -0.03, 0.11] litres/year) or beer purchases (-0.05 [95% CI -0.11, 0.02] litres/year). Purchases of ready-to-drink beverages increased by 0.10 [95% CI 0.09, 0.11] litres/year (+ 84%). Total alcohol purchases increased in the three highest income groups, whereas they decreased in the two lowest groups (p for the interaction < 0.0001). Conclusions: The increased purchases of alcohol as ready-to-drink beverages were, on the average, compensated for by a decrease in purchases of other alcoholic beverages. Higher prices probably limited the purchases among lower income groups and younger consumers, while the increase was sharper in higher income groups.
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Affiliation(s)
| | | | | | | | | | | | - Tomi Lintonen
- Finnish Foundation for Alcohol Studies c/o THL,
Helsinki, Finland
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49
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Mair C, Sumetsky N, Dougherty M, Thakar M. Do Changes to the Alcohol Retail Environment Reduce Interpersonal Violence? CURR EPIDEMIOL REP 2022; 9:282-289. [PMCID: PMC9672597 DOI: 10.1007/s40471-022-00315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Michelle Dougherty
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Maya Thakar
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
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Ayares G, Idalsoaga F, Arnold J, Fuentes-López E, Arab JP, Díaz LA. Public Health Measures and Prevention of Alcohol-Associated Liver Disease. J Clin Exp Hepatol 2022; 12:1480-1491. [PMID: 36340308 PMCID: PMC9630023 DOI: 10.1016/j.jceh.2022.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/25/2022] [Indexed: 12/12/2022] Open
Abstract
Hazardous alcohol consumption causes approximately 4% of deaths globally, constituting one of the leading risk factors for the burden of the disease worldwide. Alcohol has several health consequences, such as alcohol-associated liver disease, hepatocellular carcinoma, nonliver neoplasms, physical injury, cardiac disease, and psychiatric disorders. Alcohol misuse significantly affects workforce productivity, with elevated direct and indirect economic costs. Due to the high impact of alcohol consumption on the population, public health has led to the development of a range of strategies to reduce its harmful effects. Regulatory public health policies (PHP) for alcohol can exist at the global, regional, international, national, or subnational levels. Effective strategies incorporate a multilevel, multicomponent approach, targeting multiple determinants of drinking and alcohol-related harms. The World Health Organization categorizes the PHP into eight categories: national plan to fight the harmful consequences of alcohol, national license and production and selling control, taxes control and pricing policies, limiting drinking age, restrictions on alcohol access, driving-related alcohol policies, control over advertising and promotion, and government monitoring systems. These policies are supported by evidence from different populations, demonstrating that determinants of alcohol use depend on several factors such as socioeconomic level, age, sex, ethnicity, production, availability, marketing, and others. Although most policies have a significant individual effect, a higher number of PHP are associated with a lower burden of disease due to alcohol. The excessive consequences of alcohol constitute a call for action, and clinicians should advocate for developing and implementing a new PHP on alcohol consumption.
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Key Words
- ACLF, Acute-on-Chronic Liver Failure
- ALD, Alcohol-associated Liver Disease
- AUC, Area Under the Curve
- AUD, Alcohol Use Disorder
- AUDIT, Alcohol Use Disorders Identification Test
- AUDIT-C, Alcohol Use Disorders Identification Test Concise
- AVT, Alcohol Volumetric Tax
- BAC, Blood Alcohol Concentration
- DALYs, Disability-adjusted life years
- GDP, Gross domestic product
- PHP, Public Health Policies
- PNPLA3, Patatin-like Phospholipase Domain-containing 3
- USA, United States
- USD, United States Dollars
- WHO, World Health Organization
- alcohol use disorders
- alcohol-associated hepatitis
- cirrhosis
- fatty liver disease
- steatosis
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Affiliation(s)
- Gustavo Ayares
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Idalsoaga
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Arnold
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Fuentes-López
- Departamento de Ciencias de La Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan P. Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis A. Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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