Has the Relationship Between Alcohol Consumption and Alcohol-Related Risky Behaviour Changed in Australia? An Exploratory Study

Age, period and cohort effects on alcohol-related risky behaviours in Australia from 2001 to 2016

AIMS

The aim of this study is to examine age, period and birth cohort trends in the prevalence of any alcohol-related risky behaviour and to compare these trends between men and women.

DESIGN AND SETTING

We used an age-period-cohort analysis of repeated cross-sectional survey data from the Australian National Drug Strategy Household Survey from 2001 to 2016.

PARTICIPANTS

Participants were 121 281 people aged 14-80 years who reported consuming alcohol in the past 12 months.

MEASUREMENTS

Any risky behaviour undertaken while under the influence of alcohol in the past 12 months (e.g. operating a motor vehicle) was measured: male or female.

FINDINGS

Controlling for age and cohort, cubic spline models showed that any alcohol-related risky behaviour declined with time among participants who consumed alcohol [2016 versus 2007 rate ratio (RR) = 0.80, 95% confidence interval (CI) = 0.76-0.84]. Risky behaviour peaked in the 1954 birth cohort (1954 versus 1971 RR = 1.42, 95% CI = 1.30-1.55) and then steadily declined with more recent birth cohorts (2002 versus 1971 RR = 0.32, 95% CI = 0.27-0.39). Risky behaviour peaked at age 21 years, followed by steady decline and stabilization at approximately age 70 years. Males were overall twice as likely as females to report alcohol-related risky behaviour (RR = 2.10, 95% CI = 1.84-2.39), but this effect was smaller in cohorts born after 1980 [1980 prevalence rate ratios (PRR) = 2.09, 95% CI = 1.81-2.43; 2002 PRR = 1.31, 95% CI = 1.03-1.68].

CONCLUSIONS

Alcohol-related risky behaviour in Australia has declined generally since 2001, with rates for recent cohorts having the sharpest decline. Risky behaviour remains most prevalent in young adults, and the male-female gap in risky behaviour is closing for more recent birth cohorts. These trends are consistent with alcohol consumption trends observed in Australia and world-wide.

The relationship between age at first drink and later risk behaviours during a period of youth drinking decline

AIMS

Alcohol consumption among teenagers in many high-income countries has steadily declined since the early 2000s. There has also been a steady increase in the average age at first drink, a reliable marker of later alcohol problems. This study measured whether young people who initiated drinking early were at increased risk of alcohol problems in young adulthood in recent cohorts where early initiation was comparatively rare.

DESIGN

Analysis of six waves of a repeated cross-sectional household survey (2001-16).

SETTING

Australia.

PARTICIPANTS

A total of 9576 young adults (aged 20-25 years) who had initiated drinking before the age of 20 years.

MEASUREMENTS

Respondents were classified into three groups based on their self-reported age at first drink (< 16, 16-17, 18-19 years). Outcome variables were self-reported experiences of memory loss while drinking, risky and delinquent behaviour while drinking and monthly or more frequent drinking occasions of 11 or more 10-g standard drinks.

FINDINGS

Later initiators reported lower levels of all outcomes [e.g. odds ratios (ORs) for memory loss were 0.56, 95% confidence interval (CI) = 0.50, 0.63] for those who first drank at 16 or 17 years compared with those who first drank at age 15 or younger). Significant interactions between age at first drink and survey year showed that early initiation was more strongly associated with harms (e.g. for memory loss, OR = 0.97, 95% CI = 0.94, 0.99 for 18-19 versus 15 or younger) in young adulthood for recent cohorts where early drinking was less common.

CONCLUSIONS

The decline in youth drinking may have contributed to a concentration of risk of alcohol problems among those young people who consume alcohol in early adolescence. Early initiation of drinking may be an increasingly important marker of broader risk taking as alcohol becomes less normative for teenagers.

Alcohol consumption, heavy episodic drinking and the perpetration of antisocial behaviours in Australia

AIMS

This study aims to understand the dose-response relationship of the volume and patterns of alcohol consumption with alcohol-related antisocial behaviours (ASB) in the general population and assess whether these relationships are consistent across various sociodemographic subgroups.

METHODS

We used data from 30,275 respondents aged (14-69) from two waves (2013 and 2016) of the National Drug Strategy Household Survey (NDSHS). Average daily alcohol consumption and heavy episodic drinking (HED) frequencies were treated as the main independent variables and self-reported ASB perpetration as the dependent variable. Bivariable and multivariable logistic regression models predicting ASB with interaction terms between alcohol consumption and various sociodemographic variables were estimated.

FINDINGS

Compared with low-risk drinking (0.01-20 g of alcohol/day), respondents drinking at risky (20.01-40 g of alcohol/day) and high risk (>40 g of alcohol per day) levels had an increased prevalence of ASB perpetration with adjusted odds ratios of 3.63 (95% CI 2.98-4.42) and 8.07 (6.72-9.71). Increasing frequency of HED was also linked to increased self-report of ASB perpetration in bivariable and multivariable models. In our interaction models, we found higher probabilities of ASB perpetration among younger and unmarried respondents for a given level of drinking.

DISCUSSION AND CONCLUSIONS

Both average daily alcohol consumption and frequency of HED predict the probability of perpetrating alcohol-related ASB. Unsurprisingly, the risk of alcohol-specific ASB increased more quickly with consumption levels for younger and single respondents, suggesting interventions to reduce consumption among younger and unmarried persons will significantly impact ASB.

Children's exposure to outdoor food advertising near primary and secondary schools in Australia

ISSUE ADDRESSED

Previous research has highlighted children's frequent exposure to advertisements of unhealthy food and beverages on television. However, the food industry is increasingly utilising non-broadcast channels such as outdoor advertising (eg billboards, bus shelters, shop fronts) for product marketing. Few studies have investigated children's exposure to outdoor food advertising around primary and secondary schools. This study aimed to quantify the presence and content of outdoor food advertisements within a 500 m radius of primary and secondary schools in Perth, Western Australia.

METHODS

A cross-sectional design was used to capture outdoor advertisements within a 500 m radial buffer around the school boundary. The INFORMAS protocol for monitoring outdoor advertising around child-serving institutions was used. Sixty-four primary and secondary schools in Perth, Australia, were selected using random sampling within socio-economic and population density strata.

RESULTS

In total, 5636 outdoor advertisements were identified within a 500 m radius of all 64 schools combined and 30% were for food. Of the 1708 food advertisements, 74% were for unhealthy (non-core) food. The most frequently advertised food products were alcohol, fast food and sugar-sweetened beverages. Only 8% of food advertisements featured a healthy product. The majority of schools (75%) had at least one food advertisement within 500 m (mean 36, range 3-190). Schools in lower socio-economic areas had more food advertisements and a significantly higher proportion of unhealthy food advertisements within 250 m.

CONCLUSION

Outdoor advertising around schools constitutes a potential frequent source of children's exposure to unhealthy food and alcohol advertising. SO WHAT?: Policy interventions restricting the content of outdoor food advertising near schools are needed.