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Casswell S, Huckle T, Parker K, Graydon‐Guy T, Leung J, Parry C, Torun P, Sengee G, Pham C, Gray‐Phillip G, Callinan S, Chaiyasong S, MacKintosh AM, Meier P, Randerson S. Effective alcohol policies are associated with reduced consumption among demographic groups who drink heavily. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:786-795. [PMID: 37087719 PMCID: PMC10947406 DOI: 10.1111/acer.15030] [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: 07/12/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Alcohol policies stand out among other noncommunicable disease-relevant policies for the lack of uptake. Composite indicators have been developed to measure the effects of alcohol control policy. We investigated whether drinking patterns among demographic groups from general population samples of drinkers from diverse countries are associated with alcohol control policy as measured by the International Alcohol Control (IAC) Policy Index. METHODS Representative samples of adult drinkers from 10 countries (five high-income and five middle-income) were surveyed about alcohol consumption, using beverage and location-specific questions. MEASUREMENTS The IAC Policy Index was analyzed with frequency, typical occasion quantity, and volume consumed. Analyses used mixed models that included interactions between country IAC Policy Index score and age group, gender, and education level. FINDINGS Each increase in IAC policy index score (reflecting more effective alcohol policy) was associated with a 13.9% decrease in drinking frequency (p = 0.006) and a 16.5% decrease in volume (p = 0.001). With each increase in IAC Policy Index score, both genders decreased for all three measures, but men less so than women. Women decreased their typical occasion quantity by 1.2% (p = 0.006), frequency by 3.1% (p < 0.001), and total volume by 4.2% (p < 0.001) compared to men. Low and mid-education groups decreased their typical occasion quantity by 2.6% (p < 0.001) and 1.6% (p = 0.001), respectively, compared to high education, while for drinking frequency the low education group increased by 7.0% (p < 0.001). There was an overall effect of age (F = 19.27, p < 0.0001), with 18-19 and 20-24-year-olds showing the largest decreases in typical occasion quantity with increasing IAC policy index score. CONCLUSIONS The IAC Policy Index, reflecting four effective policies, was associated with volume and frequency of drinking across 10 diverse countries. Each increase in the IAC Policy Index was associated with lower typical quantities consumed among groups reporting heavy drinking: young adults and less well-educated. There is value in implementing such alcohol policies and a need to accelerate their uptake globally.
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Affiliation(s)
- Sally Casswell
- SHORE & Whariki Research CentreCollege of Health, Massey UniversityAucklandNew Zealand
| | - Taisia Huckle
- SHORE & Whariki Research CentreCollege of Health, Massey UniversityAucklandNew Zealand
| | - Karl Parker
- SHORE & Whariki Research CentreCollege of Health, Massey UniversityAucklandNew Zealand
| | - Thomas Graydon‐Guy
- SHORE & Whariki Research CentreCollege of Health, Massey UniversityAucklandNew Zealand
| | - June Leung
- SHORE & Whariki Research CentreCollege of Health, Massey UniversityAucklandNew Zealand
| | - Charles Parry
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research CouncilCape TownSouth Africa
| | - Perihan Torun
- Department of Public HealthHamidiye International Medical SchoolIstanbulTurkey
| | - Gantuya Sengee
- Public Health Policy and Coordination DepartmentNational Center for Public Health of MongoliaUlaanbaatarMongolia
| | - Cuong Pham
- Center for Injury Policy and Prevention Research (CIPPR)Hanoi University of Public HealthHanoiVietnam
| | | | - Sarah Callinan
- Centre for Alcohol Policy Research (CAPR), School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
| | - Surasak Chaiyasong
- International Health Policy Program (IHPP), Ministry of Public Health & Faculty of PharmacyMahasarakham UniversityMaha SarakhamThailand
| | - Anne Marie MacKintosh
- Institute for Social Marketing and Health, Faculty of Health Sciences and SportUniversity of StirlingStirlingUK
| | - Petra Meier
- School of Health and Related ResearchUniversity of SheffieldSheffieldUK
- Present address:
MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Steve Randerson
- SHORE & Whariki Research CentreCollege of Health, Massey UniversityAucklandNew Zealand
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Neyazi N, Mosadeghrad AM, Afshari M, Isfahani P, Safi N. Strategies to tackle non-communicable diseases in Afghanistan: A scoping review. Front Public Health 2023; 11:982416. [PMID: 36908476 PMCID: PMC9992526 DOI: 10.3389/fpubh.2023.982416] [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: 06/30/2022] [Accepted: 01/31/2023] [Indexed: 02/24/2023] Open
Abstract
Non-communicable diseases (NCDs) and their risk factors are the leading cause of death worldwide and contribute to 74.3% of deaths globally in 2019. The burden of NCDs is escalating in Afghanistan. Currently, every seconds, people in Afghanistan are dying of NCDs. Addressing this challenge in Afghanistan needs effective and practical interventions. This study aimed to identify the strategies developed and implemented in countries with low non-communicable premature death. To conduct a scoping review, we followed the six-step Arksey and O'Malley protocol and searched for eligible articles on eight international databases and the gray literature. The study followed the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines. The inclusion criteria were English documents and evidence produced up to 30 November 2021 for the control of NCDs. We excluded incomplete texts, duplicates, and dissertations due to lack of access. We used EndNote X9 and MaxQDA software for data management and analysis. We conducted content analysis for this study. A total of 122 documents developed between 1984 and 2021 met the inclusion criteria. We identified 35 strategies from which the most used strategies were related to unhealthy diets and smoking cessation programs. Canada (26.4%), Korea (19.8%), and the United Kingdom (19%) have the most publications on the control and prevention of NCDs among the countries included in the study. Most strategies were implemented over 2 years (41%). This study recommends specific interventions to control and prevent NCDs for the main risk factors of tobacco use, unhealthy diet, physical inactivity, and the main non-communicable diseases such as heart diseases, cancers, diabetes, and chronic obstructive pulmonary diseases. Afghanistan Ministry of Public Health, the WHO country office, and other involved stakeholders can use the findings of this review to design and implement strategies for controlling and preventing NCDs in Afghanistan. International organizations such as the World Health Organization, United Nations Agencies, the World Bank, and other involving communities should invest in strengthening good health governance in Afghanistan. The Afghan Government should focus on promoting and funding health literacy among the public and self-care to control and prevent NCDs.
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Affiliation(s)
- Narges Neyazi
- International Campus, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Health System Development, World Health Organization Country Office, Kabul, Afghanistan
| | - Ali Mohammad Mosadeghrad
- Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Parvaneh Isfahani
- School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Najibullah Safi
- Health System Development, World Health Organization Country Office, Kabul, Afghanistan
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Foster S, Gmel G, Mohler-Kuo M. Young Swiss men's risky single-occasion drinking: Identifying those who do not respond to stricter alcohol policy environments. Drug Alcohol Depend 2022; 234:109410. [PMID: 35364420 DOI: 10.1016/j.drugalcdep.2022.109410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/24/2022] [Accepted: 03/13/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Previous research has demonstrated a preventive effect of the alcohol policy environment on alcohol consumption. However, little is known about the heterogeneity of this effect. Our aim was to examine the extent of heterogeneity in the relationship between the strictness of alcohol policy environments and heavy drinking and to identify potential moderators of the relationship. METHODS Cross-sectional data from 5986 young Swiss men participating in the cohort study on substance use risk factors (C-SURF) were analysed. The primary outcome was self-reported risky single-occasion drinking in the past 12 months (RSOD, defined as 6 standard drinks or more on a single occasion at least monthly). A previously-used index of alcohol policy environment strictness across Swiss cantons was analysed in conjunction with 21 potential moderator variables. Random forest machine learning captured high-dimensional interaction effects, while individual conditional expectations captured the heterogeneity induced by the interaction effects and identified moderators. RESULTS Predicted subject-specific absolute risk reductions in RSOD risk ranged from 16.8% to - 4.2%, indicating considerable heterogeneity. Sensation seeking and antisocial personality disorder (ASPD) were major moderators that reduced the preventive relationship between stricter alcohol policy environments and RSOD risk. They also were associated with the paradoxical observation that some individuals displayed increased RSOD risk in stricter alcohol policy environments. CONCLUSION Whereas stricter alcohol policy environments were associated with reduced average RSOD risk, additionally addressing the risk conveyed by sensation seeking and ASPD would deliver an interlocking prevention mix against young Swiss men's RSOD.
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Affiliation(s)
- Simon Foster
- Department of Child and Adolescent Psychiatry and Psychotherapy (KJPP), University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland.
| | - Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, Addiction Switzerland, Lausanne, Switzerland, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, University of the West of England, Frenchay Campus, Bristol, UK
| | - Meichun Mohler-Kuo
- La Source, School of nursing sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland, Department of Child and Adolescent Psychiatry and Psychotherapy (KJPP), University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
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Myers B, Carney T, Rooney J, Malatesta S, White LF, Parry CDH, Bouton TC, Ragan EJ, Horsburgh CR, Warren RM, Jacobson KR. Alcohol and Tobacco Use in a Tuberculosis Treatment Cohort during South Africa's COVID-19 Sales Bans: A Case Series. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5449. [PMID: 34069737 PMCID: PMC8161406 DOI: 10.3390/ijerph18105449] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND South Africa temporarily banned alcohol and tobacco sales for about 20 weeks during the COVID-19 lockdown. We described changes in alcohol and tobacco consumption after implementation of these restrictions among a small number of participants in a tuberculosis treatment cohort. METHOD The timeline follow-back procedure and Fägerstrom test for nicotine dependence was used to collect monthly alcohol and tobacco use information. We report changes in heavy drinking days (HDD), average amount of absolute alcohol (AA) consumed per drinking day, and cigarettes smoked daily during the alcohol and tobacco ban compared to use prior to the ban. RESULTS Of the 61 participants for whom we have pre-ban and within-ban alcohol use information, 17 (27.9%) reported within-ban alcohol use. On average, participants reported one less HDD per fortnight (interquartile range (IQR): -4, 1), but their amount of AA consumed increased by 37.4 g per drinking occasion (IQR: -65.9 g, 71.0 g). Of 53 participants who reported pre-ban tobacco use, 17 (32.1%) stopped smoking during the ban. The number of participants smoking >10 cigarettes per day decreased from 8 to 1. CONCLUSIONS From these observations, we hypothesize that policies restricting alcohol and tobacco availability seem to enable some individuals to reduce their consumption. However, these appear to have little effect on the volume of AA consumed among individuals with more harmful patterns of drinking in the absence of additional behavior change interventions.
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Affiliation(s)
- Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa; (T.C.); (C.D.H.P.)
- Division of Addiction Psychiatry, Department of Psychiatry & Mental Health, University of Cape Town, Cape Town 7701, South Africa
| | - Tara Carney
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa; (T.C.); (C.D.H.P.)
- Division of Addiction Psychiatry, Department of Psychiatry & Mental Health, University of Cape Town, Cape Town 7701, South Africa
| | - Jennifer Rooney
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA 02119, USA; (J.R.); (T.C.B.); (E.J.R.); (C.R.H.J.); (K.R.J.)
| | - Samantha Malatesta
- Department of Biostatistics, School of Public Health, Boston University, MA 02119, USA; (S.M.); (L.F.W.)
| | - Laura F. White
- Department of Biostatistics, School of Public Health, Boston University, MA 02119, USA; (S.M.); (L.F.W.)
| | - Charles D. H. Parry
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa; (T.C.); (C.D.H.P.)
- Department of Psychiatry, Stellenbosch University, Tygerberg 7505, South Africa
| | - Tara C. Bouton
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA 02119, USA; (J.R.); (T.C.B.); (E.J.R.); (C.R.H.J.); (K.R.J.)
| | - Elizabeth J. Ragan
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA 02119, USA; (J.R.); (T.C.B.); (E.J.R.); (C.R.H.J.); (K.R.J.)
| | - Charles Robert Horsburgh
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA 02119, USA; (J.R.); (T.C.B.); (E.J.R.); (C.R.H.J.); (K.R.J.)
- Departments of Epidemiology, Biostatistics and Global Health, Boston University School of Public Health, Boston, MA 02119, USA
| | - Robin M. Warren
- Department of Science and Innovation, National Research Foundation Centre of Excellence in Biomedical Tuberculosis Research, South Africa Medical Research Council for Tuberculosis Research, Stellenbosch University, Tygerberg 7505, South Africa;
| | - Karen R. Jacobson
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA 02119, USA; (J.R.); (T.C.B.); (E.J.R.); (C.R.H.J.); (K.R.J.)
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Huckle T, Callinan S, Pham C, Chaiyasong S, Parker K, Casswell S. Harmful drinking occurs in private homes in some high- and middle-income alcohol markets: Data from the International Alcohol Control Study. Drug Alcohol Rev 2020; 39:616-623. [PMID: 32805071 DOI: 10.1111/dar.13137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To describe how for some high- and middle-income countries, the total volume of alcohol, including volume consumed in harmful drinking occasions, is distributed across drinking locations in each country. METHODS Population surveys of drinkers were conducted as part of the International Alcohol Control Study in New Zealand, Australia, Vietnam and Thailand. Consumption data were collected using a beverage- and location-specific measure that also allows for the measurement of unrecorded alcohol. RESULTS In the high-income countries, the percentage of absolute alcohol consumed in harmful drinking occasions was 44% in New Zealand and 51% in Australia. In the middle-income countries, the proportions were 55% in Vietnam and 66% in Thailand. The vast majority of alcohol was consumed in private homes (67% or above in all four countries). Private homes were also the location where the highest percentage of alcohol was consumed in harmful drinking occasions (range 33% in New Zealand to 44% in Vietnam). Unrecorded/untaxed alcohol was of considerable importance for heavier drinking occasions in private homes in Vietnam. Bars and nightclubs were more likely locations for harmful drinking in the high-income countries relative to the middle-income countries. CONCLUSIONS As the majority of alcohol consumed in each country, including in harmful drinking occasions, was consumed in private homes, these findings make take-away alcohol a focus for alcohol policy including trading hour and pricing policies. Unrecorded alcohol was also of considerable importance in Vietnam, highlighting the importance of the policy responses being developed to address unrecorded alcohol.
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Affiliation(s)
- Taisia Huckle
- Shore and Whairki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Cuong Pham
- Centre for Injury Policy and Prevention Research, Hanoi University of Public Health, Hanoi, Vietnam
| | - Surasak Chaiyasong
- Social Pharmacy Research Unit and PhD Program in Pharmacy, Faculty of Pharmacy, Mahasarakham University, Maha Sarakham, Thailand
| | - Karl Parker
- Shore and Whairki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Sally Casswell
- Shore and Whairki Research Centre, College of Health, Massey University, Auckland, New Zealand
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Ghandour LA, Anouti S, Afifi RA. The impact of DSM classification changes on the prevalence of alcohol use disorder and 'diagnostic orphans' in Lebanese college youth: Implications for epidemiological research, health practice, and policy. PLoS One 2020; 15:e0233657. [PMID: 32502221 PMCID: PMC7274407 DOI: 10.1371/journal.pone.0233657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 05/10/2020] [Indexed: 12/02/2022] Open
Abstract
Background Studies comparing prevalence of alcohol use disorder (AUD) using DSM-IV and DSM-5 diagnostic criteria in college students are limited. This study examines changes in AUD prevalence estimates using DSM-IV versus DSM-5 and characterizes the profile of DSM-5 “diagnostic orphans.” Methods and findings A college student sample (n = 1,155; mean age: 21 ±1.97) selected conveniently from six large private and public universities in Greater Beirut, Lebanon completed an anonymous survey in May 2016. The study response rate was 83.1%. Data on DSM-IV and DSM-5 AUD criteria were gathered from 582 past-year drinkers, of which 377 (65%) were screened to have DSM-IV abuse/dependence, and 203 (35%) to have any DSM-5 AUD (58% mild, 21% moderate, and 21% severe). Overall percent agreement between measures was 68% (kappa = 0.41). One hundred and ninety-one students met one DSM-5 AUD criterion only (i.e. “diagnostic orphans,” herein DOs), of which the majority (82%) endorsed “hazardous use.” Compared to past-year drinkers with zero-endorsed DSM-5 criteria, DOs were more likely to be aged 21 or above [OR = 1.57(1.21–2.03)], less likely to perceive their socioeconomic status (SES) as poorer vs. same as others [OR = 0.17(0.07–0.43)], more likely to drink 1–2 times/week vs. ≤3 times per month [OR = 2.24(1.44–3.49)], and more likely to report past-year cigarette smoking [OR = 2.16(1.10–4.24)]. When compared to past-year drinkers with DSM-5 AUD, DOs were more likely to be pursuing a graduate or medical degree (vs. undergraduate degree) [2.06 (1.09–3.89)], and to be living with parents most of the time vs. not [OR = 2.68(1.14–6.31)]. DOs (versus drinkers with AUD) were less likely to drink at a high frequency (3–4 times /week or more vs.≤3 times per month) [OR = 0.15(0.05–0.48)], and to report past-year waterpipe smoking [OR = 0.54(0.34–0.85)], but more likely to report past-year marijuana use [1.89(1.10–3.23)]. The findings are subject to recall bias and under-reporting and the study could not infer causality because temporality of associations cannot be established in a cross-sectional study design. Conclusions DSM-IV abuse/dependence prevalence rate was higher than DSM-5 AUD prevalence mainly due to the high percentage of students who engaged in “hazardous use”. The DO screen might capture a young person in transition between non-drinking/occasional drinking to drinking frequently/developing an AUD. The prevention, identification, and management of DOs may be critical components of a national alcohol harm-reduction policy.
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Affiliation(s)
- Lilian A. Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- * E-mail:
| | - Sirine Anouti
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Rima A. Afifi
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Huckle T, Romeo J, Casswell S. A restrictive alcohol social supply law change is associated with less supply to friends under 18 years. Drug Alcohol Rev 2019; 38:737-743. [DOI: 10.1111/dar.12993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 08/19/2019] [Accepted: 08/25/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Taisia Huckle
- SHORE and Whariki Research Centre, College of HealthMassey University Auckland New Zealand
| | - Jose Romeo
- SHORE and Whariki Research Centre, College of HealthMassey University Auckland New Zealand
| | - Sally Casswell
- SHORE and Whariki Research Centre, College of HealthMassey University Auckland New Zealand
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Petersen Williams P, Morojele N, Londani M, Harker Burnhams N, Parry CDH. Alcohol Advertising, Affordability and Availability, and the Effect on Adult Heavy Drinking and Symptoms of Alcohol Problems: International Alcohol Control Study (South Africa). Subst Use Misuse 2019; 54:1751-1762. [PMID: 31076000 DOI: 10.1080/10826084.2019.1609987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Alcohol harm is a major contributor to the burden of disease in South Africa. This study aimed to identify the extent of heavy drinking and symptoms of alcohol problems among adult drinkers and associated demographic and other risk factors in the Tshwane Metropole of South Africa. Methods: A household survey was conducted using multi-stage stratified cluster random sampling. Heavy drinking was defined as consuming at least 120 mL for men and at least 90 mL for women of absolute alcohol on one occasion at least monthly while symptoms of alcohol problems were measured using the Rapid Alcohol Problems Screen 4 (RAPS4). Stata 14.0 was used for the analysis. Results: Just over half (52%) of the sample reported heavy drinking, and half (50%) reported symptoms of alcohol problems. Gender race/ethnicity, marital status, mode of transport used to purchase alcohol, perceptions of alcohol availability and exposure to alcohol promotions and advertising through SMS and free offers when buying alcohol all impacted heavy drinking. Gender, age, personal income and exposure to alcohol promotions and advertising in magazines and newspapers all impacted symptoms of alcohol problems. Conclusion: The study raises important questions about various policy related mechanisms to curtail heavy drinking and highlights the need for more extensive research to assess the nature and extent of heavy drinking and alcohol problems in South Africa.
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Affiliation(s)
- Petal Petersen Williams
- a Alcohol, Tobacco and Other Drug Research Unit , South African Medical Research Council , Cape Town , South Africa.,d Department of Psychiatry and Mental Health , University of Cape Town , Cape Town , South Africa
| | - Neo Morojele
- a Alcohol, Tobacco and Other Drug Research Unit , South African Medical Research Council , Cape Town , South Africa.,b School of Public Health and Family Medicine , University of Cape Town , Cape Town , South Africa.,c School of Public Health , University of the Witwatersrand , Johannesburg , South Africa
| | - Mukhethwa Londani
- a Alcohol, Tobacco and Other Drug Research Unit , South African Medical Research Council , Cape Town , South Africa
| | - Nadine Harker Burnhams
- a Alcohol, Tobacco and Other Drug Research Unit , South African Medical Research Council , Cape Town , South Africa.,b School of Public Health and Family Medicine , University of Cape Town , Cape Town , South Africa
| | - Charles D H Parry
- a Alcohol, Tobacco and Other Drug Research Unit , South African Medical Research Council , Cape Town , South Africa.,e Department of Psychiatry , Stellenbosch University , Cape Town , South Africa
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Trangenstein PJ, Morojele NK, Lombard C, Jernigan DH, Parry CDH. Heavy drinking and contextual risk factors among adults in South Africa: findings from the International Alcohol Control study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2018; 13:43. [PMID: 30518429 PMCID: PMC6280515 DOI: 10.1186/s13011-018-0182-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/20/2018] [Indexed: 02/06/2023]
Abstract
Background There is limited information about the potential individual-level and contextual drivers of heavy drinking in South Africa. This study aimed to identify risk factors for heavy drinking in Tshwane, South Africa. Methods A household survey using a multi-stage stratified cluster random sampling design. Complete consumption and income data were available on 713 adults. Heavy drinking was defined as consuming ≥120 ml (96 g) of absolute alcohol (AA) for men and ≥ 90 ml (72 g) AA for women at any location at least monthly. Results 53% of the sample were heavy drinkers. Bivariate analyses revealed that heavy drinking differed by marital status, primary drinking location, and container size. Using simple logistic regression, only cider consumption was found to lower the odds of heavy drinking. Persons who primarily drank in someone else’s home, nightclubs, and sports clubs had increased odds of heavy drinking. Using multiple logistic regression and adjusting for marital status and primary container size, single persons were found to have substantially higher odds of heavy drinking. Persons who drank their primary beverage from above average-sized containers at their primary location had 7.9 times the odds of heavy drinking as compared to persons who drank from average-sized containers. Some significant associations between heavy drinking and age, race, and income were found for certain beverages. Conclusion Rates of heavy drinking were higher than expected giving impetus to various alcohol policy reforms under consideration in South Africa. Better labeling of the alcohol content of different containers is needed together with limiting production, marketing and serving of alcohol in large containers.
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Affiliation(s)
- Pamela J Trangenstein
- Alcohol Research Group, 6001 Shellmound St., Suite 450, Emeryville, CA, 94608, USA.,Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA
| | - Neo K Morojele
- Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, 1 Soutpansberg Rd, Prinshof 349-Jr, Pretoria, 0084, South Africa.,School of Public Health, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2000, South Africa.,School of Public Health and Family Medicine, University of Cape Town, Falmouth Rd, Observatory, Cape Town, 7925, South Africa
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa
| | - David H Jernigan
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA
| | - Charles D H Parry
- Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Box 19070, Tygerberg, PO, 7505, South Africa. .,Department of Psychiatry, Francie van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa.
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Huckle T, Romeo JS, Wall M, Callinan S, Holmes J, Meier P, Mackintosh A, Piazza M, Chaiyasong S, Cuong PV, Casswell S. Socio-economic disadvantage is associated with heavier drinking in high but not middle-income countries participating in the International Alcohol Control Study. Drug Alcohol Rev 2018; 37 Suppl 2:S63-S71. [PMID: 29707842 PMCID: PMC6120506 DOI: 10.1111/dar.12810] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 03/01/2018] [Accepted: 03/28/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS To investigate if socio-economic disadvantage, at the individual- and country-level, is associated with heavier drinking in some middle- and high-income countries. DESIGN AND METHODS Surveys of drinkers were undertaken in some high- and middle-income countries. Participating countries were Australia, England, New Zealand, Scotland (high-income) and Peru, Thailand and Vietnam (middle-income). Disadvantage at the country-level was defined as per World Bank (categorised as middle-or high-income); individual-level measures were (i) years of education and (ii) whether and individual was under or over the poverty line in each country. Measures of heavier drinking were (i) proportion of drinkers that consumed 8+ drinks and (ii) three drinking risk groups (lower, increasing and higher). Multi-level logistic regression models were used. RESULTS Individual-level measures of disadvantage, lower education and living in poverty, were associated with heavier drinking, consuming 8+ drinks on a typical occasion or drinking at the higher risk level, when all countries were considered together. Drinkers in the middle-income countries had a higher probability of consuming 8+ drinks on a typical occasion relative to drinkers in the high-income countries. Interactions between country-level income and individual-level disadvantage were undertaken: disadvantaged drinkers in the middle-income countries were less likely to be heavier drinkers relative to those with less disadvantage in the high-income countries. DISCUSSION AND CONCLUSIONS Associations between socio-economic disadvantage and heavier drinking vary depending on country-level income. These findings highlight the value of exploring cross-country differences in heavier drinking and disadvantage and the importance of including country-level measurements to better elucidate relationships.
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Affiliation(s)
- Taisia Huckle
- Centre for Social and Health Outcomes Research and EvaluationMassey UniversityAucklandNew Zealand
| | - Jose S. Romeo
- Centre for Social and Health Outcomes Research and EvaluationMassey UniversityAucklandNew Zealand
| | - Martin Wall
- Centre for Social and Health Outcomes Research and EvaluationMassey UniversityAucklandNew Zealand
| | - Sarah Callinan
- Centre for Alcohol Policy Research, Department of Public Health, School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
| | - John Holmes
- Sheffield Alcohol Research GroupSheffield UniversitySheffieldUK
| | - Petra Meier
- Sheffield Alcohol Research GroupSheffield UniversitySheffieldUK
| | | | | | - Surasak Chaiyasong
- Health Promotion Policy Research CenterInternational Health Policy ProgramNonthaburiThailand
- Social Pharmacy Research Unit, Faculty of PharmacyMahasarakham UniversityTalatThailand
| | | | - Sally Casswell
- Centre for Social and Health Outcomes Research and EvaluationMassey UniversityAucklandNew Zealand
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Chaiyasong S, Huckle T, Mackintosh A, Meier P, Parry CDH, Callinan S, Viet Cuong P, Kazantseva E, Gray‐Phillip G, Parker K, Casswell S. Drinking patterns vary by gender, age and country-level income: Cross-country analysis of the International Alcohol Control Study. Drug Alcohol Rev 2018; 37 Suppl 2:S53-S62. [PMID: 29900623 PMCID: PMC6120521 DOI: 10.1111/dar.12820] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 04/19/2018] [Accepted: 05/06/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND AIMS Gender and age patterns of drinking are important in guiding country responses to harmful use of alcohol. This study undertook cross-country analysis of drinking across gender, age groups in some high-and middle-income countries. DESIGN AND METHODS Surveys of drinkers were conducted in Australia, England, Scotland, New Zealand, St Kitts and Nevis (high-income), Thailand, South Africa, Mongolia and Vietnam (middle-income) as part of the International Alcohol Control Study. Drinking pattern measures were high-frequency, heavier-typical quantity and higher-risk drinking. Differences in the drinking patterns across age and gender groups were calculated. Logistic regression models were applied including a measure of country-level income. RESULTS Percentages of high-frequency, heavier-typical quantity and higher-risk drinking were greater among men than in women in all countries. Older age was associated with drinking more frequently but smaller typical quantities especially in high-income countries. Middle-income countries overall showed less frequent but heavier typical quantities; however, the lower frequencies meant the percentages of higher risk drinkers were lower overall compared with high-income countries (with the exception of South Africa). DISCUSSION AND CONCLUSIONS High-frequency drinking was greater in high-income countries, particularly in older age groups. Middle-income countries overall showed less frequent drinking but heavier typical quantities. As alcohol use becomes more normalised as a result of the expansion of commercial alcohol it is likely frequency of drinking will increase with a likelihood of greater numbers drinking at higher risk levels.
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Affiliation(s)
- Surasak Chaiyasong
- Health Promotion Policy Research Center, International Health Policy ProgramNonthaburiThailand
- Social Pharmacy Research Unit, Faculty of PharmacyMahasarakham UniversityMaha SarakhamThailand
| | - Taisia Huckle
- Massey University, SHORE and Whariki Research CentreAucklandNew Zealand
| | | | - Petra Meier
- Sheffield Alcohol Research Group, ScHARRUniversity SheffieldSheffieldUK
| | - Charles D. H. Parry
- Alcohol, Tobacco and Other Drug Research UnitMedical Research CouncilCape TownSouth Africa
- Department of PsychiatryStellenbosch UniversityCape TownSouth Africa
| | - Sarah Callinan
- Centre for Alcohol Policy Research, School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
| | - Pham Viet Cuong
- Center for Injury Policy and Prevention Research, Hanoi School of Public HealthHanoiVietnam
| | - Elena Kazantseva
- Public Health, Research, Education and External Affairs DepartmentNational Center of Mental Health of MongoliaUlaanbaatarMongolia
| | - Gaile Gray‐Phillip
- St Kitts‐Nevis National Council on Drug Abuse Prevention SecretariatBasseterreSaint Kitts and Nevis
| | - Karl Parker
- Massey University, SHORE and Whariki Research CentreAucklandNew Zealand
| | - Sally Casswell
- Massey University, SHORE and Whariki Research CentreAucklandNew Zealand
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12
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Casswell S, Huckle T, Wall M, Parker K, Chaiyasong S, Parry CDH, Viet Cuong P, Gray-Phillip G, Piazza M. Policy-relevant behaviours predict heavier drinking and mediate the relationship with age, gender and education status: Analysis from the International Alcohol Control Study. Drug Alcohol Rev 2018; 37 Suppl 2:S86-S95. [PMID: 29464804 PMCID: PMC6635757 DOI: 10.1111/dar.12669] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 12/19/2017] [Accepted: 01/04/2018] [Indexed: 11/29/2022]
Abstract
Introduction and Aims To investigate behaviours related to four alcohol policy variables (policy‐relevant behaviours) and demographic variables in relation to typical quantities of alcohol consumed on‐premise in six International Alcohol Control study countries. Design and Methods General population surveys with drinkers using a comparable survey instrument and data analysed using path analysis in an overall model and for each country. Measures: typical quantities per occasion consumed on‐premise; gender, age; years of education, prices paid, time of purchase, time to access alcohol and liking for alcohol advertisements. Results In the overall model younger people, males and those with fewer years of education consumed larger typical quantities. Overall lower prices paid, later time of purchase and liking for alcohol ads predicted consuming larger typical quantities; this was found in the high‐income countries, less consistently in the high‐middle‐income countries and not in the low middle‐income country. Three policy‐relevant behaviours (prices paid, time of purchase, liking for alcohol ads) mediated the relationships between age, gender, education and consumption in high‐income countries. Discussion and Conclusions International Alcohol Control survey data showed a relationship between policy‐relevant behaviours and typical quantities consumed and support the likely effect of policy change (trading hours, price and restrictions on marketing) on heavier drinking. The path analysis also revealed policy‐relevant behaviours were significant mediating variables between the effect of age, gender and educational status on consumption. However, this relationship is clearest in high‐income countries. Further research is required to understand better how circumstances in low‐middle‐income countries impact effects of policies.
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Affiliation(s)
- Sally Casswell
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Taisia Huckle
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Martin Wall
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Karl Parker
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Surasak Chaiyasong
- Health Promotion Policy Research Center, International Health Policy Program, Nonthaburi, Thailand.,Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Charles D H Parry
- Public Health, Research, Education and External Affairs Department, National Alcohol, Tobacco and Other Drug Research Unit, Medical Research Council, Pretoria, South Africa.,Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Pham Viet Cuong
- Center for Injury Policy and Prevention Research, Hanoi University of Public Health, Hanoi, Vietnam
| | - Gaile Gray-Phillip
- National Council on Drug Abuse Prevention, Basseterre, St Kitts and Nevis
| | - Marina Piazza
- National Institute of Health, Universidad Peruana Cayetano Heredia, Lima, Peru
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13
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Viet Cuong P, Casswell S, Parker K, Callinan S, Chaiyasong S, Kazantseva E, Meier P, MacKintosh AM, Piazza M, Gray-Phillip G, Parry CDH. Cross-country comparison of proportion of alcohol consumed in harmful drinking occasions using the International Alcohol Control Study. Drug Alcohol Rev 2018; 37 Suppl 2:S45-S52. [PMID: 29441632 PMCID: PMC6120468 DOI: 10.1111/dar.12665] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/20/2017] [Accepted: 01/04/2018] [Indexed: 01/06/2023]
Abstract
INTRODUCTION AND AIMS This study examines the proportion of alcohol markets consumed in harmful drinking occasions in a range of high-, middle-income countries and assesses the implications of these findings for conflict of interest between alcohol producers and public health and the appropriate role of the alcohol industry in alcohol policy space. DESIGN AND METHODS Cross-sectional surveys were conducted in 10 countries as part of the International Alcohol Control study. Alcohol consumption was measured using location- and beverage-specific measures. A level of consumption defined as harmful use of alcohol was chosen and the proportion of the total market consumed in these drinking occasions was calculated for both commercial and informal alcohol. RESULTS In all countries, sizeable proportions of the alcohol market were consumed during harmful drinking occasions. In general, a higher proportion of alcohol was consumed in harmful drinking occasions by respondents in the middle-income countries than respondents in the high-income countries. The proportion of informal alcohol consumed in harmful drinking occasions was lower than commercial alcohol. DISCUSSION AND CONCLUSIONS Informal alcohol is less likely to be consumed in harmful drinking occasions compared with commercial alcohol. The proportion of commercial alcohol consumed in harmful drinking occasions in a range of alcohol markets shows the reliance of the transnational alcohol corporations on harmful alcohol use. This reliance underpins industry lobbying against effective policy and support for ineffective approaches. The conflict of interest between the alcohol industry and public health requires their exclusion from the alcohol policy space.
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Affiliation(s)
- Pham Viet Cuong
- Center for Injury Policy and Prevention Research, Hanoi University of Public Health, Hanoi, Vietnam
| | - Sally Casswell
- SHORE and Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Karl Parker
- SHORE and Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Sarah Callinan
- Centre for Alcohol Policy Research, Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Surasak Chaiyasong
- Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Health Promotion Policy Research Center, International Health Policy Program, Ministry of Public Health, Mahasarakham, Thailand
| | - Elena Kazantseva
- Public Health, Research, Education and External Affairs Department, National Center of Mental Health of Mongolia, Ulaanbaatar, Mongolia
| | - Petra Meier
- Sheffield Alcohol Research Group, School of Health and Related Research, Sheffield University, Sheffield, UK
| | | | | | - Gaile Gray-Phillip
- National Council on Drug Abuse Prevention, Basseterre, Saint Kitts and Nevis
| | - Charles D H Parry
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa.,Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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14
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Casswell S, Morojele N, Williams PP, Chaiyasong S, Gordon R, Gray-Phillip G, Viet Cuong P, MacKintosh AM, Halliday S, Railton R, Randerson S, Parry CDH. The Alcohol Environment Protocol: A new tool for alcohol policy. Drug Alcohol Rev 2018; 37 Suppl 2:S18-S26. [PMID: 29314356 PMCID: PMC6208285 DOI: 10.1111/dar.12654] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/25/2017] [Accepted: 12/05/2017] [Indexed: 11/30/2022]
Abstract
Introduction and Aim To report data on the implementation of alcohol policies regarding availability and marketing, and drink driving, along with ratings of enforcement from two small high‐income to three high‐middle income countries, and one low‐middle income country. Method This study uses the Alcohol Environment Protocol, an International Alcohol Control study research tool, which documents the alcohol policy environment by standardised collection of data from administrative sources, observational studies and interviews with key informants to allow for cross‐country comparison and change over time. Results All countries showed adoption to varying extents of key effective policy approaches outlined in the World Health Organization Global Strategy to Reduce the Harmful Use of Alcohol (2010). High‐income countries were more likely to allocate resources to enforcement. However, where enforcement and implementation were high, policy on availability was fairly liberal. Key Informants judged alcohol to be very available in both high‐ and middle‐income countries, reflecting liberal policy in the former and less implementation and enforcement and informal (unlicensed) sale of alcohol in the latter. Marketing was largely unrestricted in all countries and while drink‐driving legislation was in place, it was less well enforced in middle‐income countries. Conclusion In countries with fewer resources, alcohol policies are less effective because of lack of implementation and enforcement and, in the case of marketing, lack of regulation. This has implications for the increase in consumption taking place as a result of the expanding distribution and marketing of commercial alcohol and consequent increases in alcohol‐related harm.
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Affiliation(s)
- Sally Casswell
- SHORE & Whariki Research Centre, Massey University, Auckland, New Zealand.,UK Centre for Tobacco & Alcohol Studies, Nottingham, UK
| | - Neo Morojele
- Alcohol, Tobacco and Other Drug Research Unit, Medical Research Council, Pretoria, South Africa
| | - Petal Petersen Williams
- Alcohol, Tobacco and Other Drug Research Unit, Medical Research Council, Pretoria, South Africa.,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Surasak Chaiyasong
- Health Promotion Policy Research Center, International Health Policy Program, Nonthaburi, Thailand.,Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Maha Sarakham, Thailand
| | - Ross Gordon
- Department of Marketing and Management, Faculty of Business and Economics, Macquarie University, Sydney, Australia
| | - Gaile Gray-Phillip
- St. Kitts-Nevis National Council on Drug Abuse Prevention Secretariat, Basseterre, St. Kitts and Nevis
| | | | | | - Sharon Halliday
- St. Kitts-Nevis National Council on Drug Abuse Prevention Secretariat, Basseterre, St. Kitts and Nevis.,RAPHA Healthcare Services North Carolina, Durham, USA
| | - Renee Railton
- SHORE & Whariki Research Centre, Massey University, Auckland, New Zealand
| | - Steve Randerson
- SHORE & Whariki Research Centre, Massey University, Auckland, New Zealand
| | - Charles D H Parry
- Alcohol, Tobacco and Other Drug Research Unit, Medical Research Council, Pretoria, South Africa.,Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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15
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Huckle T, Casswell S, Mackintosh AM, Chaiyasong S, Viet Cuong P, Morojele N, Parry CDH, Meier P, Holmes J, Callinan S, Piazza M, Kazantseva E, Bayandorj T, Gray-Phillip G, Haliday S, Chun S, Welch M, Graydon-Guy T, Parker K. The International Alcohol Control Study: Methodology and implementation. Drug Alcohol Rev 2018; 37 Suppl 2:S10-S17. [PMID: 29292547 PMCID: PMC6120466 DOI: 10.1111/dar.12650] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 11/29/2017] [Accepted: 12/02/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION AND AIMS The International Alcohol Control (IAC) Study is a multi-country collaborative project to assess patterns of alcohol consumption and the impact of alcohol control policy. The aim of this paper is to report the methods and implementation of the IAC. DESIGN AND METHODS The IAC has been implemented among drinkers 16-65 years in high- and middle-income countries: Australia, England, Scotland, New Zealand, St Kitts and Nevis, Thailand, South Africa, Peru, Mongolia and Vietnam (the latter four samples were sub-national). Two research instruments were used: the IAC survey of drinkers and the Alcohol Environmental Protocol (a protocol for policy analysis). The survey was administered via computer-assisted interview and the Alcohol Environmental Protocol data were collected via document review, administrative or commercial data and key informant interviews. RESULTS The IAC instruments were readily adapted for cross-country use. The IAC methodology has provided cross-country survey data on key measures of alcohol consumption (quantity, frequency and volume), aspects of policy relevant behaviour and policy implementation: availability, price, purchasing, marketing and drink driving. The median response rate for all countries was 60% (range 16% to 99%). Where data on alcohol available for consumption were available the validity of survey consumption measures were assessed by calculating survey coverage found to be 86% or above. Differential response bias was handled, to the extent it could be, using post-stratification weights. DISCUSSION AND CONCLUSIONS The IAC study will allow for cross-country analysis of drinking patterns, the relationship between alcohol use and policy relevant behaviour in different countries.
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Affiliation(s)
- Taisia Huckle
- Massey University, SHORE & Whariki Research Centre, Auckland, New Zealand
| | - Sally Casswell
- Massey University, SHORE & Whariki Research Centre, Auckland, New Zealand
| | | | - Surasak Chaiyasong
- Health Promotion Policy Research Center, International Health Policy Program, Thailand.,Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Talat, Thailand
| | - Pham Viet Cuong
- Center for Injury Policy and Prevention Research, Hanoi University of Public Health, Hanoi, Vietnam
| | - Neo Morojele
- Alcohol, Tobacco and Other Drug Research Unit, Medical Research Council, Pretoria, South Africa.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Charles D H Parry
- Alcohol, Tobacco and Other Drug Research Unit, Medical Research Council, Pretoria, South Africa.,Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Petra Meier
- Sheffield Alcohol Research Group, School of Health and Related Research, University Sheffield, Sheffield, UK
| | - John Holmes
- Sheffield Alcohol Research Group, School of Health and Related Research, University Sheffield, Sheffield, UK
| | - Sarah Callinan
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | | | - Elena Kazantseva
- Public Health, Research, Education and External Affairs Department, National Center of Mental Health of Mongolia, Ulaanbaatar, Mongolia
| | - Tsogzolmaa Bayandorj
- Public Health, Research, Education and External Affairs Department, National Center of Mental Health of Mongolia, Ulaanbaatar, Mongolia
| | - Gaile Gray-Phillip
- St Kitts-Nevis National Council on Drug Abuse Prevention Secretariat, Basseterre, Saint Kitts and Nevis
| | | | | | | | - Thomas Graydon-Guy
- Massey University, SHORE & Whariki Research Centre, Auckland, New Zealand
| | - Karl Parker
- Massey University, SHORE & Whariki Research Centre, Auckland, New Zealand
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16
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Amista NF, Chun S, Yun M. Relationship between Alcohol Purchasing Time and Alcohol Use Disorder in South Korea. Osong Public Health Res Perspect 2017; 8:405-414. [PMID: 29354399 PMCID: PMC5749488 DOI: 10.24171/j.phrp.2017.8.6.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 09/03/2017] [Accepted: 11/27/2017] [Indexed: 11/05/2022] Open
Abstract
Objectives Currently, time of alcohol purchase is not part of the policies to regulate alcohol consumption in South Korea. This study was conducted to determine the relationship between alcohol purchasing time and alcohol use disorder. Methods The survey for this study was conducted in geographically diverse regions of South Korea in 2012. Respondents’ purchasing behaviors for both on-licensed (i.e., allows for consumption within the premises) and off-licensed (i.e., where alcohol is consumed off the premises) outlets and time of alcohol consumption were collected. Alcohol consumption patterns were examined using the Rapid Alcohol Problem Screen 4 (RAPS4). Data were also analyzed by age, gender and purchasing time. Results Results showed that among the off-licensed premises, supermarkets appear to be the most popular venue while for on-licensed premises; alcohol was generally consumed inside hotels/pubs regardless of age and gender of the purchaser. Purchasing of alcohol was highest during the day and early evening period (9:00 a.m. to 9:59 p.m.). Females are most likely to abuse alcohol than males during the early morning period and is that period after 12:00 midnight. Conclusion Analysis suggests that the survey instrument used in the International Alcohol Control Study is being used to collect data on alcohol purchasing time consumption; therefore, the potential is there to provide accurate results to contribute appropriate policy responses to reduce alcohol related-harm.
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Affiliation(s)
- Narcie Faith Amista
- Department of Health-Bio Convergence, Graduate School, Sahmyook University, Seoul, Korea.,Korean Institute on Alcohol Problems, Sahmyook University, Seoul, Korea
| | - Sungsoo Chun
- Department of Health-Bio Convergence, Graduate School, Sahmyook University, Seoul, Korea.,Korean Institute on Alcohol Problems, Sahmyook University, Seoul, Korea
| | - Mieun Yun
- Korean Institute on Alcohol Problems, Sahmyook University, Seoul, Korea.,Department of Food and Nutrition, Sahmyook University, Seoul, Korea
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17
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Wall M, Casswell S, Callinan S, Chaiyasong S, Viet Cuong P, Gray-Phillip G, Parry CDH. Alcohol taxes' contribution to prices in high and middle-income countries: Data from the International Alcohol Control Study. Drug Alcohol Rev 2017; 37 Suppl 2:S27-S35. [PMID: 29168256 PMCID: PMC6120534 DOI: 10.1111/dar.12638] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 12/02/2022]
Abstract
Introduction Taxation is increasingly being used as an effective means of influencing behaviour in relation to harmful products. In this paper we use data from six participating countries of the International Alcohol Control Study to examine and evaluate their comparative prices and tax regimes. Methods We calculate taxes and prices for three high‐income and three middle‐income countries. The data are drawn from the International Alcohol Control survey and from the Alcohol Environment Protocol. Tax systems are described and then the rates of tax on key products presented. Comparisons are made using the Purchasing Power Parity rates. The price and purchase data from each country's International Alcohol Control survey is then used to calculate the mean percentage of retail price paid in tax weighted by actual consumption. Results Both ad valorem and specific per unit of alcohol taxation systems are represented among the six countries. The prices differ widely between countries even though presented in terms of Purchasing Power Parity. The percentage of tax in the final price also varies widely but is much lower than the 75% set by the World Health Organization as a goal for tobacco tax. Conclusion There is considerable variation in tax systems and prices across countries. There is scope to increase taxation and this analysis provides comparable data, including the percentage of tax in final price, from some middle and high‐income countries for consideration in policy discussion.
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Affiliation(s)
- Martin Wall
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Sally Casswell
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Sarah Callinan
- Centre for Alcohol Policy Research, Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Surasak Chaiyasong
- Health Promotion Policy Research Centre, International Health Policy Program, Ministry of Public Health & Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Pham Viet Cuong
- Centre for Injury Policy and Prevention Research, Hanoi School of Public Health, Hanoi, Vietnam
| | - Gaile Gray-Phillip
- National Council on Drug Abuse Prevention, Basseterre, Saint Kitts and Nevis
| | - Charles D H Parry
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa.,South Africa and Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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18
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Wall M, Casswell S. Drinker Types, Harm, and Policy-Related Variables: Results from the 2011 International Alcohol Control Study in New Zealand. Alcohol Clin Exp Res 2017; 41:1044-1053. [PMID: 28372021 DOI: 10.1111/acer.13372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/06/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND The aim was to identify a typology of drinkers in New Zealand based on alcohol consumption, beverage choice, and public versus private drinking locations and investigate the relationship between drinker types, harms experienced, and policy-related variables. METHODS Model-based cluster analysis of male and female drinkers including volumes of alcohol consumed in the form of beer, wine, spirits, and ready-to-drinks (RTDs) in off- and on-premise settings. Cluster membership was then related to harm measures: alcohol dependence, self-rated health; and to 3 policy-relevant variables: liking for alcohol adverts, price paid for alcohol, and time of purchase. RESULTS Males and females were analyzed separately. Men fell into 4 and women into 14 clearly discriminated clusters. The male clusters consumed a relatively high proportion of alcohol in the form of beer. Women had a number of small extreme clusters and some consumed mainly spirits-based RTDs, while others drank mainly wine. Those in the higher consuming clusters were more likely to have signs of alcohol dependency, to report lower satisfaction with their health, to like alcohol ads, and to have purchased late at night. CONCLUSIONS Consumption patterns are sufficiently distinctive to identify typologies of male and female alcohol consumers. Women drinkers are more heterogeneous than men. The clusters relate differently to policy-related variables.
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Affiliation(s)
- Martin Wall
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Sally Casswell
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
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19
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Wall M, Casswell S, Yeh LC. Purchases by heavier drinking young people concentrated in lower priced beverages: Implications for policy. Drug Alcohol Rev 2017; 36:352-358. [PMID: 28294436 DOI: 10.1111/dar.12495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 08/24/2016] [Accepted: 08/25/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS Alcohol is an increasingly important risk factor in the global burden of disease. The acute harms experienced and persistence of drinking patterns established in adolescence motivate investigating influences on youth drinking. The aim is to examine association between heavier drinking in young people and their choice of beverage type, purchase outlet and price. DESIGN AND METHODS A nationally representative sample of New Zealand drinkers (N = 1056) aged 16-19 years recruited using random digit dialling was surveyed in 2012 as part of the International Alcohol Control study. Typical quantities consumed and frequency of alcohol consumption categorised respondents into lower, medium and heavier consumption groups. Beverage choice, prices paid and on or off-premise purchase were related to consumption using univariate analysis. Logistic analysis was used to examine multivariate factors predicting membership of consumption groups. RESULTS Twenty percent of the sample consumed six or more drinks at least once a week, increasing to 1 in 4 for those 18 years and older. Heavier drinkers consumed more alcohol in the form of ready to drinks (RTD) especially high-potency RTDs. Lower consumers drank greater proportion of wine. Heavier drinkers paid less than medium consumers who paid less than lower consumers. High-potency RTDs were cheaper per unit of alcohol than other beverages and chosen by heavier drinkers resulting in lower prices. DISCUSSION AND CONCLUSIONS Heavy consumption of alcohol remains common in New Zealand young drinkers. Heavier drinkers paid less to purchase alcohol and consumed more alcohol in the form of high-potency RTDs. [Wall M, Casswell S, Yeh L-C. Purchases by heavier drinking young people concentrated in lower priced beverages: Implications for policy. Drug Alcohol Rev 2017;36:352-358].
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Affiliation(s)
- Martin Wall
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Sally Casswell
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Li-Chia Yeh
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
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Casswell S, Huckle T, Wall M, Parker K. Policy-Relevant Behaviors Predict Heavier Drinking in Both On and Off Premises and Mediate the Relationship Between Heavier Alcohol Consumption and Age, Gender, and Socioeconomic Status-Analysis from the International Alcohol Control Study. Alcohol Clin Exp Res 2016; 40:385-92. [PMID: 26842257 DOI: 10.1111/acer.12947] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/23/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Our goal was to investigate the role of behaviors amenable to policy change in mediating the relationship between alcohol consumption in off and on premises, age, and 2 measures of socioeconomic status (education and income). METHODS A cross-sectional general population survey was analyzed by using Bayesian path analysis to understand direct and mediating pathways. A total of 1,900 drinkers (past 6 months), aged 18 to 65 years, living in households with landline phones participated in the study. Measures were as follows: typical quantities of alcohol consumed per occasion, frequency of drinking, both off and on premise; gender, age groups; and years of education, personal income, prices paid, time of purchase, and liking for alcohol advertisements. RESULTS Later times of purchase predicted larger quantities consumed (on and off premise) and more frequent drinking (on premise only). Younger people and males purchased later, and this mediated their heavier consumption. Lower prices paid predicted larger quantities consumed (on premise) and higher frequency of drinking (off premise). Younger and male respondents paid lower prices, and this mediated larger quantities consumed on premise and more frequent drinking off premise. Less well educated paid lower prices, and this mediated drinking more frequently off premise among this group. Liking for alcohol ads predicted drinking larger quantities and higher frequency both off and on premise. Younger and male respondents reported greater liking for ads, and this mediated their consumption of larger quantities and more frequent drinking both on and off premise. Those with higher income drank larger amounts on premise and more frequently on and off, but there were no mediating effects from the policy-relevant variables. CONCLUSIONS Heavier drinking patterns by young people and those less well educated could be ameliorated by attention to alcohol policy.
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Affiliation(s)
- Sally Casswell
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Taisia Huckle
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Martin Wall
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Karl Parker
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
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Casswell S, Callinan S, Chaiyasong S, Cuong PV, Kazantseva E, Bayandorj T, Huckle T, Parker K, Railton R, Wall M. How the alcohol industry relies on harmful use of alcohol and works to protect its profits. Drug Alcohol Rev 2016; 35:661-664. [DOI: 10.1111/dar.12460] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/28/2016] [Accepted: 07/01/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Sally Casswell
- SHORE and Whariki Research Centre; College of Health, Massey University; Auckland New Zealand
| | - Sarah Callinan
- Centre for Alcohol Policy Research, Department of Public Health, School of Psychology and Public Health; La Trobe University; Melbourne Australia
| | - Surasak Chaiyasong
- Social Pharmacy Research Unit, Faculty of Pharmacy; Mahasarakham University, Health Promotion Policy Research Center, International Health Policy Program, Ministry of Public Health; Thailand
| | - Pham Viet Cuong
- Center for Injury Policy and Prevention Research; Hanoi School of Public Health; Hanoi Vietnam
| | - Elena Kazantseva
- Public Health, Research, Education and External Affairs Department; National Center of Mental Health of Mongolia; Ulaanbaatar Mongolia
| | - Tsogzolmaa Bayandorj
- Public Health, Research, Education and External Affairs Department; National Center of Mental Health of Mongolia; Ulaanbaatar Mongolia
| | - Taisia Huckle
- SHORE and Whariki Research Centre; College of Health, Massey University; Auckland New Zealand
| | - Karl Parker
- SHORE and Whariki Research Centre; College of Health, Massey University; Auckland New Zealand
| | - Renee Railton
- SHORE and Whariki Research Centre; College of Health, Massey University; Auckland New Zealand
| | - Martin Wall
- SHORE and Whariki Research Centre; College of Health, Massey University; Auckland New Zealand
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Gill JS, Rush R, Black H, O'May FP, Chick J, Rees C, McPake B. The enigma of 'harmful' alcohol consumption: evidence from a mixed methods study involving female drinkers in Scotland. Perspect Public Health 2015; 136:34-42. [PMID: 26420581 DOI: 10.1177/1757913915603039] [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: 11/15/2022]
Abstract
BACKGROUND/AIMS An appreciation of the drinking patterns of population subgroups may usefully inform tailored interventions. For this purpose, research has highlighted a need to better describe the drinking behaviour of UK women. This study aims to characterise the purchasing and consumption behaviour of female heavy, harmed, drinkers in contact with Scottish health services in two cities and to explore the factors that influence the link to harm. METHODS Mixed methods study involving cross-sectional survey questionnaires and one-to-one interviews (5). The questionnaires documented (1) demographic data (including derived deprivation score), last week's (or 'typical' weekly) consumption (type, brand, volume, price, place of purchase), self-reported illnesses, and (2) Alcohol-Related Problem Questionnaire score. A total of 181 patients with serious health problems linked to alcohol were recruited within National Health Service (NHS) hospital clinics (in- and outpatient settings), in two Scottish cities during 2012. RESULTS Median consumption was 157.6 UK units for the recorded week, with almost exclusive purchase from 'off-sale' retail outlets. Preferred drinks were white cider, vodka and white wine. Increasing problems was positively associated with drinking more in the week, being younger and belonging to Glasgow. CONCLUSION For Scottish women, the current definition of 'harmful' consumption likely captures a fourfold variation in alcohol intake, with gender differences less apparent. While current alcohol-related harm is positively associated with dose and being younger, there is clear evidence of an influence of the less tangible 'Glasgow effect'. Future harm concerns are warranted by data relating to pattern, alcohol dose and cigarette use.
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Affiliation(s)
- Jan S Gill
- School of Nursing, Midwifery & Social Care, Edinburgh Napier University, UK
| | - Robert Rush
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Heather Black
- School of Nursing, Midwifery & Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK
| | - Fiona P O'May
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Jonathan Chick
- School of Nursing, Midwifery & Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK
| | - Cheryl Rees
- Division of Nursing, School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Barbara McPake
- Institute for International Health and Development, School of Health Sciences, Queen Margaret University, Edinburgh, UKThe Nossal Institute for Global Health, The University of Melbourne, Carlton, VIC, Australia
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