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Morris D, Angus C, Gillespie D, Stevely AK, Pryce R, Wilson L, Henney M, Meier PS, Holmes J, Brennan A. Estimating the effect of transitioning to a strength-based alcohol tax system on alcohol consumption and health outcomes: a modelling study of tax reform in England. Lancet Public Health 2024:S2468-2667(24)00191-9. [PMID: 39299247 DOI: 10.1016/s2468-2667(24)00191-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 08/05/2024] [Accepted: 08/06/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Increasing the amount of alcohol taxation is among the most effective measures for addressing the rising global burden of alcohol harm. However, less is known about the effect of changing alcohol tax structures. Substantial reforms to UK alcohol taxation structures enacted in August, 2023, mean that all alcohol is taxed based on its ethanol content, beers and ciders sold in on-trade premises (eg, public houses) are taxed at a reduced rate (hereafter called draught relief), and beer and particularly cider remain taxed at lower rates than other alcohol of equivalent strength. We aimed to model the effect of these reforms on alcohol consumption and health and economic outcomes, and the effects of hypothetical alternative scenarios. METHODS The Sheffield Tobacco and Alcohol Policy Model was used to estimate policy effects on alcohol consumption. The model is an individual-based microsimulation that uses data from the Health Survey for England, Living Costs and Food Survey, Hospital Episode Statistics, and the Office for National Statistics. Spending and revenues to retailers and the Government were estimated cumulatively for a 5-year period post-intervention. Policy effects on all-cause deaths, years of life lost, hospital admissions, and admissions costs were estimated cumulatively for a 20-year period post-intervention. FINDINGS The reform was estimated to decrease mean weekly alcohol consumption per drinker by less than 0·05 (-0·34%) units (1 unit=8 g/10 mL ethanol), and prevent 2307 deaths and 11 510 hospital admissions during 20 years compared with no policy change. Removing draught relief was estimated to prevent 1441 further deaths and 14 247 further admissions. Hypothetical scenarios showed that removing draught relief would only slightly improve public health outcomes, and increasing tax rates for beer and ciders to match other drinks of equivalent strength would reduce consumption by a further 2·5 units per week (-17%) and deaths by approximately 74 465. INTERPRETATION Alcohol tax structures based on alcohol strength enable tax policy to improve public health in a targeted way. However, the UK reforms are unlikely to substantially improve health outcomes as they do not raise taxes overall. Raising tax rates for the lowest taxed beer and ciders, which are favoured by those who consume harmful amounts of alcohol, could achieve substantially greater public health benefits and reduce health inequalities. FUNDING National Institute for Health and Care Research and UK Prevention Research Partnership.
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Affiliation(s)
- Damon Morris
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK; SPECTRUM Consortium, Edinburgh, UK.
| | - Colin Angus
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK; SPECTRUM Consortium, Edinburgh, UK
| | - Duncan Gillespie
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK; SPECTRUM Consortium, Edinburgh, UK
| | - Abigail K Stevely
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Robert Pryce
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Luke Wilson
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Madeleine Henney
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Petra S Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - John Holmes
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK; SPECTRUM Consortium, Edinburgh, UK
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Taylor N, Livingston M. The market matters: Shifting the minimum unit price. Drug Alcohol Rev 2024; 43:1331-1333. [PMID: 38741360 DOI: 10.1111/dar.13866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/05/2024] [Accepted: 04/30/2024] [Indexed: 05/16/2024]
Affiliation(s)
- Nicholas Taylor
- National Drug Research Institute, Curtin University, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
- School of Psychology, Deakin University, Geelong, Australia
| | - Michael Livingston
- National Drug Research Institute, Curtin University, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
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Davies T, O'Brien P, Bowden J, Petticrew M, Pettigrew S. The prevalence and magnitude of price promotions in online alcohol retail outlets. Drug Alcohol Rev 2024. [PMID: 39169526 DOI: 10.1111/dar.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 05/05/2024] [Accepted: 08/07/2024] [Indexed: 08/23/2024]
Abstract
INTRODUCTION We examined the prevalence of price promotions (i.e., proportion of products on price promotion) and the magnitude of price promotions (i.e., size of the price discount compared to the regular price) among online alcohol retailers. METHODS In August 2023, we web-scraped product information for all alcoholic beverages available for sale in the online stores of two leading alcohol retailers in Sydney, Australia. Products were classified into five primary alcohol categories: wine, spirits, beer, cider and premix drinks. We considered three types of price promotion: temporary price discounts (e.g., 'was $5 now $4'), multi-buy discounts (e.g., buy one get one free) and 'any six' discounts (e.g., 5% off when purchased in a bundle of any six similar products). The prevalence and mean magnitude of price promotions were estimated overall and by product category and price promotion type. RESULTS In total, data for 11,184 products were collected. Of these, 62% were the subject of at least one of the assessed forms of price promotion. The most frequently price-promoted category was wine (91% of products), followed by spirits (35%), premix drinks (30%), cider (28%) and beer (21%). Of all price promotions, 61% were 'any six' discounts, 31% were temporary price discounts, and 7% were multi-buy discounts. Across all price promotions, the mean magnitude of price discount relative to the regular price was 11% and ranged from less than 1% to 71%. DISCUSSION AND CONCLUSIONS Policymakers should consider restricting price promotions as part of a suite of strategies to reduce alcohol-related harms.
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Affiliation(s)
- Tazman Davies
- Faculty of Medicine, UNSW Sydney, The George Institute for Global Health, Sydney, Australia
| | - Paula O'Brien
- Melbourne Law School, University of Melbourne, Melbourne, Australia
| | - Jacqueline Bowden
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Mark Petticrew
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Simone Pettigrew
- Faculty of Medicine, UNSW Sydney, The George Institute for Global Health, Sydney, Australia
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Marzan MB, Callinan S, Livingston M, Jiang H. Modelling the impacts of volumetric and minimum unit pricing for alcohol on social harms in Australia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 129:104502. [PMID: 38943908 DOI: 10.1016/j.drugpo.2024.104502] [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: 02/02/2024] [Revised: 05/12/2024] [Accepted: 06/09/2024] [Indexed: 07/01/2024]
Abstract
AIMS Alcohol pricing policies may reduce alcohol-related harms, yet little work has been done to model their effectiveness beyond health outcomes especially in Australia. We aim to estimate the impacts of four taxation and minimum unit pricing (MUP) interventions on selected social harms across sex and age subgroups in Australia. METHODS We used econometrics and epidemiologic simulations using demand elasticity and risk measures. We modelled four policies including (A) uniform excise rates (UER) (based on alcohol units) (B) MUP $1.30 on all alcoholic beverages (C) UER + 10 % (D) MUP$ 1.50. People who consumed alcohol were classified as (a) moderate (≤ 14 Australian standard drinks (SDs) per week) (b) Hazardous (15-42 SDs per week for men and 14-35 ASDs for women) and (c) Harmful (> 42 SDs per week for men and > 35 ASDs for women). Outcomes were sickness absence, sickness presenteeism, unemployment, antisocial behaviours, and police-reported crimes. We used relative risk functions from meta-analysis, cohort study, cross-sectional survey, or attributable fractions from routine criminal records. We applied the potential impact fraction to estimate the reduction in social harms by age group and sex after implementation of pricing policies. RESULTS All four modelled pricing policies resulted in a decrease in the overall mean baseline of current alcohol consumption, primarily due to fewer people drinking harmful amounts. These policies also reduced the total number of crimes and workplace harms compared to the current taxation system. These reductions were consistent across all age and sex subgroups. Specifically, sickness absence decreased by 0.2-0.4 %, alcohol-related sickness presenteeism by 7-9 %, unemployment by 0.5-0.7 %, alcohol-related antisocial behaviours by 7.3-11.1 %, and crimes by 4-6 %. Of all the policies, the implementation of a $1.50 MUP resulted in the largest reductions across most outcome measures. CONCLUSION Our results highlight that alcohol pricing policies can address the burden of social harms in Australia. However, pricing policies should just form part of a comprehensive alcohol policy approach along with other proven policy measures such as bans on aggressive marketing of alcoholic products and enforcing the restrictions on the availability of alcohol through outlet density regulation or reduced hours of sale to have a more impact on social harms.
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Affiliation(s)
- Melvin Barrientos Marzan
- Department of Obstetrics and Gynaecology and Newborn Health, Melbourne Medical School, University of Melbourne, Melbourne, Australia.
| | - Sarah Callinan
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Australia; National Drug Research Institute, Curtin University, Perth, Australia; Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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Kudła J, Podsiadło A, Woźniak R. The effectiveness of regulations preventing alcohol-related road traffic crashes and fatalities in the European Union countries. JOURNAL OF SAFETY RESEARCH 2024; 88:161-173. [PMID: 38485359 DOI: 10.1016/j.jsr.2023.11.003] [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: 03/31/2023] [Revised: 08/05/2023] [Accepted: 11/07/2023] [Indexed: 03/19/2024]
Abstract
INTRODUCTION This article addresses the impact of policy measures on the number of alcohol-related crashes and fatalities in European Union countries. In particular, it assesses (1) whether mild or severe penalty measures should be used to reduce the number of crashes and fatalities caused by alcohol; and (2) whether alcoholic beverages should be treated differently or proportionally to their alcohol content. METHODS This study analyzed the number of alcohol-related crashes and fatalities in 24 European Union countries between 2002 and 2014. The methodology involved fixed-effects panel models, models with instrumental variables, the Hausman-Taylor model, and seemingly unrelated regressions (SUR). SUR improve the results of coefficient estimates when the data are not complete. RESULTS The results of the SUR indicated that vehicle impoundment, community service, and alcolocks correlate with lower crashes, while detention correlates with lower fatalities. Furthermore, a higher alcohol content in beverages is positively associated with fatalities and negatively associated with the number of crashes. CONCLUSIONS Mild and harsh measures for preventing alcohol-related crashes and fatalities differ in effectiveness; therefore, they should be used simultaneously. Blood alcohol concentration limits were found to be an ineffective tool for preventing crashes and fatalities under the influence of alcohol. PRACTICAL IMPLICATIONS The regulatory restrictions on different types of alcohol should be stricter for hard alcohol (especially spirits) and lower for low-alcohol beverages, such as beer, if fewer fatalities are preferred to fewer crashes.
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Emslie C, Dimova E, O'Brien R, Whiteford M, Johnsen S, Rush R, Smith ID, Stockwell T, Whittaker A, Elliott L. The impact of alcohol minimum unit pricing on people with experience of homelessness: Qualitative study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 118:104095. [PMID: 37307788 DOI: 10.1016/j.drugpo.2023.104095] [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: 03/21/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Alcohol Minimum Unit Pricing (MUP) was introduced in Scotland in May 2018. Existing evidence suggests MUP can reduce alcohol consumption in the general population, but there is little research about its impact on vulnerable groups. This qualitative study explored experiences of MUP among people with experience of homelessness. METHODS We conducted qualitative semi-structured interviews with a purposive sample of 46 people with current or recent experience of homelessness who were current drinkers when MUP was introduced. Participants (30 men and 16 women) were aged 21 to 73 years. Interviews focused on views and experiences of MUP. Data were analysed using thematic analysis. RESULTS People with experience of homelessness were aware of MUP but it was accorded low priority in their hierarchy of concerns. Reported impacts varied. Some participants reduced their drinking, or moved away from drinking strong white cider, in line with policy intentions. Others were unaffected because the cost of their preferred drink (usually wine, vodka or beer) did not change substantially. A minority reported increased involvement in begging. Wider personal, relational and social factors also played an important role in responses to MUP. CONCLUSION This is the first qualitative study to provide a detailed exploration of the impact of MUP among people with experience of homelessness. Our findings suggest that MUP worked as intended for some people with experience of homelessness, while a minority reported negative consequences. Our findings are of international significance to policymakers, emphasising the need to consider the impact of population level health policies on marginalised groups and the wider contextual factors that affect responses to policies within these groups. It is important to invest further in secure housing and appropriate support services and to implement and evaluate harm reduction initiatives such as managed alcohol programmes.
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Affiliation(s)
- Carol Emslie
- Research Centre for Health (ReaCH), Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK.
| | - Elena Dimova
- Research Centre for Health (ReaCH), Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Rosaleen O'Brien
- Research Centre for Health (ReaCH), Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Martin Whiteford
- Research Centre for Health (ReaCH), Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Sarah Johnsen
- Institute for Social Policy, Housing and Equalities Research (I-SPHERE), Heriot-Watt University, Riccarton, Edinburgh, EH14 4AS, Scotland, UK
| | - Robert Rush
- Independent consultant, 16a Denham Green Terrace, Edinburgh, EH5 3PF, Scotland, UK
| | - Iain D Smith
- Substance Use Service, St Ninians Community Hub, Mayfield Street, Stirling, FK7 0BS, Scotland, UK
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Box 1700 STN CSC, Victoria, BC, Canada
| | - Anne Whittaker
- NMAHP Research Unit, Faculty of Health Sciences and Sport, Pathfoot Building, University of Stirling, FK9 4LA, Scotland, UK
| | - Lawrie Elliott
- Research Centre for Health (ReaCH), Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
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Jiang H, Room R. Commentary on Brennan et al.: Pros and cons of minimum unit price for alcohol. Addiction 2023; 118:834-835. [PMID: 36859757 PMCID: PMC10952525 DOI: 10.1111/add.16165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 02/08/2023] [Indexed: 03/03/2023]
Affiliation(s)
- Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
- Department of Public Health, School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
- Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
| | - Robin Room
- Centre for Alcohol Policy Research, School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health SciencesStockholm UniversityStockholmSweden
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Taylor N, Miller P, Coomber K, Livingston M, Jiang H, Buykx P, Scott D, Baldwin R, Chikritzhs T. Estimating the impact of the minimum alcohol price on consumers' alcohol expenditure in the Northern Territory, Australia. Aust N Z J Public Health 2023:100053. [PMID: 37202337 DOI: 10.1016/j.anzjph.2023.100053] [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: 03/02/2023] [Accepted: 03/15/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVE From October 2018, the Northern Territory (NT) government introduced a minimum unit price (MUP) for alcohol of $1.30 per standard drink. We assessed industry claims that the MUP penalised all drinkers by examining the alcohol expenditure of drinkers not targeted by the policy. METHODS Participants recruited by a market research company using phone sampling (n=766, 15% consent fraction) completed a survey in 2019, post-MUP. Participants reported their drinking patterns and their preferred liquor brand. Estimated annual alcohol expenditure for each participant was calculated by collating the cheapest advertised price per standard drink of their preferred brand pre-and-post-MUP. Participants were grouped as consuming within the Australian drinking guidelines ("moderate") or over them ("heavy"). RESULTS Based on post-MUP drinking patterns, moderate consumers had an average annual alcohol expenditure of AU$327.66 (CIs=325.61, 329.71) pre-MUP, which increased by AU$3.07 (0.94%) post-MUP. Heavy consumers had an estimated average annual alcohol expenditure of AU$2898.82 (CIs=2877.06, 2920.58) pre-MUP, which increased by AU$37.12 (1.28%). CONCLUSIONS The MUP policy was associated with an increase of AU$3.07 in alcohol annual expenditure for moderate consumers. IMPLICATIONS FOR PUBLIC HEALTH This article provides evidence that counters the alcohol industry's messaging, enabling an evidence-based discussion in an area dominated by vested interest.
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Affiliation(s)
- Nicholas Taylor
- National Drug Research Institute, Curtin University, Melbourne, Australia; School of Psychology, Deakin University, Waterfront Campus, Geelong, Australia.
| | - Peter Miller
- School of Psychology, Deakin University, Waterfront Campus, Geelong, Australia
| | - Kerri Coomber
- School of Psychology, Deakin University, Waterfront Campus, Geelong, Australia
| | - Michael Livingston
- National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Heng Jiang
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Penny Buykx
- The University of Newcastle, Newcastle, Australia
| | - Debbie Scott
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia
| | - Ryan Baldwin
- School of Psychology, Deakin University, Waterfront Campus, Geelong, Australia
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, Perth, Australia
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Moustafa AA, Alvinia NP, Liu L, Richard Y, Hanafy AA, Bagadood NH, Hamza EA. Drinking motives as a predictor of readiness to change alcohol use. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04245-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
AbstractDrinking motives have been identified as important predictors of alcohol consumption. Similarly, the degree of readiness to change (RTC) can predict behavioral changes when drinking alcohol. However, the link between drinking motives and RTC has not been explored in previous research. The aim of this study is to investigate whether the four drinking motives (coping, enhancement, social, conformity) can predict the three stages of RTC (precontemplation, contemplation and action) in relation to alcohol consumption. Two hundred and fifty-two undergraduates’ students completed an online self-assessment survey on Qualtrics that assessed motives for alcohol use, drinking behavior, and RTC. Hierarchical regressions showed that among the four specific drinking motives, coping motives significantly predicted all three stages of RTC; conformity motives positively predicted the action stage of change; social motives negatively predicted the precontemplation and action stages of change; enhancement motives were not significant in predicting RTC stages. These results indicate that the three RTC levels can be predicted by coping, social, and conformity motives, but not by enhancement motives. Additionally, given the importance of coping motives, it might be useful to address and include healthier coping mechanisms as part of clinical interventions and prevention methods to circumvent unsafe drinking behaviors independent of a single RTC stage.
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Manthey J, Jasilionis D, Jiang H, Meščeriakova O, Petkevičienė J, Radišauskas R, Štelemėkas M, Rehm J. The impact of alcohol taxation increase on all-cause mortality inequalities in Lithuania: an interrupted time series analysis. BMC Med 2023; 21:22. [PMID: 36647069 PMCID: PMC9841962 DOI: 10.1186/s12916-022-02721-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/21/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Taxation increases which reduce the affordability of alcohol are expected to reduce mortality inequalities. A recent taxation increase in Lithuania offers the unique possibility to test this hypothesis. METHODS Census-linked mortality data between 2011 and 2019 were used to calculate monthly sex- and education-stratified age-standardized mortality rates for the population aged 40 to 70 years. As primary outcome, we analysed the difference in age-standardized all-cause mortality rates between the population of lowest versus highest educational achievement. The impact of the 2017 taxation increase was evaluated using interrupted time series analyses. To identify whether changes in alcohol use can explain the observed effects on all-cause mortality, the education-based mortality differences were then decomposed into n = 16 cause-of-death groupings. RESULTS Between 2012 and 2019, education-based all-cause mortality inequalities in Lithuania declined by 18% among men and by 14% among women. Following the alcohol taxation increase, we found a pronounced yet temporary reduction of mortality inequalities among Lithuanian men (- 13%). Subsequent decomposition analyses suggest that the reduction in mortality inequalities between lower and higher educated men was mainly driven by narrowing mortality differences in injuries and infectious diseases. CONCLUSIONS A marked increase in alcohol excise taxation was associated with a decrease in mortality inequalities among Lithuanian men. More pronounced reductions in deaths from injuries and infectious diseases among lower as compared to higher educated groups could be the result of differential changes in alcohol use in these populations.
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Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Domantas Jasilionis
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany
- Demographic Research Centre, Faculty of Social Sciences, Vytautas Magnus University, Jonavos Str. 66, 44191, Kaunas, Lithuania
| | - 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 3M7, Canada
| | - Olga Meščeriakova
- Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių Av. 15, 50162, Kaunas, Lithuania
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania
| | - Jürgen Rehm
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- 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 3M7, Canada
- Department of Psychiatry, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5T 2S1, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya Str., 8, B. 2, 119992, Moscow, Russian Federation
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Brennan A, Angus C, Pryce R, Buykx P, Henney M, Gillespie D, Holmes J, Meier PS. Effectiveness of subnational implementation of minimum unit price for alcohol: policy appraisal modelling for local authorities in England. Addiction 2022; 118:819-833. [PMID: 36367289 DOI: 10.1111/add.16084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/21/2022] [Indexed: 11/13/2022]
Abstract
AIMS Evidence exists on the potential impact of national level minimum unit price (MUP) policies for alcohol. This study investigated the potential effectiveness of implementing MUP at regional and local levels compared with national implementation. DESIGN Evidence synthesis and computer modelling using the Sheffield Alcohol Policy Model (Local Authority version 4.0; SAPMLA). SETTING Results are produced for 23 Upper Tier Local Authorities (UTLAs) in North West England, 12 UTLAs in North East England, 15 UTLAs in Yorkshire and Humber, the nine English Government Office regions and England as a whole. CASES Health Survey for England (HSE) data 2011-13 (n = 24 685). MEASUREMENTS Alcohol consumption, consumer spending, retailers' revenues, hospitalizations, National Health Service costs, crimes and alcohol-attributable deaths and health inequalities. FINDINGS Implementing a local £0.50 MUP for alcohol in northern English regions is estimated to result in larger percentage reductions in harms than the national average. The reductions for England, North West, North East and Yorkshire and Humber regions, respectively, in annual alcohol-attributable deaths are 1024 (-10.4%), 205 (-11.4%), 121 (-17.4%) and 159 (-16.9%); for hospitalizations are 29 943 (-4.6%), 5956 (-5.5%), 3255 (-7.9%) and 4610 (-6.9%); and for crimes are 54 229 (-2.4%), 8528 (-2.5%), 4380 (-3.5%) and 8220 (-3.2%). Results vary among local authorities; for example, annual alcohol-attributable deaths estimated to change by between -8.0 and -24.8% throughout the 50 UTLAs examined. CONCLUSIONS A minimum unit price local policy for alcohol is likely to be more effective in those regions, such as the three northern regions of England, which have higher levels of alcohol consumption and higher rates of alcohol harm than for the national average. In such regions, the minimum unit price policy would achieve larger reductions in alcohol consumption, alcohol-attributable mortality, hospitalization rates, NHS costs, crime rates and health inequalities.
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Affiliation(s)
- Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert Pryce
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Penny Buykx
- School of Health and Related Research, University of Sheffield, Sheffield, UK.,School of Humanities and Social Science, University of Newcastle, Callaghan, NSW, Australia
| | - Madeleine Henney
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Petra S Meier
- School of Health and Related Research, University of Sheffield, Sheffield, UK.,MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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12
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Miller M, Mojica-Perez Y, Livingston M, Kuntsche E, Wright CJC, Kuntsche S. The who and what of women's drinking: Examining risky drinking and associated socio-demographic factors among women aged 40-65 years in Australia. Drug Alcohol Rev 2022; 41:724-731. [PMID: 35081266 DOI: 10.1111/dar.13428] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Recent trends in Australian national survey data show an increase in alcohol use among middle-aged people, amidst declines in alcohol use among other population groups. There is limited research, however, on middle-aged women's alcohol use. This study aimed to examine patterns in alcohol use among Australian women aged 40-65 and the associated sociodemographic and contextual factors. METHODS Cross-sectional data from six waves of the National Drug Strategy Household Survey (2001-2019). We estimated the prevalence of long-term risky drinking (>2 Australian standard drinks per day) and risky-single occasion drinking (>5 Australian standard drinks on one occasion) among middle-aged women. Logistic regression models were estimated using 2019 data to examine demographic characteristics and contextual factors associated with alcohol use. RESULTS Since 2001, there has been a statistically significant increase in long-term risky drinking and risky-single occasion drinking amongst middle-aged women in Australia. Educational attainment, marital status and employment status were negatively associated with risky drinking, whereas rurality, age and location of use were positively associated with risky drinking. Beverage type was both positively and negatively associated with risky drinking. DISCUSSION AND CONCLUSIONS Given the significant increase in alcohol use amongst middle-aged women in Australia, prevention efforts are needed for this group, which may focus in particular on home drinking and the impact of rurality on alcohol use.
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Affiliation(s)
- Mia Miller
- The George Institute for Global Health, Sydney, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Yvette Mojica-Perez
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Emmanuel Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Cassandra J C Wright
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
| | - Sandra Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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13
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O'Brien JW, Tscharke BJ, Bade R, Chan G, Gerber C, Mueller JF, Thomas KV, Hall WD. A wastewater-based assessment of the impact of a minimum unit price (MUP) on population alcohol consumption in the Northern Territory, Australia. Addiction 2022; 117:243-249. [PMID: 34184809 DOI: 10.1111/add.15631] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/11/2021] [Accepted: 06/16/2021] [Indexed: 12/29/2022]
Abstract
AIM To test if there was a reduction in alcohol consumption in wastewater samples in the Northern Territory of Australia after the implementation of a minimum unit alcohol price policy (MUP) in October 2018. DESIGN, SETTING, CASES Between August 2016 and February 2020, wastewater samples were collected across 66 sites in the Northern Territory and all other states and territories in Australia. Samples were collected every 2 months in capital cities and every 4 months in regional places during this period. Overall, 4917 samples were taken (2816 before MUP and 2101 after). MEASUREMENTS The number of standard drinks per 1000 people per day in the respective catchment areas was estimated based on the concentration of an alcohol-specific metabolite, ethyl sulphate in the samples (using the excretion factor of ethyl sulphate, the flow of wastewater entering the wastewater treatment plants and the population of each wastewater catchment). FINDINGS Results from a linear mixed model showed that there was a large drop in alcohol consumption immediately after the MUP in Northern Territory [estimated drop = 1231, 99% confidence interval (CI) = 830, 1633; 38.75%]. There was no significant drop in all other states/territories except for Queensland, which showed a significant but much smaller drop (estimated drop: 310; 99% CI = 114, 550). One year after the MUP, the drop narrowed to 520 (99% CI = 189, 851) and was no longer statistically significant in February 2020 (15 months after MUP; estimated drop = 283, 99% CI = -114, 681). CONCLUSIONS Per-capita consumption of alcohol appears to have decreased substantially in the Northern Territory of Australia immediately after the implementation of a minimum unit price but consumption steadily recovered and almost returned to the pre-MUP consumption level after 15 months.
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Affiliation(s)
- Jake W O'Brien
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, QLD, Australia
| | - Benjamin J Tscharke
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, QLD, Australia
| | - Richard Bade
- Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Gary Chan
- National Centre for Youth Substance Use Research (NCYSUR), The University of Queensland, Brisbane, QLD, Australia
| | - Cobus Gerber
- Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, QLD, Australia
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, QLD, Australia
| | - Wayne D Hall
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, QLD, Australia.,National Centre for Youth Substance Use Research (NCYSUR), The University of Queensland, Brisbane, QLD, Australia
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14
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Manthey J, Jasilionis D, Jiang H, Meščeriakova-Veliulienė O, Petkevičienė J, Radišauskas R, Rehm J, Štelemėkas M. Interrupted time series analyses to assess the impact of alcohol control policy on socioeconomic inequalities in mortality in Lithuania: a study protocol. BMJ Open 2021; 11:e053497. [PMID: 34873010 PMCID: PMC8650476 DOI: 10.1136/bmjopen-2021-053497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/14/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Alcohol use is a major risk factor for mortality. Previous studies suggest that the alcohol-attributable mortality burden is higher in lower socioeconomic strata. This project will test the hypothesis that the 2017 increase of alcohol excise taxes linked to lower all-cause mortality rates in previous analyses will reduce socioeconomic mortality inequalities. METHODS AND ANALYSIS Data on all causes of deaths will be obtained from Statistics Lithuania. Record linkage will be implemented using personal identifiers combining data from (1) the 2011 whole-population census, (2) death records between 1 March 2011 (census date) and 31 December 2019, and (3) emigration records, for individuals aged 40-70 years. The analyses will be performed separately for all-cause and for alcohol-attributable deaths. Monthly age-standardised mortality rates will be calculated by sex, education and three measures of socioeconomic status (SES). Inequalities in mortality will be assessed using absolute and relative indicators between low and high SES groups. We will perform interrupted time series analyses, and test the impact of the 2017 rise in alcohol excise taxation using generalised additive mixed models. In these models, we will control for secular trends for economic development. ETHICS AND DISSEMINATION This work is part of project grant 1R01AA028224-01 by the National Institute on Alcohol Abuse and Alcoholism. It has been granted research ethics approval 050/2020 by Centre for Addiction and Mental Health Research Ethics Board on 17 April 2020, renewed on 30 March 2021. The time series of mortality inequalities as well as the statistical code will be made publicly available, allowing other researchers to adapt the proposed method to other jurisdictions.
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Affiliation(s)
- Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Domantas Jasilionis
- Laboratory of Demographic Data, Max- Planck- Institute for Demographic Research, Rostock, Germany
- Demographic Research Centre, University of Leipzig, Vytautas Magnus University, Kaunas, Lithuania
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Olga Meščeriakova-Veliulienė
- Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Mindaugas Štelemėkas
- Health Research Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
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15
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Bingham AL, De Silva AP, Vaisey AM, Temple-Smith MJ, Spark SY, Hocking JS. Alcohol availability and prevalent Chlamydia trachomatis in young Australians: a multi-level analysis. Sex Health 2021; 18:460-465. [PMID: 34844665 DOI: 10.1071/sh21098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022]
Abstract
Background Prevalence of sexually transmissible infections (STIs) has been associated with availability of alcohol. This paper investigates potential associations between prevalent cases of chlamydia in young people in Australia and the availability of alcohol within their local area, defined as postcode of residence. Methods Alcohol availability was determined at the postcode level using liquor licensing data, classified as total number of licences, number of 'take-away' licences and number of licenses by population. Participant data were drawn from a survey targeting Australians aged 16-29years in rural and regional Australia, capturing demographic details including postcode of residence, indicators of sexual behaviour including condom use and chlamydia test results. Mixed-effects logistic regression was used to examine potential associations between first, alcohol availability and chlamydia, and second, between condom use and chlamydia. Results We found little evidence of associations between alcohol availability and chlamydia in either unadjusted or adjusted models. After adjusting for alcohol availability, we observed significant associations between inconsistent condom use and chlamydia prevalence, whether alcohol availability was measured as total number (adjusted odds ratio (AOR) 2.20; 95% confidence interval (CI) 1.20, 3.70), number of take-away licenses (AOR 2.19; 95% CI1.30, 3.69) or licenses per 1000 population (AOR 2.19; 95% CI 1.30, 3.68). Conclusion Little evidence of association between alcohol availability and chlamydia at the postcode level was found. Further research is required to determine appropriate measures of 'local area' and how characteristics thereof may impact on sexual health.
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Affiliation(s)
- Amie L Bingham
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Anurika P De Silva
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Alaina M Vaisey
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | | | - Simone Y Spark
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
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16
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Asrani SK, Mellinger J, Arab JP, Shah VS. Reducing the Global Burden of Alcohol-Associated Liver Disease: A Blueprint for Action. Hepatology 2021; 73:2039-2050. [PMID: 32986883 PMCID: PMC9361217 DOI: 10.1002/hep.31583] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/18/2020] [Accepted: 09/08/2020] [Indexed: 12/12/2022]
Abstract
Alcohol-associated liver disease (ALD) is a major driver of global liver related morbidity and mortality. There are 2.4 billion drinkers (950 million heavy drinkers) and the lifetime prevalence of any alcohol use disorder (AUD) is 5.1%-8.6%. In 2017, global prevalence of alcohol-associated compensated and decompensated cirrhosis was 23.6 million and 2.5 million, respectively. Combined, alcohol-associated cirrhosis and liver cancer account for 1% of all deaths worldwide with this burden expected to increase. Solutions for this growing epidemic must be multi-faceted and focused on both population and patient-level interventions. Reductions in ALD-related morbidity and mortality require solutions that focus on early identification and intervention, reducing alcohol consumption at the population level (taxation, reduced availability and restricted promotion), and solutions tailored to local socioeconomic realities (unrecorded alcohol consumption, focused youth education). Simple screening tools and algorithms can be applied at the population level to identify alcohol misuse, diagnose ALD using non-invasive serum and imaging markers, and risk-stratify higher-risk ALD/AUD patients. Novel methods of healthcare delivery and platforms are needed (telehealth, outreach, use of non-healthcare providers, partnerships between primary and specialty care/tertiary hospitals) to proactively mitigate the global burden of ALD. An integrated approach that combines medical and AUD treatment is needed at the individual level to have the highest impact. Future needs include (1) improving quality of ALD data and standardizing care, (2) supporting innovative healthcare delivery platforms that can treat both ALD and AUD, (3) stronger and concerted advocacy by professional hepatology organizations, and (4) advancing implementation of digital interventions.
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Affiliation(s)
- Sumeet K Asrani
- Baylor University Medical Center, Dallas, TX, United States,Corresponding Author and reprint requests Sumeet K Asrani MD MSc, Baylor University Medical Center, Dallas Texas, 2148208500
| | - Jessica Mellinger
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI
| | - Juan P Arab
- Depto. Gastroenterología y Hepatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Vijay S Shah
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
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17
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Adamson E, Clifford S, Wallace T, Smith JA. Industry views about the Banned Drinker Register in the Northern Territory: Early lessons from a qualitative evaluation. Drug Alcohol Rev 2020; 40:210-219. [PMID: 32974978 PMCID: PMC7891360 DOI: 10.1111/dar.13174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Abstract
Introduction and Aims The Northern Territory Government has recently planned and implemented an extensive suite of alcohol harm minimisation policies, including the reintroduction of the Banned Drinker Register (BDR). It is an explicit alcohol supply reduction measure that places persons who consume alcohol at harmful levels onto a register, prohibiting the purchase of alcohol from take‐away liquor outlets. This paper explores industry stakeholders' perspectives regarding the extent to which the BDR is meeting its objectives to improve community health and safety by reducing alcohol‐related harms. Design and Methods Interviews and one focus group were conducted with 66 alcohol industry stakeholders from urban and remote locations. Focusing on outcomes both central (crime and safety) and peripheral (health and therapeutic support) to the stakeholders' interest, the authors used inductive thematic analysis to examine participants' perceptions about the effectiveness of the BDR. Results Analysis revealed mixed views about the effectiveness of the BDR. There is a tension between the objective to address public amenity and decrease crime, as expressed by the participants, compared to the health‐focused approach to therapeutic services and referrals identified in other sources. Discussion and Conclusions Drawing on these findings, alongside other relevant sources, the authors argue there is a need for a more effective communication strategy to the public and professional community to enhance the capacity of the BDR to meet its goals. The authors recognise the limitations of alcohol industry stakeholder views and identify the need for a comprehensive evaluation approach that includes multiple stakeholder perspectives.
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Affiliation(s)
| | | | - Tessa Wallace
- Menzies School of Health Research, Darwin, Australia
| | - James A Smith
- Menzies School of Health Research, Darwin, Australia
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18
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Pechholdová M, Jasilionis D. Contrasts in alcohol-related mortality in Czechia and Lithuania: Analysis of time trends and educational differences. Drug Alcohol Rev 2020; 39:846-856. [PMID: 32909686 PMCID: PMC7756221 DOI: 10.1111/dar.13157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/18/2020] [Accepted: 07/29/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Globally, Czechia and Lithuania are among the top-ranking countries in terms of high alcohol consumption. This study highlights notable contrasts in temporal trends in alcohol-related mortality and identifies country-specific patterns in educational differences. DESIGN AND METHODS The study uses harmonised cause-of-death series from the Human Cause of Death Database. Mortality disparities by education were assessed using census-linked mortality data. Directly standardised death rates were used to estimate levels of national and group-specific mortality. Relative and absolute mortality differences by education were assessed by range-type measures (Poisson regression mortality ratios and rate differences) and Gini-type measures. RESULTS Between 1994-1995 and 2016, the absolute difference between Czechia and Lithuania in terms of alcohol-related age-standardised death rates (per 1 000 000) decreased from 450 for males and 130 for females to 76 in males and 11 in females. In both countries, alcohol-related mortality was markedly higher among persons of lower education levels. Lithuanian males experienced the highest absolute inequalities measured by rate difference between the low and high educated (740 per million), while Lithuanian females showed the most pronounced relative inequalities (6.70-fold difference between low and high educated). The corresponding figures were less than half for Czechia. DISCUSSION AND CONCLUSIONS Reducing educational disparities in alcohol-related mortality within both countries would have a substantial impact on overall levels. Policies aimed at targeting the lowest priced and illegal alcohols and reducing levels of harmful drinking should be a priority, especially in Lithuania.
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Affiliation(s)
- Markéta Pechholdová
- Department of Demography, Faculty of Informatics and Statistics, University of Economics, Prague, Czech Republic
| | - Domantas Jasilionis
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany.,Demographic Research Centre, Faculty of Social Sciences, Vytautas Magnus University, Kaunas, Lithuania
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