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Kronsten VT, Shawcross DL. Editorial: Sounding the alarm-The rising global burden of adolescent and young adult alcohol-related liver disease. Aliment Pharmacol Ther 2024; 60:519-520. [PMID: 38970151 DOI: 10.1111/apt.18140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/08/2024]
Abstract
LINKED CONTENTThis article is linked to Danpanichkul et al papers. To view these articles, visit https://doi.org/10.1111/apt.18101 and https://doi.org/10.1111/apt.18157
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Affiliation(s)
- Victoria T Kronsten
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, Institute of Liver Studies, King's College London, London, UK
- Institute of Liver Studies, King's College Hospital, London, UK
| | - Debbie L Shawcross
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, Institute of Liver Studies, King's College London, London, UK
- Institute of Liver Studies, King's College Hospital, London, UK
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Giles L, Mackay D, Richardson E, Lewsey J, Robinson M, Beeston C. Evaluating the impact of minimum unit pricing (MUP) on alcohol sales after 3 years of implementation in Scotland: A controlled interrupted time-series study. Addiction 2024; 119:1378-1386. [PMID: 38685192 DOI: 10.1111/add.16492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/02/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND AIMS On 1 May 2018, Scotland introduced minimum unit pricing (MUP), a strength-based floor price below which alcohol cannot be sold, throughout all alcoholic beverages. The legislation necessitates an evaluation of its impact across a range of outcomes that will inform whether MUP will continue beyond its sixth year. We measured the impact of MUP on per-adult alcohol sales (as a proxy for consumption) after 3 years of implementation. DESIGN, SETTING AND PARTICIPANTS Controlled interrupted time-series regression was used to assess the impact of MUP on alcohol sales in Scotland after 3 years of implementation, with England and Wales (EW) being the control group. In adjusted analyses, we included household disposable income, on-trade alcohol sales (in off-trade analyses) and substitution between drink categories (in drink category analyses) as covariates. MEASUREMENTS Weekly data were assessed on the volume of pure alcohol sold in Scotland and EW between January 2013 and May 2021, expressed as litres of pure alcohol per adult. The impact of MUP on total (on- and off-trade combined), off-trade and on-trade alcohol sales was assessed separately. RESULTS The introduction of MUP in Scotland was associated with a 3.0% (95% confidence interval = 1.8-4.2%) net reduction in total alcohol sales per adult after adjustment for the best available geographical control, disposable income and substitution. This reflects a 1.1% fall in Scotland in contrast to a 2.4% increase in EW. The reduction in total alcohol sales in Scotland was driven by reduced sales of beer, spirits, cider and perry. The reduction in total sales was due to reductions in sales of alcohol through the off-trade. There was no evidence of any change in on-trade alcohol sales. CONCLUSION Minimum unit pricing has been effective in reducing population-level alcohol sales in Scotland in the 3 years since implementation.
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Affiliation(s)
| | - Daniel Mackay
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Jim Lewsey
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mark Robinson
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Institute for Social Science Research, University of Queensland, Indooroopilly, Queensland, Australia
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Nguyen DT, Donnelly M, Hoang MV, O’Neill C. An investigation into patterns of Alcohol drinking in Scotland after the introduction of minimum unit pricing. PLoS One 2024; 19:e0308218. [PMID: 39088518 PMCID: PMC11293661 DOI: 10.1371/journal.pone.0308218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/18/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND In 2018, Scotland became the second country to implement minimum unit pricing (MUP) for all types of alcoholic beverages. The aim of this study was to examine the effect of the policy. METHOD Three national household-level surveys were used: Scottish Health Surveys (2008-2021), Health Surveys in England (2011-2019), and Northern Ireland Continuous Household Survey (2011-2015). First, a generalized ordered logistic model examined patterns of drinking solely in Scotland from 2008-2021 covering current drinking, drinking categories and the weekly consumption (in alcohol units). Secondly, difference-in-difference (DID) analysis was employed to examine changes in "social drinking" behaviours in Scotland after the announcement in 2012 (2011-2015, Northern Ireland and England as comparators) and after the adoption of the policy in 2018 (England as a comparator, with two timeframes 2016-2019 and 2013-2019). RESULTS Overall, drinking in Scotland began to decline prior to 2012 and dropped further with the enactment of MUP in 2018. In response to MUP, the likelihood of abstention increased along with a slight decrease in the prevalence of heavy drinking. The overall amount of drinking fell by about 8% after 2012 and 12% after 2018 (as compared to 2008-2011 level), with a significant decline seen in moderate drinkers but not of those who drank at hazardous or harmful levels. The DID analyses confirmed the reduction in current drinking in Scotland starting since 2012 and continued post-MUP in 2018. CONCLUSION This study points to the impact of MUP in Scotland with a potential role for 'policy signalling' by the Scottish Government's with a multiple-buy discount ban and MUP's announcement since 2011-2012. Indications of impact include a clear decline in alcohol consumption levels and a small but noteworthy change in prevalence of overall drinking and heavy drinking.
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Affiliation(s)
- Duyen Thuy Nguyen
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Center for Population Health Sciences, Hanoi University of Public Health, North Tu Liem district, Hanoi, Vietnam
| | - Michael Donnelly
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Minh Van Hoang
- Center for Population Health Sciences, Hanoi University of Public Health, North Tu Liem district, Hanoi, Vietnam
| | - Ciaran O’Neill
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
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Boyd J, Holmes J, Gibbs N, Buckley C, Purshouse R, Meier P. How can agent-based modelling provide new insights into the impact of minimum unit pricing in Scotland? Drug Alcohol Rev 2024. [PMID: 38840445 DOI: 10.1111/dar.13880] [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: 01/18/2024] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 06/07/2024]
Abstract
In recent years we have gained insight into the impact of minimum unit pricing (MUP)-a legal floor price below which a given volume of alcohol cannot be sold-on population-level reductions in alcohol sales, consumption and harm. However, several questions remain unanswered including how individual-level purchasing changes impact the local economy (e.g., balance between on-licence and off-licence outlets), lead to long-term population-level trends (e.g., youth drinking) and social harms (e.g., violence). Agent-based modelling captures heterogeneity, emergence, feedback loops and adaptive and dynamic features, which provides an opportunity to understand the nuanced effects of MUP. Agent-based models (ABM) simulate heterogeneous agents (e.g., individuals, organisations) often situated in space and time that interact with other agents and/or with their environment, allowing us to identify the mechanisms underlying social phenomena. ABMs are particularly useful for theory development, and testing and simulating the impacts of policies and interventions. We illustrate how ABMs could be applied to generate novel insights and provide best estimates of social network effects, and changes in purchasing behaviour and social harms, due to the implementation of MUP. ABMs like other modelling approaches can simulate alternative implementations of MUP (e.g., policy intensity [£0.50, £0.60] or spatial scales [local, national]) but can also provide an understanding of the potential impact of MUP on different population groups (e.g., alcohol exposure of young people who are not yet drinking). Using ABMs to understand the impact of MUP would provide new insights to complement those from traditional epidemiological and other modelling methods.
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Affiliation(s)
- Jennifer Boyd
- Salvation Army Centre for Addictions Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - John Holmes
- School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Naomi Gibbs
- School of Medicine and Population Health, University of Sheffield, Sheffield, UK
- Centre for Health Economics, University of York, York, UK
| | - Charlotte Buckley
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - Robin Purshouse
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Manca F, Lewsey J, Mackay D, Angus C, Fitzpatrick D, Fitzgerald N. The effect of a minimum price per unit of alcohol in Scotland on alcohol-related ambulance call-outs: A controlled interrupted time-series analysis. Addiction 2024; 119:846-854. [PMID: 38286951 DOI: 10.1111/add.16436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/20/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND AND AIMS On 1 May 2018, Scotland introduced a minimum unit price (MUP) of £0.50 for alcohol, with one UK unit of alcohol being 10 ml of pure ethanol. This study measured the association between MUP and changes in the volume of alcohol-related ambulance call-outs in the overall population and in call-outs subsets (night-time call-outs and subpopulations with higher incidence of alcohol-related harm). DESIGN An interrupted time-series (ITS) was used to measure variations in the daily volume of alcohol-related call-outs. We performed uncontrolled ITS on both the intervention and control group and a controlled ITS built on the difference between the two series. Data were from electronic patient clinical records from the Scottish Ambulance Service. SETTING AND CASES Alcohol-related ambulance call-outs (intervention group) and total ambulance call-outs for people aged under 13 years (control group) in Scotland, from December 2017 to March 2020. MEASUREMENTS Call-outs were deemed alcohol-related if ambulance clinicians indicated that alcohol was a 'contributing factor' in the call-out and/or a validated Scottish Ambulance Service algorithm determined that the call-out was alcohol-related. FINDINGS No statistically significant association in the volume of call-outs was found in both the uncontrolled series [step change = 0.062, 95% confidence interval (CI) = -0.012, 0.0135 P = 0.091; slope change = -0.001, 95% CI = -0.001, 0.1 × 10-3 P = 0.139] and controlled series (step change = -0.01, 95% CI = -0.317, 0.298 P = 0.951; slope change = -0.003, 95% CI = -0.008, 0.002 P = 0.257). Similarly, no significant changes were found for the night-time series or for any population subgroups. CONCLUSIONS There appears to be no statistically significant association between the introduction of minimum unit pricing for alcohol in Scotland and the volume of alcohol-related ambulance call-outs. This was observed overall, across subpopulations and at night-time.
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Affiliation(s)
- Francesco Manca
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jim Lewsey
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Daniel Mackay
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - David Fitzpatrick
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Niamh Fitzgerald
- SPECTRUM (Shaping Public hEalth poliCies To Reduce ineqUalities and harM) Consortium, Institute for Social Marketing and Health (ISM), Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
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Manca F, Parab R, Mackay D, Fitzgerald N, Lewsey J. Evaluating the impact of minimum unit pricing for alcohol on road traffic accidents in Scotland after 20 months: An interrupted time series study. Addiction 2024; 119:509-517. [PMID: 37853919 DOI: 10.1111/add.16371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND AND AIMS On 1 May 2018, Scotland implemented Minimum Unit Pricing (MUP) of £0.50 per unit of alcohol with the aim to lower alcohol consumption and related harms, and reduce health inequalities. We measured the impact of MUP on the most likely categories of road traffic accidents (RTAs) to be affected by drink-driving episodes (fatal and nighttime) up to 20 months after the policy implementation. Further, we checked whether any association varied by level of socio-economic deprivation. METHODS An interrupted time series design was used to evaluate the impact of MUP on fatal and nighttime RTAs in Scotland and any effect modification across socio-economic deprivation groups. RTAs in England and Wales (E&W) were used as a comparator. Covariates representing severe weather events, bank holidays, seasonal and underlying trends were adjusted for. RESULTS In Scotland, MUP implementation was associated with 40.5% (95% confidence interval: 15.5%, 65.4%) and 11.4% (-1.1%, 24.0%) increases in fatal and nighttime RTAs, respectively. There was no evidence of differential impacts of MUP by level of socio-economic deprivation. While we found a substantial increase in fatal RTAs associated with MUP, null effects observed in nighttime RTAs and high uncertainty in sensitivity analyses suggest caution be applied before attributing causation to this association. CONCLUSION There is no evidence of an association between the introduction of minimum unit pricing for alcohol in Scotland and a reduction in fatal and nighttime road traffic accidents, these being outcome measure categories that are proxies of outcomes that directly relate alcohol consumption to road traffic accidents.
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Affiliation(s)
- Francesco Manca
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Rakshita Parab
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Daniel Mackay
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Niamh Fitzgerald
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Jim Lewsey
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Holloway K, Buhociu M, Murray S, Livingston W, Perkins A. Assessing the early influence of COVID-19 in an analysis of the immediate implementation of Minimum Pricing for Alcohol on drinkers in Wales. NORDIC STUDIES ON ALCOHOL AND DRUGS 2024; 41:57-74. [PMID: 38356791 PMCID: PMC10863556 DOI: 10.1177/14550725231202066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 09/04/2023] [Indexed: 02/16/2024] Open
Abstract
Background: The Welsh Government has commissioned a number of projects to consider the influence their implementation of Minimum Pricing for Alcohol (MPA) legislation in March 2020 had on the alcohol consumption and related behaviours of drinkers. Given the MPA's overlap with the COVID-19 pandemic and its related lockdown measures and restrictions, this rapidly became a story about the early impact of COVID-19 as it did MPA. This paper captures the core thematic messages from this specific strand of work, and in doing so reflects on (1) how early experiences of COVID-19 and the first lockdown influenced consumption and purchasing of alcohol behaviours and, in turn, (2) how relevant the introduction of MPA was for any of these. Methods: Semi-structured interviews were conducted by telephone with 32 drinkers 9 months after the implementation of the legislation in March 2020. The sample was recruited from three sources: the National Survey for Wales; a third sector organisation offering housing support to the homeless; and through an online survey on MPA. Results: COVID-19 had more relevance than MPA to drinkers. Furthermore, when MPA did have an influence on their behaviour, it was felt most keenly by the harmful drinkers in the study. These drinkers described spending more on alcohol, switching to other potentially more harmful substances, such as crack cocaine and synthetic cannabinoids, and more involvement in acquisitive crime and begging after the price increase. While our results might be an early indication of the influence of MPA on harmful drinkers, the small sample of this group in our study limits the generalisability of the findings. Conclusion: To date, the implementation of MPA has had little influence on the drinking patterns or lives of the drinkers in our sample. It is important that future research examines the longer-term influences of MPA before any conclusions on its effectiveness can be drawn.
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Affiliation(s)
- Katy Holloway
- Centre for Criminology, University of South Wales, Pontypridd, UK
| | - Marian Buhociu
- Centre for Criminology, University of South Wales, Pontypridd, UK
| | - Shannon Murray
- Centre for Criminology, University of South Wales, Pontypridd, UK
| | - Wulf Livingston
- School of Social and Life Sciences, Wrexham Glyndwr University, Wrexham, UK
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Hu A, Zhao X, Room R, Hao W, Xiang X, Jiang H. The effects of alcohol tax policies on alcohol consumption and alcohol use disorders in Mainland of China: an interrupted time series analysis from 1961-2019. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:746-755. [PMID: 38059570 DOI: 10.1080/00952990.2023.2280948] [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: 04/07/2023] [Accepted: 11/04/2023] [Indexed: 12/08/2023]
Abstract
Background: Overwhelming evidence suggests that increasing alcohol taxes is an effective strategy for curbing alcohol consumption. However, research on the effects of such strategies in low- and middle-income nations is limited.Objective: The aim is to explore the temporal effect of alcohol tax policy in China.Methods: We employ interrupted time series analysis to investigate the temporal effects of tax policy changes on alcohol consumption and related consequences in Mainland China from 1961 to 2019. The study population, the total population of mainland region of China, aged more than 15 years.Results: The results show that the volume tax policy, which was announced in 2000 and implemented in 2001, led to an immediate reduction in the alcohol consumption (coefficient = -0.429, p < .001). Following the implementation of higher alcohol taxes in 1998 and 2001, the prevalence of alcohol use disorders (AUDs) and related years lived with disability (YLDs) gradually decreased. The relaxation of tax policy in 2006 led to a significant increase in alcohol consumption, both immediately (coefficient = 0.406, p < .001) and in the middle term (coefficient = 0.495, p < .001), as well as contribute to an immediate or medium term significant increase in the prevalence of AUDs (coefficient = 0.038, p = .010; coefficient = 0.032, p < .001) and YLDs (coefficient = 4.363, p = .001; coefficient = 4.226, p < .001).Conclusion: This study demonstrates that changes in alcohol consumption and related consequences (increase or decrease) have followed corresponding changes in alcohol tax policies (easing or tightening), indicating that increasing alcohol taxes can be an effective strategy in China for controlling alcohol consumption and related harms.
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Affiliation(s)
- Aqian Hu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaoxi Zhao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Robin Room
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Wei Hao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaojun Xiang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - 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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Rau M, Nitschmann S. [Does alcohol minimum unit pricing lead to a reduction in deaths and hospitalizations?]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2023; 64:1013-1014. [PMID: 37707520 DOI: 10.1007/s00108-023-01580-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Monika Rau
- Medizinische Klinik II, Schwerpunkt Hepatologie, Universitätsklinik Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland.
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Holmes J. Is minimum unit pricing for alcohol having the intended effects on alcohol consumption in Scotland? Addiction 2023; 118:1609-1616. [PMID: 36905242 DOI: 10.1111/add.16185] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/10/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND AND AIMS The Scottish Government introduced minimum unit pricing (MUP) for alcohol on 1 May 2018. This means retailers in Scotland cannot sell alcohol to consumers for less than £0.50 per unit (1 UK unit = 8 g ethanol). The Government intended the policy to increase the price of cheap alcohol, cut alcohol consumption overall and particularly among those drinking at hazardous or harmful levels, and ultimately reduce alcohol-related harm. This paper aims to summarise and assess the evidence to date evaluating the impact of MUP on alcohol consumption and related behaviours in Scotland. ARGUMENT Evidence from analyses of population-level sales data suggest, all else being equal, MUP reduced the volume of alcohol sold in Scotland by ~ 3.0% to 3.5%, with the largest reductions affecting cider and spirits sales. Analyses of two time series datasets on household-level alcohol purchasing and individual-level alcohol consumption suggest reductions in purchasing and consumption among those drinking at hazardous and harmful levels, but offer conflicting results for those drinking at the most harmful levels. These subgroup analyses are methodologically robust, but the underlying datasets have important limitations as they rely on non-random sampling strategies. Further studies identified no clear evidence of reduced alcohol consumption among those with alcohol dependence or those presenting to emergency departments and sexual health clinics, some evidence of increased financial strain among people with dependence and no evidence of wider negative outcomes arising from changes in alcohol consumption behaviours. CONCLUSIONS Minimum unit pricing for alcohol in Scotland has led to reduced consumption, including among heavier drinkers. However, there is uncertainty regarding its impact on those at greatest risk and some limited evidence of negative outcomes, specifically financial strain, among people with alcohol dependence.
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Affiliation(s)
- John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Hughes J, Livingston W, Buykx P, Johnston A, Little S, McCarthy T, McLean A, Perkins A, Wright A, Holmes J. Views on minimum unit pricing for alcohol before its introduction among people with alcohol dependence in Scotland: A qualitative interview study. Drug Alcohol Rev 2023; 42:1338-1348. [PMID: 37380168 DOI: 10.1111/dar.13704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/04/2023] [Accepted: 05/29/2023] [Indexed: 06/30/2023]
Abstract
INTRODUCTION Scotland implemented a minimum price per unit of alcohol (MUP) of £0.50 in May 2018 (1 UK unit = 10 mL/8 g ethanol). Some stakeholders expressed concerns about the policy having potential negative consequences for people with alcohol dependence. This study aimed to investigate anticipated impacts of MUP on people presenting to alcohol treatment services in Scotland before policy implementation. METHODS Qualitative interviews were conducted with 21 people with alcohol dependence accessing alcohol treatment services in Scotland between November 2017 and April 2018. Interviews examined respondents' current and anticipated patterns of drinking and spending, effects on their personal life, and their views on potential policy impact. Interview data were thematically analysed using a constant comparison method. RESULTS Three key themes were identified: (i) strategies used to manage the cost of alcohol and anticipated responses to MUP; (ii) broader effects of MUP; and (iii) awareness and preparedness for MUP. Respondents expected to be impacted by MUP, particularly those on low incomes and those with more severe dependence symptoms. They anticipated using familiar strategies including borrowing and reprioritising spending to keep alcohol affordable. Some respondents anticipated negative consequences. Respondents were sceptical about the short-term benefits of MUP for current drinkers but felt it might prevent harm for future generations. Respondents had concerns about the capacity of treatment services to meet support needs. DISCUSSION AND CONCLUSIONS People with alcohol dependence identified immediate concerns alongside potential long-term benefits of MUP before its introduction. They also had concerns over the preparedness of service providers.
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Affiliation(s)
- Jane Hughes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Wulf Livingston
- Faculty of Social and Life Sciences, Glyndwr University, Wrexham, UK
| | - Penny Buykx
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- College of Human and Social Futures, University of Newcastle, Newcastle, Australia
| | | | | | | | - Alex McLean
- Gartnaval Hopsital Mental Health Unit, NHS Greater Glasgow & Clyde, Glasgow, UK
| | | | - Alex Wright
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Stevely AK, Mackay D, Alava MH, Brennan A, Meier PS, Sasso A, Holmes J. Evaluating the effects of minimum unit pricing in Scotland on the prevalence of harmful drinking: a controlled interrupted time series analysis. Public Health 2023; 220:43-49. [PMID: 37263177 DOI: 10.1016/j.puhe.2023.04.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/06/2023] [Accepted: 04/21/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVES In May 2018, the Scottish Government introduced a minimum unit price (MUP) for alcohol of £0.50 (1 UK unit = 8 g ethanol) to reduce alcohol consumption, particularly among people drinking at harmful levels. This study aimed to evaluate MUP's impact on the prevalence of harmful drinking among adults in Scotland. STUDY DESIGN This was a controlled interrupted monthly time series analysis of repeat cross-sectional data collected via 1-week drinking diaries from adult drinkers in Scotland (N = 38,674) and Northern England (N = 71,687) between January 2009 and February 2020. METHODS The primary outcome was the proportion of drinkers consuming at harmful levels (>50 [men] or >35 [women] units in diary week). The secondary outcomes included the proportion of drinkers consuming at hazardous (≥14-50 [men] or ≥14-35 [women] units) and moderate (<14 units) levels and measures of beverage preferences and drinking patterns. Analyses also examined the prevalence of harmful drinking in key subgroups. RESULTS There was no significant change in the proportion of drinkers consuming at harmful levels (β = +0.6 percentage points; 95% confidence interval [CI] = -1.1, +2.3) or moderate levels (β = +1.4 percentage points; 95% confidence interval = -1.1, +3.8) after the introduction of MUP. The proportion consuming at hazardous levels fell significantly by 3.5 percentage points (95% CI = -5.4, -1.7). There were no significant changes in other secondary outcomes or in the subgroup analyses after correction for multiple testing. CONCLUSIONS Introducing MUP in Scotland was not associated with reductions in the proportion of drinkers consuming at harmful levels but did reduce the prevalence of hazardous drinking. This adds to previous evidence that MUP reduced overall alcohol consumption in Scotland and consumption among those drinking above moderate levels.
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Affiliation(s)
- A K Stevely
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK.
| | - D Mackay
- School of Health and Wellbeing, University of Glasgow, UK
| | - M H Alava
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, UK
| | - A Brennan
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, UK
| | - P S Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - A Sasso
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK; European Commission, Joint Research Center (JRC), Ispra, Italy
| | - J Holmes
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK
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Manca F, Zhang L, Fitzgerald N, Mackay D, McAuley A, Sharp C, Lewsey J. The Effect of Minimum Unit Pricing for Alcohol on Prescriptions for Treatment of Alcohol Dependence: A Controlled Interrupted Time Series Analysis. Int J Ment Health Addict 2023:1-16. [PMID: 37363757 PMCID: PMC10202053 DOI: 10.1007/s11469-023-01070-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/28/2023] Open
Abstract
In 2018, Scotland introduced a minimum unit price (MUP) for alcohol to reduce alcohol-related harms. We aimed to study the association between MUP introduction and the volume of prescriptions to treat alcohol dependence, and volume of new patients receiving such prescriptions. We also examined whether effects varied across different socio-economic groups. A controlled interrupted time series was used to examine variations of our two outcomes. The same prescriptions in England and prescriptions for methadone in Scotland were used as controls. There was no evidence of an association between MUP implementation and the volume of prescriptions for alcohol dependence (immediate change: 2.74%, 95% CI: -0.068 0.014; slope change: 0% 95%CI: -0.001 0.000). A small, significant increase in slope in number of new patients receiving prescriptions was observed (0.2% 95%CI: 0.001 0.003). However, no significant results were confirmed after robustness checks. We found also no variation across different socioeconomic groups. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-023-01070-6.
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Affiliation(s)
- Francesco Manca
- School of Health and Wellbeing. UK, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ UK
| | - Lisong Zhang
- School of Health and Wellbeing. UK, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ UK
| | - Niamh Fitzgerald
- Institute for Social Marketing and Health (ISM). UK, University of Stirling, Stirling, UK
| | - Daniel Mackay
- School of Health and Wellbeing. UK, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ UK
| | | | - Clare Sharp
- Institute for Social Marketing and Health (ISM). UK, University of Stirling, Stirling, UK
| | - Jim Lewsey
- School of Health and Wellbeing. UK, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ UK
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14
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Graham CJ. Minimum unit alcohol pricing in Scotland: Is England next? BMJ 2023; 380:56. [PMID: 36631137 DOI: 10.1136/bmj.p56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Christopher J Graham
- University of Manchester, Manchester, UK
- Royal College of Physicians of Edinburgh, Edinburgh, Scotland
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15
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Uusitalo L, Nevalainen J, Rahkonen O, Erkkola M, Saarijärvi H, Fogelholm M, Lintonen T. Changes in alcohol purchases from grocery stores after authorising the sale of stronger beverages: The case of the Finnish alcohol legislation reform in 2018. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 39:589-604. [PMID: 36452445 PMCID: PMC9703366 DOI: 10.1177/14550725221082364] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/07/2022] [Indexed: 08/17/2023] Open
Abstract
Aims: The Finnish alcohol law was reformed in January 2018. The availability of alcoholic beverages in grocery stores increased as the legal limit for retail sales of alcoholic drinks was raised from 4.7% to 5.5% alcohol, and the requirement of production by fermentation was abolished. We analysed how the inclusion of strong beers, ciders, and ready-to-drink beverages in grocery stores was reflected in alcohol purchases, and how these changes differed by age, sex, level of education and household income. Design: The study sample included 47,066 loyalty card holders from the largest food retailer in Finland. The data consisted of longitudinal, individual-level information on alcohol purchases from grocery stores, covering the time period between 1 January 2017 and 31 December 2018. The volumes of absolute alcohol during a calendar year from beers, ciders, ready-to-drink beverages, and in total, were calculated. Alcohol purchases in 2017 and 2018 were compared. Results: There was no overall change in the total alcohol (0.04 [95% CI -0.03, 0.11] litres/year) or beer purchases (-0.05 [95% CI -0.11, 0.02] litres/year). Purchases of ready-to-drink beverages increased by 0.10 [95% CI 0.09, 0.11] litres/year (+ 84%). Total alcohol purchases increased in the three highest income groups, whereas they decreased in the two lowest groups (p for the interaction < 0.0001). Conclusions: The increased purchases of alcohol as ready-to-drink beverages were, on the average, compensated for by a decrease in purchases of other alcoholic beverages. Higher prices probably limited the purchases among lower income groups and younger consumers, while the increase was sharper in higher income groups.
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Affiliation(s)
| | | | | | | | | | | | - Tomi Lintonen
- Finnish Foundation for Alcohol Studies c/o THL,
Helsinki, Finland
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16
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Craig P, Campbell M, Bauman A, Deidda M, Dundas R, Fitzgerald N, Green J, Katikireddi SV, Lewsey J, Ogilvie D, de Vocht F, White M. Making better use of natural experimental evaluation in population health. BMJ 2022; 379:e070872. [PMID: 36280251 PMCID: PMC7613963 DOI: 10.1136/bmj-2022-070872] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mhairi Campbell
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Adrian Bauman
- School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Manuela Deidda
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Ruth Dundas
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Niamh Fitzgerald
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Judith Green
- Wellcome Centre for Cultures and Environments of Health, University of Exeter, Exeter, UK
| | - Srinivasa Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jim Lewsey
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - David Ogilvie
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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17
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Rehm J, O'Donnell A, Kaner EFS, Jane LLopis E, Manthey J, Anderson P. Differential impact of minimum unit pricing on alcohol consumption between Scottish men and women: controlled interrupted time series analysis. BMJ Open 2022; 12:e054161. [PMID: 35851006 PMCID: PMC9315916 DOI: 10.1136/bmjopen-2021-054161] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the immediate impact of the introduction of minimum unit pricing (MUP) in Scotland on alcohol consumption and whether the impact differed by sex, level of alcohol consumption, age, social grade and level of residential deprivation of respondents. DESIGN Primary controlled interrupted time series analysis and secondary before-and-after analysis of the impact of introducing MUP in Scotland using alcohol consumption data for England as control. SETTING Data from Kantar Worldpanel's Alcovision survey, a continuous retrospective online timeline follow-back diary survey of the previous week's alcohol consumption. PARTICIPANTS 53 347 women and 53 143 men. INTERVENTIONS Introduction of a minimum price of 50 pence per UK unit (6.25 pence/g) for the sale of alcohol in Scotland on 1 May 2018. MAIN OUTCOME MEASURES Number of grams of alcohol consumed per week, in total, in off-trade (eg, at home) and in on-trade (eg, in pubs, restaurants). RESULTS Primary interrupted time series analyses found that the introduction of MUP was associated with a drop in reported weekly total alcohol consumption of 5.94 g (95% CI 1.29 to 10.60), a drop in off-trade consumption of 3.27 g (95% CI -0.01 to 6.56) and a drop in on-trade consumption of 2.67 g (95% CI -1.48 to 6.82). Associated reductions were larger for women than for men and were greater among heavier drinkers than for lighter drinkers, except for the 5% of heaviest drinking men for whom an associated increase in consumption was found. Secondary before-and-after analyses found that reductions in consumption were greater among older respondents and those living in less deprived areas. The introduction of MUP was not associated with a reduction in consumption among younger men and men living in more deprived areas. CONCLUSIONS Greater policy attention needs to be addressed to the heaviest drinking men, to younger men and to men who live in more deprived areas.
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Affiliation(s)
- Jürgen Rehm
- Social and Epidemiological Research, CAMH, Toronto, Ontario, Canada
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen F S Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eva Jane LLopis
- Department of Health Promotion, Maastricht University, Maastricht, Limburg, The Netherlands
- ESADE Business School, Ramon Llull University, Barcelona, Spain
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Peter Anderson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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18
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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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19
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Fitzgerald N, Manca F, Uny I, Martin JG, O'Donnell R, Ford A, Begley A, Stead M, Lewsey J. Lockdown and licensed premises: COVID-19 lessons for alcohol policy. Drug Alcohol Rev 2021; 41:533-545. [PMID: 34904313 PMCID: PMC9300075 DOI: 10.1111/dar.13413] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 01/24/2023]
Abstract
Introduction The COVID‐19 pandemic necessitated unprecedented changes in alcohol availability, including closures, curfews and restrictions. We draw on new data from three UK studies exploring these issues to identify implications for premises licensing and wider policy. Methods (i) Semi‐structured interviews (n = 17) with licensing stakeholders in Scotland and England reporting how COVID‐19 has reshaped local licensing and alcohol‐related harms; (ii) semi‐structured interviews (n = 15) with ambulance clinicians reporting experiences with alcohol during the pandemic; and (iii) descriptive and time series analyses of alcohol‐related ambulance callouts in Scotland before and during the first UK lockdown (1 January 2019 to 30 June 2020). Results COVID‐19 restrictions (closures, curfews) affected on‐trade premises only and licensing stakeholders highlighted the relaxation of some laws (e.g. on takeaway alcohol) and a rise in home drinking as having long‐term risks for public health. Ambulance clinicians described a welcome break from pre‐pandemic mass public intoxication and huge reductions in alcohol‐related callouts at night‐time. They also highlighted potential long‐term risks of increased home drinking. The national lockdown was associated with an absolute fall of 2.14 percentage points [95% confidence interval (CI) −3.54, −0.74; P = 0.003] in alcohol‐related callouts as a percentage of total callouts, followed by a daily increase of +0.03% (95% CI 0.010, 0.05; P = 0.004). Discussion and Conclusions COVID‐19 gave rise to both restrictions on premises and relaxations of licensing, with initial reductions in alcohol‐related ambulance callouts, a rise in home drinking and diverse impacts on businesses. Policies which may protect on‐trade businesses, while reshaping the night‐time economy away from alcohol‐related harms, could offer a ‘win–win’ for policymakers and health advocates.
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Affiliation(s)
- Niamh Fitzgerald
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK.,SPECTRUM Consortium, Edinburgh, UK
| | - Francesco Manca
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Isabelle Uny
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Jack Gregor Martin
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Rachel O'Donnell
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Allison Ford
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Amelie Begley
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Martine Stead
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Jim Lewsey
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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20
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Alcohol Consumption during the COVID-19 Lockdown Period: Predictors of At-Risk Drinking at Different AUDIT-C Cut-Off Thresholds. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413042. [PMID: 34948646 PMCID: PMC8701825 DOI: 10.3390/ijerph182413042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/26/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022]
Abstract
During the COVID-19 pandemic, alcohol consumption was largely confined to drinking in the home. There has been little research examining variables associated with risk in home drinking. The study employed an online survey of (n = 1128) individuals who had been recruited for their face recognition skills (n = 838, 70.9% females, mean age 45.05 (12.3 SD)). The main dependent variables were three different AUDIT-C cut-off scores for at-risk drinking: (a) 5 for both genders as recommended by Public Health England, (b) 7 for females and 8 for males (cut-off for students and young people) and (c) 8 for both genders (individuals seeking online help for their drinking). Among the independent variables were gender and age, motivations for home drinking using the Home Drinking Assessment Scale (HDAS), purchasing patterns, context of drinking and health and wellbeing. The predictors following hierarchical logistic regressions were for (a) purchasing alcohol online or at a supermarket and emotional HDAS scores, (b) purchasing alcohol online or at a supermarket and for parties, drinking alone and with other members of the household and emotional and practical reason HDAS scores, (c) as for b with the addition that men were more likely to be at-risk drinkers. At-risk drinking in the pandemic was explained by motivational reasons, purchasing patterns and situational factors.
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21
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Finlay IG, Severi K. Commentary on Robinson et al.: England needs minimum pricing to tackle alcohol's hidden harms-Scotland's experience shows minimum unit pricing (MUP) on off-trade alcohol sales is effective. Addiction 2021; 116:2708-2709. [PMID: 34085346 DOI: 10.1111/add.15578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Ilora G Finlay
- Commission on Alcohol Harms (supported by the Alcohol Health Alliance UK) and House of Lords, London, UK
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22
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Gibbs N, Angus C, Dixon S, Parry C, Meier P. Effects of minimum unit pricing for alcohol in South Africa across different drinker groups and wealth quintiles: a modelling study. BMJ Open 2021; 11:e052879. [PMID: 34373316 PMCID: PMC8354280 DOI: 10.1136/bmjopen-2021-052879] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To quantify the potential impact of minimum unit pricing (MUP) for alcohol on alcohol consumption, spending and health in South Africa. We provide these estimates disaggregated by different drinker groups and wealth quintiles. DESIGN We developed an epidemiological policy appraisal model to estimate the effects of MUP across sex, drinker groups (moderate, occasional binge, heavy) and wealth quintiles. Stakeholder interviews and workshops informed model development and ensured policy relevance. SETTING South African drinking population aged 15+. PARTICIPANTS The population (aged 15+) of South Africa in 2018 stratified by drinking group and wealth quintiles, with a model time horizon of 20 years. MAIN OUTCOME MEASURES Change in standard drinks (SDs) (12 g of ethanol) consumed, weekly spend on alcohol, annual number of cases and deaths for five alcohol-related health conditions (HIV, intentional injury, road injury, liver cirrhosis and breast cancer), reported by drinker groups and wealth quintile. RESULTS We estimate an MUP of R10 per SD would lead to an immediate reduction in consumption of 4.40% (-0.93 SD/week) and an increase in spend of 18.09%. The absolute reduction is greatest for heavy drinkers (-1.48 SD/week), followed by occasional binge drinkers (-0.41 SD/week) and moderate drinkers (-0.40 SD/week). Over 20 years, we estimate 20 585 fewer deaths and 9 00 332 cases averted across the five health-modelled harms.Poorer drinkers would see greater impacts from the policy (consumption: -7.75% in the poorest quintile, -3.19% in richest quintile). Among the heavy drinkers, 85% of the cases averted and 86% of the lives saved accrue to the bottom three wealth quintiles. CONCLUSIONS We estimate that MUP would reduce alcohol consumption in South Africa, improving health outcomes while raising retail and tax revenue. Consumption and harm reductions would be greater in poorer groups.
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Affiliation(s)
- Naomi Gibbs
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Simon Dixon
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Charles Parry
- Alcohol, Tobacco and Other Drugs Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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