1
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Farkouh EK, Vallance K, Wettlaufer A, Giesbrecht N, Asbridge M, Farrell-Low AM, Gagnon M, Price TR, Priore I, Shelley J, Sherk A, Shield KD, Solomon R, Stockwell TR, Thompson K, Vishnevsky N, Naimi TS. An assessment of federal alcohol policies in Canada and priority recommendations: Results from the 3rd Canadian Alcohol Policy Evaluation Project. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024:10.17269/s41997-024-00889-3. [PMID: 38739320 DOI: 10.17269/s41997-024-00889-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/02/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To systematically assess the Canadian federal government's current alcohol policies in relation to public health best practices. METHODS The 2022 Canadian Alcohol Policy Evaluation (CAPE) Project assessed federal alcohol policies across 10 domains. Policy domains were weighted according to evidence for their relative impact, including effectiveness and scope. A detailed scoring rubric of best practices was developed and externally reviewed by international experts. Policy data were collected between June and December 2022, using official legislation, government websites, and data sources identified from previous iterations of CAPE as sources. Contacts within relevant government departments provided any additional data sources, reviewed the accuracy and completeness of the data, and provided amendments as needed. Data were scored independently by members of the research team. Final policy scores were tabulated and presented as a weighted overall average score and as unweighted domain-specific scores. RESULTS Compared to public health best practices, the federal government of Canada scored 37% overall. The three most impactful domains-(1) pricing and taxation, (2) marketing and advertising controls, and (3) impaired driving countermeasures-received some of the lowest scores (39%, 10%, and 40%, respectively). Domain-specific scores varied considerably from 0% for minimum legal age policies to 100% for controls on physical availability of alcohol. CONCLUSION Many evidence-informed alcohol policies have not been adopted, or been adopted only partially, by the Canadian federal government. Urgent adoption of the recommended policies is needed to prevent and reduce the enormous health, social, and economic costs of alcohol use in Canada.
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Affiliation(s)
- Elizabeth K Farkouh
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA.
| | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Ashley Wettlaufer
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
| | - Norman Giesbrecht
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Amanda M Farrell-Low
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Marilou Gagnon
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Tina R Price
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Isabella Priore
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Jacob Shelley
- Faculty of Law, University of Western Ontario, London, ON, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kevin D Shield
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Robert Solomon
- Faculty of Law, University of Western Ontario, London, ON, Canada
| | - Tim R Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kara Thompson
- St. Francis Xavier University, Antigonish, NS, Canada
| | - Nicole Vishnevsky
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Timothy S Naimi
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
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2
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Bailey A, Harps M, Belcher C, Williams H, Amos C, Donovan B, Sedore G, Victoria S, Graham B, Goulet-Stock S, Cartwright J, Robinson J, Farrell-Low A, Willson M, Sutherland C, Stockwell T, Pauly B. Translating the lived experience of illicit drinkers into program guidance for cannabis substitution: Experiences from the Canadian Managed Alcohol Program Study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 122:104244. [PMID: 37950943 DOI: 10.1016/j.drugpo.2023.104244] [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: 06/07/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/13/2023]
Abstract
A small but growing body of research has suggested the potential for cannabis substitution to support Managed Alcohol Program (MAP) service users to reduce acute and chronic alcohol-related harms. In 2022, researchers from the Canadian Managed Alcohol Program Study (CMAPS) noted a dearth of accessible, alcohol-specific educational resources to support service users and program staff to implement cannabis substitution pilots at several MAP sites in Canada. In this essay, we draw on over 10-years of collaboration between CMAPS, and organizations of people with lived experience (the Eastside Illicit Drinkers Group for Education (EIDGE) and SOLID Victoria) to describe our experiences co-creating cannabis education resources where none existed to support MAP sites interested in beginning to provide cannabis to participants. The research team relied on the unique lived experiences and informal cannabis-related harm reduction strategies described by EIDGE and SOLID members to create cannabis education resources that were accurate and relevant to MAP sites. EIDGE was familiar with creating peer-oriented educational resources and convened meetings and focus groups to engage peers. CMAPS research team members created standard cannabis unit equivalencies to support program delivery, and clinical advisors ensured that the stated risks and benefits of cannabis substitution, as well as tapering guidance for withdrawal management, were safe and feasible. The collaboration ultimately produced tailored client-facing and provider-facing resources. Our experience demonstrates that the lived expertise of drinkers can play an integral role in creating alcohol harm reduction informational materials, specifically those related to cannabis substitution, when combined with data from rigorous, community-based programs of research like CMAPS. We close by listing additional considerations for cannabis substitution program design for MAP settings emerging from this process of collaboration between illicit drinkers, service providers, clinicians, and researchers for consideration by other programs.
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Affiliation(s)
- Aaron Bailey
- Vancouver Area Network of Drug Users, 380 E Hastings Street, Vancouver BC V6A 1P4, Canada.
| | - Myles Harps
- Vancouver Area Network of Drug Users, 380 E Hastings Street, Vancouver BC V6A 1P4, Canada
| | - Clint Belcher
- Vancouver Area Network of Drug Users, 380 E Hastings Street, Vancouver BC V6A 1P4, Canada
| | - Henry Williams
- Vancouver Area Network of Drug Users, 380 E Hastings Street, Vancouver BC V6A 1P4, Canada
| | - Cecil Amos
- Vancouver Area Network of Drug Users, 380 E Hastings Street, Vancouver BC V6A 1P4, Canada
| | - Brent Donovan
- SOLID Victoria, 1056 N Park Street, Victoria, BC V8T 1C6, Canada
| | - George Sedore
- Vancouver Area Network of Drug Users, 380 E Hastings Street, Vancouver BC V6A 1P4, Canada
| | - Solid Victoria
- SOLID Victoria, 1056 N Park Street, Victoria, BC V8T 1C6, Canada
| | - Brittany Graham
- Vancouver Area Network of Drug Users, 380 E Hastings Street, Vancouver BC V6A 1P4, Canada
| | - Sybil Goulet-Stock
- Department of Psychology, University of Victoria, 3800 Finnerty Rd, Cornett Building (COR), A236, Victoria, BC V8P 5C2, Canada
| | - Jenny Cartwright
- Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada
| | - Jennifer Robinson
- Department of Anthropology, University of Victoria, 3800 Finnerty Rd, Cornett Building (COR), B228, Victoria, BC V8P 5C2, Canada
| | - Amanda Farrell-Low
- Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada
| | - Mark Willson
- SOLID Victoria, 1056 N Park Street, Victoria, BC V8T 1C6, Canada
| | - Christy Sutherland
- PHS Community Services Society, 9 E Hastings St, Vancouver, BC V6A 1M9, Canada
| | - Tim Stockwell
- Department of Psychology, University of Victoria, 3800 Finnerty Rd, Cornett Building (COR), A236, Victoria, BC V8P 5C2, Canada
| | - Bernie Pauly
- Department of Nursing, University of Victoria, 3800 Finnerty Rd, HSD Building, A402A, Victoria BC V8P 5C2, Canada
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3
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Sherk A, Stockwell T, Sorge J, Churchill S, Angus C, Chikritzhs T, Holmes J, Meier P, Naimi TS, Norström T, Ramstedt M, Simpura J. The public-private decision for alcohol retail systems: Examining the economic, health, and social impacts of alternative systems in Finland. NORDIC STUDIES ON ALCOHOL AND DRUGS 2023; 40:218-232. [PMID: 37255607 PMCID: PMC10225965 DOI: 10.1177/14550725231160335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 09/20/2023] Open
Abstract
Background: Organising alcohol retail systems with more or less public ownership has implications for health and the economy. The aim of the present study was to estimate the economic, health, and social impacts of alcohol use in Finland in 2018 (baseline), and in two alternative scenarios in which current partial public ownership of alcohol retail sales is either increased or fully privatised. Methods: Baseline alcohol-attributable harms and costs were estimated across five categories of death, disability, and criminal justice. Two alternate alcohol retail systems were defined as privately owned stores selling: (1) only low strength alcoholic beverages (public ownership scenario, similar to Sweden); or (2) all beverages (private ownership scenario). Policy analyses were conducted to estimate changes in alcohol use per capita. Health and economic impacts were modelled using administrative data and epidemiological modelling. Results: In Finland in 2018, alcohol use was estimated to be responsible for €1.51 billion (95% Uncertainty Estimates: €1.43 billion, €1.58 billion) in social cost, 3,846 deaths, and 270,652 criminal justice events. In the public ownership scenario, it was estimated that alcohol use would decline by 15.8% (11.8%, 19.7%) and social cost by €384.3 million (€189.5 million, €559.2 million). Full privatisation was associated with an increase in alcohol use of 9.0% (6.2%, 11.8%) and an increase in social cost of €289.7 million (€140.8 million, €439.5 million). Conclusion: The outcome from applying a novel analytical approach suggests that more public ownership of the alcohol retail system may lead to significant decreases in alcohol-caused death, disability, crime, and social costs. Conversely, full privatisation of the ownership model would lead to increased harm and costs.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Mats Ramstedt
- The Swedish Council for Information on Alcohol and Other Drugs, Sweden
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4
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Friesen EL, Staykov E, Myran DT. Understanding the association between neighbourhood socioeconomic status and grocery store alcohol sales following market liberalization in Ontario, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:254-263. [PMID: 36214995 PMCID: PMC10036712 DOI: 10.17269/s41997-022-00694-w] [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: 02/08/2022] [Accepted: 08/31/2022] [Indexed: 03/24/2023]
Abstract
OBJECTIVES In 2015, Ontario partially deregulated alcohol sales by allowing grocery stores to sell alcohol. The purpose of this study was to evaluate (1) whether neighbourhood-level socioeconomic status (SES) impacted the likelihood that a grocery store began selling alcohol, and (2) whether increases in alcohol retail availability following deregulation differed between neighbourhoods based on SES. METHODS This was a repeated cross-sectional analysis of 1062 grocery stores in 17,096 neighbourhoods in urban Ontario. The association between neighbourhood-level SES and whether a grocery store began selling alcohol was modeled using mixed effect logistic regression. The annual change in drive-distance from a neighbourhood to the closest off-premise alcohol outlet between 2015 and 2020 was modeled using mixed effect linear regression. An interaction between time and SES was included to evaluate whether this change differed between neighbourhoods based on SES. RESULTS Grocery stores in neighbourhoods in the lowest SES quintile were 39% less likely to start selling alcohol than grocery stores in neighbourhoods in the highest SES quintile (odds ratio (OR): 0.61, 95% confidence interval (CI): 0.39-0.94). As grocery store sales expanded, the distance to the closest off-premise alcohol outlet decreased by 51.8 m annually (95% CI: 48.8-54.9, p < 0.01). A significant interaction between year and SES was observed whereby this trend was more pronounced in high- versus low-SES neighbourhoods. CONCLUSION The expansion of grocery store alcohol sales increased alcohol availability, but this increase was proportionately larger in high- versus low-SES neighbourhoods. This reduced historic disparities in alcohol availability between low- and high-SES neighbourhoods.
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Affiliation(s)
- Erik Loewen Friesen
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.
| | - Emiliyan Staykov
- Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Thomas Myran
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
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5
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Friesen EL, Yu W, Buajitti E, Selby P, Rosella L, Kurdyak P. Clarifying rural-urban disparities in alcohol-related emergency department visits and hospitalizations in Ontario, Canada: A spatial analysis. J Rural Health 2023; 39:223-232. [PMID: 35866637 DOI: 10.1111/jrh.12702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE Rates of alcohol-related harm are higher in rural versus urban Canada. This study characterized the spatial distribution and regional determinants of alcohol-related emergency department (ED) visits and hospitalizations in Ontario to better understand this rural-urban disparity. METHODS This was a cross-sectional spatial analysis of rates of alcohol-related ED visits and hospitalizations by Ministry of Health subregion (n = 76) in Ontario, Canada between 2016 and 2019. Regional hot- and cold-spots of alcohol-related harm were identified using spatial autocorrelation methods. Rurality was measured as the population weighted geographic remoteness of a subregion. The associations between rurality and rates of alcohol-related ED visits and hospitalizations were evaluated using hierarchical Bayesian spatial regression models. FINDINGS Rates of alcohol-related ED visits and hospitalizations varied substantially between subregions, with high rates clustering in Northern Ontario. Overall, increasing rurality was associated with higher subregion-level rates of alcohol-related ED visits (males adjusted relative rate [aRR]: 1.67, 95% credible interval [CI]: 1.49-1.87; females aRR: 1.78, 95% CI: 1.60-1.98) and hospitalizations (males aRR: 1.34, 95% CI: 1.24-1.45; females aRR: 1.59, 95% CI: 1.45-1.74). However, after the province was separated into Northern and Southern strata, this association only held in Northern subregions. In contrast, increasing rurality was associated with lower rates of alcohol-related ED visits in Southern subregions (males aRR: 0.87, 95% CI: 0.79-0.96; females aRR: 0.88, 95% CI: 0.81-0.97). CONCLUSIONS There are regional differences in the association between rurality and alcohol-related health service use. This regional variation should be considered when developing health policies to minimize geographic disparities in alcohol-related harm.
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Affiliation(s)
- Erik Loewen Friesen
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada
| | | | - Emmalin Buajitti
- ICES, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Peter Selby
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Laura Rosella
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Paul Kurdyak
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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6
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Auchincloss AH, Niamatullah S, Adams M, Melly SJ, Li J, Lazo M. Alcohol outlets and alcohol consumption in changing environments: prevalence and changes over time. Subst Abuse Treat Prev Policy 2022; 17:7. [PMID: 35120532 PMCID: PMC8815126 DOI: 10.1186/s13011-021-00430-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND To examine whether changes in density of neighborhood alcohol outlets affected changes in alcohol consumption 1-year after regulatory changes increased alcohol availability. METHODS Person-level data came from a population-based cohort (aged 21-64) residing in/around the Philadelphia, Pennsylvania metropolitan area (2016-2018, N = 772). Fifty-eight percent lived in a state that began implementing new regulations (Pennsylvania) and the remainder lived in states without major regulatory changes (Delaware and New Jersey). Alcohol consumption was assessed as days per week (pw), drinks pw, high consumption (≥8 drinks pw), and binge drinking. Availability of off-premise alcohol outlets was assessed using 1-mile density and distance. Regression models adjusted for age, gender, race/ethnicity, income, education, health status, state and population density. RESULTS Cross-sectional analyses found that higher outlet density was associated with more alcohol consumption (days, drinks, high consumption; all p < 0.03) and residing farther from an outlet was associated with less alcohol consumption (days and drinks; all p < 0.04). In longitudinal analyses, relative to no change in outlets, exposure to more outlets was associated with 64% higher odds of drinking on more days pw (p < 0.049) and 55% higher odds of consuming more drinks pw (p < 0.081). However, the longitudinal association between changes in outlets and changes in consumption did not differ for residents in Pennsylvania vs. nearby states. In cross-sectional and longitudinal analyses, outlets were not related to binge drinking. CONCLUSION Off-premise outlets were associated with alcohol consumption consistently in cross-sectional analysis and in some longitudinal analyses. Results can inform future studies that wish to evaluate longer-term changes in increased alcohol availability and effects on consumption.
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Affiliation(s)
- Amy H Auchincloss
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA. .,Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.
| | - Saima Niamatullah
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Maura Adams
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Steven J Melly
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Jingjing Li
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Mariana Lazo
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.,Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
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7
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Ye Y, Cherpitel CJ, Terza JV, Kerr WC. Quantifying risk of injury from usual alcohol consumption: An instrumental variable analysis. Alcohol Clin Exp Res 2021; 45:2029-2039. [PMID: 34342011 PMCID: PMC8602733 DOI: 10.1111/acer.14684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/28/2021] [Accepted: 07/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Numerous studies of roadside accidents among emergency room patients show elevated risk of injury from acute alcohol consumption, i.e., recent drinking precedes the injury event. The observed effects are large and show a dose-response relationship. In contrast, studies quantifying the association between injury risk and chronic consumption, such as past-year average volume, show lower relative risk estimates than those from acute consumption. METHODS Combining data from 4 waves of US National Alcohol Surveys (NAS) for years 2000-2015 (N = 29,571, 53% overall cooperation rate), we estimated the risk of any past-year injury from past-year volume using logistic regression. This was contrasted with an instrumental variable (IV) analysis utilizing a 2-stage residual inclusion (2SRI) approach to estimate injury risk from volume, which adjusted for unobserved confounders using state beer and spirits tax rates, zip code-level outlet and bar density, and control state status as instruments. RESULTS Based on the combined US population surveys and controlling for sociodemographics, using conventional logistic regression, the odds ratios of injury from an average volume of 1, 2, and 5 drinks per day were 1.12 [95% confidence interval: 1.02, 1.24], 1.10 [1.00, 1.22], and 1.04 [0.88, 1.22], respectively. These compared with 1.67 [1.00, 2.78], 2.38 [0.87, 6.54], and 6.98 [0.57, 85.89] using the IV method. The proportion of injury attributed to alcohol also increased in magnitude, from 6.2% [0.3%, 11.9%] using the conventional approach to 17.9% [8.2%, 27.7%] using the IV method. CONCLUSIONS The association between injury and chronic alcohol consumption may be confounded by unobserved factors, resulting in a possible downward bias of the risk estimate.
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Affiliation(s)
- Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, CA
| | | | - Joseph V. Terza
- Department of Economics, Indiana University School of Liberal Arts at IUPUI
| | - William C. Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, CA
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8
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Myran DT, Staykov E, Cantor N, Taljaard M, Quach BI, Hawken S, Tanuseputro P. How has access to legal cannabis changed over time? An analysis of the cannabis retail market in Canada 2 years following the legalisation of recreational cannabis. Drug Alcohol Rev 2021; 41:377-385. [PMID: 34250645 DOI: 10.1111/dar.13351] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/04/2021] [Accepted: 06/14/2021] [Indexed: 02/01/2023]
Abstract
INTRODUCTION This study describes the legal recreational cannabis market across Canada over the 2 years following legalisation. We compared changes in access to the legal cannabis retail market for all provinces and territories (jurisdictions) in Canada and explored differences between jurisdictions. METHODS We collected data for all legal cannabis stores in Canada over five time periods following legalisation in October 2018. We examined the following measures by jurisdiction and retail model (public vs. private operation): absolute and per capita store numbers, hours of operation and store access across neighbourhoods. RESULTS Two years following legalisation, there were a total of 1183 legal cannabis stores open across Canada (3.7 stores per 100 000 individuals aged 15+). There was wide variation between jurisdictions in access to retail stores, with the lowest stores per capita in Quebec and Ontario (0.6 and 1.6 per 100 000), and the highest in Alberta and Yukon (14.3 per 100 000 in both). Jurisdictions with private retail models had more stores (4.8 vs. 1.0 per 100 000), held greater median weekly hours (80 vs. 69) and experienced greater store growth over time compared to public models. After adjusting for confounders, there were 1.96 times (95% confidence intervals: 1.84, 2.09) more cannabis stores within 1000 m of the lowest- compared to the highest-income quintile neighbourhoods. DISCUSSION AND CONCLUSIONS While access to the recreational cannabis retail market has increased following legalisation, there is substantial variation in access between jurisdictions and evidence of concentration in lower-income neighbourhoods. These differences may contribute to disparities in cannabis use and harms.
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Affiliation(s)
- Daniel T Myran
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Emiliyan Staykov
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada
| | - Nathan Cantor
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada
| | - Monica Taljaard
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Bradley I Quach
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Steven Hawken
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Peter Tanuseputro
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Bruyère Research Institute, Ottawa, Canada.,Department of Medicine, University of Ottawa, Ottawa, Canada
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9
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Subbaraman MS, Mulia N, Ye Y, Greenfield TK, Kerr WC. Alcohol policy effects on 100% chronic alcohol-attributable mortality across racial/ethnic subgroups. Prev Med 2021; 145:106450. [PMID: 33549683 PMCID: PMC8631687 DOI: 10.1016/j.ypmed.2021.106450] [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: 07/31/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
In the United States, some racial/ethnic minorities suffer from higher rates of chronic alcohol problems, and alcohol-related morbidity and mortality than Whites. Furthermore, state-level alcohol policies may affect racial/ethnic subgroups differentially. We investigate effects of beverage-specific taxes and government control of spirits retail on alcohol-related mortality among non-Hispanic Whites, non-Hispanic Blacks, non-Hispanic American Indians/Alaska Natives (AI/AN) and Hispanics using death certificate and state-level alcohol policy data for 1999-2016. Outcomes were analyzed as mortality rates (per 10,000) from 100% alcohol-attributable chronic conditions ("100% chronic AAD"). Statistical models regressed racial/ethnic-specific logged mortality rates on state-level, one-year lagged and logged beer tax, one-year lagged and logged spirits tax, and one-year lagged government-controlled spirits sales, adjusted for mortality trends, fixed effects for state, and clustering of standard errors. Government control was significantly (P < 0.05) related to 3% reductions in Overall and non-Hispanic White mortality rates, and 4% reductions in Hispanic mortality rates from 100% chronic AAD. Tax associations were not robust. Results support that government control of spirits retail is associated with significantly lower 100% AAD from chronic causes Overall and among non-Hispanic Whites and Hispanics. Government control of spirits retail may reduce both population-level 100% chronic AAD as well as racial/ethnic disparities in 100% chronic AAD.
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Affiliation(s)
| | - Nina Mulia
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | | | - William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
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10
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Gohari MR, Cook RJ, Dubin JA, Leatherdale ST. The impact of an alcohol policy change on developmental trajectories of youth alcohol use: examination of a natural experiment in Canada. Canadian Journal of Public Health 2020; 112:210-218. [PMID: 32761543 DOI: 10.17269/s41997-020-00366-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/08/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES In 2015, the Liquor Control Board of Ontario (LCBO) authorized sale of alcohol in some Ontario grocery stores. This research evaluates the impact of the new policy on alcohol use patterns of youth in a quasi-experimental setting with two control groups. METHODS The sample consists of 2267 grade 9 students attending 60 secondary schools across Ontario (n = 56) and Alberta (n = 4), who provided 4-year linked longitudinal data (2013-2014 to 2016-2017) in the COMPASS study. The study used the frequency of drinking and the frequency of binge drinking to characterize alcohol use behaviours. RESULTS Latent transition analysis found four statuses of alcohol use: abstainer, periodic drinker, low-risk drinker, and high-risk regular drinker. The new policy had no negative impact among periodic and low-risk drinkers, but the risk of transitioning from the abstainer (lowest risk status) to high-risk regular drinker (highest risk status) among the exposed cohort was 1.71 times greater post-policy than pre-policy change, compared with those of Ontario-unexposed (0.50) and Alberta-unexposed cohorts (1.00). The probability of sustaining high-risk drinking among the exposed cohort increased by a factor of 1.76, compared with 1.13-fold and 0.89-fold among the Ontario-unexposed and Alberta-unexposed cohorts, respectively. CONCLUSION Youth are more likely to transition from abstinence to high-risk regular drinking, and high-risk regular drinkers are more likely to maintain their behaviours in the jurisdictions exposed to the latest change in LCBO policy authorizing grocery stores to sell alcohol. When formulating policy interventions, youth access to alcohol should be considered in order to reduce their harmful alcohol consumption.
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Affiliation(s)
- Mahmood R Gohari
- University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada.
| | - Richard J Cook
- University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Joel A Dubin
- University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Scott T Leatherdale
- University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
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11
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Gohari MR, Cook RJ, Dubin JA, Leatherdale ST. Identifying patterns of alcohol use among secondary school students in Canada: A multilevel latent class analysis. Addict Behav 2020; 100:106120. [PMID: 31622948 DOI: 10.1016/j.addbeh.2019.106120] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Harm from alcohol use depend not only on the volume of consumption but also on drinking patterns. This study identifies patterns of alcohol consumption in youth and investigates how these patterns vary across schools and whether individual- and school-level factors are associated with engagement in patterns of alcohol consumption. METHODS The sample consists of 45,298 grade 9 to 12 students attending 89 secondary schools across Ontario and Alberta (Canada), who participated in the COMPASS study during the school year 2013-14. The frequency of drinking, the frequency of binge drinking, and age of alcohol-use initiation were used to characterize alcohol use patterns. RESULTS The multilevel latent class analysis identified 4 student-level latent groups and 2 school-level latent groups. Student-level groups of youth were characterized as non-drinkers (44.2%), light drinkers (41.8%), regular drinkers (11.1%), and heavy drinkers (2.9%). Two groups of schools were characterized as either low-use (44.9%) or high-use (55.1%) schools, with significantly different probability of membership in each student-level group. Male students (OR 1.30) and upper grades (OR 1.93) were significantly associated with membership in higher use groups of individuals. The median household income and the number of off-premise alcohol outlets had no significant association with patterns of alcohol consumption within schools. CONCLUSIONS A large proportion of students reported a level of drinking, suggesting that, in addition to delaying the onset of alcohol use, interventions need to encourage drinker students to quit drinking or lower their consumption. Schools may need to select and/or alter external interventions according to the dominant patterns of alcohol use among their students.
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Affiliation(s)
- Mahmood R Gohari
- School of Public Health and Health Systems, University of Waterloo, Canada.
| | - Richard J Cook
- Department of Statictics and Actuarial Science, University of Waterloo, Canada.
| | - Joel A Dubin
- Department of Statistics and Actuarial Science And School of Public Health and Health Systems, University of Waterloo, Canada.
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12
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Williams E, Kerr WC, Barnett SBL. Price Changes in Washington Following the 2012 Liquor Privatization: An Update Through 2016 With Comparisons to California, Idaho, and Oregon. Alcohol Clin Exp Res 2019; 44:501-510. [PMID: 31851383 DOI: 10.1111/acer.14255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 11/18/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Washington State ended their wholesale and retail monopoly on liquor on June 1, 2012, resulting in a 5-fold increase in liquor outlets in diverse store types. The legislation also included taxes at the wholesale and retail levels. This study seeks to investigate whether prices have changed from 2014 through 2016, as a follow-up to a previous study finding increases in prices from 2012 to 2014, compared to prices in other states. METHODS We developed an index of 68 brands that were popular in Washington in early 2012. Data on final liquor prices (including taxes) in Washington and California were obtained through store visits and online sources between November 2013 and March 2014, and again between April and May 2016 for Washington only. Pricing data for Idaho and Oregon were obtained from the Statistics for Alcohol Management Database over both sampling periods. Primary analyses were conducted on the utmost brands available in the majority of the stores sampled. RESULTS Liquor prices in Washington rose an average of 3.9% for 750 ml and 6.5% for 1.75-l containers overall from 2014 to 2016, while bordering states Idaho (+2.9%) and Oregon (+1.5%) experienced smaller increases for 750-ml and declines for 1.75-l containers (Idaho: -2.9%, Oregon: -4.9%). In the analyses of spirits prices in Washington compared to California, prices in California were 24.1% lower for 750-ml containers and 29.6% lower for 1.75-l containers. CONCLUSIONS Our findings indicate liquor prices in Washington have increased since our 2014 assessment at a larger percentage than prices in the neighboring control states Oregon and Idaho, with varying effects on brands, container sizes, and store types. We demonstrate privatization is associated with a different pattern of prices across store types than seen in California.
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Affiliation(s)
- Edwina Williams
- Public Health Institute, Alcohol Research Group, Emeryville, California
| | - William C Kerr
- Public Health Institute, Alcohol Research Group, Emeryville, California
| | - Sarah Beth L Barnett
- Public Health Institute, Alcohol Research Group, Emeryville, California.,University of California, Berkeley, Berkeley, California
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Castillo-Carniglia A, Pear VA, Tracy M, Keyes KM, Cerdá M. Limiting Alcohol Outlet Density to Prevent Alcohol Use and Violence: Estimating Policy Interventions Through Agent-Based Modeling. Am J Epidemiol 2019; 188:694-702. [PMID: 30608509 DOI: 10.1093/aje/kwy289] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 12/12/2018] [Accepted: 12/12/2018] [Indexed: 12/27/2022] Open
Abstract
Increasing alcohol outlet density is well-documented to be associated with increased alcohol use and problems, leading to the policy recommendation that limiting outlet density will decrease alcohol problems. Yet few studies of decreasing problematic outlets and outlet density have been conducted. We estimated the association between closing alcohol outlets and alcohol use and alcohol-related violence, using an agent-based model of the adult population in New York City. The model was calibrated according to the empirical distribution of the parameters across the city's population, including the density of on- and off-premise alcohol outlets. Interventions capped the alcohol outlet distribution at the 90th to the 50th percentiles of the New York City density, and closed 5% to 25% of outlets with the highest levels of violence. Capping density led to a lower population of light drinkers (42.2% at baseline vs. 38.1% at the 50th percentile), while heavy drinking increased slightly (12.0% at baseline vs. 12.5% at the 50th percentile). Alcohol-related homicides and nonfatal violence remained unchanged. Closing the most violent outlets was not associated with changes in alcohol use or related problems. Results suggest that focusing solely on closing alcohol outlets might not be an effective strategy to reduce alcohol-related problems.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Chile, Santiago, Chile
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Sacramento, California
| | - Veronica A Pear
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Sacramento, California
| | - Melissa Tracy
- Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Albany, New York
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Magdalena Cerdá
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Sacramento, California
- Department of Population Health, New York University School of Medicine, New York, New York
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Stockwell T, Sherk A, Norström T, Angus C, Ramstedt M, Andréasson S, Chikritzhs T, Gripenberg J, Holder H, Holmes J, Mäkelä P. Estimating the public health impact of disbanding a government alcohol monopoly: application of new methods to the case of Sweden. BMC Public Health 2018; 18:1400. [PMID: 30577827 PMCID: PMC6303908 DOI: 10.1186/s12889-018-6312-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 12/07/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Government alcohol monopolies were created in North America and Scandinavia to limit health and social problems. The Swedish monopoly, Systembolaget, reports to a health ministry and controls the sale of all alcoholic beverages with > 3.5% alcohol/volume for off-premise consumption, within a public health mandate. Elsewhere, alcohol monopolies are being dismantled with evidence of increased consumption and harms. We describe innovative modelling techniques to estimate health outcomes in scenarios involving Systembolaget being replaced by 1) privately owned liquor stores, or 2) alcohol sales in grocery stores. The methods employed can be applied in other jurisdictions and for other policy changes. METHODS Impacts of the privatisation scenarios on pricing, outlet density, trading hours, advertising and marketing were estimated based on Swedish expert opinion and published evidence. Systematic reviews were conducted to estimate impacts on alcohol consumption in each scenario. Two methods were applied to estimate harm impacts: (i) alcohol attributable morbidity and mortality were estimated utilising the International Model of Alcohol Harms and Policies (InterMAHP); (ii) ARIMA methods to estimate the relationship between per capita alcohol consumption and specific types of alcohol-related mortality and crime. RESULTS Replacing government stores with private liquor stores (Scenario 1) led to a 20.0% (95% CI, 15.3-24.7) increase in per capita consumption. Replacement with grocery stores (Scenario 2) led to a 31.2% (25.1-37.3%) increase. With InterMAHP there were 763 or + 47% (35-59%) and 1234 or + 76% (60-92%) more deaths per year, for Scenarios 1 and 2 respectively. With ARIMA, there were 850 (334-1444) more deaths per year in Scenario 1 and 1418 more in Scenario 2 (543-2505). InterMAHP also estimated 10,859 or + 29% (22-34%) and 16,118 or + 42% (35-49%) additional hospital stays per year respectively. CONCLUSIONS There would be substantial adverse consequences for public health and safety were Systembolaget to be privatised. We demonstrate a new combined approach for estimating the impact of alcohol policies on consumption and, using two alternative methods, alcohol-attributable harm. This approach could be readily adapted to other policies and settings. We note the limitation that some significant sources of uncertainty in the estimates of harm impacts were not modelled.
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Affiliation(s)
- Tim Stockwell
- Canadian Institute for Substance Use Research (CISUR), Department of Psychology, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2 Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research (CISUR), Social Dimensions of Health Program, University of Victoria, Victoria, BC Canada
| | - Thor Norström
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| | | | - Mats Ramstedt
- The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden
| | - Sven Andréasson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Tanya Chikritzhs
- Health Sciences, National Drug Research Institute, Curtin University, Perth, Australia
| | - Johanna Gripenberg
- Department of Clinical Neuroscience, Stockholm Prevents Alcohol and Drug Problems (STAD), Karolinska Institutet, Stockholm, Sweden
| | - Harold Holder
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA USA
| | | | - Pia Mäkelä
- National Institute for Health and Welfare, Helsinki, Finland
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Seid AK, Berg-Beckhoff G, Stock C, Bloomfield K. Is proximity to alcohol outlets associated with alcohol consumption and alcohol-related harm in Denmark? NORDIC STUDIES ON ALCOHOL AND DRUGS 2018; 35:118-130. [PMID: 32934521 PMCID: PMC7434201 DOI: 10.1177/1455072518759829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 01/18/2018] [Indexed: 12/12/2022] Open
Abstract
Background: This study examined the associations between distance from residence to the nearest alcohol outlet with alcohol consumption as well as with alcohol-related harm. Methods: Data on alcohol consumption, alcohol-related harm and sociodemographics were obtained from the 2011 Danish Drug and Alcohol Survey (n = 5133) with respondents aged 15–79 years. The information on distances from residence to the nearest alcohol outlets was obtained from Statistics Denmark. Multiple logistic and linear regressions were used to examine the association between distances to outlets and alcohol consumption whereas alcohol-related harm was analysed using negative binomial regression. Results: Among women it was found that those living closer to alcohol outlets were more likely to report alcohol-related harm (p < 0.05). This was not true for men. No association was found between distances to outlets and alcohol consumption (volume of drinking and risky single occasion drinking). Conclusions: This study found some support for an association between closer distances between place of residence and alcohol outlets and alcohol-related harm for women. Future studies in the Nordic region should continue to examine the association between physical alcohol availability (nearest distance to an outlet and outlet densities) and alcohol consumption as well as alcohol-related problems using different outlet types.
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Slaunwhite AK, McEachern J, Ronis ST, Peters PA. Alcohol distribution reforms and school proximity to liquor sales outlets in New Brunswick. Canadian Journal of Public Health 2018; 108:e488-e496. [PMID: 29356654 DOI: 10.17269/cjph.108.6132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 12/19/2017] [Accepted: 07/07/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this project was to evaluate how changes to the sale of alcohol in New Brunswick would be distributed across urban and rural communities, and low- and high-income neighbourhoods. The study objectives were to 1) estimate the population living close to alcohol outlets before and after liquor distribution reforms, 2) identify communities or regions that would be more or less affected, and 3) determine whether expanding access to alcohol products would reduce school proximity to retailers. METHODS Data from Statistics Canada, Desktop Mapping Technologies Inc. (DMTI), and geocoded publicly available information were spatially linked and analyzed using descriptive statistics. The populations living within 499 m, 500-999 m and 1-5 km of an outlet were estimated, and the distances from schools to stores were examined by geographic characteristics and neighbourhood socio-economic status. RESULTS Permitting the sale of alcohol in all grocery stores throughout the province would increase the number of liquor outlets from 153 to 282 and would increase the population residing within 499 m of an outlet by 97.49%, from 19 886 to 39 273 residents. The sale of alcohol in grocery stores would result in an additional 35 liquor sales outlets being located within 499 m of schools. Low-income neighbourhoods would have the highest number and proportion of stores within 499 m of schools. CONCLUSION The findings of this study demonstrate the importance of considering social, economic and health inequities in the context of alcohol policy reforms that will disproportionately affect low-income neighbourhoods and youth living within these areas.
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Affiliation(s)
- Amanda K Slaunwhite
- Institute for Circumpolar Health Studies, University of Alaska Anchorage, Anchorage, USA; Centre for Addictions Research of British Columbia, Victoria, BC.
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Zhao J, Stockwell T. The impacts of minimum alcohol pricing on alcohol attributable morbidity in regions of British Colombia, Canada with low, medium and high mean family income. Addiction 2017; 112:1942-1951. [PMID: 28600882 DOI: 10.1111/add.13902] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/18/2016] [Accepted: 06/02/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Previous research indicates that minimum alcohol pricing (MAP) is associated negatively with alcohol-attributable (AA) hospitalizations. Modeling studies predict that this association will be stronger for people on lower incomes. The objective of this study was to test whether the association between MAP and AA hospitalizations is greater in low-income regions. DESIGN Cross-sectional versus time-series analysis using multivariate multi-level effect models. SETTING All 89 Local Health Areas in British Columbia (BC), Canada, 2002-13 (48 quarters). PARTICIPANTS BC population. MEASUREMENTS Quarterly rates of AA hospital admissions, mean consumer price index-adjusted minimum dollars per standard alcoholic drink and socio-demographic covariates. FINDINGS Family income was related inversely to the effect of minimum prices on rates of some types of AA morbidity. A 1% price increase was associated with reductions of 3.547% [95% confidence interval (CI) = -5.719, -1.377; P < 0.01] in low family-income regions and 1.64% (95% CI = -2.765, -0.519; P < 0.01) across all income regions for 100% acute AA hospital admissions. Delayed (lagged) effects on chronic AA morbidity were found 2-3 years after minimum price increases for low income regions and all regions combined; a 1% increase in minimum price was associated with reductions of 2.242% (95% CI = -4.097, -0.388; P < 0.05) for 100% chronic AA and 2.474% (95% CI = -3.937, -1.011; P < 0.01) for partially chronic AA admissions for low-income regions. CONCLUSION In Canada, minimum price increases for alcohol are associated with reductions in alcohol attributable hospitalizations, especially for populations with lower income, both for immediate effects on acute hospitalizations and delayed effects on chronic hospitalizations.
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Affiliation(s)
- Jinhui Zhao
- Centre for Addictions Research of BC (CARBC), University of Victoria, Victoria, BC, Canada
| | - Tim Stockwell
- Centre for Addictions Research of BC (CARBC), University of Victoria, Victoria, BC, Canada
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18
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Willmore J, Marko TL, Taing D, Sampasa-Kanyinga H. The burden of alcohol-related morbidity and mortality in Ottawa, Canada. PLoS One 2017; 12:e0185457. [PMID: 28957368 PMCID: PMC5619783 DOI: 10.1371/journal.pone.0185457] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 09/13/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Alcohol-related morbidity and mortality are significant public health issues. The purpose of this study was to describe the prevalence and trends over time of alcohol consumption and alcohol-related morbidity and mortality; and public attitudes of alcohol use impacts on families and the community in Ottawa, Canada. METHODS Prevalence (2013-2014) and trends (2000-2001 to 2013-2014) of alcohol use were obtained from the Canadian Community Health Survey. Data on paramedic responses (2015), emergency department (ED) visits (2013-2015), hospitalizations (2013-2015) and deaths (2007-2011) were used to quantify the acute and chronic health effects of alcohol in Ottawa. Qualitative data were obtained from the "Have Your Say" alcohol survey, an online survey of public attitudes on alcohol conducted in 2016. RESULTS In 2013-2014, an estimated 595,300 (83%) Ottawa adults 19 years and older drank alcohol, 42% reported binge drinking in the past year. Heavy drinking increased from 15% in 2000-2001 to 20% in 2013-2014. In 2015, the Ottawa Paramedic Service responded to 2,060 calls directly attributable to alcohol. Between 2013 and 2015, there were an average of 6,100 ED visits and 1,270 hospitalizations per year due to alcohol. Annually, alcohol use results in at least 140 deaths in Ottawa. Men have higher rates of alcohol-attributable paramedic responses, ED visits, hospitalizations and deaths than women, and young adults have higher rates of alcohol-attributable paramedic responses. Qualitative data of public attitudes indicate that alcohol misuse has greater repercussions not only on those who drink, but also on the family and community. CONCLUSIONS Results highlight the need for healthy public policy intended to encourage a culture of drinking in moderation in Ottawa to support lower risk alcohol use, particularly among men and young adults.
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Subbaraman MS, Kerr WC. Opinions on the Privatization of Distilled-Spirits Sales in Washington State: Did Voters Change Their Minds? J Stud Alcohol Drugs 2017; 77:568-76. [PMID: 27340960 DOI: 10.15288/jsad.2016.77.568] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE In November 2011, voters in Washington State approved Initiative 1183 (I-1183), which ended the government monopoly on distilled-spirits sales. The current study examined the relationship between demographics, spirits use, and voting outcomes, as well as how these variables related to wanting to change one's vote. METHOD The sample consisted of 1,202 adults recruited through random-digit-dial methods and reached via telephone between January and April 2014. Bivariate tests and multivariable regressions were used for statistical analyses. RESULTS Most notably, those who voted Yes on I-1183 had almost eight times the odds of wanting to change their votes compared with those who voted No. Older age, higher education, and being a spirits buyer/drinker were significantly associated with voting (vs. not voting). Among nonvoters, a larger proportion of those who reported that I-1183 was a success (vs. not) were spirits drinkers/nonbuyers. Those who reported that I-1183 was not a success were more likely to report that the number of liquor stores should be decreased. Opinions on taxes were not related to wanting to change one's vote or thinking that I-1183 had been a success. CONCLUSIONS The result of the I-1183 election likely would have been different if voters could know their future opinions of the actual situation resulting from privatization. This finding is particularly important for states considering privatization. Results also indicate that spirits drinkers/buyers may be more invested in privatization than nonbuyers and that the increased availability of spirits may affect opinions regarding privatization.
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Affiliation(s)
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California
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20
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WHO's Global Strategy to Reduce the Harmful use of Alcohol: An Assessment of Recent Policies and Interventions in Finland and Ontario, Canada. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017. [DOI: 10.2478/nsad-2013-0023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim This paper assesses alcohol policies and interventions in Finland and the Canadian province of Ontario, using the policy options and interventions recommended in WHO's Global strategy to reduce the harmful use of alcohol (2010). Data & Methods The information and data are based on archival sources, surveys, legislative and government documents, and published papers. The paper assesses both jurisdictions on 10 areas in the WHO document and their sub-topics: 1. leadership, 2. health services response, 3. community action, 4. drinking and driving policies and countermeasures, 5. availability of alcohol, 6. marketing of alcoholic beverages, 7. pricing policies, 8. reducing the negative consequences of drinking and alcohol intoxication, 9. reducing the public health impact of illicit alcohol and informally produced alcohol, and 10. monitoring and surveillance. Results Ontario had several recent noteworthy developments in line with WHO recommendations: health services response, controls of drinking and driving, pricing policies, reducing the negative consequences of drinking and intoxication, and monitoring and surveillance. Finland has emphasised pricing policies in recent years, and there have also been significant developments in community action, controls of drinking and driving, alcohol advertising, and monitoring and surveillance. Conclusions Challenges and opportunities for strengthening the policy responses are noted, as well as topics for future research.
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Stockwell T, Zhao J, Marzell M, Gruenewald PJ, Macdonald S, Ponicki WR, Martin G. Relationships Between Minimum Alcohol Pricing and Crime During the Partial Privatization of a Canadian Government Alcohol Monopoly. J Stud Alcohol Drugs 2015; 76:628-34. [PMID: 26098040 DOI: 10.15288/jsad.2015.76.628] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The purpose of this study was to estimate the independent effects of increases in minimum alcohol prices and densities of private liquor stores on crime outcomes in British Columbia, Canada, during a partial privatization of off-premise liquor sales. METHOD A time-series cross-sectional panel study was conducted using mixed model regression analysis to explore associations between minimum alcohol prices, densities of liquor outlets, and crime outcomes across 89 local health areas of British Columbia between 2002 and 2010. Archival data on minimum alcohol prices, per capita alcohol outlet densities, and ecological demographic characteristics were related to measures of crimes against persons, alcohol-related traffic violations, and non-alcohol-related traffic violations. Analyses were adjusted for temporal and regional autocorrelation. RESULTS A 10% increase in provincial minimum alcohol prices was associated with an 18.81% (95% CI: ±17.99%, p < .05) reduction in alcohol-related traffic violations, a 9.17% (95% CI: ±5.95%, p < .01) reduction in crimes against persons, and a 9.39% (95% CI: ±3.80%, p < .001) reduction in total rates of crime outcomes examined. There was no significant association between minimum alcohol prices and non-alcohol-related traffic violations (p > .05). Densities of private liquor stores were not significantly associated with alcohol-involved traffic violations or crimes against persons, though they were with non-alcohol-related traffic violations. CONCLUSIONS Reductions in crime events associated with minimum-alcohol-price changes were more substantial and specific to alcohol-related events than the countervailing increases in densities of private liquor stores. The findings lend further support to the application of minimum alcohol prices for public health and safety objectives.
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Affiliation(s)
- Tim Stockwell
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, British Columbia, Canada.,Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Jinhui Zhao
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, British Columbia, Canada
| | - Miesha Marzell
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Paul J Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California
| | - Scott Macdonald
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, British Columbia, Canada.,School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
| | - William R Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California
| | - Gina Martin
- School of Medicine, University of St. Andrews, St. Andrews, Scotland
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Gmel G, Holmes J, Studer J. We have to become more specific: A reply to Morrison et al. Drug Alcohol Rev 2015; 35:58-60. [PMID: 26642843 DOI: 10.1111/dar.12365] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 10/22/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Gerhard Gmel
- Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland.,Swiss Institute for the Prevention of Alcohol and Drug Problems, Lausanne, Switzerland.,Centre for Addiction and Mental Health, Toronto, Canada.,University of the West of England, Bristol, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Joseph Studer
- Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland
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Fitterer JL, Nelson TA, Stockwell T. A Review of Existing Studies Reporting the Negative Effects of Alcohol Access and Positive Effects of Alcohol Control Policies on Interpersonal Violence. Front Public Health 2015; 3:253. [PMID: 26636055 PMCID: PMC4644794 DOI: 10.3389/fpubh.2015.00253] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 10/26/2015] [Indexed: 11/16/2022] Open
Abstract
Alcohol consumption often leads to elevated rates of violence yet alcohol access policies continue to relax across the globe. Our review establishes the extent alcohol policy can moderate violent crime through alcohol availability restrictions. Results were informed from comprehensive selection of peer-reviewed journals from 1950 to October 2015. Our search identified 87 relevant studies on alcohol access and violence conducted across 12 countries. Seventeen studies included quasi-control design, and 23 conducted intervention analysis. Seventy-one (82%) reported a significant relationship between alcohol access and violent offenses. Alcohol outlet studies reported the greatest percentage of significant results (93%), with trading hours (63%), and alcohol price following (58%). Results from baseline studies indicated the effectiveness of increasing the price of commonly consumed alcohol, restricting the hours of alcohol trading, and limiting the number of alcohol outlets per region to prevent violent offenses. Unclear are the effects of tax reductions, restriction of on-premises re-entry, and different outlet types on violent crime. Further, the generalization of statistics over broad areas and the low number of control/intervention studies poses some concern for confounding or correlated effects on study results, and amount of information for local-level prevention of interpersonal violence. Future studies should focus on gathering longitudinal data, validating models, limiting crime data to peak drinking days and times, and wherever possible collecting the joint distribution between violent crime, intoxication, and place. A greater uptake of local-level analysis will benefit studies comparing the influence of multiple alcohol establishment types by relating the location of a crime to establishment proximity. Despite, some uncertainties particular studies showed that even modest policy changes, such as 1% increases in alcohol price, 1 h changes to closing times, and limiting establishment densities to <25 outlets per postal code substantively reduce violent crime.
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Affiliation(s)
- Jessica L Fitterer
- Spatial Pattern Analysis and Research Laboratory, Department of Geography, University of Victoria , Victoria, BC , Canada
| | - Trisalyn A Nelson
- Spatial Pattern Analysis and Research Laboratory, Department of Geography, University of Victoria , Victoria, BC , Canada
| | - Timothy Stockwell
- Centre for Addictions Research of British Columbia, Psychology Department, University of Victoria , Victoria, BC , Canada
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Morrison C, Cerdá M, Gorman DM, Gruenewald PJ, Mair CF, Naimi TS, Scribner R, Stockwell T, Toomey TL, Wieczorek WF. Commentary on Gmel et al. (2015): Are alcohol outlet densities strongly associated with alcohol-related outcomes? A critical review of recent evidence. Drug Alcohol Rev 2015; 35:55-57. [PMID: 26450352 DOI: 10.1111/dar.12340] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Christopher Morrison
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, USA.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Magdalena Cerdá
- Department of Emergency Medicine, School of Medicine, University of California Davis, Davis, USA
| | - Dennis M Gorman
- School of Public Health, Texas A&M Health Science Center, College Station, USA
| | - Paul J Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, USA
| | - Christina F Mair
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, USA.,Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, USA
| | - Timothy S Naimi
- Section of General Internal Medicine, Boston University Medical Center, Boston, USA
| | - Richard Scribner
- School of Public Health, Louisiana State University, New Orleans, USA
| | - Tim Stockwell
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, Canada.,Department of Psychology, University of Victoria, Victoria, Canada
| | - Traci L Toomey
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, USA
| | - William F Wieczorek
- Center for Health and Social Research, State University of New York College at Buffalo, Buffalo, USA
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Rushmer RK, Cheetham M, Cox L, Crosland A, Gray J, Hughes L, Hunter DJ, McCabe K, Seaman P, Tannahill C, Van Der Graaf P. Research utilisation and knowledge mobilisation in the commissioning and joint planning of public health interventions to reduce alcohol-related harms: a qualitative case design using a cocreation approach. HEALTH SERVICES AND DELIVERY RESEARCH 2015. [DOI: 10.3310/hsdr03330] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BackgroundConsiderable resources are spent on research to establish what works to improve the nation’s health. If the findings from this research are used, better health outcomes can follow, but we know that these findings are not always used. In public health, evidence of what works may not ‘fit’ everywhere, making it difficult to know what to do locally. Research suggests that evidence use is a social and dynamic process, not a simple application of research findings. It is unclear whether it is easier to get evidence used via a legal contracting process or within unified organisational arrangements with shared responsibilities.ObjectiveTo work in cocreation with research participants to investigate how research is utilised and knowledge mobilised in the commissioning and planning of public health services to reduce alcohol-related harms.Design, setting and participantsTwo in-depth, largely qualitative, cross-comparison case studies were undertaken to compare real-time research utilisation in commissioning across a purchaser–provider split (England) and in joint planning under unified organisational arrangements (Scotland) to reduce alcohol-related harms. Using an overarching realist approach and working in cocreation, case study partners (stakeholders in the process) picked the topic and helped to interpret the findings. In Scotland, the topic picked was licensing; in England, it was reducing maternal alcohol consumption.MethodsSixty-nine interviews, two focus groups, 14 observations of decision-making meetings, two local feedback workshops (n = 23 andn = 15) and one national workshop (n = 10) were undertaken. A questionnaire (n = 73) using a Behaviourally Anchored Rating Scale was issued to test the transferability of the 10 main findings. Given the small numbers, care must be taken in interpreting the findings.FindingsNot all practitioners have the time, skills or interest to work in cocreation, but when there was collaboration, much was learned. Evidence included professional and tacit knowledge, and anecdotes, as well as findings from rigorous research designs. It was difficult to identify evidence in use and decisions were sometimes progressed in informal ways and in places we did not get to see. There are few formal evidence entry points. Evidence (prevalence and trends in public health issues) enters the process and is embedded in strategic documents to set priorities, but local data were collected in both sites to provide actionable messages (sometimes replicating the evidence base).ConclusionsTwo mid-range theories explain the findings. If evidence hassaliency(relates to ‘here and now’ as opposed to ‘there and then’) andimmediacy(short, presented verbally or visually and with emotional appeal) it is more likely to be used in both settings. A second mid-range theory explains how differing tensions pull and compete as feasible and acceptable local solutions are pursued across stakeholders. Answering what works depends on answering for whom and where simultaneously to find workable (if temporary) ‘blends’. Gaining this agreement across stakeholders appeared more difficult across the purchaser–provider split, because opportunities to interact were curtailed; however, more research is needed.FundingThis study was funded by the Health Services and Delivery Research programme of the National Institute for Health Research.
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Affiliation(s)
- Rosemary K Rushmer
- School of Health and Social Care, Health and Social Care Institute, Teesside University, Middlesbrough, UK
| | - Mandy Cheetham
- School of Health and Social Care, Health and Social Care Institute, Teesside University, Middlesbrough, UK
| | - Lynda Cox
- Clinical Directorates, NHS England, Newcastle upon Tyne, UK
| | - Ann Crosland
- Department of Pharmacy, Health and Wellbeing, University of Sunderland, Sunderland, UK
| | - Joanne Gray
- Department of Public Health and Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | | | - David J Hunter
- Centre for Public Policy and Health, School of Medicine, Pharmacy and Health, Wolfsan Research Institute, Durham University, Durham, UK
| | - Karen McCabe
- Department of Pharmacy, Health and Wellbeing, University of Sunderland, Sunderland, UK
| | - Pete Seaman
- Glasgow Centre for Population Health, Glasgow, UK
| | | | - Peter Van Der Graaf
- School of Health and Social Care, Health and Social Care Institute, Teesside University, Middlesbrough, UK
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Gmel G, Holmes J, Studer J. Are alcohol outlet densities strongly associated with alcohol-related outcomes? A critical review of recent evidence. Drug Alcohol Rev 2015; 35:40-54. [PMID: 26120778 DOI: 10.1111/dar.12304] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 05/19/2015] [Indexed: 01/15/2023]
Affiliation(s)
- Gerhard Gmel
- Alcohol Treatment Centre; Lausanne University Hospital CHUV; Lausanne Switzerland
- Swiss Institute for the Prevention of Alcohol and Drug Problems; Lausanne Switzerland
- Centre for Addiction and Mental Health; Toronto Canada
- University of the West of England, Frenchay Campus; Bristol UK
| | - John Holmes
- School of Health and Related Research; University of Sheffield; Sheffield UK
| | - Joseph Studer
- Alcohol Treatment Centre; Lausanne University Hospital CHUV; Lausanne Switzerland
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Kerr WC, Williams E, Greenfield TK. Analysis of Price Changes in Washington Following the 2012 Liquor Privatization. Alcohol Alcohol 2015; 50:654-60. [PMID: 26109262 DOI: 10.1093/alcalc/agv067] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 04/28/2015] [Indexed: 11/14/2022] Open
Abstract
AIMS In June, 2012 the state of Washington ended a wholesale and retail monopoly on liquor sales resulting in about five times as many stores selling liquor. Three-tier restrictions were also removed on liquor, while beer and wine availability did not increase. Substantial taxes at both the wholesale and retail levels were implemented and it was expected that prices would rise. METHODS To evaluate price changes after privatization we developed an index of about 68 brands that were popular in Washington during early 2012. Data on final liquor prices (including all taxes) in Washington were obtained through store visits and on-line sources between November 2013 and March of 2014. Primary analyses were conducted on five or six brand indexes to allow the inclusion of most stores. RESULTS Washington liquor prices rose by an average of 15.5% for the 750 ml size and by 4.7% for the 1.75 l size, while only small changes were seen in the bordering states of Oregon and Idaho. Prices were found to vary greatly by store type. Liquor Superstores had generally the lowest prices while drugstore, grocery and especially smaller Liquor Store prices were found to be substantially higher. CONCLUSION Our findings indicate that liquor prices in Washington increased substantially after privatization and as compared to price changes in bordering states, with a much larger increase seen for the 750 ml size and with wide variation across store types. However, persistent drinkers looking for low prices will be able to find them in certain stores.
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Affiliation(s)
- William C Kerr
- Alcohol Research Group, Public Health Institute, 6475 Christie Ave., Suite 400, Emeryville, CA 94608, USA
| | - Edwina Williams
- Alcohol Research Group, Public Health Institute, 6475 Christie Ave., Suite 400, Emeryville, CA 94608, USA
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, 6475 Christie Ave., Suite 400, Emeryville, CA 94608, USA
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Scherer M, Fell JC, Thomas S, Voas RB. Effects of Dram Shop, Responsible Beverage Service Training, and State Alcohol Control Laws on Underage Drinking Driver Fatal Crash Ratios. TRAFFIC INJURY PREVENTION 2015; 16 Suppl 2:S59-65. [PMID: 26436244 PMCID: PMC4602396 DOI: 10.1080/15389588.2015.1064909] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
OBJECTIVES In this study, we aimed to determine whether three minimum legal drinking age 21 (MLDA-21) laws-dram shop liability, responsible beverage service (RBS) training, and state control of alcohol sales-have had an impact on underage drinking and driving fatal crashes using annual state-level data, and compared states with strong laws to those with weak laws to examine their effect on beer consumption and fatal crash ratios. METHODS Using the Fatality Analysis Reporting System, we calculated the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes as our key outcome measure. We used structural equation modeling to evaluate the three MLDA-21 laws. We controlled for covariates known to impact fatal crashes including: 17 additional MLDA-21 laws; administrative license revocation; blood alcohol concentration limits of.08 and.10 for driving; seat belt laws; sobriety checkpoint frequency; unemployment rates; and vehicle miles traveled. Outcome variables, in addition to the fatal crash ratios of drinking to nondrinking drivers under age 21 included state per capita beer consumption. RESULTS Dram shop liability laws were associated with a 2.4% total effect decrease (direct effects: β =.019, p =.018). Similarly, RBS training laws were associated with a 3.6% total effect decrease (direct effect: β =.048, p =.001) in the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes. There was a significant relationship between dram shop liability law strength and per capita beer consumption, F (4, 1528) = 24.32, p <.001, partial η(2) =.016, showing states with strong dram shop liability laws (Mean (M) = 1.276) averaging significantly lower per capita beer consumption than states with weak laws (M = 1.340). CONCLUSIONS Dram shop liability laws and RBS laws were both associated with significantly reduced per capita beer consumption and fatal crash ratios. In practical terms, this means that dram shop liability laws are currently associated with saving an estimated 64 lives in the 45 jurisdictions that currently have the law. If the remaining 6 states adopted the dram shop law, an additional 9 lives could potentially be saved annually. Similarly, RBS training laws are associated with saving an estimated 83 lives in the 37 jurisdictions that currently have the laws. If the remaining 14 states adopted these RBS training laws, we estimate that an additional 28 lives could potentially be saved.
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Affiliation(s)
| | | | - Sue Thomas
- Pacific Institute for Research and Evaluation
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Manafò E, Giesbrecht N, Gupta R. Survey of Ontario health professionals’ knowledge, attitudes and beliefs of alcohol-related harms: key findings. JOURNAL OF SUBSTANCE USE 2013. [DOI: 10.3109/14659891.2013.790497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Grubesic TH, Pridemore WA, Williams DA, Philip-Tabb L. Alcohol Outlet Density and Violence: The Role of Risky Retailers and Alcohol-Related Expenditures. Alcohol Alcohol 2013; 48:613-9. [DOI: 10.1093/alcalc/agt055] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Zhao J, Stockwell T, Martin G, Macdonald S, Vallance K, Treno A, Ponicki WR, Tu A, Buxton J. The relationship between minimum alcohol prices, outlet densities and alcohol-attributable deaths in British Columbia, 2002-09. Addiction 2013; 108:1059-69. [PMID: 23398533 DOI: 10.1111/add.12139] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 10/26/2012] [Accepted: 01/23/2013] [Indexed: 12/18/2022]
Abstract
AIM To investigate relationships between periodic increases in minimum alcohol prices, changing densities of liquor stores and alcohol-attributable (AA) deaths in British Columbia, Canada. DESIGN Cross-section (16 geographic areas) versus time-series (32 annual quarters) panel analyses were conducted with AA deaths as dependent variables and price, outlet densities and socio-demographic characteristics as independent variables. SETTING AND PARTICIPANTS Populations of 16 Health Service Delivery Areas in British Columbia, Canada. MEASUREMENTS Age-sex-standardized rates of acute, chronic and wholly AA mortality; population densities of restaurants, bars, government and private liquor stores; minimum prices of alcohol in dollars per standard drink. FINDINGS A 10% increase in average minimum price for all alcoholic beverages was associated with a 31.72% [95% confidence interval (CI): ± 25.73%, P < 0.05] reduction in wholly AA deaths. Significantly negative lagged associations were also detected up to 12 months after minimum price increases for wholly but not for acute or chronic AA deaths. Significant reductions in chronic and total AA deaths were detected between 2 and 3 years after minimum price increases. Significant but inconsistent lagged associations were detected for acute AA deaths. A 10% increase in private liquor stores was associated with a 2.45% (95% CI: ± 2.39%, P < 0.05), 2.36% (95% CI: ± 1.57%, P < 0.05) and 1.99% (95% CI: ± 1.76%, P < 0.05) increase in acute, chronic and total AA mortality rates. CONCLUSION Increases in the minimum price of alcohol in British Columbia, Canada, between 2002 and 2009 were associated with immediate and delayed decreases in alcohol-attributable mortality. By contrast, increases in the density of private liquor stores were associated with increases in alcohol-attributable mortality.
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Affiliation(s)
- Jinhui Zhao
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, BC, Canada
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Stockwell T, Zhao J, Martin G, Macdonald S, Vallance K, Treno A, Ponicki W, Tu A, Buxton J. Minimum alcohol prices and outlet densities in British Columbia, Canada: estimated impacts on alcohol-attributable hospital admissions. Am J Public Health 2013; 103:2014-20. [PMID: 23597383 DOI: 10.2105/ajph.2013.301289] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES We investigated whether periodic increases in minimum alcohol prices were associated with reduced alcohol-attributable hospital admissions in British Columbia. METHODS The longitudinal panel study (2002-2009) incorporated minimum alcohol prices, density of alcohol outlets, and age- and gender-standardized rates of acute, chronic, and 100% alcohol-attributable admissions. We applied mixed-method regression models to data from 89 geographic areas of British Columbia across 32 time periods, adjusting for spatial and temporal autocorrelation, moving average effects, season, and a range of economic and social variables. RESULTS A 10% increase in the average minimum price of all alcoholic beverages was associated with an 8.95% decrease in acute alcohol-attributable admissions and a 9.22% reduction in chronic alcohol-attributable admissions 2 years later. A Can$ 0.10 increase in average minimum price would prevent 166 acute admissions in the 1st year and 275 chronic admissions 2 years later. We also estimated significant, though smaller, adverse impacts of increased private liquor store density on hospital admission rates for all types of alcohol-attributable admissions. CONCLUSIONS Significant health benefits were observed when minimum alcohol prices in British Columbia were increased. By contrast, adverse health outcomes were associated with an expansion of private liquor stores.
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Affiliation(s)
- Tim Stockwell
- Tim Stockwell, Jinhui Zhao, Gina Martin, Scott Macdonald, and Kate Vallance are with the Centre for Addictions Research of British Columbia, University of Victoria, British Columbia. Tim Stockwell is also with the Department of Psychology, University of Victoria. Andrew Treno and William Ponicki are with the Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California. Andrew Tu and Jane Buxton are with the British Columbia Centre for Disease Control, Vancouver, British Columbia
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Treno AJ, Ponicki WR, Stockwell T, Macdonald S, Gruenewald PJ, Zhao J, Martin G, Greer A. Alcohol outlet densities and alcohol price: the British Columbia experiment in the partial privatization of alcohol sales off-premise. Alcohol Clin Exp Res 2013; 37:854-9. [PMID: 23316802 DOI: 10.1111/acer.12065] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 09/22/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcohol beverage prices or taxes have been shown to be related to alcohol sales and use and related problems. What is not clear are the mechanisms underlying these relationships. METHODS This study examines the relationship between alcohol outlet density under conditions of the partial privatization of off-premise consumption in British Columbia (BC) occurring over the past decade. Two hypotheses are tested. First, reflecting basic supply-demand principles, greater geographic densities of alcohol outlets will be directly related to reductions in beverage prices in response to greater competition. Second, reflecting the effects of niche marketing and resulting market stratification, increased densities of private liquor stores will be especially related to reductions in beverage prices within this outlet category. Data were collected from: (i) a survey of BC private store prices and practices, (ii) alcohol outlet location information, and (iii) data on demographic characteristics. Multilevel models examine the relationships between prices at individual private liquor stores and the densities of government liquor stores, private liquor stores, bars, and restaurants, controlling for background demographics and geographic unit level effects. Spatial dependencies were also examined. RESULTS Increased densities of private liquor stores were associated with lower mean prices of beer and all alcohol aggregated across brands at the store level. There appeared to be no outlet level effect on discounting patterns, however, with the mean price differences apparently reflecting differences in the quality of brands carried rather than unequal prices for any given brand. CONCLUSIONS Increased densities of private off-sale alcohol outlets appear to result in lower prices charged at said establishments independently of other types of alcohol outlets suggesting that they represent an emerging marketing niche in the context of off-sale outlet privatization.
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Affiliation(s)
- Andrew J Treno
- Pacific Institute for Research and Evaluation, Berkeley, CA 94704, USA.
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Stockwell T, Auld MC, Zhao J, Martin G. Does minimum pricing reduce alcohol consumption? The experience of a Canadian province. Addiction 2012; 107:912-20. [PMID: 22168350 DOI: 10.1111/j.1360-0443.2011.03763.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Minimum alcohol prices in British Columbia have been adjusted intermittently over the past 20 years. The present study estimates impacts of these adjustments on alcohol consumption. DESIGN Time-series and longitudinal models of aggregate alcohol consumption with price and other economic data as independent variables. SETTING British Columbia (BC), Canada. PARTICIPANTS The population of British Columbia, Canada, aged 15 years and over. MEASUREMENTS Data on alcohol prices and sales for different beverages were provided by the BC Liquor Distribution Branch for 1989-2010. Data on household income were sourced from Statistics Canada. FINDINGS Longitudinal estimates suggest that a 10% increase in the minimum price of an alcoholic beverage reduced its consumption relative to other beverages by 16.1% (P < 0.001). Time-series estimates indicate that a 10% increase in minimum prices reduced consumption of spirits and liqueurs by 6.8% (P = 0.004), wine by 8.9% (P = 0.033), alcoholic sodas and ciders by 13.9% (P = 0.067), beer by 1.5% (P = 0.043) and all alcoholic drinks by 3.4% (P = 0.007). CONCLUSIONS Increases in minimum prices of alcoholic beverages can substantially reduce alcohol consumption.
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Affiliation(s)
- Tim Stockwell
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, BC, Canada.
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Hahn RA, Middleton JC, Elder R, Brewer R, Fielding J, Naimi TS, Toomey TL, Chattopadhyay S, Lawrence B, Campbell CA. Effects of alcohol retail privatization on excessive alcohol consumption and related harms: a community guide systematic review. Am J Prev Med 2012; 42:418-27. [PMID: 22424256 DOI: 10.1016/j.amepre.2012.01.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 10/26/2011] [Accepted: 01/06/2012] [Indexed: 11/16/2022]
Abstract
CONTEXT Excessive alcohol consumption is the third-leading cause of preventable death in the U.S. This systematic review is one in a series exploring effectiveness of interventions to reduce alcohol-related harms. EVIDENCE ACQUISITION The focus of this review was on studies evaluating the effects of the privatization of alcohol retail sales on excessive alcohol consumption and related harms. Using Community Guide methods for conducting systematic reviews, a systematic search was conducted in multiple databases up to December 2010. Reference lists of acquired articles and review papers were also scanned for additional studies. EVIDENCE SYNTHESIS A total of 17 studies assessed the impact of privatizing retail alcohol sales on the per capita alcohol consumption, a well-established proxy for excessive alcohol consumption; 9 of these studies also examined the effects of privatization on the per capita consumption of alcoholic beverages that were not privatized. One cohort study in Finland assessed the impact of privatizing the sales of medium-strength beer (MSB) on self-reported alcohol consumption. One study in Sweden assessed the impact of re-monopolizing the sale of MSB on alcohol-related harms. Across the 17 studies, there was a 44.4% median increase in the per capita sales of privatized beverages in locations that privatized retail alcohol sales (interquartile interval: 4.5% to 122.5%). During the same time period, sales of nonprivatized alcoholic beverages decreased by a median of 2.2% (interquartile interval: -6.6% to -0.1%). Privatizing the sale of MSB in Finland was associated with a mean increase in alcohol consumption of 1.7 liters of pure alcohol per person per year. Re-monopolization of the sale of MSB in Sweden was associated with a general reduction in alcohol-related harms. CONCLUSIONS According to Community Guide rules of evidence, there is strong evidence that privatization of retail alcohol sales leads to increases in excessive alcohol consumption.
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Affiliation(s)
- Robert A Hahn
- Community Guide Branch, Epidemiology and Analysis Program Office, CDC, Atlanta, Georgia 30333, USA.
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Livingston M. Alcohol outlet density and harm: comparing the impacts on violence and chronic harms. Drug Alcohol Rev 2012; 30:515-23. [PMID: 21896074 DOI: 10.1111/j.1465-3362.2010.00251.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS A number of studies have previously identified relationships between the density of alcohol outlets and rates of violence, with different types of outlets related to violence in different locations. The previous work in Australia has been limited to studies based on police data, which are subject to numerous biases. This study extends the previous work by utilising hospital admissions as a less biased outcome measure, incorporating a 14 year longitudinal design and by developing comparative models for violence and rates of alcohol use disorders. DESIGN AND METHODS The study examines trends in postcode-level hospital admission data for assault and for alcohol use disorders over a 14 year period (n = 186) and their relationship with the density of three kinds of alcohol outlets. Fixed-effects models are developed to control for the differences between postcodes and for the overall trends in outlet density and morbidity rates. RESULTS The results of this study suggest that the density of alcohol outlets where the main activity is alcohol consumption (i.e. pubs) is positively related to rates of assault-related hospital admissions, while the density of off-premise alcohol outlets is related to the rate of alcohol use disorders. DISCUSSION AND CONCLUSIONS These findings have significant implications for alcohol policies in Victoria, in particular pointing to the significant contribution of packaged alcohol outlets to both acute and chronic alcohol-related harm.
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Affiliation(s)
- Michael Livingston
- School of Population Health, University of Melbourne, Melbourne, Australia.
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Czech S, Shakeshaft A, Sanson-Fisher R, Breen C. The development and application of a proxy measure of alcohol-related traffic crashes for rural communities. ACCIDENT; ANALYSIS AND PREVENTION 2011; 43:2160-2165. [PMID: 21819847 DOI: 10.1016/j.aap.2011.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 05/24/2011] [Accepted: 06/14/2011] [Indexed: 05/31/2023]
Abstract
CONTEXT To date, no studies have adequately examined whether community-level, rather than individual-level, characteristics, are associated with high rates of alcohol-related traffic crashes (ARTC). OBJECTIVE This study aims to identify a proxy measure of ARTC most appropriate to rural communities in New South Wales (NSW), Australia, and to identify community characteristics that predict higher rates of ARTC. METHODS ARTC (2001-2007) incident data from 20 rural communities in NSW were obtained. Cost data were applied to take account of ARTCs of different severity. RESULTS The method used to define a proxy measure of ARTCs for NSW generally was found to be inadequate when applied to local communities within NSW: specifically, two time periods were found to be alcohol-related for local communities only and seven time periods were found to be non-alcohol-related for local communities only. Applying a community-specific proxy measure of ARTCs to 20 communities identified substantial variation in ARTC cost-ratios, ranging from 1.20 to 0.15. Higher cost-ratios were statistically significantly predicted by the proportion of residents who were male and less than 25 years. CONCLUSIONS Proxy measures of ARTCs represent an ideal method of utilising routinely collected data to identify specific types of ARTCs that are most relevant to a defined community, identify community-specific factors associated with higher rates of ARTCs and measure the impact of interventions tailored to those risk factors. Such measures ought to be community-specific because these results suggest national or provincial-level definitions are not necessarily directly applicable to local communities. These results show substantial variability between communities in their rates of ARTC and identify communities with higher proportions of young males as being at increased risk.
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Affiliation(s)
- Suzanne Czech
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia.
| | - Robert Sanson-Fisher
- School of Medicine and Health Science, University of Newcastle, Newcastle, NSW, Australia
| | - Courtney Breen
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia
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WILKINSON CLAIRE, LIVINGSTON MICHAEL. Distances to on- and off-premise alcohol outlets and experiences of alcohol-related amenity problems. Drug Alcohol Rev 2011; 31:394-401. [DOI: 10.1111/j.1465-3362.2011.00346.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Anderson P. Policy Implications of the WHO Strategy to Reduce the Harmful Use of Alcohol. SUCHT-ZEITSCHRIFT FUR WISSENSCHAFT UND PRAXIS 2011. [DOI: 10.1024/0939-5911.a000099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Aims: To describe the supporting evidence and policy implications of the 10 target areas of the WHO strategy to reduce the harmful use of alcohol. Methods: Based on published systematic reviews of the literature and publications of the World Health Organization, the supporting evidence and policy implications of the 10 target areas are described. Findings: There is evidence to support action in each of the 10 target areas: leadership, awareness and commitment; health services’ response; community action; drink-driving policies; availability of alcohol; marketing of alcoholic beverages; pricing policies; reducing the negative consequences of intoxication; reducing the public health impact of illegal and informal alcohol; and monitoring and surveillance. Conclusions: The following policy measures have the strongest evidence: increasing alcohol taxes; government monopolies for the retail sale of alcohol; restricting the density of outlets and the days and hours of sale; increasing the minimum age of purchase; lowering the legal BAC levels for driving; introducing random breath-testing for driving; implementing widespread brief advice for hazardous and harmful alcohol consumption; and ensuring treatment for alcohol use disorders. There is reasonable evidence to support the introduction of a minimum price per gram of alcohol; restricting the volume of commercial communications; and enforcing the restrictions of sales to intoxicated and under-age people.
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Affiliation(s)
- Peter Anderson
- Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands
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Stockwell T, Zhao J, Macdonald S, Vallance K, Gruenewald P, Ponicki W, Holder H, Treno A. Impact on alcohol-related mortality of a rapid rise in the density of private liquor outlets in British Columbia: a local area multi-level analysis. Addiction 2011; 106:768-76. [PMID: 21244541 DOI: 10.1111/j.1360-0443.2010.03331.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To study relationships between rates of alcohol-related deaths and (i) the density of liquor outlets and (ii) the proportion of liquor stores owned privately in British Columbia (BC) during a period of rapid increase in private stores. DESIGN Multi-level regression analyses assessed the relationship between population rates of private liquor stores and alcohol-related mortality after adjusting for potential confounding. SETTING The 89 local health areas of BC, Canada across a 6-year period from 2003 to 2008, for a longitudinal sample with n = 534. MEASUREMENTS Population rates of liquor store density, alcohol-related death and socio-economic variables obtained from government sources. FINDINGS The total number of liquor stores per 1000 residents was associated significantly and positively with population rates of alcohol-related death (P < 0.01). A conservative estimate is that rates of alcohol-related death increased by 3.25% for each 20% increase in private store density. The percentage of liquor stores in private ownership was also associated independently with local rates of alcohol-related death after controlling for overall liquor store density (P < 0.05). Alternative models confirmed significant relationships between changes in private store density and mortality over time. CONCLUSIONS The rapidly rising densities of private liquor stores in British Columbia from 2003 to 2008 was associated with a significant local-area increase in rates of alcohol-related death.
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Affiliation(s)
- Tim Stockwell
- Centre for Addictions Research of British Columbia, University of Victoria, British Columbia, Canada.
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Giesbrecht N, Stockwell T, Kendall P, Strang R, Thomas G. Alcohol in Canada: reducing the toll through focused interventions and public health policies. CMAJ 2011; 183:450-5. [PMID: 21324848 PMCID: PMC3050949 DOI: 10.1503/cmaj.100825] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Norman Giesbrecht
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ont.
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Popova S, Patra J, Sarnocinska-Hart A, Gnam WH, Giesbrecht N, Rehm J. Cost of privatisation versus government alcohol retailing systems: Canadian example. Drug Alcohol Rev 2011; 31:4-12. [PMID: 21355934 DOI: 10.1111/j.1465-3362.2010.00276.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS Alcohol retail monopolies have been established in many countries to restrict alcohol availability and thus, minimise alcohol-related harm.The aim of this study was to estimate the impact of the privatisation of alcohol sales on the burden and direct health-care, law enforcement costs and indirect costs (lost productivity due to disability or premature mortality) in Canada. DESIGN AND METHODS Simulation modelling. International Guidelines for the Estimation of the Avoidable Costs of Substance Abuse were used. All burden and costs were compared with the baseline taken from the aggregate Cost Study on Substance Abuse in Canada 2002. RESULTS If all Canadian provinces and territories were to privatise alcohol sales we assume that consumption would increase from 10% to 20% based on available Canadian literature. Under the 10% scenario the costs would increase from 6% ($828 million) and under the 20% scenario costs would increase 12% ($1.6 billion).This increase is substantially greater than the tax and mark-up revenue gained from increased sales,and represents a net loss. DISCUSSION AND CONCLUSIONS Alcohol-attributable burden and associated costs will increase markedly if all Canadian provinces and territories gave up the government alcohol retailing systems.For public health and economic reasons, governments should continue to have a strong role in alcohol retailing.
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Affiliation(s)
- Svetlana Popova
- Public Health and Regulatory Policies, Centre for Addiction and Mental Health, Toronto, Canada.
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Abstract
This paper examines access to alcohol, trends in consumption, drinking patterns, damage from alcohol, and developments in prevention and alcohol policy – focusing on the Canadian experience over the last two decades. Consumption, as measured by official sales, declined initially and then has increased since 1996. During this time there was a gradual increase in access to alcohol, with steeper increase in some jurisdictions undergoing partial or full privatization of retail alcohol sales. According to survey data, the proportion drinking in a high risk manner is greater among youth and young adults, and the trend in the proportion of high risk drinkers does not necessarily follow the trend in alcohol sales. In light of intensive and multi-dimensional efforts to curtail drinking and driving, these rates have gone down during the period under study. Several provinces have introduced alcohol strategies and a national strategy introduced in 2007 is being implemented. Nevertheless there are ongoing challenges of getting alcohol on the broader public health agenda, even though it is major contributor to disease and disability. The rising consumption and increased access to alcohol, combined with intensive marketing, represent a major public health challenge. It is unlikely that there will be significant strides in reducing the damage from alcohol to Canadian populations, unless there is a substantial change in the status quo involving implementation of the most effective policies and prevention strategies.
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Affiliation(s)
| | - Gerald Thomas
- Centre for Addictions Research of British Columbia, Victoria, British Columbia
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Stockwell T, Reist D, Macdonald S, Benoit C, Jansson M. Addiction research centres and the nurturing of creativity: the Centre for Addictions Research of British Columbia, Canada. Addiction 2010; 105:207-15. [PMID: 20078479 PMCID: PMC4445644 DOI: 10.1111/j.1360-0443.2009.02789.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The Centre for Addictions Research of British Columbia (CARBC) was established as a multi-campus and multi-disciplinary research centre administered by the University of Victoria (UVic) in late 2003. Its core funding is provided from interest payments on an endowment of CAD 10.55 million dollars. It is supported by a commitment to seven faculty appointments in various departments at UVic. The Centre has two offices, an administration and research office in Victoria and a knowledge exchange unit in Vancouver. The two offices are collaborating on the implementation of CARBC's first 5-year plan which seeks to build capacity in British Columbia for integrated multi-disciplinary research and knowledge exchange in the areas substance use, addictions and harm reduction. Present challenges include losses to the endowment caused by the 2008/2009 economic crisis and difficulties negotiating faculty positions with the university administration. Despite these hurdles, to date each year has seen increased capacity for the Centre in terms of affiliated scientists, funding and staffing as well as output in terms of published reports, electronic resources and impacts on policy and practice. Areas of special research interest include: drug testing in the work-place, epidemiological monitoring, substance use and injury, pricing and taxation policies, privatization of liquor monopolies, polysubstance use, health determinants of indigenous peoples, street-involved youth and other vulnerable populations at risk of substance use problems. Further information about the Centre and its activities can be found on http://www.carbc.ca.
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Affiliation(s)
- Tim Stockwell
- Centre for Addictions Research of British Columbia, University of Victoria, BC, Canada
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