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Kilian C, Klinger S, Manthey J, Rehm J, Huckle T, Probst C. National and regional prevalence of interpersonal violence from others' alcohol use: a systematic review and modelling study. Lancet Reg Health Eur 2024; 40:100905. [PMID: 38680248 PMCID: PMC11047785 DOI: 10.1016/j.lanepe.2024.100905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/19/2024] [Accepted: 03/28/2024] [Indexed: 05/01/2024]
Abstract
Background While alcohol use is an established risk factor for interpersonal violence, the extent to which people are affected by interpersonal violence from others' drinking has not yet been quantified for different world regions. This modelling study aims to provide the first estimates of the national and regional prevalence of interpersonal violence from others' drinking. Methods An international systematic literature search (02/28/2023, Prospero: CRD42022337364) was conducted to identify general adult population studies assessing the prevalence of interpersonal violence from others' drinking with no restrictions to publication date or language. Reports that did not provide data on interpersonal violence from others' drinking (primary outcome), were no original research studies, or captured a selected group of people only, were excluded. Observed prevalence data were extracted and used to build fractional response regression models to predict past-year prevalence of emotional and physical violence from others' drinking in 2019. Random-effects meta-regression models were used to aggregate the observed prevalence of sexual and intimate partner violence. Study risk of bias (ROB) was assessed using a modified version of the Newcastle-Ottawa Scale. Findings Out of 13,835 identified reports, 50 were included covering just under 830,000 individuals (women: 347,112; men: 322,331; men/women combined: 160,057) from 61 countries. With an average prevalence of 16·8% (95% CI: 15·2-18·3%) and 28·3% (95% CI: 23·9-32·4%) in men and women combined in the GBD super regions High Income and Central Europe, Eastern Europe, & Central Asia, respectively, emotional violence was the most common form of interpersonal violence from others' drinking. Physical violence averaged around 3% (women) and 5% (men) in both regions. The pooled prevalence of sexual violence from others' drinking in men and women was 1·3% (95% CI: 0·5-3·3%, 95% PI: 0·1-16·9%) and 3·4% (95% CI: 1·4-8·3%, 95% PI: 0·2-35·3%), respectively, and ranged between 0·4% (95% CI: 0·1-1·6%, 95% PI: 0·0-7·3%) and 2·7% (95% CI: 1·1-6·3%, 95% PI: 0·2-30·0%) for different forms of intimate partner violence. ROB was moderate or critical for most reports; accounting for critical ROB did not substantially alter our results. Interpretation The share of the population experiencing harms from others' drinking is significant and should be an integral part of public health strategies. Funding Research reported in this publication was supported by the Canadian Institutes of Health Research (CIHR; grant: CIHR FRN 477887).
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Affiliation(s)
- Carolin Kilian
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
| | - Sinja Klinger
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, Dresden 01187, Germany
| | - Jakob Manthey
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, Leipzig 04103, Germany
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Germany
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, Ontario M5S 1A8, Canada
- Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| | - Taisia Huckle
- Social and Health Outcomes Research and Evaluation & Whariki Research Centre, Massey University, 90 Symonds Street, Auckland 1010, New Zealand
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany
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Manthey J, Jacobsen B, Klinger S, Schulte B, Rehm J. Restricting alcohol marketing to reduce alcohol consumption: A systematic review of the empirical evidence for one of the 'best buys'. Addiction 2024; 119:799-811. [PMID: 38173418 DOI: 10.1111/add.16411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/16/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND AND AIMS Even though a ban of alcohol marketing has been declared a 'best buy' of alcohol control policy, comprehensive systematic reviews on its effectiveness to reduce consumption are lacking. The aim of this paper was to systematically review the evidence for effects of total and partial bans of alcohol marketing on alcohol consumption. METHODS This descriptive systematic review sought to include all empirical studies that explored how changes in the regulation of alcohol marketing impact on alcohol consumption. The search was conducted between October and December 2022 considering various scientific databases (Web of Science, PsycINFO, MEDLINE, Embase) as well as Google and Google Scholar. The titles and abstracts of a total of 2572 records were screened. Of the 26 studies included in the full text screening, 11 studies were finally included in this review. Changes in consumption in relation to marketing bans were determined based on significance testing in primary studies. Four risk of bias domains (confounding, selection bias, information bias and reporting bias) were assessed. RESULTS Seven studies examined changes in marketing restrictions in one location (New Zealand, Thailand, Canadian provinces, Spain, Norway). In the remaining studies, between 17 and 45 locations were studied (mostly high-income countries from Europe and North America). Of the 11 studies identified, six studies reported null findings. Studies reporting lower alcohol consumption following marketing restrictions were of moderate, serious and critical risk of bias. Two studies with low and moderate risk of bias found increasing alcohol consumption post marketing bans. Overall, there was insufficient evidence to conclude that alcohol marketing bans reduce alcohol consumption. CONCLUSIONS The available empirical evidence does not support the claim of alcohol marketing bans constituting a best buy for reducing alcohol consumption.
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Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Britta Jacobsen
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Sinja Klinger
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Bernd Schulte
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jürgen Rehm
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse and WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
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Manthey J, Gobiņa I, Isajeva L, Neneman J, Reile R, Štelemėkas M, Rehm J. The Impact of Raising Alcohol Taxes on Government Tax Revenue: Insights from Five European Countries. Appl Health Econ Health Policy 2024; 22:363-374. [PMID: 38386271 PMCID: PMC11021250 DOI: 10.1007/s40258-024-00873-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Reducing the affordability of alcoholic beverages by increasing alcohol excise taxation can lead to a reduction in alcohol consumption but the impact on government alcohol excise tax revenue is poorly understood. This study aimed to (a) describe cross-country tax revenue variations and (b) investigate how changes in taxation were related to changes in government tax revenue, using data from Estonia, Germany, Latvia, Lithuania and Poland. METHODS For the population aged 15 years or older, we calculated the annual per capita alcohol excise tax revenue, total tax revenue, gross domestic product and alcohol consumption. In addition to descriptive analyses, joinpoint regressions were performed to identify whether changes in alcohol excise taxation were linked to changes in alcohol excise revenue since 1999. RESULTS In 2022, the per capita alcohol excise tax revenue was lowest in Germany (€44.2) and highest in Estonia (€218.4). In all countries, the alcohol excise tax revenue was mostly determined by spirit sales (57-72% of total alcohol tax revenue). During 2010-20, inflation-adjusted per capita alcohol excise tax revenues have declined in Germany (- 22.9%), Poland (- 19.1%) and Estonia (- 4.2%) and increased in Latvia (+ 56.8%) and Lithuania (+ 49.3%). In periods of policy non-action, alcohol consumption and tax revenue showed similar trends, but tax level increases were accompanied by increased revenue and stagnant or decreased consumption. CONCLUSIONS Increasing alcohol taxation was not linked to decreased but increased government revenue. Policymakers can increase revenue and reduce alcohol consumption and harm by increasing alcohol taxes.
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Affiliation(s)
- Jakob Manthey
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany.
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Laura Isajeva
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Jarosław Neneman
- Institute of Economics, Faculty of Economics and Sociology, University of Lodz, Lodz, Poland
| | - Rainer Reile
- Department for Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jürgen Rehm
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program on Substance Abuse, Program on Substance Abuse and WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
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Manthey J, Klinger S, Rosenkranz M, Schwarzkopf L. Cannabis use, health problems, and criminal offences in Germany: national and state-level trends between 2009 and 2021. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01778-z. [PMID: 38502205 DOI: 10.1007/s00406-024-01778-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024]
Abstract
The German federal government plans to decriminalise cannabis. The impact of this policy on use prevalence, cannabis-related health and legal problems cannot be fully anticipated and should be viewed in context with current trends. We used routine data on (a) cannabis use (population-based surveys), (b) cannabis-related diagnoses (ICD-10 code F12) in outpatient medical settings and (c) minor law offences (registered violations against the narcotics law for possessing small amounts) to analyse age and sex-specific trends by federal state between 2009 and 2021. To enable comparisons across time and federal state besides crude prevalence rates, age-standardised rates were calculated. Between 2009 and 2021, the age-standardised prevalence of cannabis use (5.7-10.6%), rate of diagnoses (1.1-3.7 per 1,000), and legal offences (1.8-3.1 per 1,000) increased, with the largest increase noted for cannabis-related diagnoses. Relatively, increases were most pronounced for older users (40-to-59-year-olds: use and offences; 35-to-44-year-olds: cannabis-related diagnoses) and rather stagnant for minors. Cannabis use and health problems appear to be more pronounced in Northern and city states, while no clear geographic trend was observed for law offences. Cannabis-related outpatient treatment demand has risen more steeply than use prevalence suggesting an increasing challenge for the health care system. Despite rising rates for documented offences, the long-term implications of law violations on social and occupational life are poorly understood but may be considered for evaluations of the proposed law changes.
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Affiliation(s)
- Jakob Manthey
- Centre of Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
- Institute for Interdisciplinary Addiction and Drug Research, Lokstedter Weg 24, 20251, Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Sinja Klinger
- Institute for Interdisciplinary Addiction and Drug Research, Lokstedter Weg 24, 20251, Hamburg, Germany
| | - Moritz Rosenkranz
- Centre of Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- Institute for Interdisciplinary Addiction and Drug Research, Lokstedter Weg 24, 20251, Hamburg, Germany
| | - Larissa Schwarzkopf
- IFT Institut Für Therapieforschung, Mental Health and Addiction Research, Leopoldstrasse 175, 80804, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Clinic of the Ludwig Maximilians University Munich, Ziemssenstrasse 5, 80336, Munich, Germany
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Hall W, Manthey J, Stjepanović D. Cannabis use and cannabis use disorders and their treatment in the Europe. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01776-1. [PMID: 38489067 DOI: 10.1007/s00406-024-01776-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/02/2024] [Indexed: 03/17/2024]
Abstract
This paper introduces the special issue on cannabis use in Europe. It describes data on the prevalence of cannabis use in Europe and the more limited data on the prevalence of cannabis use disorders, one of the most common forms of drug problem treated in many countries in Europe. It summarises what research has indicated about the adverse effects of acute and chronic cannabis use and discusses potential health system responses that may reduce some of these harms. These include public education about the risks of cannabis use; screening and brief interventions in primary medical settings; and specialist treatment for cannabis use disorders. It briefly indicates the special issues that may need to be addressed in dealing with the high rates of comorbidity between cannabis use disorders, other types of drug use disorders, and common mental disorders.
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Affiliation(s)
- Wayne Hall
- The National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia.
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Daniel Stjepanović
- The National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
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Manthey J, Jacobsen B, Schulte B, Rehm J. Rescheduling alcohol marketing bans within the World Health Organization menu of policy options. Addiction 2024. [PMID: 38456583 DOI: 10.1111/add.16476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Britta Jacobsen
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Bernd Schulte
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jürgen Rehm
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse and WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
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Olderbak S, Möckl J, Manthey J, Lee S, Rehm J, Hoch E, Kraus L. Trends and projection in the proportion of (heavy) cannabis use in Germany from 1995 to 2021. Addiction 2024; 119:311-321. [PMID: 37816631 DOI: 10.1111/add.16356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 08/07/2023] [Indexed: 10/12/2023]
Abstract
AIMS To measure the current trends of cannabis use in Germany, measure trends in the proportion of heavy cannabis users and estimate future cannabis use rates. DESIGN Repeated waves of the Epidemiological Survey on Substance Abuse, a cross-sectional survey conducted between 1995 and 2021 with a two-stage participant selection strategy where respondents completed a survey on substance use delivered through the post, over the telephone or on-line. SETTING Germany. PARTICIPANTS/CASES German-speaking participants aged between 18 and 59 years living in Germany who self-reported on their cannabis use in the past 12 months (n = 78 678). With the application of a weighting scheme, the data are nationally representative. MEASUREMENTS Questions on the frequency of cannabis use in the past 12 months and self-reported changes in frequency of use due to the COVID-19 pandemic. FINDINGS The prevalence of past 12-month cannabis users increased from 4.4% [95% confidence interval (CI) = 3.7, 5.1] in 1995 to 10.0% (95% CI = 8.9, 11.3) in 2021. Modeling these trends revealed a significant increase that accelerated over the past decade. The proportion of heavy cannabis users [cannabis use (almost) daily or at least 200 times per year] among past-year users has remained steady from 1995 (11.4%, 95% CI = 7.7, 16.5) to 2018 (9.5%, 95% CI = 7.6, 11.9), but significantly increased to 15.7% (95% CI = 13.1, 18.8) in 2021 during the COVID-19 pandemic. Extrapolating from these models, the prevalence of 12-month cannabis users in 2024 is expected to range between 10.4 and 15.0%, while the proportion of heavy cannabis users is unclear. CONCLUSIONS Trends from 1995 to 2021 suggest that the prevalence of past 12-month cannabis users in Germany will continue to increase, with expected rates between 10.4 and 15.0% for the German-speaking adult population, and that at least one in 10 cannabis users will continue to use cannabis heavily (almost daily or 200 + times in the past year).
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Affiliation(s)
| | - Justin Möckl
- IFT Institut für Therapieforschung, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Jakob Manthey
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Sara Lee
- IFT Institut für Therapieforschung, Munich, Germany
| | - Jürgen Rehm
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Program on Substance Abuse and WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| | - Eva Hoch
- IFT Institut für Therapieforschung, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Munich, Germany
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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Kotz D, Kastaun S, Manthey J, Hoch E, Klosterhalfen S. Cannabis Use in Germany. Dtsch Arztebl Int 2024; 121:52-57. [PMID: 37967282 PMCID: PMC10979436 DOI: 10.3238/arztebl.m2023.0237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND The federal government of Germany is planning to liberalize the recreational cannabis market for adults. We aimed to collect key baseline data on frequency of use, routes of administration, and co-use of cannabis and inhaled nicotine or tobacco products in the population. METHODS Based on data from a national survey of 9644 people aged >14 years, we analyzed self-reported use of cannabis in the past 12 months and preferred route of administration (single choice: smoked with tobacco; smoked without tobacco; inhaled without tobacco; consumed with food; consumed in another form). RESULTS The prevalence of past-year cannabis use was 4.6% (95% CI [4,2; 5,1%]), with higher rates among 14-24- (11.4%) and 25-39-year-olds (8.2%) as well as among co-users of inhaled nicotine or tobacco products, particularly waterpipe users (27.0%). Smoking cannabis with or without tobacco was the preferred route of administration, reported by 92.4% (95% CI [89,6; 94,6%]). It was most frequently reported by 14-24-year-olds and by co-users of inhaled nicotine or tobacco products. CONCLUSION Smoking remains the predominant form of using cannabis-especially among younger users, who are at greatest risk of cannabis-related consequences. The true prevalence of cannabis use may have been underestimated in our study, however, as not all participants answered the questions on cannabis. Nevertheless, preventive and harm reduction efforts are needed to reduce the harm from using cannabis. Continuous monitoring is required to evaluate the effects of the forthcoming law changes in Germany.
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Affiliation(s)
- Daniel Kotz
- Institute of General Practice (ifam), Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society (chs), Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf
- Department of Behavioural Science and Health, University College London, London, UK
| | - Sabrina Kastaun
- Institute of General Practice (ifam), Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society (chs), Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf
- Institute of General Practice (ifam), Patient-Physician Communication Research Unit, Centre for Health and Society (chs), Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf (UKE)
- Department of Psychiatry, Medical Faculty, University of Leipzig
| | - Eva Hoch
- IFT Institut für Therapieforschung, Center for Mental Health and Addiction Research, Munich
- Department of Psychology, Division of Clinical Psychology and Psychological Treatment, Ludwig-Maximilans-Universität München, Munich
- Department of Psychiatry and Psychotherapy, Cannabinoid Research Group, University Hospital, LMU Munich, Munich
| | - Stephanie Klosterhalfen
- Institute of General Practice (ifam), Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society (chs), Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf
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Štelemėkas M, Goštautaitė Midttun N, Lange S, Liutkutė-Gumarov V, Manthey J, Miščikienė L, Petkevičienė J, Radišauskas R, Rehm J, Trišauskė J, Telksnys T, Thompson MJ. Unrecorded alcohol consumption in Lithuania: a modelling study for 2000-2021. Alcohol Alcohol 2023; 58:612-618. [PMID: 37807756 PMCID: PMC10642605 DOI: 10.1093/alcalc/agad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/30/2023] [Accepted: 09/10/2023] [Indexed: 10/10/2023] Open
Abstract
The aim of the study was to estimate unrecorded alcohol consumption in Lithuania for the period 2000-2021 using an indirect method for modelling consumption based on official consumption data and indicators of alcohol-related harm. Methodology employed for estimating the unrecorded alcohol consumption was proposed by Norström and was based on the country's 2019 European Health Interview Survey and indicators of fully alcohol-attributable mortality. The proportion of unrecorded alcohol consumption was estimated as 8.30% (95% CI 7.7-8.9%) for 2019 in Lithuania. The estimated total (recorded and unrecorded) alcohol per capita consumption among individuals 15 years of age and older in 2019 was 12.2 L of pure alcohol, 1.01 (95% CI 0.94-1.09%) L of which is likely unrecorded. The lowest unrecorded alcohol level was estimated for 2009 and 2014, while 2018 had the highest level (i.e. 9.33% of total alcohol per capita consumption). Unrecorded alcohol consumption in Lithuania is likely to be modest when compared to recorded alcohol consumption, the latter of which still remains a major challenge to public health.
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Affiliation(s)
- Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
- Lithuanian Tobacco and Alcohol Control Coalition, Stiklių st. 8, Vilnius 01131, Lithuania
| | - Nijolė Goštautaitė Midttun
- Lithuanian Tobacco and Alcohol Control Coalition, Stiklių st. 8, Vilnius 01131, Lithuania
- Mental Health Initiative, Teatro st. 3-10, Vilnius 03107, Lithuania
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8thfloor, Toronto, ON M5T1R8, Canada
| | - Vaida Liutkutė-Gumarov
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
- Lithuanian Tobacco and Alcohol Control Coalition, Stiklių st. 8, Vilnius 01131, Lithuania
| | - Jakob Manthey
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, Leipzig 04103,Germany
| | - Laura Miščikienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
| | - Ričardas Radišauskas
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių pr. 15, Kaunas 50103, Lithuania
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8thfloor, Toronto, ON M5T1R8, Canada
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
- Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON M5T1P8, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia, 81-95 Roc Boronat St., Barcelona 08005, Spain
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, ON M5S1A8, Canada
| | - Justina Trišauskė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
| | - Tadas Telksnys
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
| | - Mark James Thompson
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str.18, Kaunas 47181, Lithuania
- Institute for Wealth and Asset Management, Zurich University of Applied Sciences, Winterthur, Switzerland
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Manthey J, Armstrong MJ, Hayer T, Myran DT, Pacula RL, Queirolo R, Rehm J, Wirth M, Zobel F. How to interpret studies on the impact of legalizing cannabis. Addiction 2023; 118:2242-2243. [PMID: 37544768 DOI: 10.1111/add.16314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/08/2023]
Affiliation(s)
- Jakob Manthey
- Centre of Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Michael J Armstrong
- Department of Finance, Operations and Information Systems, Brock University, St Catharines, Canada
| | - Tobias Hayer
- Institute of Public Health and Nursing Research, Department for Health and Society, University of Bremen, Bremen, Germany
| | - Daniel T Myran
- Bruyère Research Institute, Ottawa, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Rosalie Liccardo Pacula
- Price School of Public Policy and Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, California, Los Angeles, USA
| | - Rosario Queirolo
- Department of Social Sciences, Universidad Católica del Uruguay, Montevideo, Uruguay
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Centre of Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse and designated WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| | - Marielle Wirth
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
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11
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Rehm J, Badaras R, Ferreira-Borges C, Galkus L, Gostautaite Midttun N, Gobiņa I, Janik-Koncewicz K, Jasilionis D, Jiang H, Kim KV, Lange S, Liutkutė-Gumarov V, Manthey J, Miščikienė L, Neufeld M, Petkevičienė J, Radišauskas R, Reile R, Room R, Stoppel R, Tamutienė I, Tran A, Trišauskė J, Zatoński M, Zatoński WA, Zurlytė I, Štelemėkas M. Impact of the WHO "best buys" for alcohol policy on consumption and health in the Baltic countries and Poland 2000-2020. Lancet Reg Health Eur 2023; 33:100704. [PMID: 37953993 PMCID: PMC10636269 DOI: 10.1016/j.lanepe.2023.100704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 11/12/2023]
Abstract
Alcohol use is a major risk factor for burden of disease. This narrative review aims to document the effects of major alcohol control policies, in particular taxation increases and availability restrictions in the three Baltic countries (Estonia, Latvia, and Lithuania) between 2000 and 2020. These measures have been successful in curbing alcohol sales, in general without increasing consumption of alcoholic beverages from unrecorded sources; although for more recent changes this may have been partly due to the COVID-19 pandemic. Moreover, findings from time-series analyses suggest improved health, measured as reductions in all-cause and alcohol-attributable mortality, as well as narrowing absolute mortality inequalities between lower and higher educated groups. For most outcomes, there were sex differences observed, with alcohol control policies more strongly affecting males. In contrast to this successful path, alcohol control policies were mostly dismantled in the neighbouring country of Poland, resulting in a rising death toll due to liver cirrhosis and other alcohol-attributable deaths. The natural experiment in this region of high-income European countries with high consumption levels highlights the importance of effective alcohol control policies for improving population health.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada
- Faculty of Medicine, Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg 20246, Germany
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada
- Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, Ontario M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada
- Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St., Barcelona 08005, Spain
| | - Robertas Badaras
- Faculty of Medicine, Clinic of Anaesthesiology and Intensive Care, Centre of Toxicology, Vilnius University, M. K. Čiurlionio g. 21, Vilnius LT-03101, Lithuania
| | - Carina Ferreira-Borges
- World Health Organization, Regional Office for Europe, UN City, Marmorvej 5, Copenhagen DK-2100, Denmark
| | - Lukas Galkus
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Nijole Gostautaite Midttun
- Lithuanian Tobacco and Alcohol Control Coalition, Stikliu 8, Vilnius 01131, Lithuania
- Mental Health Initiative, Teatro 3-10, Vilnius 03107, Lithuania
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Kronvalda Boulevard 9, Riga LV-1010, Latvia
- Institute of Public Health, Riga Stradiņš University, Kronvalda Boulevard 9, Riga LV-1010, Latvia
| | - Kinga Janik-Koncewicz
- Institute – European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, Kalisz 62-800, Poland
- Health Promotion Foundation, Mszczonowska 51, Nadarzyn 05-830, Poland
| | - Domantas Jasilionis
- Max Planck Institute for Demographic Research, Laboratory of Demographic Data, Konrad-Zuse-Str. 1, Rostock 18057, Germany
- Vytautas Magnus University, Demographic Research Centre, Jonavos g. 66, Kaunas 44191, Lithuania
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada
- Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, Ontario M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada
| | - Vaida Liutkutė-Gumarov
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Jakob Manthey
- Faculty of Medicine, Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg 20246, Germany
- Medical Faculty, Department of Psychiatry, University of Leipzig, Semmelweisstraße 10, Leipzig 04103, Germany
| | - Laura Miščikienė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Maria Neufeld
- World Health Organization, Regional Office for Europe, UN City, Marmorvej 5, Copenhagen DK-2100, Denmark
| | - Janina Petkevičienė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Faculty of Public Health, Department of Preventive Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Ričardas Radišauskas
- Faculty of Public Health, Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, Kaunas 50162, Lithuania
| | - Rainer Reile
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Department for Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, Tallinn 11619, Estonia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria 3086, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm 106 91, Sweden
| | - Relika Stoppel
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Ilona Tamutienė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Department of Public Administration, Faculty of Political Science and Diplomacy at Vytautas Magnus University, V.Putvinskio Str 23, Kaunas LT-44243, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada
| | - Justina Trišauskė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Mateusz Zatoński
- Institute – European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, Kalisz 62-800, Poland
| | - Witold A. Zatoński
- Institute – European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, Kalisz 62-800, Poland
- Health Promotion Foundation, Mszczonowska 51, Nadarzyn 05-830, Poland
| | - Ingrida Zurlytė
- WHO Country Office Lithuania, A. Jakšto g. 12, LT-01105 Vilnius, Lithuania
| | - Mindaugas Štelemėkas
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Faculty of Public Health, Department of Preventive Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
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Manthey J, Pons‐Cabrera MT, Rosenkranz M, Lopez‐Pelayo H. Measuring cannabis quantities in online surveys: A rapid review and proposals for ways forward. Int J Methods Psychiatr Res 2023; 32:e1971. [PMID: 37089041 PMCID: PMC10485338 DOI: 10.1002/mpr.1971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/04/2023] [Accepted: 04/15/2023] [Indexed: 04/25/2023] Open
Abstract
OBJECTIVES Cannabis use quantities are relevant for determining cannabis-related harms. This research aims to provide an overview of the available methods to assess quantities through self-report. METHODS A rapid review of various strategies to collect information on cannabis use quantities through self-report. Two independent literature searches resulted in n = 38 studies included for review. RESULTS A total of n = 14 studies employed methods for collecting cannabis use quantities that are not suitable for online surveys (e.g., rolling a fake joint). Of the remaining n = 24 studies with items that are suitable for online surveys, the quantity assessment was performed in three different ways. The data collection was either carried out by asking (a) for the total number of joints (i.e., crude joint method), (b) for the total weight (i.e., crude weight method), or (c) for specific products separately, for example, for the amount of flower and resin (i.e., product-specific method). In only n = 8 studies, cannabis use quantities were ascertained by providing visual aids (e.g., illustration of various amounts of flower). CONCLUSIONS The crude joint method and the product-specific method are the two most promising methods to collect information on cannabis use quantities. Using visual aids may potentially improve the accuracy of those methods.
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Affiliation(s)
- Jakob Manthey
- Department of Psychiatry and PsychotherapyCenter for Interdisciplinary Addiction Research (ZIS)University Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
- Department of PsychiatryMedical FacultyUniversity of LeipzigLeipzigGermany
| | - Maria Teresa Pons‐Cabrera
- Grup de Recerca en Addicions ClínicInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)Unitat de Conductes AddictivesServei de Psiquiatria Psicologia (ICN)Hospital Clínic de BarcelonaBarcelonaSpain
| | - Moritz Rosenkranz
- Department of Psychiatry and PsychotherapyCenter for Interdisciplinary Addiction Research (ZIS)University Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
| | - Hugo Lopez‐Pelayo
- Grup de Recerca en Addicions ClínicInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)Unitat de Conductes AddictivesServei de Psiquiatria Psicologia (ICN)Hospital Clínic de BarcelonaBarcelonaSpain
- Red de Investigación en Atención Primaria de Adicciones (RIAPAd)BarcelonaSpain
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Kilian C, Manthey J, Braddick F, López-Pelayo H, Rehm J. Social disparities in alcohol's harm to others: evidence from 32 European countries. Int J Drug Policy 2023; 118:104079. [PMID: 37271071 DOI: 10.1016/j.drugpo.2023.104079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Alcohol use can cause harm not only to the person who consumes it but also to others. Prior research has found that these alcohol-attributable harms to others differ across socioeconomic groups, though several findings have been contradictory. The aim of this contribution was to study the role of individual-level and population-level income inequalities in alcohol's harm to others among women and men. METHODS Logistic regression analysis of cross-sectional survey data from 2021, covering 39,629 respondents from 32 European countries. Harms from others' drinking were defined as experiences of physical harm, involvement in a serious argument, or involvement in a traffic accident, due to another person's drinking, within the past year. We examined the association of individual-level income and country-specific income inequality (Gini index) with harms from a known person's or a stranger's drinking, adjusting for the respondent's age, daily drinking levels, and at least monthly risky single-occasion drinking. RESULTS At the individual level, people with lower incomes had 21% to 47% increased odds of reporting harms from a known person's drinking (women and men) or stranger's drinking (men only) than their same-gender counterparts in the highest income quintile. At the national level, countries with higher income inequality showed increased risks of harms from a known person's drinking among women (OR = 1.09, 95% confidence interval [CI]: 1.05 - 1.14), while among men the risk of harm from strangers' drinking decreased with higher income inequality (OR = 0.86, 95% CI: 0.81 - 0.92). These associations with income inequality were observed among respondents from all but the lowest income groups. CONCLUSION Alcohol can cause harm to others, with women and people with low incomes being disproportionally exposed to these harms. Alcohol control policies targeting high consumption levels, especially among men, as well as upstream policies to reduce inequalities, are needed to lower the health burden of alcohol beyond those who consume it.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
| | - Jakob Manthey
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Fleur Braddick
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Hugo López-Pelayo
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain; Addictions Unit, Psychiatry Department, Hospital Clínic, Barcelona, Spain
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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Manthey J, Kilian C, Schäfer I, Wirth M, Schulte B. Changes in the alcohol-specific disease burden during the COVID-19 pandemic in Germany: interrupted time series analyses. Eur J Public Health 2023:ckad103. [PMID: 37365723 PMCID: PMC10393477 DOI: 10.1093/eurpub/ckad103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 pandemic has been linked to changes in alcohol consumption, access to healthcare services and alcohol-attributable harm. In this contribution, we quantify changes in alcohol-specific mortality and hospitalizations at the onset of the COVID-19 pandemic in March 2020 in Germany. METHODS We obtained monthly counts of deaths and hospital discharges between January 2013 and December 2020 (n = 96 months). Alcohol-specific (International Classification of Diseases, tenth revision codes: F10.X; G31.2, G62.1, G72.1, I42.6, K29.2, K70.X, K85.2, K86.0, Q86.0, T51.X) diagnoses were further split into codes reflective of acute vs. chronic harm from alcohol consumption. To quantify the change in alcohol-specific deaths and hospital discharges, we performed sex-stratified interrupted time series analyses using generalized additive mixed models for the population aged 45-74. Immediate (step) and cumulative (slope) changes were considered. RESULTS Following March 2020, we observed immediate increases in alcohol-specific mortality among women but not among men. Between the years of 2019 and 2020, we estimate that alcohol-specific mortality among women has increased by 10.8%. Hospital discharges were analyzed separately for acute and chronic conditions. The total number of hospital discharges fell by 21.4% and 25.1% for acute alcohol-specific conditions for women and men, respectively. The total number of hospital discharges for chronic alcohol-specific conditions fell by 7.4% and 8.1% for women and men, respectively. CONCLUSIONS Increased consumption among people with heavy drinking patterns and reduced utilization of addiction-specific healthcare services during the pandemic might explain excess mortality. During times of public health crises, access to addiction-specific services needs to be ensured.
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Affiliation(s)
- Jakob Manthey
- Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, University of Leipzig, Leipzig, Germany
| | - Carolin Kilian
- Institute of Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Ingo Schäfer
- Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Marielle Wirth
- Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Bernd Schulte
- Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Manthey J, Obradors-Pineda A. Prices of flower and resin in cannabis social clubs: Analyses of register data from 220,000 collections. Drug Alcohol Rev 2023. [PMID: 37183527 DOI: 10.1111/dar.13680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Cannabis social clubs (CSC) are community-based non-profit organisations that aim to minimise cannabis-related harm for their members. This contribution seeks to: (i) compare the cost of cannabis flower and resin in CSCs to the national average retail price on the illegal market; and (ii) identify possible quantity discounts for cannabis flower and resin distributed to members of CSCs. METHODS Routine data from four CSCs located in Barcelona, Spain, contained information on n = 220,465 collections of cannabis resin and flower (0.01-39 g per collection). The costs for 1 g of cannabis flower and resin per collection were determined. The mean national prices on illicit cannabis were obtained from Spanish police reports. RESULTS On average, members paid 6.19€ for 1 g flower (median: 6€; interquartile range: 6-7€) and 8.54€ for 1 g resin (median: 7€; interquartile range: 6-9€), with less variations for flower than for resin. Compared to the national average, prices appeared to be higher for cannabis products distributed in CSCs, but comparisons were limited by a lack of data on the variation of national prices. For resin, doubling the quantity was associated with a 20.7% (95% confidence interval 20.4-21.2%; p < 0.001) fee discount. DISCUSSION AND CONCLUSIONS Cannabis in CSCs may be more costly than the estimated national average for the illicit market. No meaningful price discount could be observed for flower but for resin. Pricing policies pursued by CSCs may help to disincentivise consumption of larger amounts but may also bar socioeconomically disadvantaged users from accessing safer alternatives than the illegal market.
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Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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Manthey J, Kokole D, Riedel-Heller S, Rowlands G, Schäfer I, Schomerus G, Soellner R, Kilian C. Improving alcohol health literacy and reducing alcohol consumption: recommendations for Germany. Addict Sci Clin Pract 2023; 18:28. [PMID: 37161561 PMCID: PMC10169338 DOI: 10.1186/s13722-023-00383-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/24/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Although the detrimental health effects of alcohol are well established, consumption levels are high in many high-income countries such as Germany. Improving alcohol health literacy presents an integrated approach to alcohol prevention and an important complement to alcohol policy. Our aim was to identify and prioritize measures to enhance alcohol health literacy and hence to reduce alcohol consumption, using Germany as an example. METHODS A series of recommendations for improving alcohol health literacy were derived from a review of the literature and subsequently rated by five experts. Recommendations were rated according to their likely impact on enhancing (a) alcohol health literacy and (b) reducing alcohol consumption. Inter-rater agreement was assessed using a two-way intra-class correlation coefficient (ICC). RESULTS Eleven recommendations were established for three areas of action: (1) education and information, (2) health care system, and (3) alcohol control policy. Education and information measures were rated high to increase alcohol health literacy but low to their impact on alcohol consumption, while this pattern was reversed for alcohol control policies. The ratings showed good agreement (ICC: 0.85-0.88). CONCLUSIONS Improving alcohol health literacy and reducing alcohol consumption should be considered complementary and become part of a comprehensive alcohol strategy to curb the health, social, and economic burden of alcohol.
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Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Daša Kokole
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD, Maastricht, The Netherlands
| | - Steffi Riedel-Heller
- Public Health Sciences Institute, Campus for Ageing & Vitality, Westgate Rd, Newcastle Upon Tyne, NE4 6BE, UK
| | - Gill Rowlands
- Institute of Social Medicine, Medical Faculty, Occupational Health and Public Health (ISAP), University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Ingo Schäfer
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Georg Schomerus
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany
| | - Renate Soellner
- Institute for Psychology, University of Hildesheim, Universitätsplatz 1, 34414, Hildesheim, Germany
| | - Carolin Kilian
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research (IMHPR), 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
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Manthey J, Jacobsen B, Hayer T, Kalke J, López-Pelayo H, Pons-Cabrera MT, Verthein U, Rosenkranz M. The impact of legal cannabis availability on cannabis use and health outcomes: A systematic review. Int J Drug Policy 2023; 116:104039. [PMID: 37126997 DOI: 10.1016/j.drugpo.2023.104039] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/06/2023] [Accepted: 04/15/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND For alcohol, regulating availability is an effective way to reduce consumption and harm. Similarly, the higher availability of medical cannabis dispensaries has been linked to increased cannabis consumption and harm. For recreational cannabis markets, such a link is suspected but still poorly understood. METHODS A systematic literature review (PROSPERO registration number 342357) was conducted on 1 July 2022 in common libraries (Medline, Web of Science, PsycInfo, Psyndex, CINAHL, Embase, SCOPUS, Cochrane) for publications since 2012. Studies linking variations in the availability of legal cannabis products to behavioral outcomes (cannabis use or related health indicators) were included, while studies focusing solely on the legalization of medical cannabis were excluded. The risk of bias was assessed using an adapted version of the Newcastle-Ottawa-Scale. RESULTS After screening n = 6,253 studies, n = 136 were selected for full-text review, out of which n = 13 met the inclusion criteria, reporting on n = 333,550 study participants and n = 855,630 presentations to emergency departments. All studies were conducted in North America, with the majority from Western US states. Using longitudinal (n = 1), cross-sectional (n = 4), or repeated cross-sectional (n = 8) study designs, an increased availability of legal cannabis was linked to increased current cannabis use and health-related outcomes (vomiting, psychosis, or cannabis-involved pregnancies), regardless of the indicator employed to measure availability (proximity or density) among both adults and adolescents. The positive correlation between cannabis availability and consumption is most pronounced among those groups who have been less exposed to cannabis before legalization. The association between the availability of legal cannabis and risky use indicators was less consistent. CONCLUSIONS Groups who have been least exposed to cannabis before legalization may be most susceptible to increased availability. In jurisdictions with legal cannabis markets, restrictions on the number of legal cannabis retailers, especially in densely populated areas, appear warranted.
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Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; Institute for Interdisciplinary Addiction and Drug Research, Lokstedter Weg 24, 20251 Hamburg, Germany; Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany.
| | - Britta Jacobsen
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; Institute for Interdisciplinary Addiction and Drug Research, Lokstedter Weg 24, 20251 Hamburg, Germany
| | - Tobias Hayer
- University of Bremen, Institute of Public Health and Nursing Research, Department for Health and Society, Grazerstr. 2, 28359 Bremen, Germany
| | - Jens Kalke
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; Institute for Interdisciplinary Addiction and Drug Research, Lokstedter Weg 24, 20251 Hamburg, Germany
| | - Hugo López-Pelayo
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Unitat de Conductes Addictives, Servei de Psiquiatria Psicologia (ICN), Hospital Clínic de Barcelona, Barcelona, Spain; Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Spain
| | - Maria Teresa Pons-Cabrera
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Unitat de Conductes Addictives, Servei de Psiquiatria Psicologia (ICN), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Uwe Verthein
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
| | - Moritz Rosenkranz
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; Institute for Interdisciplinary Addiction and Drug Research, Lokstedter Weg 24, 20251 Hamburg, Germany
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Manthey J, Braddick F, López-Pelayo H, Shield K, Rehm J, Kilian C. Unrecorded alcohol use in 33 European countries: Analyses of a comparative survey with 49,000 people who use alcohol. Int J Drug Policy 2023; 116:104028. [PMID: 37116403 DOI: 10.1016/j.drugpo.2023.104028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND Using data from 33 European countries (including all EU member states), this study aimed to 1) estimate the prevalence of unrecorded alcohol use among past-week alcohol users, 2) describe how unrecorded alcohol use is associated with drinking patterns, and 3) estimate the contribution of unrecorded alcohol to the total amount of alcohol consumed annually in these countries. METHODS Data from 25,728 adults who drank alcohol in the past week and self-reported their use of unrecorded alcohol in 2021 were analysed. Prevalence of unrecorded alcohol use in the last week was estimated for those with low, medium, and high risk drinking categorised using the WHO-recommended risk thresholds and definition of risky single occasion drinking. Prevalence estimates were weighted for the country-specific gender, age, and geographical population distribution. An adjusted weighted proportion of unrecorded drinking occasions in total drinking occasions was calculated and compared to 2020 recorded annual per capita consumption estimates. RESULTS Among past-week alcohol users, the average prevalence of past-week unrecorded alcohol use was 12.1% (95% CI: 11.7-12.5%), with considerable difference between countries (min: 2.0% in Malta; max: 27.0% in Greece). Unrecorded alcohol use was much more prevalent among people with high-risk alcohol use in the past week (24.2%, 95% confidence interval [CI]: 22.9-25.5%) compared to people with low- (6.5, 95% CI: 6.0-6.9%) or medium-risk alcohol intake in the past week (13.6%, 95% CI: 12.9-14.3%). Unrecorded alcohol accounted for 7% of per capita consumption in 2020. CONCLUSIONS This is the first comparable assessment of unrecorded alcohol use across EU and affiliated countries. The findings add support to the observation that availability of unrecorded alcohol may contribute to risky drinking in Europe. The observed country variations may be related to differences in country-specific pricing policies and measures to reduce the production and consumption of unrecorded alcoholic beverages.
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Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany.
| | - Fleur Braddick
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS); Rosselló, 149-153, 08036 Barcelona, Spain
| | - Hugo López-Pelayo
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS); Rosselló, 149-153, 08036 Barcelona, Spain; Addictions Unit, Psychiatry Department, Hospital Clínic; Villarroel 170, 08036 Barcelona, Spain
| | - Kevin Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 3M1, Canada; Dalla Lana School of Public Health; Institute of Health Policy, Management and Evaluation; & Department of Psychiatry, University of Toronto (UofT), Toronto, Canada; PAHO/WHO Collaborating Centre at CAMH, Toronto, Canada & WHO European Region Collaborating Centre at Public Health Institute of Catalonia, Barcelona, Spain
| | - Jürgen Rehm
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 3M1, Canada; Dalla Lana School of Public Health; Institute of Health Policy, Management and Evaluation; & Department of Psychiatry, University of Toronto (UofT), Toronto, Canada; PAHO/WHO Collaborating Centre at CAMH, Toronto, Canada & WHO European Region Collaborating Centre at Public Health Institute of Catalonia, Barcelona, Spain; Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, Germany; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Carolin Kilian
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS); Rosselló, 149-153, 08036 Barcelona, Spain; Addictions Unit, Psychiatry Department, Hospital Clínic; Villarroel 170, 08036 Barcelona, Spain
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Kilian C, Klinger S, Rehm J, Manthey J. Alcohol use, dementia risk, and sex: a systematic review and assessment of alcohol-attributable dementia cases in Europe. BMC Geriatr 2023; 23:246. [PMID: 37098501 PMCID: PMC10127029 DOI: 10.1186/s12877-023-03972-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 04/13/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND High-risk alcohol use is an established modifiable risk factor for dementia. However, prior reviews have not addressed sex differences in alcohol-related dementia risk. In this systematic review, we take a sex-specific perspective towards the alcohol-dementia link, taking into account the age of dementia onset. METHODS We searched electronic databases for original cohort or case-control studies investigating the association between alcohol use and dementia. Two restrictions were considered: First, studies had to report results stratified by sex. Second, given the fact that the age at dementia onset seems to affect the alcohol-dementia link, studies were required to distinguish between early-onset and late-onset dementia (cut-off: 65 years). Additionally, the contribution of alcohol to dementia incidence was quantified for a set of 33 European countries for the year 2019. RESULTS We reviewed 3,157 reports, of which 7 publications were finally included and summarised narratively. A lower dementia risk when drinking alcohol infrequent or at moderate levels was found in men (three studies) and women (four studies). High-risk use and alcohol use disorders increased the risk of mild cognitive impairment and dementia, particularly early-onset dementia. Estimating the alcohol-attributable share of incident dementia cases revealed that 3.2% and 7.8% of incident dementia cases were estimated to be attributable to high-risk alcohol use (at least 24 g of pure alcohol per day) in 45-to-64-year-old women and men, respectively. CONCLUSIONS Research to date has paid little attention to the sex-specific link of alcohol and dementia. In the absence of sex-specific research, the established recommendations on high-risk alcohol use should be employed to communicate the alcohol-attributable dementia risk.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
| | - Sinja Klinger
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Program On Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Jakob Manthey
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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Lange S, Jiang H, Štelemėkas M, Tran A, Cherpitel C, Giesbrecht N, Midttun NG, Jasilionis D, Kaplan MS, Manthey J, Xuan Z, Rehm J. Evaluating the Impact of Alcohol Policy on Suicide Mortality: A Sex-Specific Time-Series Analysis for Lithuania. Arch Suicide Res 2023; 27:339-352. [PMID: 34779348 PMCID: PMC9098693 DOI: 10.1080/13811118.2021.1999873] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE It is reasonable to believe that the alcohol policy environment can impact the suicide mortality rates in a given country, considering the well-known link between alcohol use and death by suicide. The current literature, albeit limited, suggests that an increase in alcohol taxation may result in a decrease in deaths by suicide and that the effect is sex-specific. Therefore, the objective of the current study was to test the impact of three alcohol control policy enactments (in 2008, 2017 and 2018) on suicide mortality among adults 25-74 years of age in Lithuania, by sex. METHODS To estimate the unique impact of three alcohol control policies, we conducted interrupted time-series analyses by employing a generalized additive mixed model on monthly sex-specific age-standardized suicide mortality rates from January 2001 to December 2018. RESULTS Analyses showed a significant impact of the 2017 (p = 0.016) alcohol control policy on suicide mortality for men only. Specifically, we estimated that in the year following the 2017 policy enactment, approximately 57 (95% CI: 9-107) deaths by suicide were prevented among men, 25-74 years of age. The three policy enactments tested were not found to significantly impact the suicide mortality rate among women. CONCLUSION Alcohol control policies involving pricing, which result in a notable decrease in alcohol affordability, could be a cost-effective indirect suicide prevention mechanism in not only countries of the former Soviet Union, but in other high-income countries with a comparable health care system to that in Lithuania. HIGHLIGHTSIncreasing excise tax on alcohol was found to have a sex-specific impact on suicide mortalityThe 2017 alcohol policy prevented 57 deaths by suicide among men, 25-74 years of age, in the following yearAlcohol pricing policies may be a cost-effective indirect suicide prevention mechanism.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
| | - Cheryl Cherpitel
- Public Health Institute, Alcohol Research Group, Emeryville CA, USA
| | - Norman Giesbrecht
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | | | - Domantas Jasilionis
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany
- Demographic Research Centre, Faculty of Social Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Mark S. Kaplan
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles CA, USA
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Ziming Xuan
- Department of Community Health Sciences, Boston University School of Public Health, Boston MA, USA
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry, University of Toronto, Toronto ON, Canada
- Institute of Medical Science, University of Toronto, Toronto ON, Canada
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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Kim KV, Rehm J, Feng X, Jiang H, Manthey J, Radišauskas R, Štelemėkas M, Tran A, Zafar A, Lange S. Impact of alcohol control policy on hemorrhagic and ischemic stroke mortality rates in Lithuania: An interrupted time series analysis. Adicciones 2023; 0:1828. [PMID: 36975071 PMCID: PMC10884980 DOI: 10.20882/adicciones.1828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Given the causal impact of alcohol use on stroke, alcohol control policies should presumably reduce stroke mortality rates. This study aimed to test the impact of three major Lithuanian alcohol control policies implemented in 2008, 2017 and 2018 on sex- and stroke subtype-specific mortality rates, among individuals 15+ years-old. Joinpoint regression analyses were performed for each sex- and stroke subtype-specific group to identify timepoints corresponding with significant changes in mortality rate trends. To estimate the impact of each policy, interrupted time series analyses using a generalized additive mixed model were performed on monthly sex- and stroke subtype-specific age-standardized mortality rates from January 2001-December 2018. Significant average annual percent decreases were found for all sex- and stroke subtype-specific mortality rate trends. The alcohol control policies were most impactful on ischemic stroke mortality rates among women. The 2008 policy was followed by a positive level change of 4,498 ischemic stroke deaths per 100,000 women and a negative monthly slope change of -0.048 ischemic stroke deaths per 100,000 women. Both the 2017 and 2018 policy enactment timepoints coincided with a significant negative level change for ischemic stroke mortality rates among women, at -0.901 deaths and -1.431 deaths per 100,000 population, respectively. Hemorrhagic stroke mortality among men was not affected by any of the policies, and hemorrhagic stroke mortality among women and ischemic stroke mortality among men were only associated with the 2008 policy. Our study findings suggest that the impact of alcohol control policies on stroke mortality may vary by sex and subtype.
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Affiliation(s)
- Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON Dalla Lana School of Public Health, University of Toronto, Toronto ON.
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Kilian C, Carr S, Schulte B, Manthey J. Increased alcohol-specific mortality in Germany during COVID-19: State-level trends from 2010 to 2020. Drug Alcohol Rev 2023; 42:633-640. [PMID: 36352737 PMCID: PMC9878067 DOI: 10.1111/dar.13573] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The COVID-19 pandemic may have led to an increase in the alcohol-specific mortality. Against this backdrop, the aim of this report is to explore alcohol-specific mortality trends in Germany of the years 2010 to 2020. METHOD Alcohol-specific mortality data aggregated by sex, 5-year age groups and state were collected from the annual cause-of-death statistics and analysed descriptively by visual inspection. RESULTS The overall alcohol-specific mortality rate (age-standardised) has mainly decreased between 2010 and 2020. However, increased alcohol-specific mortality rates for the year 2020 compared to 2019 were found for both, women (+4.8%) and men (+5.5%), particularly in age groups between 40 and 69 years. Changes in alcohol-specific mortality rates differed between federated states, with steeper increases in East Germany. DISCUSSION AND CONCLUSIONS Different mechanisms related to the increase in alcohol consumption, particularly among high-risk drinkers, and reduced resources in health care may have led to an increase in alcohol-specific mortality in Germany in 2020. Despite the recent decline in the alcohol-specific mortality in Germany, an increase in the death toll was observed in 2020.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
- Institute for Mental Health Policy ResearchCentre for Addiction and Mental HealthTorontoCanada
| | - Sinclair Carr
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry and PsychotherapyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Bernd Schulte
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry and PsychotherapyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Jakob Manthey
- Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry and PsychotherapyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
- Department of Psychiatry, Medical FacultyUniversity of LeipzigLeipzigGermany
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Solovei A, Rovira P, Anderson P, Jané-Llopis E, Natera Rey G, Arroyo M, Medina P, Mercken L, Rehm J, de Vries H, Manthey J. Improving alcohol management in primary health care in Mexico: A return-on-investment analysis. Drug Alcohol Rev 2023; 42:680-690. [PMID: 36646970 DOI: 10.1111/dar.13598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 10/13/2022] [Accepted: 12/07/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Alcohol screening, brief advice and referral to treatment (SBIRT) in primary health care is an effective strategy to decrease alcohol consumption at population level. However, there is relatively scarce evidence regarding its economic returns in non-high-income countries. The current paper aims to estimate the return-on-investment of implementing a SBIRT program in Mexican primary health-care settings. METHODS Empirical data was collected in a quasi-experimental study, from 17 primary health-care centres in Mexico City regarding alcohol screening delivered by 145 health-care providers. This data was combined with data from a simulation study for a period of 10 years (2008 to 2017). Economic investments were calculated from a public sector health-care perspective as clinical consultation costs (salary and material costs) and program costs (set-up, adaptation, implementation strategies). Economic return was calculated as monetary gains in the public sector health-care, estimated via simulated reductions in alcohol consumption, dependent on population coverage of alcohol interventions delivered to primary health-care patients. RESULTS Results showed that scaling up a SBIRT program in Mexico over a 10-year period would lead to positive return-on-investment values ranging between 21% in scenario 4 (confidence interval -8.6%, 79.5%) and 110% in scenario 5 (confidence interval 51.5%, 239.8%). Moreover, over the 10-year period, up to 16,000 alcohol-related deaths could be avoided as a result of implementing the program. DISCUSSION AND CONCLUSIONS SBIRT implemented at national level in Mexico may lead to substantial financial gains from a public sector health-care perspective.
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Affiliation(s)
- Adriana Solovei
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Communication Science, Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
| | - Peter Anderson
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Eva Jané-Llopis
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- ESADE, University Ramon Llull, Barcelona, Spain
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Miriam Arroyo
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Perla Medina
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Liesbeth Mercken
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Health Psychology, Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Jakob Manthey
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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24
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Rehm J, Lange S, Gobiņa I, Janik-Koncewicz K, Miščikienė L, Reile R, Stoppel R, Tran A, Ferreira-Borges C, Jasilionis D, Jiang H, Kim KV, Manthey J, Neufeld M, Petkevičienė J, Radišauskas R, Room R, Liutkutė-Gumarov V, Zatoński WA, Štelemėkas M. Classifying alcohol control policies enacted between 2000 and 2020 in Poland and the Baltic countries to model potential impact. Addiction 2023; 118:449-458. [PMID: 36471145 PMCID: PMC10884981 DOI: 10.1111/add.16102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
AIMS The study's aim is to identify and classify the most important alcohol control policies in the Baltic countries (Estonia, Latvia and Lithuania) and Poland between 2000 and 2020. METHODS Policy analysis of Baltic countries and Poland, predicting potential policy impact on alcohol consumption, all-cause mortality and alcohol-attributable hospitalizations was discussed. RESULTS All Baltic countries implemented stringent availability restrictions on off-premises trading hours and different degrees of taxation increases to reduce the affordability of alcoholic beverages, as well as various degrees of bans on alcohol marketing. In contrast, Poland implemented few excise taxation increases or availability restrictions and, in fact, reduced stipulations on prior marketing bans. CONCLUSIONS This classification of alcohol control policies in the Baltic countries and Poland provides a basis for future modeling of the impact of implementing effective alcohol control policies (Baltic countries), as well as the effects of loosening such policies (Poland).
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Affiliation(s)
- Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse and designated WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| | - Shannon Lange
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Kinga Janik-Koncewicz
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska, Nadarzyn, Poland
| | - Laura Miščikienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rainer Reile
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department for Epidemiology and Biostatistics, National institute for Health Development, Tallinn, Estonia
| | - Relika Stoppel
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Economics, University of Potsdam, Potsdam, Germany
| | - Alexander Tran
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | | | - Domantas Jasilionis
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany
- Demographic Research Centre, Vytautas Magnus University, Kaunas, Lithuania
| | - Huan Jiang
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kawon Victoria Kim
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Maria Neufeld
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Vaida Liutkutė-Gumarov
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Witold A Zatoński
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
- Health Promotion Foundation, Mszczonowska, Nadarzyn, Poland
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Rehm J, Rovira P, Manthey J, Anderson P. Reduction of Alcoholic Strength: Does It Matter for Public Health? Nutrients 2023; 15:nu15040910. [PMID: 36839266 PMCID: PMC9959344 DOI: 10.3390/nu15040910] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
In this work, reduction of alcoholic strength was discussed as a means to reduce consumption and alcohol-attributable harm. Statistical modelling was conducted to (1) estimate its potential for the largest six Western and Central European countries (France, Germany, Italy, Poland, Spain, UK); (2) calculate the increase in taxation necessary to reach this potential, and (3) estimate the mortality gains achieved with the introduction of no- or low-alcohol beverages in the UK and Spain. The high public health potential of reducing alcoholic strength was demonstrated via modelling a scenario in which the strength of all beverages was reduced by 10%, which would avert thousands of deaths in these six European countries per year. However, methods by which to achieve these gains were not clear, as the alcohol industry has shown no inclination toward reductions in the alcoholic strength of beer, wine, or spirits via a reformulation on a large scale. The increase of excise taxation to achieve the public health gains of such a reduction would result in markedly increasing prices-a situation unlikely to be implemented in Europe. Finally, the introduction of beer and wine with an alcoholic strength below 0.5% led to some substitutions of higher-strength beverages, but did not show a marked public health impact. New taxation initiatives to achieve the potential of a reduction of alcoholic strength will need to be implemented.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5S 3M1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia/Agència de Salut Pública de Catalunya, Departament de Salut, Generalitat de Catalunya, Roc Boronat 81-95, 08005 Barcelona, Spain
- Correspondence: ; Tel.: +1-416-535-8501 (ext. 36173)
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia/Agència de Salut Pública de Catalunya, Departament de Salut, Generalitat de Catalunya, Roc Boronat 81-95, 08005 Barcelona, Spain
| | - Jakob Manthey
- Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Peter Anderson
- Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands
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Manthey J. Welchen Beitrag leistet die Wissenschaft in der deutschen Debatte um die Cannabislegalisierung? SUCHT 2023. [DOI: 10.1024/0939-5911/a000797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- Jakob Manthey
- Zentrum für Interdisziplinäre Suchtforschung (ZIS), Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Deutschland
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Deutschland
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27
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Manthey J. Harm Reduction und Cannabis: Was ändert sich durch die Legalisierung? SUCHT 2023. [DOI: 10.1024/0939-5911/a000798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Zusammenfassung: Durch die Legalisierung ergeben sich zahlreiche Chancen, aber auch Unsicherheiten in Bezug auf Schadensminderung. Die Chancen liegen unter anderem in der verbesserten Aufklärung über gesundheitliche Risiken und in der Früherkennung von riskantem Cannabiskonsum. Weiterhin können die durch die Repression verursachten, umfangreichen Schäden durch die Legalisierung zu einem großen Teil reduziert bzw. verhindert werden. Schließlich sollten Instrumente wie THC-Mindestpreis und THC-gekoppelte Besteuerung, sowie Beschränkungen der Verkaufslizenzen und der Verkaufszeiten und -orte genutzt werden, um den Konsum zu steuern und Schäden zu minimieren. Größere Unsicherheiten bestehen insbesondere im Zusammenhang mit der Kommerzialisierung der Märkte sowie in der Regulierung des Eigenanbaus. Zusammenfassend ist zu erwarten, dass durch eine sorgfältige Regulierung die individuellen und gesellschaftlichen cannabisbedingten Schäden reduziert werden können.
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Affiliation(s)
- Jakob Manthey
- Zentrum für Interdisziplinäre Suchtforschung (ZIS), Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Deutschland
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Deutschland
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28
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Manthey J, Jasilionis D, Jiang H, Meščeriakova O, Petkevičienė J, Radišauskas R, Štelemėkas M, Rehm J. The impact of alcohol taxation increase on all-cause mortality inequalities in Lithuania: an interrupted time series analysis. BMC Med 2023; 21:22. [PMID: 36647069 PMCID: PMC9841962 DOI: 10.1186/s12916-022-02721-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/21/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Taxation increases which reduce the affordability of alcohol are expected to reduce mortality inequalities. A recent taxation increase in Lithuania offers the unique possibility to test this hypothesis. METHODS Census-linked mortality data between 2011 and 2019 were used to calculate monthly sex- and education-stratified age-standardized mortality rates for the population aged 40 to 70 years. As primary outcome, we analysed the difference in age-standardized all-cause mortality rates between the population of lowest versus highest educational achievement. The impact of the 2017 taxation increase was evaluated using interrupted time series analyses. To identify whether changes in alcohol use can explain the observed effects on all-cause mortality, the education-based mortality differences were then decomposed into n = 16 cause-of-death groupings. RESULTS Between 2012 and 2019, education-based all-cause mortality inequalities in Lithuania declined by 18% among men and by 14% among women. Following the alcohol taxation increase, we found a pronounced yet temporary reduction of mortality inequalities among Lithuanian men (- 13%). Subsequent decomposition analyses suggest that the reduction in mortality inequalities between lower and higher educated men was mainly driven by narrowing mortality differences in injuries and infectious diseases. CONCLUSIONS A marked increase in alcohol excise taxation was associated with a decrease in mortality inequalities among Lithuanian men. More pronounced reductions in deaths from injuries and infectious diseases among lower as compared to higher educated groups could be the result of differential changes in alcohol use in these populations.
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Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany. .,Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Domantas Jasilionis
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany.,Demographic Research Centre, Faculty of Social Sciences, Vytautas Magnus University, Jonavos Str. 66, 44191, Kaunas, Lithuania
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Olga Meščeriakova
- Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania.,Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių Av. 15, 50162, Kaunas, Lithuania
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės 18, 47181, Kaunas, Lithuania
| | - Jürgen Rehm
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.,Department of Psychiatry, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5T 2S1, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya Str., 8, B. 2, 119992, Moscow, Russian Federation
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Kilian C, Manthey J, Neufeld M, Rehm J. Affordability of Alcoholic Beverages in the European Union. Eur Addict Res 2023; 29:63-66. [PMID: 36244336 DOI: 10.1159/000527096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/02/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND From a public health perspective, alcohol taxation should be designed to reduce alcohol affordability and thus alcohol consumption and related harms. OBJECTIVES In this brief report, we estimate alcohol affordability in European Union Member States and associated countries and investigate whether affordability is related to national alcohol excise duties. METHOD Beverage-specific affordability for beer, wine, and spirits were estimated based on the number of standard drinks a household could purchase based on their median monthly disposable household income in 2020. To determine the pooled affordability of alcohol, the beverage-specific estimates were weighted by the share of the beverage-specific per capita consumption in total recorded consumption. Pearson and Spearman rank correlations were calculated to establish the association between alcohol affordability and alcohol excise duty rates. All data were retrieved from official sources. RESULTS On average, a European household can purchase 1,628 standard drinks of alcohol with its monthly income, with affordability being highest in Germany, Austria, France, and Luxembourg. The affordability of spirits, but not that of beer or wine, was inversely correlated with the beverage-specific excise duty rates. CONCLUSIONS Alcohol is affordable in the Member States of the European Union and associated countries, and low levels of excise duties on beer and wine appear to be unrelated to their affordability. Alcohol taxes should be increased to effectively reduce the affordability of alcoholic beverages in order to lower the alcohol-related health burden in Europe.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jakob Manthey
- Department of Psychiatry and Psychotherapy, Centre for Interdisciplinary Addiction Research (ZIS), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Maria Neufeld
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Centre for Interdisciplinary Addiction Research (ZIS), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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30
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Möckl J, Lindemann C, Manthey J, Schulte B, Reimer J, Pogarell O, Kraus L. Estimating the prevalence of alcohol-related disorders and treatment utilization in Bremen 2016/2017 through routine data linkage. Front Psychiatry 2023; 14:1002526. [PMID: 36778636 PMCID: PMC9909027 DOI: 10.3389/fpsyt.2023.1002526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/03/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In Germany, most individuals with alcohol dependence are recognized by the health care system and about 16% per year receive addiction-specific care. This paper aimed to analyze the prevalence and treatment utilization rate of people with alcohol dependence by type of addiction-specific care in the federal state of Bremen using routine and survey data. METHODS The number of individuals with alcohol dependence was estimated using data from the 2018 Epidemiological Survey of Substance Abuse (ESA). Furthermore, linked routine data of two statutory health insurances (SHIs), the German pension insurance (GPI), and the communal hospital group Gesundheit Nord - Bremen Hospital Group (GeNo), from 2016/2017, were analyzed. Based on SHI data, the administrative prevalence of various alcohol-related diagnoses according to the International Classification of Diseases (ICD-10), in various treatment settings, was extrapolated to the total population of Bremen. Based on all routine data sources, treatment and care services for individuals with alcohol dependence were also extrapolated to Bremen's total population. Care services included outpatient addiction care visits and addiction-specific treatments, [i.e., qualified withdrawal treatment (QWT), outpatient pharmacotherapy as relapse prevention, and rehabilitation treatment]. RESULTS Of the survey-estimated 15,792 individuals with alcohol dependence in Bremen, 72.4% (n = 11,427) had a diagnosis documented with an ICD-10 code for alcohol dependence (F10.2) or withdrawal state (F10.3-4). One in 10 individuals with alcohol dependence (n = 1,577) used one or more addiction-specific care services during the observation period. Specifically, 3.7% (n = 675) received outpatient addiction care, 3.9% (n = 736) initiated QWT, 0.8% (n = 133) received pharmacotherapy, and 2.6% (n = 405) underwent rehabilitation treatment. The share of seeking addiction-specific treatment after diagnosis was highest among younger and male patients. CONCLUSION Although more than half of the individuals with alcohol dependence are documented in the health system, utilization rates of addiction-specific treatments are low. These low utilization rates suggest that there are existing barriers to transferring patients with alcohol dependence into addiction-specific care. Strengthening primary medical care provision in dealing with alcohol-related disorders and improving networking within the addiction support system appear to be particularly appropriate.
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Affiliation(s)
- Justin Möckl
- Department of Epidemiology and Diagnostics, Institut für Therapieforschung (IFT), Centre for Mental Health and Addiction Research, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Christina Lindemann
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Medical Psychology, Center for Health Care Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jakob Manthey
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Bernd Schulte
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Reimer
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Zentrum für Psychosoziale Medizin, Klinikum Itzehoe, Itzehoe, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Ludwig Kraus
- Department of Epidemiology and Diagnostics, Institut für Therapieforschung (IFT), Centre for Mental Health and Addiction Research, Munich, Germany.,Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden.,Institute of Psychology, Eötvös Loránd University (ELTE), Budapest, Hungary
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31
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Havemann-Reinecke U, Manthey J, Verthein U, Patzak J, Thomasius R, Tsamitros N, Gutwinksi S. Kommentare zu M. Adams und T. Effertz (2022): Notwendige Voraussetzungen einer kontrollierten Freigabe von Cannabis und anderer THC-haltiger Produkte. SUCHT 2022. [DOI: 10.1024/0939-5911/a000792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Jakob Manthey
- Zentrum für Interdisziplinäre Suchtforschung (ZIS), Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Deutschland
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Deutschland
| | - Uwe Verthein
- Zentrum für Interdisziplinäre Suchtforschung (ZIS), Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Deutschland
| | | | | | - Nikolaos Tsamitros
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen (UMG), Deutschland
| | - Stefan Gutwinksi
- Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Charité – Universitätsmedizin Berlin, Freie Universität Berlin und Humboldt-Universität zu Berlin, Deutschland
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32
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Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany.
| | - Kevin Shield
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; WHO/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany; Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; WHO Collaborating Centre and Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
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33
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Lorenzetti V, Hindocha C, Petrilli K, Griffiths P, Brown J, Castillo-Carniglia Á, Caulkins JP, Englund A, El Sohly MA, Gage SH, Groshkova T, Gual A, Hammond D, Lawn W, López-Pelayo H, Manthey J, Mokrysz C, Liccardo Pacula R, van Laar M, Vandrey R, Wadsworth E, Winstock A, Hall W, Curran HV, Freeman TP. The iCannTookit: a consensus-based, flexible framework for measuring contemporary cannabis use. Addiction 2022; 117:2558-2560. [PMID: 35603918 DOI: 10.1111/add.15956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, the Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health, Australian Catholic University, Melbourne, Australia
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Paul Griffiths
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Portugal
| | - Jamie Brown
- Behavioural Science and Health Institute of Epidemiology and Health, University College London, London, UK
| | - Álvaro Castillo-Carniglia
- Society and Health Research Center and School of Public Health, Universidad Mayor, Chile.,Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | | | - Amir Englund
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mahmoud A El Sohly
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA.,Department Pharmaceutics and Drug Delivery, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Suzanne H Gage
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Teodora Groshkova
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Portugal
| | - Antoni Gual
- Psychiatry Department, Neurosciences Institute, Hospital Clinic, IDIBAPS, RTA, Barcelona, Spain
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Hugo López-Pelayo
- Psychiatry Department, Neurosciences Institute, Hospital Clinic, IDIBAPS, RTA, Barcelona, Spain
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Rosalie Liccardo Pacula
- USC Sol Price School of Public Policy, USC Leonard D. Schaeffer Center for Health Policy and Economics, Los Angeles, CA, USA
| | | | - Ryan Vandrey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elle Wadsworth
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Adam Winstock
- Behavioural Science and Health Institute of Epidemiology and Health, University College London, London, UK.,Global Drug Survey, London, UK
| | - Wayne Hall
- National Addiction Centre, King's College London, London, UK.,National Centre for Youth Substance Use Research, The University of Queensland, Australia
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
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Jiang H, Feng X, Lange S, Tran A, Manthey J, Rehm J. Estimating effects of health policy interventions using interrupted time-series analyses: a simulation study. BMC Med Res Methodol 2022; 22:235. [PMID: 36045338 PMCID: PMC9429656 DOI: 10.1186/s12874-022-01716-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 08/22/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND A classic methodology used in evaluating the impact of health policy interventions is interrupted time-series (ITS) analysis, applying a quasi-experimental design that uses both pre- and post-policy data without randomization. In this paper, we took a simulation-based approach to estimating intervention effects under different assumptions. METHODS Each of the simulated mortality rates contained a linear time trend, seasonality, autoregressive, and moving-average terms. The simulations of the policy effects involved three scenarios: 1) immediate-level change only, 2) immediate-level and slope change, and 3) lagged-level and slope change. The estimated effects and biases of these effects were examined via three matched generalized additive mixed models, each of which used two different approaches: 1) effects based on estimated coefficients (estimated approach), and 2) effects based on predictions from models (predicted approach). The robustness of these two approaches was further investigated assuming misspecification of the models. RESULTS When one simulated dataset was analyzed with the matched model, the two analytical approaches produced similar estimates. However, when the models were misspecified, the number of deaths prevented, estimated using the predicted vs. estimated approaches, were very different, with the predicted approach yielding estimates closer to the real effect. The discrepancy was larger when the policy was applied early in the time-series. CONCLUSION Even when the sample size appears to be large enough, one should still be cautious when conducting ITS analyses, since the power also depends on when in the series the intervention occurs. In addition, the intervention lagged effect needs to be fully considered at the study design stage (i.e., when developing the models).
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Affiliation(s)
- Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario, M5T 3M7, Canada.
| | - Xinyang Feng
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario M5T 3M7 Canada
| | - Shannon Lange
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1 Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, Ontario M5T 1R8 Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8 Canada
| | - Alexander Tran
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1 Canada
| | - Jakob Manthey
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany ,grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany ,grid.9647.c0000 0004 7669 9786Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Jürgen Rehm
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario M5T 3M7 Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, Ontario M5T 1R8 Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8 Canada ,grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany ,grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany ,grid.17063.330000 0001 2157 2938Institute of Medical Science (IMS), University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, Ontario M5S 1A8 Canada ,grid.448878.f0000 0001 2288 8774Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, Moscow, Russian Federation 119992
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Schomerus G, Leonhard A, Manthey J, Morris J, Neufeld M, Kilian C, Speerforck S, Winkler P, Corrigan PW. The stigma of alcohol-related liver disease and its impact on healthcare. J Hepatol 2022; 77:516-524. [PMID: 35526787 DOI: 10.1016/j.jhep.2022.04.026] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 02/08/2023]
Abstract
People with alcohol-related liver disease (ALD) experience stigma and discrimination. This review summarises the evidence on stigma in healthcare and its implications for people with ALD, drawing from the literature on the stigma associated with mental illness and, specifically, alcohol use disorder (AUD). Public stigma, self-stigma and structural stigma all contribute to failure to seek help or delays in seeking help, inferior healthcare, and negative health outcomes, which increase the overall burden of ALD. Stigma can be experienced, but also anticipated and avoided, with both scenarios negatively impacting on ALD healthcare. Blaming people with ALD for their condition is central to the stigma of ALD. Stigma affects ALD healthcare at all stages, from prevention, early detection and intervention, to allocation of scarce resources in liver transplantation. People with lived experience need to be empowered to lead action against the stigmatisation of patients with ALD. Promulgating a dynamic model of individual and social responsibility for AUD, a continuum model of harmful alcohol use, and establishing training on ALD-related stigma for healthcare professionals are strategies to address stigma. Integrating addiction and ALD services, providing stigma-free prevention, and overcoming the frequent separation of addiction services from general healthcare are necessary. Beyond healthcare, addressing social inequality, the social dimensions of ALD risk and outcomes, and ensuring equal access to services is necessary to improve outcomes for all people with ALD. More research is needed on the stigma of ALD in low- and middle-income countries and in countries with restrictive drinking norms. Interventions to reduce the stigma of ALD and facilitate early help-seeking need to be developed and evaluated.
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Affiliation(s)
- Georg Schomerus
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany.
| | - Anya Leonhard
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany
| | - Jakob Manthey
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - James Morris
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom
| | - Maria Neufeld
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sven Speerforck
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany
| | - Petr Winkler
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czechia; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Patrick W Corrigan
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
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Rehm J, O'Donnell A, Kaner EFS, Jane LLopis E, Manthey J, Anderson P. Differential impact of minimum unit pricing on alcohol consumption between Scottish men and women: controlled interrupted time series analysis. BMJ Open 2022; 12:e054161. [PMID: 35851006 PMCID: PMC9315916 DOI: 10.1136/bmjopen-2021-054161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the immediate impact of the introduction of minimum unit pricing (MUP) in Scotland on alcohol consumption and whether the impact differed by sex, level of alcohol consumption, age, social grade and level of residential deprivation of respondents. DESIGN Primary controlled interrupted time series analysis and secondary before-and-after analysis of the impact of introducing MUP in Scotland using alcohol consumption data for England as control. SETTING Data from Kantar Worldpanel's Alcovision survey, a continuous retrospective online timeline follow-back diary survey of the previous week's alcohol consumption. PARTICIPANTS 53 347 women and 53 143 men. INTERVENTIONS Introduction of a minimum price of 50 pence per UK unit (6.25 pence/g) for the sale of alcohol in Scotland on 1 May 2018. MAIN OUTCOME MEASURES Number of grams of alcohol consumed per week, in total, in off-trade (eg, at home) and in on-trade (eg, in pubs, restaurants). RESULTS Primary interrupted time series analyses found that the introduction of MUP was associated with a drop in reported weekly total alcohol consumption of 5.94 g (95% CI 1.29 to 10.60), a drop in off-trade consumption of 3.27 g (95% CI -0.01 to 6.56) and a drop in on-trade consumption of 2.67 g (95% CI -1.48 to 6.82). Associated reductions were larger for women than for men and were greater among heavier drinkers than for lighter drinkers, except for the 5% of heaviest drinking men for whom an associated increase in consumption was found. Secondary before-and-after analyses found that reductions in consumption were greater among older respondents and those living in less deprived areas. The introduction of MUP was not associated with a reduction in consumption among younger men and men living in more deprived areas. CONCLUSIONS Greater policy attention needs to be addressed to the heaviest drinking men, to younger men and to men who live in more deprived areas.
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Affiliation(s)
- Jürgen Rehm
- Social and Epidemiological Research, CAMH, Toronto, Ontario, Canada
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen F S Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eva Jane LLopis
- Department of Health Promotion, Maastricht University, Maastricht, Limburg, The Netherlands
- ESADE Business School, Ramon Llull University, Barcelona, Spain
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Peter Anderson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Rastogi A, Manthey J, Wiemker V, Probst C. Alcohol consumption in India: a systematic review and modelling study for sub-national estimates of drinking patterns. Addiction 2022; 117:1871-1886. [PMID: 34873774 DOI: 10.1111/add.15777] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 11/17/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS In India, alcohol per capita consumption (APC) has substantially increased over the past 2 decades. Although consumption does vary across the country, consistent state-level data are lacking. We aimed to identify all state-level alcohol exposure estimates since 2000 to (i) model consistent current drinking (CD) (12 months) prevalence estimates for all 36 states/union territories (UT) in 2019 and (ii) compare state-level CD trends with national-level APC trends. DESIGN A systematic review for studies on the Indian state-level prevalence of CD, lifetime abstinence (LA), alcohol use disorders (AUD) or the quantity of alcohol consumed among current drinkers (QU) was conducted. Subsequently, statistical modelling was applied. SETTING Data were collected and modelled for all Indian states/UTs. PARTICIPANTS Studies since 2000 referring to the general adult population (≥15 years) of at least one Indian state/UT were eligible. The total sample size covered was ~29 600 000 (males: females, 1:1.6). MEASUREMENTS Results on LA, AUD and QU were summarized descriptively. For (i) the state-, sex- and age-specific CD prevalence was estimated using random intercept fractional response models. For (ii) random intercept and slope models were performed. FINDINGS Of 2870 studies identified, 30 were retained for data extraction. LA, AUD and QU data were available for 31, 36 and 12 states/UTs, respectively. CD model estimates ranged from 6.4% (95% CI = 2.1%-18.1%; males) in Lakshadweep and 1.3% (95% CI = 0.7%-2.6%; females) in Delhi to 76.1% (95% CI = 68.1%-82.6%; males) and 63.7% (95% CI = 49.4%-75.7%; females) in Arunachal Pradesh. Over time, CD decreased in most states/UTs in the observed data, contradicting increasing national-level APC trends. CONCLUSIONS Alcohol use (measured as consistent current drinking) in India has large regional variations, with alcohol consumption being most prevalent in the North-East, Chhattisgarh, Telangana, Himachal Pradesh, Punjab and Jharkhand.
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Affiliation(s)
- Ankit Rastogi
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Veronika Wiemker
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Charlotte Probst
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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38
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Lorenzetti V, Hindocha C, Petrilli K, Griffiths P, Brown J, Castillo‐Carniglia Á, Caulkins JP, Englund A, ElSohly MA, Gage SH, Groshkova T, Gual A, Hammond D, Lawn W, López‐Pelayo H, Manthey J, Mokrysz C, Pacula RL, van Laar M, Vandrey R, Wadsworth E, Winstock A, Hall W, Curran HV, Freeman TP. The International Cannabis Toolkit (iCannToolkit): a multidisciplinary expert consensus on minimum standards for measuring cannabis use. Addiction 2022; 117:1510-1517. [PMID: 34590359 PMCID: PMC9298052 DOI: 10.1111/add.15702] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The lack of an agreed international minimum approach to measuring cannabis use hinders the integration of multidisciplinary evidence on the psychosocial, neurocognitive, clinical and public health consequences of cannabis use. METHODS A group of 25 international expert cannabis researchers convened to discuss a multidisciplinary framework for minimum standards to measure cannabis use globally in diverse settings. RESULTS The expert-based consensus agreed upon a three-layered hierarchical framework. Each layer-universal measures, detailed self-report and biological measures-reflected different research priorities and minimum standards, costs and ease of implementation. Additional work is needed to develop valid and precise assessments. CONCLUSIONS Consistent use of the proposed framework across research, public health, clinical practice and medical settings would facilitate harmonisation of international evidence on cannabis consumption, related harms and approaches to their mitigation.
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Affiliation(s)
- Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, the Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health SciencesAustralian Catholic UniversityMelbourneAustralia
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit (CPU)University College LondonLondonUK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathUK
| | - Paul Griffiths
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)LisbonPortugal
| | - Jamie Brown
- Behavioural Science and Health Institute of Epidemiology and HealthUniversity College LondonLondonUK
| | - Álvaro Castillo‐Carniglia
- Society and Health Research Center and School of Public HealthUniversidad MayorSantiagoChile
- Department of Population HealthNYU Grossman School of MedicineNew YorkNYUSA
| | | | - Amir Englund
- Addictions Department, Institute of Psychiatry, Psychology & NeuroscienceKings College LondonLondonUK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Mahmoud A. ElSohly
- National Center for Natural Products Research, School of PharmacyUniversity of MississippiUniversityMSUSA
- Department Pharmaceutics and Drug Delivery, School of PharmacyUniversity of Mississippi, UniversityMSUSA
| | - Suzanne H. Gage
- Department of Psychology, Institute of Population HealthUniversity of LiverpoolLiverpoolUK
| | - Teodora Groshkova
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)LisbonPortugal
| | - Antoni Gual
- Psychiatry DepartmentNeurosciences Institute, Hospital Clínic, IDIBAPS, RTABarcelonaSpain
| | - David Hammond
- School of Public Health and Health SystemsUniversity of WaterlooWaterlooCanada
| | - Will Lawn
- Clinical Psychopharmacology Unit (CPU)University College LondonLondonUK
- Addictions Department, Institute of Psychiatry, Psychology & NeuroscienceKings College LondonLondonUK
| | - Hugo López‐Pelayo
- Psychiatry DepartmentNeurosciences Institute, Hospital Clínic, IDIBAPS, RTABarcelonaSpain
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
- Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit (CPU)University College LondonLondonUK
| | - Rosalie Liccardo Pacula
- USC Sol Price School of Public PolicyUSC Leonard D. Schaeffer Center for Health Policy & EconomicsLos AngelesCAUSA
| | | | - Ryan Vandrey
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Elle Wadsworth
- School of Public Health and Health SystemsUniversity of WaterlooWaterlooCanada
| | - Adam Winstock
- Behavioural Science and Health Institute of Epidemiology and HealthUniversity College LondonLondonUK
- Global Drug SurveyLondonUK
| | - Wayne Hall
- National Addiction Centre, King's College LondonLondonUK
- National Centre for Youth Substance Use ResearchThe University of QueenslandBrisbaneAustralia
| | - H. Valerie Curran
- Clinical Psychopharmacology Unit (CPU)University College LondonLondonUK
| | - Tom P. Freeman
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathUK
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Lorenzetti V, Hindocha C, Petrilli K, Griffiths P, Brown J, Castillo‐Carniglia Á, Caulkins JP, Englund A, ElSohly MA, Gage SH, Groshkova T, Gual A, Hammond D, Lawn W, López‐Pelayo H, Manthey J, Mokrysz C, Liccardo Pacula R, van Laar M, Vandrey R, Wadsworth E, Winstock A, Hall W, Curran HV, Freeman TP. The iCannToolkit: a tool to embrace measurement of medicinal and non-medicinal cannabis use across licit, illicit and cross-cultural settings. Addiction 2022; 117:1523-1525. [PMID: 35289010 PMCID: PMC9314823 DOI: 10.1111/add.15855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, the Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of HealthAustralian Catholic UniversityMelbourneAustralia
| | - Chandni Hindocha
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathSomersetUK
| | - Paul Griffiths
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)Portugal
| | - Jamie Brown
- Department of Behavioural Science and Health, Institute of Epidemiology & Health CareUniversity College LondonLondonUK
| | - Álvaro Castillo‐Carniglia
- Society and Health Research CenterUniversidad Mayor, Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), and Millennium Nucleus on Sociomedicine (SocioMed)Chile
- Department of Population HealthNYU Grossman School of MedicineNew YorkNYUSA
| | | | - Amir Englund
- Addictions Department, Institute of Psychiatry, Psychology & NeuroscienceKings College LondonLondonUK
- Department of Psychosis StudiesInstitute of Psychiatry, Psychology & Neuroscience, King'’s College LondonLondonUK
| | - Mahmoud A. ElSohly
- National Center for Natural Products Research, School of PharmacyUniversity of Mississippi, UniversityMississippiUSA
- Department Pharmaceutics and Drug Delivery, School of PharmacyUniversity of Mississippi, UniversityMSUSA
| | - Suzanne H. Gage
- Department of Psychology, Institute of Population HealthUniversity of LiverpoolLiverpoolUK
| | - Teodora Groshkova
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)Portugal
| | - Antoni Gual
- Addictions Research Group. Psychiatry DepartmentNeurosciences Institute. Hospital Clínic. IDIBAPS. RTA. BarcelonaSpain
| | - David Hammond
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - Will Lawn
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
| | - Hugo López‐Pelayo
- Addictions Research Group. Psychiatry DepartmentNeurosciences Institute. Hospital Clínic. IDIBAPS. RTA. BarcelonaSpain
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- Department of Psychiatry, Medical FacultyUniversity of LeipzigLeipzigGermany
| | - Claire Mokrysz
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
| | - Rosalie Liccardo Pacula
- USC Sol Price School of Public PolicyUSC Leonard D. Schaeffer Center for Health Policy & EconomicsCaliforniaLos AngelesUSA
| | | | - Ryan Vandrey
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Elle Wadsworth
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - Adam Winstock
- Department of Behavioural Science and Health, Institute of Epidemiology & Health CareUniversity College LondonLondonUK
- Global Drug SurveyLondonUK
| | - Wayne Hall
- Queensland Alliance for Environmental Health Sciences, The University of QueenslandAustralia
- National Centre for Youth Substance Use ResearchThe University of QueenslandAustralia
| | | | - Tom P. Freeman
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathSomersetUK
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Allamani A, Voller F, Bravi S, Pepe P, Biffino M, Buscema PM, Maurelli G, Massini G, Einstein S, Manthey J, Rehm J. Alcohol Addiction: One Entity or Different Entities? A DSM-4-Based Attempt Toward a Geographicization of Alcohol Addiction and Abuse. Alcohol Alcohol 2022; 57:687-695. [PMID: 35596950 DOI: 10.1093/alcalc/agac021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/12/2022] [Accepted: 04/05/2022] [Indexed: 11/13/2022] Open
Abstract
AIM To examine whether in Europe perceptions of 'alcoholism' differ in a discrete manner according to geographical area. METHOD Secondary analysis of a data set from a European project carried out in 2013-2014 among 1767 patients treated in alcohol addiction units of nine countries/regions across Europe. The experience of all 11 DSM-4 criteria used for diagnosing 'alcohol dependence' and 'alcohol abuse' were assessed in patient interviews. The analysis was performed through Multiple Correspondence Analysis. RESULTS The symptoms of 'alcohol dependence' and 'alcohol abuse', posited by DSM-IV, were distributed according to three discrete geographical patterns: a macro-area mainly centered on drinking beer and spirit, a culture traditionally oriented toward wine and a mixed intermediate alcoholic beverage situation. CONCLUSION These patterns of perception seem to parallel the diverse drinking cultures of Europe.
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Affiliation(s)
| | - Fabio Voller
- Agenzia Regionale di Sanita' Toscana, Firenze 50141, Italy
| | - Stefano Bravi
- Agenzia Regionale di Sanita' Toscana, Firenze 50141, Italy
| | - Pasquale Pepe
- Agenzia Regionale di Sanita' Toscana, Firenze 50141, Italy
| | - Marco Biffino
- Epidemiologia, ASL Toscana Centro, Firenze 50135, Italy
| | - Paolo Massimo Buscema
- Department of Mathematical and Statistical Sciences, University of Colorado, Denver, CO 80204, USA.,Semeion Research Centre of Sciences of Communication, Rome 00128, Italy
| | - Guido Maurelli
- Semeion Research Centre of Sciences of Communication, Rome 00128, Italy
| | - Giulia Massini
- Semeion Research Centre of Sciences of Communication, Rome 00128, Italy
| | - S Einstein
- Institute for the Study of Substance Use and Misuse; Middle Eastern Summer Institute on Drug Use; Founding Editor, Substance Use & Misuse, 9380140, Israel
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden 01187, Germany.,Centre for Interdisciplinary Addiction Research, UKE Hamburg-Eppendorf, Hamburg 20246, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig 04103, Germany
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
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41
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Zafar A, Rehm J, Feng X, Jiang H, Kim KV, Manthey J, Radišauskas R, Štelemėkas M, Petkevičienė J, Tran A, Lange S. The Impact of Alcohol Control Policy on Pneumonia Mortality in Lithuania: An Interrupted Time-Series Analysis. Epidemiol Infect 2022; 150:1-25. [PMID: 35440352 PMCID: PMC9128348 DOI: 10.1017/s0950268822000711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 12/04/2022] Open
Abstract
Despite the growing body of evidence suggesting that alcohol consumption is associated with an increased risk of and poorer treatment outcomes from pneumonia, little is known about the association between alcohol control policy and pneumonia mortality. As such, this study aimed to assess the impact of three alcohol control policies legislated in 2008, 2017 and 2018 in Lithuania on sex-specific pneumonia mortality rates among individuals 15+ years of age. An interrupted time-series analysis using a generalised additive mixed model was performed for each policy. Of the three policies, only the 2008 policy resulted in a significant slope change (i.e. decline) in pneumonia mortality rates among males; no significant slope change was observed among females. The low R 2 values for all sex-specific models suggest that other external factors are likely also influencing the sex-specific pneumonia mortality rates in Lithuania. Overall, the findings from this study suggest alcohol control policy's targeting affordability may be an effective way to reduce pneumonia mortality rates, among males in particular. However, further research is needed to fully explore their impact.
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Affiliation(s)
- Anush Zafar
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo ON, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry, University of Toronto, Toronto ON, Canada
- Institute of Medical Science, University of Toronto, Toronto ON, Canada
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, L.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Xinyang Feng
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto ON, Canada
- Department of Psychiatry, University of Toronto, Toronto ON, Canada
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Tran A, Jiang H, Lange S, Manthey J, Štelemėkas M, Badaras R, Petkevičienė J, Radišauskas R, Room R, Rehm J. Can alcohol control policies reduce cirrhosis mortality? An interrupted time-series analysis in Lithuania. Liver Int 2022; 42:765-774. [PMID: 35023617 PMCID: PMC8930681 DOI: 10.1111/liv.15151] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/16/2021] [Accepted: 12/27/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS The relationship between alcohol consumption and cirrhosis is well established. Policies that can influence population-level use of alcohol should, in turn, impact cirrhosis. We examined the effect of population-level alcohol control policies on cirrhosis mortality rates in Lithuania - a high-income European Union country with high levels of alcohol consumption. METHODS Age-standardized, monthly liver mortality data (deaths per 100,000 adults, aged 15+) from Lithuania were analysed from 2001 to 2018 (n = 216 months) while controlling for economic confounders (gross domestic product and inflation). An interrupted time-series analysis was conducted to estimate the effect of three alcohol control policies implemented in 2008, 2017 and 2018 and the number of cirrhosis deaths averted. RESULTS There was a significant effect of the 2008 (P < .0001) and 2017 (P = .0003) alcohol control policies but a null effect of the 2018 policy (P = .40). Following the 2008 policy, the cirrhosis mortality rate dropped from 4.93 to 3.41 (95% CI: 3.02-3.80) deaths per 100,000 adults, which equated to 493 deaths averted. Further, we found that following the 2017 policy, the mortality rate dropped from 2.85 to 2.01 (95% CI: 1.50-2.52) deaths per 100,000 adults, corresponding to 245 deaths averted. CONCLUSIONS Our findings support the hypothesis that alcohol control policies can have a significant, immediate effect on cirrhosis mortality. These policy measures are cost-effective and aid in reducing the burden of liver disease.
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Affiliation(s)
- Alexander Tran
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | - Huan Jiang
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Shannon Lange
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Ontario, Canada,Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Robertas Badaras
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Ontario, Canada,Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada,Clinic of Anaesthesiology and Intensive Care, Faculty of Medicine, Centre of Toxicology, Vilnius University, Vilnius, Lithuania,Vilnius University Emergency Hospital, Vilnius, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania,Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, Australia,Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Jürgen Rehm
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany,Institute of Medical Science (IMS), University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, Ontario, Canada,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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Manthey J, Carr S, Anderson P, Bautista N, Braddick F, O’Donnell A, Jané-Llopis E, López-Pelayo H, Medina P, Mejía-Trujillo J, Pérez-Gómez A, Piazza M, Rehm J, Solovei A, Rey GN, de Vries H, Schulte B. Reduced alcohol consumption during the COVID-19 pandemic: Analyses of 17 000 patients seeking primary health care in Colombia and Mexico. J Glob Health 2022; 12:05002. [PMID: 35356652 PMCID: PMC8932607 DOI: 10.7189/jogh.12.05002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background During the COVID-19 pandemic, an increase of heavy alcohol use has been reported in several high-income countries. We examined changes in alcohol use during the pandemic among primary health care (PHC) patients in two middle income countries, Colombia and Mexico. Methods Data were collected during routine consultations in 34 PHC centres as part of a large-scale implementation study. Providers measured patients’ alcohol consumption with the three item ‘Alcohol Use Disorders Identification Test’ (AUDIT-C). Generalized linear mixed models were performed to examine changes in two dependent variables over time (pre-pandemic and during pandemic): 1) the AUDIT-C score and 2) the proportion of heavy drinking patients (8+ on AUDIT-C). Results Over a period of more than 600 days, data from N = 17 273 patients were collected. During the pandemic, the number of patients with their alcohol consumption measured decreased in Colombia and Mexico. Each month into the pandemic was associated with a 1.5% and 1.9% reduction in the mean AUDIT-C score in Colombia and Mexico, respectively. The proportion of heavy drinking patients declined during the pandemic in Colombia (pre-pandemic: 5.4%, 95% confidence interval (CI) = 4.8% to 6.0%; during the pandemic: 0.8%, 95% CI = 0.6% to 1.1%) but did not change in Mexico. Conclusions Average consumption levels declined and the prevalence of heavy drinking patterns did not increase. In addition to reduced opportunities for social drinking during the pandemic, changes in the population seeking PHC and restrictions in alcohol availability and affordability are likely drivers for lower levels of alcohol use by patients in this study.
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Affiliation(s)
- Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Sinclair Carr
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Peter Anderson
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Natalia Bautista
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Huipulco, Ciudad de México, CDMX, Mexico
| | - Fleur Braddick
- Addictions Unit, Psychiatry Dept, Hospital Clínic, Barcelona, Spain
| | - Amy O’Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eva Jané-Llopis
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Univ. Ramon Llull, ESADE, Barcelona, Spain
- Institute for Mental Health Policy Research, CAMH, Toronto, Canada
| | - Hugo López-Pelayo
- Addictions Unit, Psychiatry Dept, Hospital Clínic, Barcelona, Spain
- Red de Trastornos Adictivos, Instituto Carlos III, Madrid, Spain
- Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Perla Medina
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Huipulco, Ciudad de México, CDMX, Mexico
| | | | | | - Marina Piazza
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
- Institute for Mental Health Policy Research, CAMH, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Adriana Solovei
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Guillermina Natera Rey
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Huipulco, Ciudad de México, CDMX, Mexico
| | - Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Bernd Schulte
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
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Kilian C, O'Donnell A, Potapova N, López‐Pelayo H, Schulte B, Miquel L, Paniello Castillo B, Schmidt CS, Gual A, Rehm J, Manthey J. Changes in alcohol use during the
COVID
‐19 pandemic in Europe: A meta‐analysis of observational studies. Drug Alcohol Rev 2022; 41:918-931. [PMID: 35187739 PMCID: PMC9111882 DOI: 10.1111/dar.13446] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 02/07/2023]
Abstract
Issues Numerous studies have examined the impact of the COVID‐19 pandemic on alcohol use changes in Europe, with concerns raised regarding increased use and related harms. Approach We synthesised observational studies published between 1 January 2020 and 31 September 2021 on self‐reported changes in alcohol use associated with COVID‐19. Electronic databases were searched for studies evaluating individual data from European general and clinical populations. We identified 646 reports, of which 56 general population studies were suitable for random‐effects meta‐analyses of proportional differences in alcohol use changes. Variations by time, sub‐region and study quality were assessed in subsequent meta‐regressions. Additional 16 reports identified were summarised narratively. Key Findings Compiling reports measuring changes in overall alcohol use, slightly more individuals indicated a decrease than an increase in their alcohol use during the pandemic [3.8%, 95% confidence interval (CI) 0.00–7.6%]. Decreases were also reported more often than increases in drinking frequency (8.0%, 95% CI 2.7–13.2%), quantity consumed (12.2%, 95% CI 8.3–16.2%) and heavy episodic drinking (17.7%, 95% CI 13.6–21.8%). Among people with pre‐existing high drinking levels/alcohol use disorder, high‐level drinking patterns appear to have solidified or intensified. Implications Pandemic‐related changes in alcohol use may be associated with pre‐pandemic drinking levels. Increases among high‐risk alcohol users are concerning, suggesting a need for ongoing monitoring and support from relevant health‐care services. Conclusion Our findings suggest that more people reduced their alcohol use in Europe than increased it since the onset of the pandemic. However high‐quality studies examining specific change mechanisms at the population level are lacking.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Dresden Germany
| | - Amy O'Donnell
- Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - Nina Potapova
- Grup de Recerca en Addiccions Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unitat Conductes Addictives Hospital Clínic Barcelona Spain
| | - Hugo López‐Pelayo
- Grup de Recerca en Addiccions Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unitat Conductes Addictives Hospital Clínic Barcelona Spain
| | - Bernd Schulte
- Centre for Interdisciplinary Addiction Research University Medical Center Hamburg‐Eppendorf, Department of Psychiatry Hamburg Germany
| | - Laia Miquel
- Grup de Recerca en Addiccions Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unitat Conductes Addictives Hospital Clínic Barcelona Spain
| | - Blanca Paniello Castillo
- Grup de Recerca en Addiccions Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unitat Conductes Addictives Hospital Clínic Barcelona Spain
- Department of Global Public Health (student) Karolinska Institute Stockholm Sweden
| | - Christiane Sybille Schmidt
- Centre for Interdisciplinary Addiction Research University Medical Center Hamburg‐Eppendorf, Department of Psychiatry Hamburg Germany
| | - Antoni Gual
- Grup de Recerca en Addiccions Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unitat Conductes Addictives Hospital Clínic Barcelona Spain
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Dresden Germany
- Centre for Interdisciplinary Addiction Research University Medical Center Hamburg‐Eppendorf, Department of Psychiatry Hamburg Germany
- Institute for Mental Health Policy Research Centre for Addiction and Mental Health Toronto Canada
- Dalla Lana School of Public Health University of Toronto Toronto Canada
- Faculty of Medicine, Institute of Medical Science University of Toronto, Medical Sciences Building Toronto Canada
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Dresden Germany
- Centre for Interdisciplinary Addiction Research University Medical Center Hamburg‐Eppendorf, Department of Psychiatry Hamburg Germany
- Department of Psychiatry, Medical Faculty University of Leipzig Leipzig Germany
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Abstract
Spain is one of the countries of the European Union in which alcohol consumption has decreased in the past decades. The aim of this paper is to distinguish different phases of the level of alcohol consumption in Spain since 1990. Adult alcohol consumption per capita data between 1990 and 2019 were analysed for temporal trends using the Joinpoint regression model. An additional analysis using interrupted time-series between 1962 and 2016 was performed using data from Global Information System on Alcohol and Health. Data from the survey on alcohol and other drugs in Spain were collected and a narrative review was conducted to identify possible reasons for the trends found. Five point changes were identified on the timeline between 1990 and 2019, including: a decrease of 3.2% per year from 1990 to 1995, an increase of 1.1% per year from 1995 to 2000, a period of stability from 2000 to 2006, a decrease of 4.5% per year from 2006 to 2011, and a period of stability from 2011 onwards. These changes can largely be explained by the different public health measures carried out by the Spanish government, as well as the change in the pattern of consumption in society, which shifted its alcoholic beverage preference from wine to beer, and increased its binge-drinking behaviour. Further studies such as interrupted time-series analyses should test if indeed the hypothesized measures on public health have been effective; this could inform future policies in Spain and in other countries.
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Kilian C, Neufeld M, Manthey J, Alavidze S, Bobrova A, Baron-Epel O, Berisha M, Bilici R, Davletov K, Isajeva L, Kantaş Yılmaz F, Karatkevich T, Mereke A, Musić Milanović S, Galstyan K, Muslić L, Okoliyski M, Shabani Z, Štelemėkas M, Sturua L, Sznitman SR, Ünübol B, Ferreira-Borges C, Rehm J. Self-reported changes in alcohol and tobacco use during COVID-19: findings from the eastern part of WHO European Region. Eur J Public Health 2022; 32:474-480. [PMID: 35137046 PMCID: PMC9159328 DOI: 10.1093/eurpub/ckac011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background The COVID-19 pandemic might impact substance use behaviours around the globe. In this study, we investigate changes in alcohol and tobacco use in the second half of 2020 in countries of the eastern part of the WHO European Region. Methods Self-reported changes in alcohol and tobacco use among 11 295 adults from 18 countries in the eastern part of the WHO European Region were collected between August 2020 and January 2021. The non-probabilistic sample was weighted for age, gender and education. For each country, proportions of respondents reporting a decrease, no change or increase in substance use over the past 3 months were examined, and multinomial regression models were used to test associations with age, gender and past-year alcohol use. Results In most countries, about half of the respondents indicating past-year alcohol or tobacco use reported no change in their substance use. Of those alcohol users who reported changes in their alcohol use, a larger proportion reported a decrease than an increase in most countries. The opposite was true for tobacco use. Women, young adults and past-year harmful alcohol users were identified as being more likely to change their substance use behaviour. Conclusion We found diverging overall trends for alcohol and tobacco use in the second half of 2020. The patterns of change vary according to age, gender and past-year substance use. Individuals at risk to increase their substance use during the COVID-19 pandemic require most policy considerations.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, 01187, Germany, Chemnitzer Straße 46
| | - Maria Neufeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, 01187, Germany, Chemnitzer Straße 46.,World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Leontyevsky Pereulok 9, 125009, Russian Federation.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S, Canada, 3M1
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, 01187, Germany, Chemnitzer Straße 46.,Department of Psychiatry, Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany, Martinistraße 52.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, 04103, Germany, Semmelweisstraße 10
| | - Sophiko Alavidze
- National Center for Disease Control and Public Health, 99, Kakheti highway, Tbilisi, 0198, Georgia
| | - Anastacia Bobrova
- National Academy of Sciences of Belarus Institute of Economics, Surganova 1. Minsk, 220072, Belarus
| | - Orna Baron-Epel
- School of Public Health, University of Haifa, Mount Carmel, Haifa, 31905, Israel
| | - Merita Berisha
- Department for Social Medicine, National Institute of Public Health of Kosova, Kosovo, 10000, Prishtina.,Cathedra for Social Medicine, Medical Faculty, University of Prishtina, Prishtina, 10000, Kosovo
| | - Rabia Bilici
- .Erenköy Mental Health and Neurological Diseases Training and Research Hospital, University of Health Sciences Turkey, Sinan, Ercan Street, Kazasker 34736, Kadıkoy, Istanbul, Turkey
| | | | - Laura Isajeva
- Centre for Disease Prevention and Control, Riga, street, Latvia, Duntes 22 k-5, 1005
| | - Fatma Kantaş Yılmaz
- Department of Health Management, University of Health Sciences Turkey, Haydarpaşa Campus, Turkey, 34668, Uskudar, Istanbul
| | - Tatsiana Karatkevich
- Republican Scientific and Practical Centre for Mental Health, Minsk, trakt, Belarus, Dolginovskii 152, 220053
| | - Alibek Mereke
- Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Sanja Musić Milanović
- .Croatian Institute of Public Health, Rockefeller, 10000, Croatia, str. 7, Zagreb.,School of Medicine, University of Zagreb, Šalata 3, Zagreb, 10000, Croatia
| | - Kristine Galstyan
- Public Health Department, Ministry of Health of the Republic of Armenia, Yerevan, 0010, Armenia
| | - Ljiljana Muslić
- .Croatian Institute of Public Health, Rockefeller, 10000, Croatia, str. 7, Zagreb
| | - Michail Okoliyski
- WHO Country Office in Bulgaria, Ivan, Sofia, 1431, Bulgaria, 15, Geshov Blvd
| | - Zana Shabani
- Ministry of Health in Kosovo, Prishtina, Kosovo, 10000
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, Kaunas, 47181, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, Kaunas, 47181, Lithuania
| | - Lela Sturua
- National Center for Disease Control and Public Health, 99, Kakheti highway, Tbilisi, 0198, Georgia.,.Petre Shotadze Tbilisi Medical Academy, /, 0144, Georgia, 512 Ketevan Dedofali Ave, Tbilisi
| | - Sharon R Sznitman
- School of Public Health, University of Haifa, Mount Carmel, Haifa, 31905, Israel
| | - Başak Ünübol
- .Erenköy Mental Health and Neurological Diseases Training and Research Hospital, University of Health Sciences Turkey, Sinan, Ercan Street, Kazasker 34736, Kadıkoy, Istanbul, Turkey
| | - Carina Ferreira-Borges
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Leontyevsky Pereulok 9, 125009, Russian Federation
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, 01187, Germany, Chemnitzer Straße 46.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S, Canada, 3M1.,Department of Psychiatry, Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany, Martinistraße 52.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T, 1P8, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario, M5S, Canada, Room 2374 1A8.,Centre for Addiction and Mental Health, .Campbell Family Mental Health Research Institute, 33 Ursula Franklin Street, Toronto, Ontario, M5S, Canada, 3M1.,Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario, M5T, 1R8, Canada.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8, b. 2, Moscow, 119991, Russian Federation
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Solovei A, Manthey J, Anderson P, Mercken L, Jané Llopis E, Natera Rey G, Pérez Gómez A, Mejía Trujillo J, Bustamante I, Piazza M, Pérez de León A, Arroyo M, de Vries H, Rehm J, Evers S. Costs of an Alcohol Measurement Intervention in Three Latin American Countries. Int J Environ Res Public Health 2022; 19:700. [PMID: 35055522 PMCID: PMC8776036 DOI: 10.3390/ijerph19020700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/26/2021] [Accepted: 01/04/2022] [Indexed: 11/16/2022]
Abstract
Alcohol measurement in health care settings is an effective intervention for reducing alcohol-related harm. However, in many countries, costs related to alcohol measurement have not yet been transparently assessed, which may hinder its adoption and implementation. Costs of an alcohol measurement programme in three upper-middle-income Latin American countries were assessed via questionnaires and compared, as part of the quasi-experimental SCALA study. Additional to the intervention costs, the costs of three implementation strategies: standard training and clinical package, intensive training and clinical package, and community support, were assessed and subsequently translated into costs per additional alcohol measurement session. Results demonstrated that costs for one alcohol measurement session ranged between Int$ 0.67 and Int$ 1.23 in Colombia, Int$ 1.19 and Int$ 2.57 in Mexico, and Int$ 1.11 and Int$ 2.14 in Peru. Costs were mainly driven by the salaries of the health professionals. Implementation strategies costs per additional alcohol measurement session ranged between Int$ 1.24 and Int$ 6.17. In all three countries, standard training and a clinical package may be a promising implementation strategy with a relatively low cost per additional alcohol measurement session.
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Affiliation(s)
- Adriana Solovei
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P. Debyeplein 1, 6229HA Maastricht, The Netherlands; (P.A.); (L.M.); (E.J.L.); (H.d.V.)
| | - Jakob Manthey
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; (J.M.); (J.R.)
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Peter Anderson
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P. Debyeplein 1, 6229HA Maastricht, The Netherlands; (P.A.); (L.M.); (E.J.L.); (H.d.V.)
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK
| | - Liesbeth Mercken
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P. Debyeplein 1, 6229HA Maastricht, The Netherlands; (P.A.); (L.M.); (E.J.L.); (H.d.V.)
- Department of Health Psychology, Faculty of Psychology and Educational Sciences, Open University Postbus 2960, 6401DL Heerlen, The Netherlands
| | - Eva Jané Llopis
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P. Debyeplein 1, 6229HA Maastricht, The Netherlands; (P.A.); (L.M.); (E.J.L.); (H.d.V.)
- ESADE Business School, University Ramon Llull, Av. de Pedralbes, 60, 62, 08034 Barcelona, Spain
- Institute for Mental Health Policy Research, CAMH, 33 Russell Street, Toronto, ON M5S 2S1, Canada
| | - Guillermina Natera Rey
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calz México-Xochimilco 101, Huipulco, Mexico City 14370, Mexico; (G.N.R.); (A.P.d.L.); (M.A.)
| | - Augusto Pérez Gómez
- Corporación Nuevos Rumbos, Calle 108 A # 4-15, Bogota 110111, Colombia; (A.P.G.); (J.M.T.)
| | - Juliana Mejía Trujillo
- Corporación Nuevos Rumbos, Calle 108 A # 4-15, Bogota 110111, Colombia; (A.P.G.); (J.M.T.)
| | - Inés Bustamante
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Urb Ingeniería, Lima 15102, Peru; (I.B.); (M.P.)
| | - Marina Piazza
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Urb Ingeniería, Lima 15102, Peru; (I.B.); (M.P.)
| | - Alejandra Pérez de León
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calz México-Xochimilco 101, Huipulco, Mexico City 14370, Mexico; (G.N.R.); (A.P.d.L.); (M.A.)
| | - Miriam Arroyo
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calz México-Xochimilco 101, Huipulco, Mexico City 14370, Mexico; (G.N.R.); (A.P.d.L.); (M.A.)
| | - Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P. Debyeplein 1, 6229HA Maastricht, The Netherlands; (P.A.); (L.M.); (E.J.L.); (H.d.V.)
| | - Jürgen Rehm
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; (J.M.); (J.R.)
- Institute for Mental Health Policy Research, CAMH, 33 Russell Street, Toronto, ON M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON M5T 3M7, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya Str., 8, b. 2, 119992 Moscow, Russia
| | - Silvia Evers
- Department of Health Services Research CAPHRI Care, Public Health Research Institute, Maastricht University, POB 616, 6200MD Maastricht, The Netherlands;
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Kummetat JL, Leonhard A, Manthey J, Speerforck S, Schomerus G. Understanding the Association between Alcohol Stigma and Alcohol Consumption within Europe: A Cross-Sectional Exploratory Study. Eur Addict Res 2022; 28:446-454. [PMID: 36088900 DOI: 10.1159/000526200] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 07/18/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Stigma towards alcohol-related conditions is more pronounced than stigma against any other mental illness and has remained high throughout past decades. Although alcohol consumption is a known and persistent contributor to the burden of disease and interpersonal threat and may thus shape public attitudes towards consumption, no study to date has provided an overview of the prevalence of alcohol stigma and its association with (a) alcohol consumption and (b) harm attributable to alcohol across Europe. As a social reaction to thresholds of accepted use of alcohol, stigma could impact consumption, resulting in a reduced quantity or at least less harmful drinking patterns. This contribution provides an initial overview by addressing the following research questions. (i) What are the country-level prevalence rates of alcohol stigma compared across European countries? (ii) Is alcohol stigma associated with (a) alcohol consumption and (b) alcohol-attributable harm? (iii) Is there an association between alcohol stigma and alcohol consumption by type of beverage? METHODS We combined data on country-level desire for social distance towards "heavy drinkers" (European Values Survey, operationalization of "alcohol stigma") with indicators of alcohol consumption, including adult per capita consumption (APC), heavy episodic drinking, consumption by type of beverage (wine, beer, spirits), and harm attributable to alcohol, namely age-standardized disability-adjusted life years lost to alcohol consumption (AADALYs) for 28 countries. Linear regression models were applied. RESULTS (i) Social distance varied noticeably across countries (M = 62.9%, SD = 16.3%) in a range of 28.3% and 87.3%. (ii) APC was significantly positive related to social distance (β = 0.55, p = 0.004). (iii) Wine consumption was significantly negative related to social distance; the opposite was true for spirits consumption. No association was found for beer consumption. The best model fit was achieved with APC (β = 0.48, p = 0.002) and wine per capita consumption (β = -0.55, p < 0.001) explaining 57.0% (adjusted R2) of the variance in social distance. CONCLUSION Our study shows a strong relationship between country-level alcohol stigma and alcohol consumption. If stigma was to deter people from harmful alcohol consumption, it would be expected that higher levels of alcohol stigma are associated with lower levels of overall alcohol consumption or consumption of spirits in particular. Instead, stigma seems to be a reaction to harmful drinking patterns without changing these patterns for the better.
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Affiliation(s)
| | - Anya Leonhard
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Jakob Manthey
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany.,Institute of Clinical Psychology and Psychotherapy, Technical University, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Speerforck
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Georg Schomerus
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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Bloomfield K, Kilian C, Manthey J, Rehm J, Brummer J, Grittner U. Changes in Alcohol Use in Denmark during the Initial Months of the COVID-19 Pandemic: Further Evidence of Polarization of Drinking Responses. Eur Addict Res 2022; 28:297-308. [PMID: 35545059 PMCID: PMC9254281 DOI: 10.1159/000524379] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 03/18/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The year 2020 was marked by the COVID-19 pandemic. Policy responses to COVID-19 affected social and economic life and the availability of alcohol. Previous research has shown an overall small decrease in alcohol use in Denmark in the first months of the pandemic. The present paper focused on identifying which subgroups of individuals had decreased or increased their consumption. MATERIALS AND METHODS Data were collected between May and July 2020 (n = 2,566 respondents, convenience sample). Weights were applied to reflect the actual Danish general population. Variables included the pre-pandemic alcohol consumption, change in alcohol consumption in the past month, socio-demographics, and reported economic consequences. Responses to a single item assessing changes in alcohol consumption in the past month were classified as no change, increase, or decrease in consumption. Regression models investigated how changes in consumption were linked to pre-pandemic drinking levels, socio-demographics (gender, age groups, education), and reported economic consequences. RESULTS While 39% of participants reported decreased consumption levels and 34% had stable levels, 27% increased consumption. Characteristics associated with changes in consumption were associated with both increases and decreases in consumption: younger people, those with higher consumption levels before the pandemic, and those with lower education more often both reported increases as well as decreases in consumption. DISCUSSION/CONCLUSIONS We confirmed that more people decreased rather than increased their alcohol consumption in the first few months of the pandemic in Denmark. Characteristics associated with changes in consumption such as younger age, higher consumption levels, and lower education demonstrated a polarization of drinking since these were associated with both increases and decreases in consumption. Public health authorities should monitor alcohol use and other health behaviours for increased risks during the pandemic.
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Affiliation(s)
- Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark,Institute of Biometry and Clinical Epidemiology, Charité − Universitätsmedizin Berlin, Berlin, Germany,Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark,Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Julie Brummer
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
| | - Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité − Universitätsmedizin Berlin, Berlin, Germany,Berlin Institute of Health, Berlin, Germany,*Ulrike Grittner,
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50
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Probst C, Manthey J, Ferreira-Borges C, Neufeld M, Rakovac I, Andreasyan D, Sturua L, Novik I, Hagverdiyev G, Obreja G, Altymysheva N, Ergeshov M, Shukrov S, Saifuddinov S, Rehm J. Cross-sectional study on the characteristics of unrecorded alcohol consumption in nine newly independent states between 2013 and 2017. BMJ Open 2021; 11:e051874. [PMID: 34911714 PMCID: PMC8679101 DOI: 10.1136/bmjopen-2021-051874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 11/04/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES As unrecorded alcohol use contributes to a substantial burden of disease, this study characterises this phenomenon in newly independent states (NIS) of the former Soviet Union with regard to the sources of unrecorded alcohol, and the proportion of unrecorded of total alcohol consumption. We also investigate associated sociodemographic characteristics and drinking patterns. DESIGN Cross-sectional data on overall and unrecorded alcohol use in the past 7 days from WHO STEPwise Approach to NCD Risk Factor Surveillance (STEPS) surveys. Descriptive statistics were calculated at the country level, hierarchical logistic and linear regression models were used to investigate sociodemographic characteristics and drinking patterns associated with using unrecorded alcohol. SETTING Nine NIS (Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkmenistan and Uzbekistan) in the years 2013-2017. PARTICIPANTS Nationally representative samples including a total of 36 259 participants. RESULTS A total of 6251 participants (19.7%; 95% CI 7.9% to 31.5%) reported alcohol consumption in the past 7 days, 2185 of which (35.1%; 95% CI 8.2% to 62.0%) reported unrecorded alcohol consumption with pronounced differences between countries. The population-weighted average proportion of unrecorded consumption in nine NIS was 8.7% (95% CI 5.9% to 12.4%). The most common type of unrecorded alcohol was home-made spirits, followed by home-made beer and wine. Older (45-69 vs 25-44 years) and unemployed (vs employed) participants had higher odds of using unrecorded alcohol. More nuanced sociodemographic differences were observed for specific types of unrecorded alcohol. CONCLUSIONS This contribution is the first to highlight both, prevalence and composition of unrecorded alcohol consumption in nine NIS. The observed proportions and sources of unrecorded alcohol are discussed in light of local challenges in policy implementation, especially in regard to the newly formed Eurasian Economic Union (EAEU), as some but not all NIS are in the EAEU.
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Affiliation(s)
- Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry, University of Leipzig, Leipzig, Germany
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russian Federation
| | - Maria Neufeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- WHO European Office for Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russian Federation
| | - Ivo Rakovac
- WHO European Office for Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russian Federation
| | - Diana Andreasyan
- National Health Information Analytic Center, Ministry of Health, Yerevan, Armenia
| | - Lela Sturua
- Non-communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Irina Novik
- Republican Scientific And Practical Center For Medical Technologies, Minsk, Belarus
| | | | - Galina Obreja
- Department of Social Medicine and Management, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova (the Republic of)
| | - Nurila Altymysheva
- Republican Health Promotion Center, Ministry of Health, Bishkek, Kyrgyzstan
| | - Muhammet Ergeshov
- Department of Treatment and Prevention, Ministry of Health and Medical Industry of Turkmenistan, Ashgabat, Turkmenistan
| | - Shukhrat Shukrov
- Central Project Implementation Bureau of the Health-3 Project, Tashkent, Uzbekistan
| | - Safar Saifuddinov
- Republic of Tajikistan Ministry of Health and Social Protection of the Population, Dushanbe, Tajikistan
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- 18 Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
- Department of International Health Projects, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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