Abstract
Alcohol consumption is a major risk factor for premature mortality. Although alcohol control policies are known to impact all-cause mortality rates, the effect that policies have on specific age groups is an important area of research. This study investigates the effect of alcohol control policies implemented in 2009 and 2017 in Lithuania on all-cause mortality rates. All-cause mortality rates (deaths per 100,000 people) were obtained for 2001–2018 by 10-year age groups (20–29, 30–39, 40–49 years, etc.). All-cause mortality rates, independent of macro-level secular trends (e.g., economic trends) were examined. Following a joinpoint analysis to control for secular trends, an interrupted time series analysis showed that alcohol control policies had a significant effect on all-cause mortality rates (p = .018), with the most significant impact occurring among young adults (20–29 and 30–39 years of age). For these age groups, their mortality rate decreased during the 12 months following policy implementation (following the policy in 2009 for those 20–29 years of age, p = .0026, and following the policy in 2017 for those 30–39 years of age, p = .011). The results indicate that alcohol control policy can impact all-cause mortality rates, above and beyond secular trends, and that the impact is significant among young adults.
Highlights
Alcohol consumption is a major risk factor for premature mortality
To address the challenge of determining causality in quasi-experimental designs and time series data, we employ a two-stage data analysis technique in which a base model containing the underlying secular trends is created. Building on this base model, and on the work of Štelemėkas and colleagues32, we aim to determine whether the effect of two specific sets of alcohol control policies implemented in Lithuania have an effect on all-cause mortality rates when secular trends are used as a covariate
Autocorrelation was observed in the dataset and was corrected for, using an autoregressive integrated moving average (ARIMA) model
Summary
Alcohol consumption is a major risk factor for premature mortality. alcohol control policies are known to impact all-cause mortality rates, the effect that policies have on specific age groups is an important area of research. Following a joinpoint analysis to control for secular trends, an interrupted time series analysis showed that alcohol control policies had a significant effect on all-cause mortality rates (p = .018), with the most significant impact occurring among young adults (20–29 and 30–39 years of age). The World Health Organization (WHO) recommends a set of policies as “best buys”, which are both effective and cost-effective to implement with respect to reducing alcohol-related harm These alcohol control policies (increase of excise taxes, restrictions on physical availability, and bans or comprehensive restrictions on advertising and marketing) have been linked to a reduction in all-cause mortality rates in the Russian Federation. In young and middle-aged adults (15–49 years old), alcohol consumption is a leading risk factor for premature death, whereas other risk factors, such as smoking and high BMI cause greater loss of life among older a dults. Lower socioeconomic status and lower education individuals are more likely to die due to alcohol-related causes following reduced alcohol t axation
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