Alcohol Control Measures Research Articles

Does higher alcohol consumption affect attitudes towards alcohol control measures in Estonia?

ObjectivesTo analyze whether higher alcohol consumption is associated with negative attitudes towards stricter alcohol control policy measures in Estonia. Study designCross-sectional analysis of nationally representative data from 2022 (n = 2059). MethodsAttitudes towards seven alcohol control measures and their association with high-risk alcohol consumption (>140 g absolute alcohol for men and >70 g for women per week) were analyzed using used descriptive statistics and binary logistic regression using nationally representative data on Estonian 15–74-year-old population. ResultsIn general, high-risk consumption associated with lower acceptance for alcohol control policies. Although men had higher prevalence of opposing alcohol control measure for every item considered, both men and women with high-risk alcohol consumption were significantly more likely to be against alcohol control measures in general even after accounting for the variation by demographic characteristics. ConclusionsAs public opinion is detrimental to the successful implementation of alcohol policies, these findings emphasize the need to communicate alcohol-related harms to the public in order to increase awareness and support for alcohol control policies.

Changes in attitudes toward alcohol control policies in Lithuania: findings from two representative surveys in 2015 and 2020

ABSTRACT Background: A set of evidence‐based alcohol control policy measures was adopted in the period 2016–2020 in Lithuania. The present study fills a knowledge gap on how changes in alcohol control policy are associated with attitudes toward different alcohol policy measures. Objective: This study aims to explore whether support for key alcohol control policy measures in Lithuania declined following implementation of alcohol control measures. Methods: Data came from the Standard European Alcohol Survey. Two representative surveys with the same questionnaire, were conducted in Lithuania in 2015 (N = 1513, 51.7% female, response rate was 38.9%) and 2020 (N = 1015, 50.6% female, response rate was 38.0%). Multi-stage stratified probability sampling was applied. Surveys were carried out using computer-assisted face-to-face interviews, descriptive statistics and multiple logistic regression analyses was applied. We used a binomial logistic regression analysis and the Pearson chi-square test. Results: There was a significant decline in a proportion of respondents who agreed that the number of alcohol selling places should be kept low (OR: 0.84, p = .032), alcohol prices should be kept high (OR: 0.83, p = .027), and the police should be allowed to randomly check whether the driver is sober (OR: 0.65, p < .001). The proportion of respondents who agree that individuals are responsible enough with their drinking significantly declined (OR: 0.76, p = .003). Conclusion: Support for restrictions on alcohol-selling points, increase in alcohol price, and random alcohol testing of drivers declined following the adoption of new alcohol control policy measures. Our findings might be beneficial for policy-makers planning alcohol control policies and information campaigns.

The role of civil society organizations in alcohol control during the COVID-19 pandemic across six countries in Africa

BackgroundThe differing global trends in alcohol consumption and policy measures implemented during the COVID-19 pandemic warrant a closer look at the actions taken by civil society organisations (CSOs) and community-led efforts to describe how they may influence and accelerate action for change in alcohol control measures. This paper analyses actions undertaken by CSOs at the national and local levels to safeguard communities and improve alcohol control policies during the COVID-19 pandemic in six African countries.MethodsA cross-sectional survey was distributed via email to CSOs involved in alcohol prevention, outreach and policy development in Kenya, Lesotho, Namibia, South Africa, Tanzania and Zimbabwe. Individuals (n = 19) working at CSOs responded to the questionnaire from February to March 2022. Questions related to the role of CSOs during the pandemic are analysed and synthesised in this paper. 19 CSOs respondents representing the six countries were included in the study.ResultsAction areas led by CSOs during the COVID-19 pandemic included: (i) direct lobbying advocacy, (ii) conducting public awareness media campaigns and (iii) legal and regulatory interventions linked to the pandemic.ConclusionsGiven the size of the challenges governments faced during the COVID-19 pandemic, the role of CSOs, during the ongoing pandemic and beyond, has become even more relevant to strengthen advocacy and public health interventions for alcohol control in Southern Africa. For this, CSOs should have a “seat at the table” when public health policies are designed, discussed and enforced.

A scientometric study of tobacco and alcohol use as risk factors for oral cavity health

Background/purposeTobacco and alcohol are the well-known carcinogenic agents of oral cavity health. The purpose of this study was to investigate the scientometric characteristics of alcohol and tobacco use and oral health. Materials and methodsThe papers on alcohol and tobacco use and oral cavity were published since 1885 and 1895, respectively. All the eligible papers were retrieved on March 20, 2023 from the Scopus database. ResultsThere are 2529 and 1545 papers on tobacco smoking and alcohol drinking and oral cavity in the Scopus database, respectively. Based on the frequency of keywords in all included papers, both smoking and drinking are involved in mouth neoplasms, oral cancer, leukoplakia, and periodontal diseases. In the papers on tobacco and alcohol use and oral cavity, the same research keywords confirm tobacco and alcohol use associate with oral cancer risk possibly through influencing genetics and gene and protein expression. For the distinctive keywords, nicotine, smoking cessation, and electronic cigarette are unique keywords of tobacco use. Acetaldehyde, alcohol dehydrogenase, and alcohol metabolism are unique ones of alcohol use. ConclusionThis study for the first time reports the scientometric characteristics of tobacco and alcohol use and oral health, which might aid healthcare authorities to promote tobacco and alcohol control measures focused on the necessities of their population.

Contribution of alcohol use to the global burden of cirrhosis and liver cancer from 1990 to 2019 and projections to 2044

BackgroundIdentifying the temporal trends of cirrhosis and liver cancer attributable to alcohol use in both the past and the future can formulate the control strategies.MethodsData on cirrhosis and liver cancer attributable to alcohol use from 1990 to 2019, including mortality and disability-adjusted life year (DALY) rates were collected from the 2019 Global Burden of Disease (GBD) study. To analyze the temporal trends, the average annual percentage change (AAPC) was calculated, and the Bayesian age-period-cohort model was applied.ResultDeaths and DALY of cirrhosis and liver cancer attributable to alcohol use increased year by years, but the age-standardized death rate (ASDR) and age-standardized DALY rate declined or remained stable from 1990 to 2019 in most regions of the world. The burden of cirrhosis attributable to alcohol increased in low-middle social-development index (SDI) regions, while the burden of liver cancer increased in high-SDI regions. Eastern Europe and Central Asia have the highest burden of cirrhosis and liver cancer caused by alcohol use. Deaths and DALYs are mainly distributed in people aged 40+ years, but there is an increasing trend in people aged under 40 years. New deaths from cirrhosis and liver cancer attributable to alcohol use are predicted to increase in the next 25 years, but the ASDR of cirrhosis in males will increase slightly.ConclusionsAlthough the age-standardized rate of cirrhosis and liver cancer due to alcohol use have decreased, the absolute burden increased and will continue to increase. Therefore, alcohol control measures should be further strengthened and improved through effective national policies.

Support for evidence-based alcohol policy in Ireland: results from a representative household survey.

Alcohol use is a leading risk factor for death and disability and there is a need for evidence-based policy measures to tackle excess alcohol consumption and related harms. The aim of this study was to examine attitudes towards alcohol control measures among the general public in the context of significant reforms undertaken in the Irish alcohol policymaking landscape. A representative household survey was conducted among individuals aged 18+ years in Ireland. Descriptive and univariate analyses were used. A total of 1069 participants took part (48% male) and there was broad support (>50%) for evidence-based alcohol policies. Support was strongest for a ban on alcohol advertising near schools and creches (85.1%) and for warning labels (81.9%). Women were more likely than men to support alcohol control policy measures while participants with harmful alcohol use patterns were significantly less likely to support these measures. Respondents with a greater awareness of the health risks of alcohol showed higher levels of support, while those who had experienced harms due to other people's drinking showed lower support compared with those who had not experienced such harms. This study provides evidence of support for alcohol control policies in Ireland. However, notable differences were found in levels of support according to sociodemographic characteristics, alcohol consumption patterns, knowledge of health risks and harms experienced. Further research on reasons behind public support towards alcohol control measures would be worthwhile, given the importance of public opinion in the development of alcohol policy.

ALCOHOLISM AND ITS TREATMENT IN INDIA : A SOCIOLOGICAL STUDY

Alcohol use is typically established during adolescence and initiation of use at a young age poses risks for short- and long-term health and social outcomes. However, there is limited understanding of the onset, progression and impact of alcohol use among adolescents in India. The aim of this review is to synthesise the evidence about prevalence, patterns and correlates of alcohol use and alcohol use disorders in adolescents from India. In recent years, rates of excessive alcohol use and alcohol related mortality have risen sharply in many countries. During the same period the relaxation of alcohol control measures and increased deuce have made it easier for people to obtain alcohol beverages. At the same time the production and distributing’ of alcoholic beverages involves the livelihood of millions of persons and provides very substantial revenues to Government. Patterns of alcohol use are affected by culture and history and intertwined with the rhythms of work life. Recent international research on gender and alcohol has clearly demonstrated that programs and policies that try to be gender–sensitive cannot ignore cultural influences. Large cross–national variation in gender differences in drinking behavior indicates that biological factors alone cannot account for differences in how women and men drink. To be gender– sensitive, education, prevention and treatment programs, and alcohol policies must take into account both biological differences in alcohol effects and culturally defined gender roles that specify expected and tolerated drinking behavior for women and men.

Alcohol ban during the COVID-19 pandemic lockdown: Lessons for preventing foetal alcohol spectrum disorder in South Africa

During the two national lockdowns implemented in South Africa to curb the spread of the coronavirus disease 2019 (COVID-19) pandemic, the sale and consumption of alcoholic beverages were prohibited. There is observational evidence from the literature suggesting a drastic reduction in the emergency and trauma unit admissions in many South African hospitals and clinics with alcohol-related restrictions. This article explores the potential benefits of the restrictions placed on the sale and consumption of alcohol during the COVID-19 pandemic on preventing foetal alcohol spectrum disorder (FASD) in South Africa. Following the potential benefits of the alcohol bans, we recommended that the current South African national liquor policy and the 2012 South African government-drafted Bill for Control of Marketing of Alcoholic Beverages should be fully implemented and enforced. Furthermore, the 'best buys' by the World Health Organization (WHO) should be adapted (based on local evidence) and executed. Implementing the abovementioned policies can reduce alcohol abuse by limiting and regulating the manufacturing, distribution, advertising, sponsorship, promotion, physical availability and hours of sale of alcoholic beverages in South Africa.Contribution:This article shows that alcohol bans during the coronavirus disease 2019 (COVID-19) lockdown reduced the short-term effects of alcohol. We believe that this could be a game-changer for the prevention of FASD in South Africa and positively impact the incidence and prevalence of FASD. This piece provides evidence that policymakers, health practitioners and academics can use to continue advocating for stricter alcohol control measures in South Africa.

Capturing Russian drinking patterns with the Alcohol Use Disorders Identification Test: An exploratory interview study in primary healthcare and narcology centers in Moscow.

Despite a considerable reduction in alcohol consumption, Russia has one of the highest levels of alcohol-attributable burden of disease worldwide due to heavy episodic drinking patterns. Further improvement of alcohol control measures, including early provision of screening and brief interventions (SBI), is needed. The legislative framework for delivering SBI in Russia was introduced in 2013. As part of the creation and validation of a Russian version of the Alcohol Use Disorders Identification Test (AUDIT), the present contribution explored challenges in using the AUDIT in Russia to inform a subsequent validation study of the tool. Qualitative in-depth expert interviews with patients and healthcare professionals from four primary healthcare and narcology facilities in Moscow. A total of 25 patients were interviewed, 9 from a preventive medicine hospital, 8 from a polyclinic, and 9 from narcology clinics. Also, 12 healthcare professionals were interviewed, 5 of whom were primary healthcare doctors and 7 were narcologists. Patients and healthcare professionals expressed difficulties in dealing with the concept of a "standard drink" in the AUDIT, which is not used in Russia. Various patients struggled with understanding the meaning of "one drinking occasion" on the test, mainly because Russian drinking patterns center around festivities and special occasions with prolonged alcohol intake. Narcology patients had specific difficulties because many of them experienced zapoi-a dynamic drinking pattern with heavy use and a withdrawal from social life, followed by prolonged periods of abstinence. Surrogate alcohol use was described as a common marker of alcohol dependence in Russia, not accounted for in the AUDIT. The provided analyses on the perception of the Russian AUDIT in different patient and professional groups suggest that a series of amendments in the test should be considered to capture the specific drinking pattern and its potential harms.

Road traffic injury risk from alcohol and cannabis use among emergency department patients in Argentina.

ABSTRACTObjective.To report the risk from alcohol, cannabis, and their combined use for non-fatal road traffic injuries for drivers, passengers, and pedestrians.Methods.Risk was estimated using the case-crossover method. Participants (N= 306) were injured patients from an emergency department in Mar del Plata, Argentina.Results.Alcohol use (OR= 6.78, CI 95% 3.75-12.25) as well as combined alcohol and cannabis use (OR= 7.05, CI 95% 1.16-42.73) significantly increased the risk of a road traffic injuries. Alcohol use increased the risk in both, women (OR= 8.87, CI 95% 2.69-29.21) and men (OR= 6.16, CI 95% 3.10-12.23); in those >30 years old (OR= 6.01, CI 95% 2.09-17.24) and those <30 years old (OR= 7.15, CI 95% 3.49-14.65). This last group also had an increased risk after combined alcohol and cannabis use (OR= 7.05, CI 95% 1.16-42.75). Both drivers (OR= 6.40, CI 95% 3.23-12.69) and passengers (OR= 13.83, CI 95% 2.87-66.42) had an increased risk after alcohol consumption.Conclusions.To our knowledge, these are the first estimates of the risk of having a road traffic injury after alcohol and cannabis consumption in one of the countries of the Southern Cone (Argentina, Chile, and Uruguay). These results highlight the urgent need to implement and enforce comprehensive alcohol control measures. Furthermore, given the global trend towards legalizing cannabis for recreational use, our results could also inform policymakers to enact or amend impaired driving laws.

Promising measures to reduce the mortality in Russia: an analytical review

The purpose of the study was to identify promising measures to reduce mortality in Russia. Methods used included analysis of systematic reviews from PubMed, Web of Science, Scopus, and Google Scholar. Results. Many reasonable measures for reducing mortality in Russia include promoting healthy behaviour (tobacco control, alcohol control, support for healthy diet, physical activity) and preventing death due to external causes. It is necessary to increase the effectiveness of disease management, including arterial hypertension, hypercholesterolemia, diabetes mellitus, cardiovascular accidents, hepatitis C, HIV. This could require intensifying digital transformation of health care, implementing modern teamwork approaches to the patient’s treatment and follow-up with greater involvement of nurses and other personnel. In terms of screening, it is essential to expand coverage and introduce modern, effective screening methods for colorectal cancer, cervical cancer, and neonatal screening. It is necessary to expand vaccination against Covid-19, vaccination of the elderly from Pneumococcus, and adolescents from HPV. Prevention of mortality from external causes should include sets of measures targeted at the prevention of suicides, traffic accidents, fires, drownings, etc., in addition to alcohol control measures. Finally, increasing health care financing, including medication provision, can bring additional years of life. Conclusions. Russia has significant potential to implement new measures to reduce the mortality rate.

Unnatural deaths, alcohol bans and curfews: Evidence from a quasi-natural experiment during COVID-19.

Coronavirus disease-19 (COVID-19) restrictions, particularly relating to the sale of alcohol and hours of curfew, have had a marked effect on the temporal pattern of unnatural deaths in South Africa.Methods. Death data were collected over 68 weeks from January 2020 to April 2021, together with information on the nature of restrictions (if any) on the sale of alcohol, and hours of curfew. Data were analysed using a simple ordinary least square (OLS) regression model to estimate the relative contribution of restrictions on the sale of alcohol and hours of curfew to the pattern of excess unnatural deaths.Results. The complete restriction on the sale of alcohol resulted in a statistically significant reduction in unnatural deaths regardless of the length of curfew. To the contrary, periods where no or limited restrictions on alcohol were in force had no significant effect, or resulted in significantly increased unnatural deaths.Conclusions. The present study highlights an association between alcohol availability and the number of unnatural deaths and demonstrates the extent to which those deaths might be averted by disrupting the alcohol supply. While this is not a long-term solution to addressing alcohol-related harm, it further raises the importance of implementing evidence-based alcohol control measures.

Alcohol-Related Deaths in Poland During a Period of Weakening Alcohol Control Measures

This population epidemiology study describes trends in overall and age- and sex-specific alcohol-related deaths in Poland between 2002 and 2017, following the weakening in 2001 of policy measures designed to reduce alchohol consumption.

Alcohol consumption, harms and policy developments in sub-Saharan Africa: The case for stronger national and regional responses.

Sub-Saharan Africa (SSA) has long been characterised as a region with weak alcohol policies, high proportions of abstainers and heavy episodic drinkers (among drinkers), and as a target for market expansion by global alcohol producers. However, inter-regional analyses of these issues are seldom conducted. Focusing mainly on the period 2000-2016, we compare alcohol consumption and harms, alcohol policy developments and alcohol industry activities over time and across the four sub-regions of SSA. Per-capita consumption of alcohol and alcohol-related disease burden have increased in Central Africa but stabilised or reduced in other regions, although they are still high. Most countries have implemented tax policies, but they have seldom adopted other World Health Organization 'best buys' for cost-effective alcohol control policies. Countries range from having minimal alcohol controls to having total bans (e.g. some Muslim-majority countries); and some, such as Botswana, have attempted stringent tax policies to address alcohol harm. Alcohol producers have continued their aggressive marketing and policy interference activities, some of which have been highlighted and, in a few instances, resisted by civil society and public health advocates, particularly in southern Africa. Increased government support and commitment are needed to be able to adopt and implement effective alcohol policies and respond to pressures from alcohol companies to which SSA remains a target market. SSA needs effective alcohol control measures in order to reverse the trajectory of worsening alcohol harms observed in some countries and reinforce improvements in alcohol harms observed in others.

Self-reported drinking behaviors and observed violation of state-mandated social restriction and alcohol control measures during the COVID-19 pandemic: Findings from nationally-representative surveys in Thailand

BackgroundIn Thailand, alcohol is consumed in social setting. The Thai government introduced a ban on alcohol sales and other measures at the beginning of COVID-19 lockdown with gradual lifts. However, drinking behaviors, behaviors of community members, and alcohol marketing activities during the ban and lifts have not been described. MethodsWe contracted a survey research firm to conduct four phone-based cross-sectional surveys between April and July 2020 (n = 6239 participants in total). Participants were recruited from all regions and Bangkok. We also summarized alcohol control measures as reported by multiple sources. We analyzed data from Waves 1 thru 4 using descriptive statistics with adjustment for sampling weight. ResultsA total of 6239 persons participated in the 4 waves of surveys. Among survey respondents who were drinkers, half did not drink alcohol during the alcohol sale ban while one-third reported drinking less than usual in the past 30 days. Almost no participant reported drinking more than usual. During the ban (Wave 1), one-sixth of respondents noticed social drinking in their areas while less than 6 percent reported witnessing alcohol sale. Online parties were the predominant alcohol marketing activity, but became less common during Wave 3 compared to Wave 2. Discussion and conclusionsEver drinkers either abstained from alcohol or drank less than usual during the ban on alcohol sale. However, social drinking and alcohol sale persisted despite the ban.

The Canadian Alcohol Policy Evaluation project: Findings from a review of provincial and territorial alcohol policies.

Effective alcohol control measures can prevent and reduce alcohol-related harms at the population level. This study aims to evaluate implementation of alcohol policies across 11 evidence-based domains in Canada's 13 jurisdictions. The Canadian Alcohol Policy Evaluation project assessed all provinces and territories on 11 evidence-based domains weighted for scope and effectiveness. A scoring rubric was developed with policy and practice indicators and peer-reviewed by international experts. The 2017 data were collected from publicly-available regulatory documents, validated by government officials, and independently scored by team members. The average score for alcohol policy implementation across Canadian provinces and territories was 43.8%; Ontario had the highest (63.9%) and Northwest Territories the lowest (38.4%) jurisdictional scores. Only six of 11 policy domains had average scores above 50% with Monitoring and Reporting scoring the highest (62.8%) and Health and Safety Messaging the lowest (25.7%). A 2017 provincial/territorial current best practice score of 86.6% was calculated taking account of the highest scores for any individual policy indicators implemented in at least one jurisdiction across the country. Most of the evidence-based alcohol policies assessed by the Canadian Alcohol Policy Evaluation project were not implemented across Canadian provinces and territories as of 2017, and many provinces showed declining scores since 2012. However, the majority of policies assessed have been implemented in at least one jurisdiction. Improved alcohol policies to reduce related harm are therefore achievable and could be implemented consistently across Canada.

Alcohol control policies in Former Soviet Union countries: A narrative review of three decades of policy changes and their apparent effects.

Issues.The last Soviet anti-alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign’s policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign’s end, the region faces diverse challenges in relation to alcohol.Approach.The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments.Key Findings.Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol-control measures. The so-called three ‘best buys’ put forward by the World Health Organization to reduce alcohol-attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries.Implications.In recent years, evidence-based alcohol policies have been actively implemented as a response to the enormous alcohol-attributable burden in many of the countries, although there is big variance across and within different jurisdictions.Conclusion.Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall.

A timely piece that resonates with the South African experience: Commentary on Stockwell et al.

The authors correctly conclude that the burden from alcohol in Canada is substantially greater than it is from COVID-19, and thus, alcohol should be given more attention. However, they fail to mention that in some countries, with the rise in COVID-19-related hospital admissions, competition can occur between COVID-19 and trauma patients for scarce hospital resources. In South Africa, this has led to the temporary banning of alcohol sales at two periods during the lockdown. Stockwell et al. highlight the fact that alcohol is deemed an 'essential service' in many countries and point to the reasons why this might have occurred, and that industry appears to be taking advantage of lockdown conditions to expand their reach in ways that might continue after the lockdown. The alcohol industry in South Africa has also used the points given by Stockwell et al. as to why governments might be reluctant to restrict alcohol at this time in pushing back against imposition of alcohol control measures, and furthermore referred to the effect of the sales ban on jobs in the alcohol and related industries and policy inconsistencies in dealing with different industries. Finally, the commentary expands on the measures presented on how governments should use the opportunity provided by the COVID-19 crisis to push for further alcohol control measures to be implemented.

Alcohol controls in the aftermath of the COVID-19 pandemic in India: Commentary on Stockwell et al.

The COVID‐19 pandemic and subsequent restrictions have resulted in additional challenges for persons with alcohol use disorders as well as for the effective operation of alcohol controls in different societies. The challenges are different in different systems and economies. Crises such as these often provide governments with opportunities to remake systems. We use the recent experience from India, which rapidly shifted between total countrywide prohibition of alcohol and unrestricted sales during this brief period, to argue against using the present crisis to bring about quick changes in alcohol policy in India. Instead, we advocate sustained, incremental pressure to develop and enforce alcohol control measures in public health delivery systems, in addition to demand reduction measures.

A Global Legal Instrument for Alcohol Control: Options, Prospects and Challenges

Alcohol is the sole major psychoactive substance with a huge negative public health and social impact without some form of international control grounded in a binding treaty. While existing rules of international law, in particular in the economic field, favour liberalisation and may hinder strong national alcohol control measures, we may be witnessing a turning of the tide due to the growing mobilisation against non-communicable diseases. The Framework Convention on Tobacco Control has been a ground-breaking development in this sense, and has led policymakers and advocates in a number of countries to raise the possibility of a similar convention on alcohol control. The present contribution compares tobacco and alcohol from this perspective and considers the feasibility of a dedicated international convention. It concludes that the political prospects of a movement in this direction are very dim at the present time; however, policy developments on other health problems and theoretical models emerging from constructivist international relations scholarship may open up promising perspectives for considering normative and institutional approaches that could strengthen the existing legal framework and facilitate political processes towards stronger forms of legalisation of global alcohol control.