Alcohol Outlet Density Research Articles

Alcohol outlet density and adolescent drinking behaviors in Thailand, 2007-2017: A spatiotemporal mixed model analysis.

This study aimed to explore the relationship between alcohol outlet density and the proportion of alcohol consumption among Thai adolescents. We utilized the alcohol consumption data from the 2007, 2011, and 2017 Tobacco and Alcohol Consumption Survey in Thailand. We analyzed the relationships between alcohol sales license figures and consumption behavior using a spatiotemporal mixed model. Our data had two levels. The upper (provincial) level featured alcohol sales license density (spatial effect), the years of survey (temporal effect), and the social deprivation index. The lower (individual) level included the demographic data of the adolescents. A total of 9,566 Thai adolescents participated in this study, based on surveys conducted in 2007 (n = 4,731), 2011 (n = 3,466), and 2017 (n = 1,369). The density of alcohol sales licenses increased the odds for the one-year current drinker category (odds ratio [OR] = 1.08, 95% confidence interval [CI], 1.04-1.45), especially in male adolescents (OR = 1.09, 95% CI, 1.04-1.14). Furthermore, it increased the odds for the heavy episodic drinker category for female adolescents (OR = 1.23, 95% CI, 1.05-1.44). Increased alcohol sales licenses are associated with higher alcohol consumption among Thai adolescents. This highlights the need for government organizations to develop and apply strategies to reduce the number of licenses for the sale of alcohol.

Interactive associations of cannabis and alcohol outlet densities with assault injuries in California: A spatiotemporal analysis.

Recreational cannabis outlets may influence rates of interpersonal violence, but research has yielded inconsistent findings. Modification by alcohol outlet density may help explain inconsistencies. We estimated the impacts of recreational cannabis outlets on neighborhood-level assault injury rates in California and evaluated whether alcohol outlet density moderated these associations. We applied Bayesian spatiotemporal analyses to ZIP code-level statewide data on alcohol outlets, recreational cannabis outlets, and injuries and deaths due to firearm and nonfirearm assault, 2017-2019, accounting for confounders and spatial autocorrelation. Using the model posteriors, we estimated parameters corresponding to hypothetical shifts in outlet densities, overall and by age, sex, and race/ethnicity. If recreational cannabis outlets were never introduced, we estimated that nonfirearm assault injuries would have been 1.63 per 100,000 lower (95%CI: -3.08, 0.01) but we observed no association with firearm assault injuries (RD per 100,000: -0.07; 95%CI: -0.34, 0.21). These associations did not depend on alcohol outlet density, but a hypothetical 20% reduction in alcohol outlet densities was associated with fewer firearm (RD per 100,000: -1.89; 95%CI: -0.46, 0.09) and nonfirearm (RD per 100,000: -5.67; 95%CI: -7.44, -3.95) assault injuries. The introduction of recreational cannabis outlets may have contributed to a small increase in nonfirearm assault injuries.

Local government officials’ account of barriers to regulating physical availability of alcohol in Nigeria

Background This study explored local government (LG) officials’ perspectives on barriers to regulating physical alcohol availability using three effective policies: alcohol licensing, alcohol outlet density, and hours and days of alcohol sale in Southwest Nigeria. Methods 31 semi-structured interviews were conducted with 34 officials (director of finance, revenue collectors, and rate officers) in 24 LG across 3 Southwestern Nigerian States (Lagos, Ogun, and Oyo). Their perceptions on barriers to regulating physical alcohol availability were discussed. Interviews were recorded, transcribed verbatim, and analyzed using Iterative Categorisation. Results Accounts of the LG officials reveal political complexities and structural barriers to regulating the physical availability of alcohol. Five major barriers were identified: lack of political will, economic benefits over public health, absence of a database on alcohol outlets, weak judiciary system, and insufficient personnel and funding. Participants reported how the government lacked the political will to formulate and implement national regulations on alcohol licensing and outlet density. LGs prioritized economic benefits from alcohol outlets over public health. Conclusion Regulating physical availability of alcohol at local levels will require the empowerment of LGs through formulating national regulations on alcohol licensing and alcohol outlet density, sufficient funding, and strengthening the judicial system at local levels.

Neighborhood Factors as Correlates of Alcohol Use in the N2 Cohort Study of Black Sexual Minority Men and Transgender Women.

Sexually minoritized men (SMM), transgender women (TW), and particularly Black SMM and Black TW may be disproportionately impacted by alcohol-related problems. Few studies have empirically examined neighborhood factors that may contribute to alcohol use, specifically among these populations. Using data from the N2 longitudinal cohort study in Chicago, IL, survey data from the second wave of longitudinal assessment (n = 126), and GPS mobility data collected during study enrollment were used to evaluate neighborhood alcohol outlet availability, neighborhood disorder, and neighborhood poverty as correlates for individual alcohol use. Neighborhood exposures were measured using 200-m derived activity space areas, created from GPS data, and with publicly accessible geospatial contextual data. Separate multi-variable quasi-poison regression models tested for association between neighborhood alcohol outlet density (AOD), measured separately for on-premise (e.g. bars) and off-premise consumption outlets (e.g. liquor stores), neighborhood poverty (defined as the percentage of neighborhood areas at 150% or greater of the U.S. poverty line), exposure to vacant buildings, and neighborhood violent crime density. Separate analytical models found no significant effect between alcohol use and on-premise neighborhood AOD (IRR = 0.99, p = 0.35), off-premise consumption AOD (IRR = 0.92, p = 0.33), or neighborhood violent crime (IRR = 1.00, p = 0.65). Vacant buildings (IRR = 1.03, p = 0.05) and levels of neighborhood poverty (1.05, p = 0.01) were found to be significantly associated with increased alcohol use. Among this population, opposed to geospatial access, neighborhood measurements indicative of disorder and poverty may have greater influence on shaping alcohol use.

Overview of State Laws Restricting Alcohol Outlet Density in the United States.

Complementing the extensive research literature demonstrating that increased alcohol outlet density is associated with excessive alcohol consumption and related harms, this article synthesizes information on the types of alcohol outlet density restrictions in US state-level laws. Statutes and regulations related to alcohol outlet density in all 50 states and the District of Columbia in effect as of January 1, 2022, were collected using Westlaw. State-level density restrictions were coded according to 4 variables and overlaid with existing research on state-specific local authority to regulate outlet density. Alcohol outlet density laws in Michigan and Massachusetts were analyzed in detail as case studies. United States. US state-level licensing laws restricting alcohol outlet density. Thirty-three states and the District of Columbia have state-level licensing laws that limit alcohol outlet density. Of those, 25 have population-based restrictions, 8 have distance-based restrictions, 7 have quotas, and 6 require the licensing agency to consider density-related factors. Within the same group of 34 jurisdictions, 22 apply restrictions to both on- and off-premises outlets, 5 apply them only to on-premises outlets, and 7 apply them only to off-premises outlets. Among the 32 states where localities lack authority to license alcohol outlets, two-thirds have state-level laws restricting outlet density. State-level density restrictions also exist in approximately two-thirds of the states where localities have licensing authority. Case studies of Michigan and Massachusetts highlight how state-level density restrictions operate in practice. Two-thirds of jurisdictions have state-level alcohol outlet density restrictions, with population-based restrictions being the most common. In addition, outlet density restrictions may exist regardless of limits on local control and whether localities with authority to enact density restrictions have done so. Policymakers and others can reference this assessment to identify examples and opportunities to strengthen the alcohol policy environment in any given state.

Investigating the spatial heterogeneity of drunk-driving events in Beijing based on a hybrid method with LISA and GeoDetector

Drunk-driving events can be divided into drunk-driving crashes (DDCs) and non-crash drunk-driving events (NDDEs). Strong spatial heterogeneity, which consists of spatial local heterogeneity and spatial stratified heterogeneity, exists in drunk-driving events. Therefore, this article proposed a hybrid method with LISA and GeoDetector to investigate the spatial heterogeneity of drunk-driving events. First, an integrated method of Getis-Ord Gi* and Anselin Local Moran’s I, which belong to LISA, was applied for the analysis of spatial local heterogeneity. Then, based on the improved GeoDetector with a highest q value, this article explored the main factors contributing to spatial stratified heterogeneity. Results show that DDCs are concentrated in the urban areas and the sub-centres located in the east of suburban, while NDDEs are predominantly found in the urban areas and the sub-centres located in the northwest and southwest of suburban. The spatial stratified heterogeneity analysis, conducted using the Factor Detector, reveals the pivotal factors influencing the spatial distribution of DDCs. Entertainment venues, alcohol outlets, and population density exhibit significant impacts, with q-values of 0.233, 0.227, and 0.203, respectively. Similarly, for NDDEs, the most influential factor is the density of entertainment venues, with a q-value of 0.243. When exploring the interaction effects between factors, the study emphasises that the interaction between population density and alcohol outlet density shows the highest q-value of 0.787. This highlights a substantial impact on the spatial formation of drunk-driving events. These findings offer valuable insights for implementing targeted measures to improve road safety and reduce the occurrence of drunk-driving events in Beijing.

Examining the role of social vulnerability, neighborhood characteristics, and geospatial patterns of firearm-related injuries and clinical outcomes in Milwaukee county

BackgroundPrevious work has shown socioenvironmental factors can influence firearm injury. Milwaukee County, Wisconsin is a diverse midwestern county with historic disinvestment in marginalized communities yielding stark segregation along racial and ethnic lines. It is also one of the many U.S. counties burdened by surging firearm injuries. The differences among communities within Milwaukee County provides a unique opportunity to explore the intersection of socioenvironmental factors that may affect clinical outcomes and geospatial patterns of firearm injury. MethodsThe trauma registry from the regional adult level 1 trauma center was queried for patients who sustained a firearm-related injury from 2015 to 2022 (N = 2402). The Social Vulnerability Index (SVI) ranking was derived using patient residence addresses to evaluate its association with traumatic injury clinical outcomes (i.e., in-hospital mortality, length of hospital stay, ICU or ventilator treatment, or injury severity score) and risk screening results for alcohol use disorder (AUD), posttraumatic stress disorder (PTSD), and depression. We evaluated hotspots of firearm injury density over time for patient residences and injury locations and distances between locations. A spatially lagged regression model tested the association between firearm injury density and SVI domains, alcohol outlet types, and park coverage. ResultsMost firearm injury patients were younger, male, racial or ethnic minorities from disadvantaged neighborhoods (SVI total; M = 0.86, SD = 0.15). SVI was not associated with any clinical outcomes. Of those screened, 12.9% screened positive for AUD and 44.5% screened at risk for PTSD, depression, or both. Hotspot analysis indicated consistent concentrations of firearm injury density. There were no differences in clinical outcomes between those injured inside or outside the home. Census tracts with lower socioeconomic status, greater off-premises and lower on-premises alcohol outlet density were associated with greater firearm injury density. ConclusionsIn Milwaukee County, firearm injury patients are injured in and often return to the same disadvantaged neighborhoods that may hamper recovery. Results replicate and expand previous work and implicate specific socioenvironmental factors for intervention and prevention of firearm injury.

Global alcohol policy implementation in Thailand: A narrative review

Alcohol consumption is growing in emerging economies. Thailand is an upper-middle-income emerging economy in Southeast Asia where the alcohol market has been under an oligopoly, which political groups are attempting to amend. The Thai Ministry of Public Health works in close partnership with the non-profit sector in alcohol control, and has recently adapted the World Health Organization’s (WHO) SAFER initiatives as part of the national alcohol agenda. In light of these ongoing changes, we conducted a narrative review with the following objectives: (1) to describe the development of alcohol control policy strategies in Thailand; and (2) to describe the current situation on alcohol policy implementation. We performed a search of the published and grey literature in both Thai and English languages using keywords related to topics of interest, and reviewed data on SAFER's effectiveness using a group of indicators (policy-attributable health outcomes). We found that Thailand has laws and regulations covering various domains of SAFER. However, gaps do exist with regard to regulation of alcohol outlet density, relatively low alcohol sales permit fees, control of online and surrogate marketing of alcoholic products, and enforcement of drinking-and-driving deterrence measures, among others. A review of the indicators showed that annual per capita alcohol consumption (APC) and prevalence of drinkers have remained constant since 2008, whereas the prevalence of binge-drinking has been on a decline since 2014. However, deaths attributable to alcohol have increased in both men and women. The findings of this narrative review may have implications for policymakers and stakeholders in behavioral health.

Interrupted Time Series Analysis of Bar/Tavern Closing Hours and Violent Crime

It is well established that alcohol outlets (ie, places that sell alcohol) attract crime, particularly during late-night hours. To evaluate the association of Maryland Senate Bill 571 (SB571), which reduced the hours of sale for bars/taverns in 1 Baltimore neighborhood from 6 am to 2 am to 9 am to 10 pm, with violent crime within that neighborhood. This controlled interrupted time series analysis compared the change in violent crime density within an 800-ft buffer around bars/taverns in the treatment neighborhood (ie, subject to SB571) and 2 control areas with a similar mean baseline crime rate, alcohol outlet density, and neighborhood disadvantage score in the City of Baltimore between May 1, 2018, and December 31, 2022. The interrupted time series using Poisson regression with overdispersion adjustment tested whether the violent crime density differed before vs after the policy change in the treatment neighborhood and whether this difference was localized to the treatment neighborhood. Statutory reduction of bar/tavern selling hours from 20 to 13 hours per day in the treatment neighborhood. The primary outcome was all violent crime, including homicide, robbery, aggravated and common assault, and forcible rape. Secondary outcomes were homicides and assaults. All violent crime measures summed the monthly incidents within 800 ft of bars/taverns from 8 pm to 4 am. For each outcome, a level change estimated the immediate change (first month after implementation), and a slope change estimated the sustained change after implementation (percent reduction after the first month). These level and slope changes were then compared between the treatment and control neighborhoods. The treatment neighborhood included 26 bars/taverns (mean [SD] population, 524.6 [234.6] residents), and the control neighborhoods included 41 bars/taverns (mean [SD] population per census block, 570.4 [217.4] residents). There was no immediate level change in density of all violent crimes the month after implementation of SB571; however, compared with the control neighborhoods, the slope of all violent crime density decreased by 23% per year in the treatment neighborhood after SB571 implementation (annualized incidence rate ratio, 0.77; 95% CI, 0.60-0.98; P = .04). Similar results were seen for homicides and assaults. Several sensitivity analyses supported the robustness of these results. This study's findings suggest that alcohol policies that reduce hours of sale could be associated with a reduction in violent crimes. Given these findings, SB571 may serve as a model for other cities looking to create safer neighborhoods.

Reducing Alcohol Use to Prevent Cancer Deaths: Estimated Effects Among U.S. Adults

The Dietary Guidelines for Americans, 2020-2025 recommends non-drinking or no more than 2 drinks for men or 1 drink for women in a day. However, even at lower levels, alcohol use increases the risk for certain cancers. This study estimated mean annual alcohol-attributable cancer deaths and the number of cancer deaths that could potentially be prevented if all U.S. adults who drank in excess of the Dietary Guidelines had instead consumed alcohol to correspond with typical consumption of those who drink within the recommended limits. Among U.S. residents aged ≥20 years, mean annual alcohol-attributable cancer deaths during 2020-2021 that could have been prevented with hypothetical reductions in alcohol use were estimated. Mean daily alcohol consumption prevalence estimates from the 2020-2021 Behavioral Risk Factor Surveillance System, adjusted to per capita alcohol sales to address underreporting of drinking, were applied to relative risks to calculate population-attributable fractions for cancers that can occur from drinking alcohol. Analyses were conducted during February-April 2023. In the U.S., an estimated 20,216 cancer deaths were alcohol-attributable/year during 2020-2021 (men: 14,562 [72.0%]; women: 5,654 [28.0%]). Approximately 16,800 deaths (83% of alcohol-attributable cancer deaths, 2.8% of all cancer deaths) could have been prevented/year if adults who drank alcohol in excess of the Dietary Guidelines had instead reduced their consumption to ≤2 drinks/day for men or ≤1 drink/day for women. Approximately 650 additional deaths could have been prevented annually if men consumed 1 drink/day, instead of 2. Implementing evidence-based alcohol policies (e.g., increasing alcohol taxes, regulating alcohol outlet density) to decrease drinking could reduce alcohol-attributable cancers, complementing clinical interventions.

Scoping review of assessment tools for, magnitudes of and factors associated with problem drinking in population-based studies

BackgroundThe term “problem drinking” includes a spectrum of alcohol problems ranging from excessive or heavy drinking to alcohol use disorder. Problem drinking is a leading risk factor for death and...

The Association of Alcohol Outlet Density With Alcohol Intake: The Multiethnic Cohort.

Neighborhood characteristics have been shown to influence lifestyle behaviors. Here we characterized alcohol outlet density in Los Angeles County, CA, and Hawaii and assessed the association of alcohol outlet density with self-reported alcohol intake in the Multiethnic Cohort. Participants (n = 178,977) had their addresses geocoded at cohort entry (1993-1996) and appended to block group-level alcohol outlet densities (on- and off-premises). Multinomial logistic regression was performed to assess the association between self-reported alcohol intake and on- and off-premise alcohol outlet densities by each state. Stratified analysis was conducted by sex, race, and ethnicity. Overall, we did not find associations between alcohol outlet density and self-reported alcohol intake in Los Angeles County, but we found that on-premise alcohol outlets were associated with 59% (odds ratio [OR] = 1.59, 95% CI [1.29, 1.96]) increased odds of consuming more than two drinks per day in Hawaii. Women living in neighborhoods with a high density of on-premise alcohol outlets (Los Angeles County: OR = 1.15, 95% CI [0.95, 1.40]; Hawaii: OR = 2.07, 95% CI [1.43, 3.01]) had an increased odds of more than two drinks per day. This study suggests that neighborhood factors are associated with individual-level behaviors and that multilevel interventions may be needed.

Did the association between alcohol outlet density and crime change during COVID shelter-in-place orders?

We investigated whether greater concentrations of on- and off-sale alcohol outlets were associated with crime and whether this association was moderated by COVID-19 shelter-in-place orders (SIP) that restricted on-premises consumption of alcohol. Crimes (2019-2020) and addresses of licenced alcohol outlets in a medium-sized California city were geocoded within census block groups (N = 61). On- and off-sale alcohol outlet density was calculated as licenced outlets/2.59 km2 (1 square mile). Multilevel negative binomial regression analyses were conducted to examine associations between alcohol outlet density and crime, and possible moderating effects of SIP, controlling for block group demographic characteristics and density of other retail businesses. On-sale outlet density was positively associated with total crimes and Part 2 crimes, while off-sale outlet density was inversely associated with total crime and Part 2 crimes. Overall, SIP was not significantly associated with crime, but moderated the associations of on-sale density with total crime and Part 1 crimes such that reductions in crime during SIP were observed in higher density areas. The association of off-sale outlets with crime was not moderated by SIP policies. On-sale outlet density, but not off-sale density, appears to be associated with increased crime. The results further indicate that restrictions in hours and service imposed by SIP policies reduced crime in high on-sale outlet density areas. These findings reinforce the importance of regulating alcohol outlet density and hours of service, especially for on-sale outlets, as a crime reduction strategy.

Individuals' travel to alcohol outlets: The fallacy of the local bar.

Studies relating alcohol outlet density around homes to alcohol consumption produce mixed results. One possible explanation is that people travel to outlets away from their homes. This study aims to characterise individuals' trips to outlets, describe these trip locations relative to other activities and estimate associations between alcohol outlet density and trips to outlets. This cross-sectional study used 2014-2018 household travel data from the Victoria Integrated Survey of Travel and Activity. We estimated the average change in the cumulative travel characteristics associated with each additional trip to bars and liquor stores, accounting for complex trips to multiple destinations. Logistic regression models estimated odds that individuals travelled to outlets in relation to outlet density in their home local government area (LGA). Among 23,512 respondents, 378 (1.6%) travelled to any bar and 79 (0.3%) any liquor store the survey day. Bar trips added 8.2 km (95% confidence interval [CI] 4.6, 11.8) and 18.1 min (95% CI 13.6, 22.6) to cumulative travel; 41% of attended bars were co-located in participants' home LGA. Greater bar and liquor store density within the home LGA were associated with overall trips to these outlet types. Individuals travel beyond their residential area to bars, but travel to liquor stores closer to home. Bar and liquor store density within individuals' home LGA were associated with trips to outlets. Trips to local bars in near home comprised a minority of trips to bars in this sample. Studies of retail alcohol access should account for trips to bars away from home.

Recovery Support and Capacity Assessment Using the Calculating an Adequate System Tool: Two Case Studies.

There are multiple, reliable, and authoritative federally managed data sources for understanding the incidence and prevalence of substance use disorder (SUD) and its sequela. However, there remains a gap in metrics representing the need and capacity for treatment and related supports within local communities. To address this challenge, Calculating an Adequate System Tool (CAST) was developed in 2016 by an interdisciplinary group of researchers at the Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality to assess the capacity of the SUD care system within a defined geographic area. It allows for risk assessment of local social and community determinants of substance abuse, as well as an assessment of local service needs across the continuum of SUD care. This article describes the application of the CAST to 2 counties in Ohio and 1 county in Montana. The purpose of using CAST for each area, results of the application, and experiences in utilizing the tool are described. Application of the CAST demonstrated unique findings within each of the geographic areas. In Ohio, recovery support services were lacking in both counties assessed, while differences in crime rate and alcohol outlet density were attributed to varying rates of drug-related hospitalization. Notable findings in Montana included an oversaturation of coalitions focused on substance use prevention and gaps in the areas of detoxification services, partial day treatment, recovery residences, and peer support specialists. CAST is a useful tool for guiding decision-making relative to substance use care needs and capacities for local geographic areas. Findings should be interpreted thoughtfully and in the context of data availability. CAST continues to be enhanced and further expanded for assessing capacity of local and statewide substance use care systems.

Abstract PR003: An examination of tobacco and alcohol outlet density in Boston to identify priority areas for cancer prevention efforts using environmental justice mapping

Abstract Background. Inequitable access to health-harming substances in the built environment can create and exacerbate race and SES-based disparities in cancer incidence and mortality. Availability and density of tobacco and alcohol outlets is associated with increased experimentation, initiation, and regular use of alcohol and tobacco products. Prior studies examining the sale of tobacco and alcohol indicate that these outlets tend to be concentrated in communities of color and low-income areas. Massachusetts has highlighted environmental justice (EJ), one’s right to be protected from hazards and live in clean, health-promoting environments, as a priority issue and identified block group populations who are at most risk of environmental burdens. The objective of this study was to (a) examine the distribution of tobacco and alcohol outlets in environmental justice block groups in Boston, and (b) compare outlet density in more deprived neighborhoods to more privileged neighborhoods. Methods. Publicly available licensing lists for tobacco and alcohol retailers with geocoded data were obtained from the City of Boston’s open data hub. Lists were de-duplicated so that retailers that sell both tobacco and alcohol products were only represented once. The environmental justice block group layer (2020) was downloaded from Mass.gov. EJ block groups meet one or more of the following criteria: ‘high minority’ (>40% non-white population), ‘low-income’, or ‘high English isolation.’ ArcGIS Pro software was used to spatially join retailer data to Boston block groups and calculate tobacco and alcohol outlet density (the number of retailers per 1,000 people). Sociodemographic and cancer mortality data from the Health of Boston Report was used to classify neighborhoods as ‘more privileged’ (Back Bay, Beacon Hill, North End, West End) or ‘more deprived’ (Dorchester, Hyde Park, Mattapan, Roslindale, Roxbury). Results. Of the 560 Boston block groups analyzed, 458 (81.8%) were considered environmental justice block groups with 60% of EJ block groups classified as ‘high minority’. There were 931 retailers that sell tobacco or alcohol products for off-premises consumption in Boston, with 86% of these retailers (n=811) located in EJ block groups. On average, tobacco and alcohol outlet density was greater in EJ block groups compared to non-EJ block groups (2.09 vs 1.25 retailers per 1,000 residents). Nearly half (48%) of environmental justice block groups in Boston are located in the most deprived neighborhoods compared to only 3.7% in the most privileged neighborhoods. Tobacco outlet density is significantly higher in deprived neighborhoods compared to privileged neighborhoods (1.25 vs 0.98, p < 0.01). However, alcohol density is lower in more deprived block groups compared to more privileged ones (0.35 vs 0.74, p < 0.01). Conclusion. Environmental justice mapping can be used as a tool to identify areas where cancer prevention efforts may be enhanced by modifying the built environment to reduce clusters of alcohol and tobacco outlets. Citation Format: Lindsay Kephart. An examination of tobacco and alcohol outlet density in Boston to identify priority areas for cancer prevention efforts using environmental justice mapping [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr PR003.

The potential adverse effects of minors' exposure to alcohol-related stimuli via licenced venues: A narrative review.

Young people are particularly impressionable when it comes to forming expectations and attitudes around alcohol consumption. Any stimuli that normalise and foster positive expectations around alcohol use may increase the risk of underage alcohol consumption. Alcohol venues that market themselves as being appropriate 'family friendly' establishments for children risk exposing minors to environments that are saturated with alcohol-related stimuli. However, research examining how exposure to licenced venues affects underage people is very limited. The aim of this narrative review was to identify and synthesise relevant evidence to better understand how attending these venues might affect minors. A narrative review of research published between January 2016 and November 2022 was conducted to investigate the potential effects on underage people of exposure to licenced venues and stimuli encountered in/around these venues. Examined stimuli included alcohol advertising, people consuming alcohol and alcohol outlets. The reviewed literature indicates that the risk of alcohol-related harm among minors is likely to increase with greater exposure to alcohol venues due to the associated exposure to alcohol advertising, exposure to others consuming alcohol and higher outlet density. In combination, these factors are likely to normalise alcohol consumption for minors and create positive alcohol expectancies. Venues serving alcohol should be discouraged from targeting families and parents should be warned about the risks associated with taking minors to venues where alcohol is sold and consumed.

How Does the Built Environment Affect Drunk-Driving Crashes? A Spatial Heterogeneity Analysis

In this research, 3356 alcohol-related traffic crashes were obtained from blood-alcohol test reports in Tianjin, China. Population density, intersection density, road density, and alcohol outlet densities, including retail density, entertainment density, restaurant density, company density, hotel density, and residential density, were extracted from 2114 traffic analysis zones (TAZs). After a spatial autocorrelation test, the multiple linear regression model (MLR), geographically weighted Poisson regression model (GWPR), and semi-parametric geographically weighted Poisson regression model (SGWPR) were utilized to explore the spatial effects of the aforementioned variables on drunk-driving crash density. The result shows that the SGWPR model based on the adaptive Gaussian function had the smallest AICc value and the best-fitting accuracy. The residential density and the intersection density are global variables, and the others are local variables that have different influences in different regions. Furthermore, we found that the influence of local variables in the economic–technological development area shows significantly different characteristics compared with other districts. Thus, a comprehensive consideration of spatial heterogeneity would be able to improve the effectiveness of the programs formulated to decrease drunk driving crashes.

Investigating the Impact of Alcohol Outlet Density on Crime Rates

Investigating the Impact of Alcohol Outlet Density on Crime Rates

Community-Level Risk Factors for Firearm Assault and Homicide: The Role of Local Firearm Dealers and Alcohol Outlets.

Identifying community characteristics associated with firearm assault could facilitate prevention. We investigated the effect of community firearm dealer and alcohol outlet densities on individual risk of firearm assault injury. In this density-sampled case-control study of Californians, January 2005-September 2015, cases comprised all residents with a fatal or nonfatal firearm assault injury. For each month, we sampled controls from the state population in a 4:1 ratio with cases. Exposures were monthly densities of county-level pawn and nonpawn firearm dealers and ZIP code-level off-premises alcohol outlets and bars and pubs ("bars/pubs"). We used case-control-weighted G-computation to estimate risk differences (RD) statewide and among younger Black men, comparing observed exposure densities to hypothetical interventions setting these densities to low. We estimated additive interactions between firearm and alcohol retailer density. Secondary analyses examined interventions targeted to high exposure density or outcome burden areas. There were 67,850 cases and 268,122 controls. Observed (vs. low) densities of pawn firearm dealers and off-premises alcohol outlets were individually associated with elevated monthly risk of firearm assault per 100,000 people (RD pawn dealers : 0.06, 95% CI: 0.05, 0.08; RD off-premises outlets : 0.01, 95% CI: 0.01, 0.03), but nonpawn firearm dealer and bar/pub density were not; models targeting only areas with the highest outcome burden were similar. Among younger Black men, estimates were larger. There was no interaction between firearm and alcohol retailer density. Our results are consistent with the hypothesis that limiting pawn firearm dealers and off-premises alcohol outlet densities can reduce interpersonal firearm violence.