Alcohol Outlets Research Articles

Do Alcohol Outlets Mediate the Effects of the Moving to Opportunity Experiment on Adolescent Excessive Drinking? A Secondary Analysis of a Randomized Controlled Trial

Background: Housing mobility impacts adolescent alcohol use, and the neighborhood built environment may impact this relationship. Methods: Moving to Opportunity (MTO) was a multi-site, three-arm, household-level experiment. MTO randomly assigned one of three treatment arms (1994–1997) allowing families living in public housing to (1) receive a voucher to be redeemed any neighborhood (2) receive a voucher to be redeemed in a neighborhood with less than 10% poverty (3) remain in public housing (control). MTO decreased girls’ alcohol use, but increased boys’ alcohol use. Treatment groups were pooled because they are similar conceptually and statistically on our primary outcome. Among youth aged 12–19 in 2001–2002 (N = 2829), we estimated controlled direct effects mediation of MTO treatment effects on youth with housing vouchers (N = 1950) vs. controls (N = 879) on past 30-day number of drinks per day on days drank, using gender-stratified Poisson regression. Mediators were density of on- and off-premises alcohol outlets per square mile at the families’ census tract of residence in 1997. Results: Treatment group youth were randomized to live in 1997 census tracts with lower off-premises, but higher on-premises, outlet density. MTO treatment (vs. controls) decreased drinking for girls via alcohol outlet density, but only at higher levels of outlet density. Treatment was 18% more beneficial when girls moved to high density neighborhoods, compared to controls who stayed living in public housing in high density neighborhoods. Conclusion: Additional social processes unmeasured in the current study may play an important role in the alcohol use and other health risks for girls.

Alcohol Use among High School Learners in the Peri-Urban Areas, South Africa: A Descriptive Study on Accessibility, Motivations and Effects.

Learners are vulnerable to alcohol use and its negative effects, largely due to accessibility of alcohol products, especially in the localities with poor socioeconomic status and infrastructure. This study aimed to determine the accessibility, motivations and effects of alcohol use among high school learners (n = 403) in Tshwane North and West, South Africa, using a descriptive, cross-sectional design. Data were collected using a validated questionnaire and analysed using STATA 17. Learners (16 ± 2 years) had poor demographic status and lifestyle behaviors. Availability of alcohol outlets (54%) near schools was reported, and learners indicated easy access (65%) to taverns and bottle stores (30%), and purchasing alcohol without a proof of identity document (70%). Motivations for alcohol use were self-pleasure (36%), coping with stress (24%) and increasing self-esteem (19%). Almost half of the learners (49%) introduced themselves to alcohol use, while others were influenced by friends (36%) and family (14%). Reported alcohol related effects were a negative impact on health (56%), brain function (25%) and school work (12%), in addition to social harms, including problems with friends (25%) and parents (17%), physical fights (19%) and engaging in risky sexual behaviour (11%). Effective strategies are necessary to address underage alcohol use and should include regulating the proximity of alcohol outlets to schools, life skills training to address learners’ drinking motives and constantly alerting parents about the relevance of modeling behaviour.

Access to Alcohol Outlets From Home and Work in Sweden: Longitudinal Associations With Problem Drinking.

The association of proximity of alcohol outlets to the workplace with problem drinking has not been previously studied. We examined longitudinal associations of living and working in proximity to alcohol outlets with problem drinking. The data consisted of 13,306 employed respondents to the Swedish Longitudinal Occupational Survey of Health between 2012 and 2018. Road distances from the respondents' home and workplace to the nearest liquor outlet, beer outlet, and bar were calculated by Statistics Sweden. We used distance variables both as categorized, to indicate changes in distance, and as continuous variables. Self-reported problem drinking was assessed using modified Cut-Annoyed-Guilty-Eye (CAGE) questions. Binomial logistic regression with generalized estimating equation was used to examine the associations. A decrease (vs. remained unchanged) in the distance from home to a liquor outlet was associated with a higher likelihood of problem drinking (odds ratio = 1.21, 95% confidence interval [1.02, 1.45]). A protective association for problem drinking was observed when the distance from home to a beer outlet increased (vs. remained unchanged) (0.65 [0.44, 0.95]). A decrease (vs. remained unchanged) in the distance from work to a bar was also associated with a higher likelihood of problem drinking (1.37 [1.00, 1.88]). The likelihood of problem drinking was increased also per 1-km decrease in distance from home to liquor outlets (1.01 [1.00, 1.02]), risk estimates being higher for women than for men. Alcohol outlet proximity to the workplace could be an additional determinant of harmful alcohol consumption behavior. Reducing the number of on- and off-premise alcohol outlets could reduce the level of harmful alcohol consumption.

Establishing the Relative Accuracy of Using City Directories as Proxies to Define and Reconstruct Historical Alcohol Environments.

Research on alcohol environments has established that poorer and minoritized communities are frequently overburdened by off-premise outlets (e.g., liquor stores). These outlets have more associated harms, including increased alcohol consumption and crime rates. Little, if any, research has shown how these socio-spatial disparities in exposure have grown or shifted over time, and no studies have established a method for re-creating historical alcohol environments. Our results suggest that in our study city of Flint, MI, disparities in the alcohol environment have narrowed since 1950. Although liquor stores are still more likely to be located in poorer and more heavily African American neighborhoods, the pattern has become insignificant over time. Furthermore, the number of alcohol outlets per capita has declined. Thus, although the city remains more overburdened with alcohol outlets than its suburbs, the disparity has shrunk. This work has implications for those working in alcohol prevention and policy, as well as in urban planning. Practitioners and researchers can use this method to model alcohol availability over time in their own communities, which helps better inform the discussion on disparities experienced in poor and minoritized neighborhoods.

Community-Level Alcohol Availability and Child Maltreatment: A Statewide Panel Analysis Over 13 Years.

Parental or caregiver alcohol use, particularly heavy regular or episodic use, can increase the risk of child maltreatment within individual families. At the national level, higher per capita alcohol consumption has been associated with increased child injury mortality in Australia. This study aimed to investigate whether an association exists between substantiated child maltreatment cases, numbers of licensed outlets, and average alcohol sales volumes at the community level (local government area [LGA]) over a 13-year period across Western Australia (WA). Annual panel data were obtained for 132 WA LGAs over the period 2001-2013. Bayesian conditional autoregressive Poisson regression was applied to test associations between numbers of substantiated child maltreatment cases and per-population densities and mean sales volumes of off-trade and on-trade alcohol outlets. Associations were adjusted for the presence of local alcohol restrictions and mandatory reporting; density of on-trade outlets; and their sales, demographic, and socioeconomic variables. Comprehensive area-level alcohol bans and policies restricting alcohol sales reduced child maltreatment by 9.6% and 38.5%, whereas mandatory reporting of child maltreatment increased substantiations by 15.3%. Counterintuitively, for each additional 1,000 L of ethanol sold per off-premise outlet, there was a 3.7% decline in child maltreatment. Local government alcohol restrictions predicted reduced child abuse and neglect. Findings that increases in off-trade outlets predicted a decreased risk of child maltreatment at a local level are seemingly at odds with these findings, but outlet density may be acting as a measure of less disorganization. Alcohol policy that affects alcohol availability can reduce child maltreatment in at-risk areas. Local area alcohol bans and interventions reducing hours of sale should be further evaluated to confirm these findings.

The spatial relationship between tuberculosis and alcohol outlets in the township of Mamelodi, South Africa

The availability of alcohol in society is known to increase the risk of a range of negative health outcomes. The aim of this research is to determine if there is a spatial association between tuberculosis and alcohol outlets in Mamelodi, South Africa. We also aim to examine whether the socio-economic characteristics of the neighbourhood in which an alcohol outlet was located was related to the magnitude of tuberculosis in the immediate vicinity of the alcohol outlet. Location quotient analysis is used to compare the extent of tuberculosis within a series of buffer intervals (100m, 200m, 300m) immediately surrounding alcohol outlets with tuberculosis across the township of Mamelodi as a whole. The density of tuberculosis around alcohol outlets in Mamelodi at all buffer distances was found to be substantially higher than across the township as a whole. These findings indicate that the risk of tuberculosis in Mamelodi is higher around alcohol outlets. Alcohol outlets located in more deprived areas of Mamelodi were significantly associated with higher density of tuberculosis relative to alcohol outlets located in more affluent neighbourhoods. Despite alcohol outlets forming an integral part of the urban landscape in townships in South Africa, they may facilitate the transmission of tuberculosis.

Trends and correlates of spatially aggregated alcohol-involved crashes among Whites and Hispanics in California.

This paper examines trends and correlates of alcohol-involved motor vehicle crashes (AMVCs) in California between 2005 and 2016 among Hispanic and non-Hispanic Whites (Whites hereafter). Together these two groups comprise 76% of the state population. The paper also examines whether alcohol outlet density, percentage of Hispanics in census tract populations, and distance to the U.S./Mexico border are related to greater risks for AMVCs. The border is of interest given the greater availability of alcohol in the area. Crash data come from Statewide Integrated Traffic Records System maintained by the California Highway Patrol. Sociodemographic and community characteristics data from the U.S. Census and alcohol outlet density were aggregated to census tracts. Total motor vehicle crashes and AMVCs were related to these characteristics using hierarchical Bayesian Poisson space-time models. There were over two million injury and fatality crashes during the period of analysis, of which 11% were AMVCs. About 1.7% of these crashes had fatalities. The rate of AMVCs increased among both Whites and Hispanics until 2008. After 2008, the rate among Whites declined through 2016 while the rate among Hispanics declined for 2 years (2009 and 2010) and increased thereafter. Crash distance from the border (RR=1.016, 95% CI=1.010 to 1.022) and percent Hispanic population (RR=1.006; 95% CI=1.003 to 1.009) were well-supported results with 95% credible intervals that did not include 1. The percentages of the following: bars/pubs, males, individuals aged 18 to 29 and 40 to 49 years, U.S. born population, individuals below the 150% poverty level, unemployed, housing vacant, and housing owner-occupied were all positively associated with AMVCs and well supported. Between 2005 and 2016 the rate of AMVCs in California declined among Whites but not among Hispanics. Population-level indicators of percent Hispanic population, distance to the U.S. Mexico border, gender, age distribution, and socioeconomic stability were positively associated with crash rates, indicating that important contextual characteristics help determine the level of AMVC rates in communities.

Alcohol Consumption Patterns: A Systematic Review of Demographic and Sociocultural Influencing Factors.

Background: Excessive alcohol consumption has negative effects not only on the drinkers’ health but also on others around them. Previous studies suggest that excessive alcohol consumption can be related to a combination of factors such as age, family background, religiosity, etc. Investigating and clarifying these roots of alcohol consumption is crucial so that the right type of interventions can be designed in a specific and targeted manner. Objectives: This work was conducted as a systematic review to reveal the factors associated with alcohol consumption and to heighten the understanding of the differences among various communities and segments of the population regarding their usage of alcohol. Data sources: A systematic search of Web of Science, PubMed, ScienceDirect, and Google Scholar was performed. Results: Forty-five studies were included in the review after excluding irrelevant records and duplicates. Conclusions: Alcohol consumption patterns can be associated with several factors related to communities and individuals, and our review revealed demographic factors, including age and proximity to alcohol outlets, as well as social factors, including family background, socioeconomic background, and religious influence. These findings can be used to establish a guideline for further studies in understanding alcohol consumption patterns among individuals according to their personal characteristics and sociocultural backgrounds.

Associations between neighborhood characteristics and dating violence: does spatial scale matter?

BackgroundDating violence (DV) is a public health problem that could have serious repercussions for the health and well-being of a large number of adolescents. Several neighborhood characteristics could influence these behaviors, but knowledge on such influences is still limited. This study aims at (1) evaluating the associations between neighborhood characteristics and DV, and (2) assessing how spatial scale influences the estimations of the latter associations.MethodsThe Québec Health Survey of High School Students (2016–2017) was used to describe DV. Neighborhoods were operationalized with polygon-based network buffers of varying sizes (ranging from 250 to 1000 m). Multiple data sources were used to describe neighborhood characteristics: crime rate, alcohol outlet density (on-premises and off-premises), walkability, greenness, green spaces density, and youth organizations density. Gendered-stratified logistic regressions were used for assessing the association between neighborhood characteristics and DV.ResultsFor boys, off-premises alcohol outlet density (500 m) is associated with an increase in perpetrating psychological DV. Crime rate (500 m) is positively associated with physical or sexual DV perpetration, and crime rate (250 m) is positively associated with physical or sexual DV victimization. Greenness (1000 m) has a protective effect on psychological DV victimization. For girls, walkability (500 m to 1000 m) is associated with a decrease in perpetrating and experiencing psychological DV, and walkability (250 m) is negatively associated with physical or sexual DV victimization.ConclusionsSeveral neighborhood characteristics are likely to influence DV, and their effects depend on the form of DV, gender, and spatial scale. Public policies should develop neighborhood-level interventions by improving neighborhood living conditions.

Assessing the impacts of alcohol outlets on crime as a natural experiment: agglomeration, churning and spatial effects.

Retail alcohol outlets appear to open in neighborhoods with low land and structure rents near sources of demand; they may 'agglomerate', open near to one another or 'churn', replace one another, over time. We used the turnover in numbers of outlets over time to measure agglomeration and churning and the impacts of openings and closings of outlets on neighborhood crime. Interrupted quasi-experiments using spatial panel population data from 3768 synthetic block areas over 6years. City of Oakland, CA, USA. City population. Census-based socio-demographic estimates and counts of openings and closings of bars/pubs, restaurants and off-premises outlets related to assault, burglary and robbery crime incidents across synthetic Census blocks. Bayesian space-time models were used to assess agglomeration and churning and measure impacts of openings/closings on crime. Churning was substantial; openings followed closings for all outlets [bars/pubs, relative risk (RR) = 50.9, 95% credible interval (CI) = 3.0-449.9; restaurants, RR = 3.1, CI = 1.5-6.1; off-premises, RR = 23.5, CI = 2.0-129.8]. Bars/pub and restaurant openings agglomerated with other outlets (e.g., RR = 1.02, CI = 1.00-1.03 and RR = 1.01, CI = 1.00-1.01), but off-premises outlets did not. Covarying out effects related to outlet densities, bar/pub openings were related to a 3.5% increase in assaults (RR = 1.04, CI = 1.01-1.06) and 6.9% increase in robberies (RR = 1.07, CI = 1.03-1.11). Restaurant openings were related to a 5.3% increase in burglaries (RR = 1.05, CI = 1.04-1.06). Openings and closings of off-premises outlets were unrelated to all three crime types. Retail alcohol outlets appear to follow a pattern of opening near to one another and replacing each other over time. Bar, pub and restaurant openings appear to be related to increases in neighborhood crime.

Associations between neighborhood built, social, or toxicant conditions and child externalizing behaviors in the Detroit metro area: a cross-sectional study of the neighborhood ‘exposome’

BackgroundThe specific ‘active ingredients’ through which neighborhood disadvantage increases risk for child psychopathology remains unclear, in large part because research to date has nearly always focused on poverty to the exclusion of other neighborhood domains. The objective of this study was to evaluate whether currently assessed neighborhood built, social, or toxicant conditions were associated with child externalizing psychopathology outcomes separately, and in a combined model, using data from the Detroit-metro county area.MethodsWe conducted principal components analyses for built, social, or toxicant conditions. Next, we fitted separate multiple regression models for each of the child externalizing psychopathology measures (oppositional defiant and conduct problems) as a function of built, social, or toxicant components.ResultsWe found that built features (more non-profits, churches, and alcohol outlets, and less agriculture and vacant properties) were associated with conduct problems, while toxicant conditions (high percent industrial, toxins released and number of pre-1978 structures) were associated with oppositional defiance problems. There was no significant association between greenspace or social conditions and child externalizing outcomes. When examined simultaneously, only the significant independent association between built conditions and conduct problems remained.ConclusionsBuilt, social, and toxicant neighborhood conditions are not interchangeable aspects of a given neighborhood. What’s more, built features are uniquely associated with child externalizing outcomes independently of other neighborhood characteristics. Future research should consider how changes in the built conditions of the neighborhood (e.g., development, decay) serve to shape child externalizing behaviors, with a focus on identifying potentially actionable elements.

Population-Based Correlates of Spatially Aggregated Drug-Related Arrests On and Off the U.S.–Mexico Border in California

The purpose of this study was to examine drug-related arrest rates in California from 2005 to 2017 with a focus on the measurement of presumptive excess arrests across areas proximate to the U.S.-Mexico border. Arrest data come from the Monthly Arrest and Citation Register (MACR) by the California Department of Justice. U.S. Census demographic population information, and alcohol outlet data from the California Department of Alcoholic Beverage Control, were aggregated at the level of 499 Law Enforcement Reporting Areas (LERA) that contributed to the MACR report. Multivariable analyses were conducted using hierarchical Bayesian Poisson spacetime models. Multivariable results showed that felony and misdemeanor arrests increased with distance from the U.S.-Mexico border (felony relative rate [RR] = 1.007, 95% CI [1.003, 1.010]; misdemeanor RR = 1.013, 95% CI [1.010, 1.016]) and were greater in areas with greater outlet concentrations (felony RR = 1.008, 95% CI [1.008, 1.008]; misdemeanor RR = 1.007, 95% CI [1.007, 1.007]) and a greater percentage of bars and pubs (felony RR = 1.031, 95% CI [1.030, 1.032]; misdemeanor RR = 1.052, 95% CI [1.051, 1.053]). Areas with greater Black populations had greater felony and fewer misdemeanor arrests (felony RR = 1.078, 95% CI [1.076, 1.079]; misdemeanor RR = 0.865, 95% CI [0.864, 0.867]). Areas with greater Hispanic populations had greater misdemeanor arrests (RR = 1.008, 95% CI [1.006, 1.009]). The percentage of off-premise outlets was inversely associated with misdemeanor arrest rates (RR = 0.995, 95% CI [0.994, 0.995]). Although arrest rates were substantively related to the racial composition of areas across California, there was no evidence of excess drug-related arrests along border areas.

Association of Neighborhood Alcohol Environment With Alcohol Intake and Cardiovascular Risk Factors in India: Cross-Sectional Evidence From APCAPS.

There are more and more proofs about the impact of neighborhood alcohol environment on alcohol-associated events. The relationship between the neighborhood availability and accessibility of alcohol outlet with individual level of alcohol consumption along with 11 cardiovascular risk factors was explored for the first time in India using data from the 3rd follow-up of the Andhra Pradesh children and parents study (APCAPS) (n = 6156, for liquor intake and 5,641 for heart and blood vessel risk elements). In fully adjusted models, volunteers in the lowest tertile performed worse than volunteers in the highest tertile of distance to the closest alcohol outlet were more probably to exhibit less alcohol consumption (−14.40 g/day, 95% CI: −26.21, −2.59). A unit per km2 rise in alcohol outlet density in 400 m buffering area was related to a rise in waist circumference (1.45 mm, 95% CI: 0.13, 2.77), SBP (0.29 mmHg, 95% CI: 0.09, 0.49), and DBP (0.19 mmHg, 95% CI: 0.03, 0.35). A unit per 100 m rise in distance to the closest alcohol outlet was related to a rise in waist circumference (−2.39 mm, 95% CI: −4.18, −0.59), SBP (−0.41 mmHg, 95% CI: −0.68, −0.15), and DBP (−0.29 mmHg, 95% CI: −0.51, −0.07). Neighborhood availability of alcohol outlets within immediate locality of participants’ households had a closer relationship with cardiovascular risk factors than that within the whole village. Public health policies designed to limit neighborhood availability and accessibility of alcohol outlets ought to be advocated in southern India.

Spatially Varying Associations of Neighborhood Disadvantage with Alcohol and Tobacco Retail Outlet Rates.

More than 30% of cancer related deaths are related to tobacco or alcohol use. Controlling and restricting access to these cancer-causing products, especially in communities where there is a high prevalence of other cancer risk factors, has the potential to improve population health and reduce the risk of specific cancers associated with these substances in more vulnerable population subgroups. One policy-driven method of reducing access to these cancer-causing substances is to regulate where these products are sold through the placement and density of businesses selling tobacco and alcohol. Previous work has found significant positive associations between tobacco, alcohol, and tobacco and alcohol retail outlets (TRO, ARO, TARO) and a neighborhood disadvantage index (NDI) using Bayesian shared component index modeling, where NDI associations differed across outlet types and relative risks varied by population density (e.g., rural, suburban, urban). In this paper, we used a novel Bayesian index model with spatially varying effects to explore spatial nonstationarity in NDI effects for TROs, AROs, and TAROs across census tracts in North Carolina. The results revealed substantial variation in NDI effects that varied by outlet type. However, all outlet types had strong positive effects in one coastal area. The most important variables in the NDI were percent renters, Black racial segregation, and the percentage of homes built before 1940. Overall, more disadvantaged areas experienced a greater neighborhood burden of outlets selling one or both of alcohol and tobacco.

Proximity to Alcohol Sellers and Dose Response Relationship Between Alcohol Consumption With Intimate Partner Violence in Rural Southwestern Uganda.

Introduction: Intimate partner violence (IPV) is associated with several adverse public health outcomes and alcohol use is one of its risk factors. Proximity to alcohol selling points could be linked with problem drinking and IPV. We aimed to determine whether proximal location to alcohol and intensity of alcohol consumption are associated with IPV in rural southwest Uganda.Methods: We conducted a cross-sectional study in rural southwest Uganda with structured interviews at household level. We used the alcohol use disorders identification test (AUDIT) and the Conflict Tactics Scale to measure past year alcohol consumption and IPV (perpetration and victimization). We estimated Euclidean distances between participants' households and nearest alcohol outlets using geographic information systems. We used generalized estimating equation models to calculate adjusted odds ratios (aOR) for the factors associated with IPV.Results: We enrolled 742 participants and median age was 41years (inter-quartile range or IQR 32-53) and 52.2% of respondents were male. The overall prevalence of IPV in the past year was 52.2%. In a multivariable regression model, women (aOR = 2.24, 95%CI 1.28, 3.91) compared to men, those living proximal to an alcohol selling point (OR = 1.77, 95% CI 1.38, 2.27) were more likely to experience IPV. There was a dose-response relationship between alcohol consumption and IPV. With non-drinkers as the reference category, the aORs were 4.54 (95% CI 2.04, 10.08) for casual drinkers, 10.53 (95% CI 4.15, 26.77) for hazardous drinkers and 15.31 (95% CI 4.73, 49.54) for alcohol dependent drinkers.Conclusion: IPV is very common and has a dose-response relationship with alcohol consumption and drinking outlet proximity. There is an urgent need for IPV and alcohol interventions programs in these rural communities. Policy to restrict proximity of alcohol outlets to residential locations should be examined as an intervention for alcohol consumption and IPV perpetration.

The relationship between alcohol outlets and crime is not an artefact of retail geography.

Background and AimsIn previous research, the spatial distribution of alcohol outlets has been shown to be related to the spatial distribution of crime. However, the spatial distribution of alcohol outlets is also related to the spatial distribution of other retail (and non‐retail) activities. We measured whether a residual relationship between alcohol outlets and crime remains statistically significant after controlling for retail density.Design and settingA cross‐sectional analysis of area unit data for Hamilton, New Zealand.MeasurementsWe constructed index measures of retail density using principal component analysis, based on counts of retail outlets (non‐alcohol outlets alone and all outlets in total). We estimated the relationship between outlets and police calls‐for‐service using negative binomial regression, controlling for social deprivation, population and demographics. In our primary analysis, we employed a two‐stage process that first accounted for the correlation between calls‐for‐service and retail density in a negative binomial regression model, then tested for correlation between alcohol outlet counts and the first‐stage residuals.FindingsThe spatial distributions of retail outlets of all types were highly correlated with each other, and all types of retail outlets (alcohol and non‐alcohol) were correlated with crime, after controlling for social deprivation, population and demographics. After controlling for index measures of retail density and other controls, statistically significant semipartial correlations remained with counts of alcohol outlets of all types. For example, in our preferred specification, which controlled for non‐alcohol retail density in the first stage, an additional off‐licence alcohol outlet was associated with 97.34 (95% confidence interval = 36.66–158.0) additional police calls‐for service.ConclusionsThere is a positive relationship between the spatial distribution of alcohol outlets and the spatial distribution of crime that appears to persist even after controlling for non‐alcohol retail density. The relationship between alcohol outlets and crime is not simply an artefact of retail geography.

Availability and promotion of alcohol across different outlet typologies and under different area-level socioeconomic status.

We aimed to characterize the availability and promotion of alcohol at alcohol outlets in Madrid and to compare them according to type of outlet and area-level socioeconomic status. We used the OHCITIES instrument to characterise the alcohol outlets in 42 census tracts of Madrid in 2016. We specified alcohol availability as the density of alcohol outlets and the number of alcohol outlets with extended opening hours (12 or more). We registered any type of promotion associated to alcohol outlets that could be perceived from outside the outlet. We calculated and compared proportions of availability and promotion by alcohol outlet (on- and off-premise) using chi-squared and Fisher Exact tests. We estimated the availability and promotion of alcohol densities per census tract according to area-level socioeconomic status. To assess statistical significance, we used Kruskal-Wallis tests. We recorded 324 alcohol outlets, 241 on-premise and 83 off-premise. Most of the outlets had extended opening hours (73.77%) and at least one sign promoting alcohol (89.51%). More on-premise outlets had extended opening hours and higher presence of alcohol promotion than off-premise (p < 0.001). Higher density of alcohol outlets, extended opening hours and presence of alcohol promotion were found in higher socioeconomic areas (all p < 0.001). These results were also observed for on-premise alcohol outlets. Alcohol availability and promotion were associated with alcohol outlets in Madrid. Future alcohol policies regulating the availability and promotion of alcohol should consider outlet types and area-level socioeconomic status.

Pre-drinking behaviour of people in the night-time economy: Evidence from a street-intercept survey in New Zealand.

Pre-drinking behaviour has grown in prevalence and generates harm for pre-drinkers and others. In this article, we answer three research questions: (i) Where and when do pre-drinkers obtain their alcohol?; (ii) What is the difference in the level of intoxication of pre-drinkers versus non-pre-drinkers, and how does this difference vary over the course of a night?; and (iii) Is the level of intoxication of pre-drinkers related to where and when they obtain their alcohol? We obtained data from 469 respondents using a street-intercept survey conducted in Hamilton, New Zealand in 2019. Data were analysed by cross-tabulation, linear regression and plotting the average intoxication level in the night-time economy over time. The majority of pre-drinkers purchase their alcohol for pre-drinking on the day of consumption. Half of the same-day purchasers purchase before 6pm. The average level of intoxication increases over the course of the night, and is unambiguously higher for pre-drinkers than non-pre-drinkers. The level of intoxication does not differ based on the source or timing of pre-drinking purchases. The main motivation for pre-drinking was price, especially among women. Pre-drinking is a contributor to intoxication in the night-time economy, but most drinkers purchase their alcohol for pre-drinking before 7pm. Further research is required to understand whether trading hours restrictions for off-premises alcohol suppliers will affect the most harmful drinking patterns. Price interventions to reduce the price differential between on-licenced and off-licence alcohol outlets offer the greatest potential to reduce pre-drinking and associated harm.

Examining how the geographic availability of alcohol within residential neighborhoods, activity spaces, and destination nodes is related to alcohol use by parents of young children

BackgroundAlcohol outlet density and drinking behaviors have been assessed based on where people live, but exposure may differ based on where people spend time. We assessed the relationship between alcohol outlet density (using three measures of geographic availability), frequency of use, and continued volume of alcohol among parents. Parents are a unique population of drinkers where the risk for harm to others can be higher as they are caring for minor children. MethodsWe conducted a cross-sectional telephone and web-based survey of 1599 parents in 2015 across 30 cities in California. Participants provided information on drinking, residential addresses, and locations of daily activities. We created three measures of alcohol availability using residential neighborhoods, convex hull polygons, and destination nodes. Data were analyzed using zero-inflated negative binomial models. ResultsDensity of bars in residential neighborhoods were related to more frequent drinking (b = 0.0139, 95% CI = 0.0016, 0.0261) and higher continued volume (b = 0.0295, 95% CI = 0.0067, 0.0522). Density of bars (b = 0.0070, 95% CI = 0.0019, 0.0121) and restaurants (b = 0.0018, 95% CI = 0.0003, 0.0033) in destination nodes were related to drinking a higher continued volume of alcohol. Higher off-premise outlet density was related to a lower continued volume (b = −0.0026, 95% CI = −0.0049, −0.0002). ConclusionsOutlet densities in residential neighborhood and destination nodes are related to frequency of drinking and continued volume of alcohol. Future work should seek to determine why and how residential neighborhoods and nodes are related to alcohol use behaviors and if they differ for parents compared to other adults.

Alcohol outlets and alcohol consumption in changing environments: prevalence and changes over time

BackgroundTo examine whether changes in density of neighborhood alcohol outlets affected changes in alcohol consumption 1-year after regulatory changes increased alcohol availability.MethodsPerson-level data came from a population-based cohort (aged 21–64) residing in/around the Philadelphia, Pennsylvania metropolitan area (2016–2018, N = 772). Fifty-eight percent lived in a state that began implementing new regulations (Pennsylvania) and the remainder lived in states without major regulatory changes (Delaware and New Jersey). Alcohol consumption was assessed as days per week (pw), drinks pw, high consumption (≥8 drinks pw), and binge drinking. Availability of off-premise alcohol outlets was assessed using 1-mile density and distance. Regression models adjusted for age, gender, race/ethnicity, income, education, health status, state and population density.ResultsCross-sectional analyses found that higher outlet density was associated with more alcohol consumption (days, drinks, high consumption; all p < 0.03) and residing farther from an outlet was associated with less alcohol consumption (days and drinks; all p < 0.04). In longitudinal analyses, relative to no change in outlets, exposure to more outlets was associated with 64% higher odds of drinking on more days pw (p < 0.049) and 55% higher odds of consuming more drinks pw (p < 0.081). However, the longitudinal association between changes in outlets and changes in consumption did not differ for residents in Pennsylvania vs. nearby states. In cross-sectional and longitudinal analyses, outlets were not related to binge drinking.ConclusionOff-premise outlets were associated with alcohol consumption consistently in cross-sectional analysis and in some longitudinal analyses. Results can inform future studies that wish to evaluate longer-term changes in increased alcohol availability and effects on consumption.