Alcohol Prevention Policies Research Articles

Prevention of hazardous use of alcohol among high school students: a study protocol for the randomized controlled trial ‘Our choice’

BackgroundAdolescent hazardous alcohol use is prevalent and has serious short- and long-term consequences. The trial ‘Our Choice’ examines efficacy, feasibility and acceptability of prevention interventions targeting school, parent, and student levels at Danish high schools. We hypothesize that students in a structural intervention (school and parent levels) reduce hazardous alcohol use and related health behaviors compared to students in an assessment only control group 12 months post baseline; and that adding group-based Motivational Interviewing (group MI) yields further improvements. The study examines the efficacy of interventions targeting multiple levels with the aim of providing novel insights into prevention of adolescent hazardous alcohol use and related health outcomes.MethodThe study employs a parallel group cluster randomized controlled trial design with three conditions: (1) structural condition targeting school and parent levels, (2) structural condition combined with group MI which also targets the student level, and (3) assessment-only control condition. A participatory approach is used to adapt and develop interventions. Sixteen high schools in Denmark and about N = 3100 first-year students (15–18 years) enrolled in high school in August 2023 will be recruited. Data will be collected via online questionnaires pre-interventions (baseline), 2, 6, 9 and 12 month post baseline and analyzed with generalized linear mixed models. The primary outcome is past month high intensity drinking; secondary outcomes are alcohol use, alcohol-related consequences, well-being, tobacco, and illegal substance use. Feasibility and acceptability will be assessed via surveys (students) and interviews (high school staff) to inform future implementation.Discussion‘Our Choice’ is the first trial to compare the efficacy of a structural intervention targeting school- and parent levels to an intervention targeting these levels and the student level via group MI – on hazardous drinking and related health outcomes among students. Preventing and reducing hazardous alcohol use during adolescence is crucial due to the short- and long-term negative consequences. The tested interventions can be implemented at low cost. The study has significant implications for adolescent health and well-being and has potential to inform evidence-based decisions on alcohol prevention policy, education, and health professions.Trial Registration NumberThe trial was retrospectively registered at ClinicalTrials.gov on August 24th, 2023. Trial Registration Number: ID NCT06018389.

Qualitative study of states' capacity to support alcohol prevention policies during the COVID-19 pandemic in the USA.

The onset of the COVID-19 pandemic accelerated rates of alcohol purchasing and related harms in the USA. The increases followed governors' emergency orders that increased alcohol availability, including the allowance of alcohol home delivery, alcohol to-go from restaurants and bars, and curbside pickup from retailers. Semi-structured interviews were conducted with 53 participants involved in state-level alcohol prevention policy across 48 states. Interviewees' perspectives on changes to alcohol prevention policies during the COVID-19 pandemic, including capacity to respond to alcohol-focused executive and legislative changes to alcohol availability, were explored. Initial codes were developed collectively and refined through successive readings of transcripts using a phenomenological, action-oriented research approach. Themes were identified semantically after all transcripts were coded and reviewed. Four themes were developed including: (i) alcohol prevention policies and capacity during COVID-19; (ii) industry-related challenges during COVID-19; (iii) limited pre-COVID-19 alcohol prevention capacity; and (iv) needs to strengthen alcohol prevention capacity. The pandemic exacerbated states' capacity limitations for alcohol prevention efforts and created additional impediments to public health messaging about alcohol health risks related to greater alcohol availability. Participants offered a myriad of strategies to improve alcohol prevention and to reduce alcohol-related harms. Recommendations included dedicated federal and state prioritisation, more funding for community organisations, greater coordination, consistent high-quality trainings, stronger surveillance and widespread prevention messaging. States' alcohol prevention efforts require dedicated leadership, additional funding and support to strengthen population-based strategies to reduce sustained alcohol-related harms associated with increases in alcohol availability.

Preventing Alcohol-Related Harm in East Africa: Stakeholder Perceptions of Readiness across Five Countries.

While alcohol-related harm is a recognized public health priority, the capacity to address and mitigate its harm is lacking, primarily in low-income countries. Recent developments including new tools that can assess readiness for preventing alcohol-related harm, specifically in low-resource settings, can be used to determine strengths and opportunities for supporting, planning, and resource allocation. In this study, we determined the perceptions of readiness and capacity for the prevention of alcohol-related harm across East Africa among stakeholders engaged in such work. We conducted a cross-sectional survey in 2020, distributed by the East Africa Alcohol Policy Alliance to their member alliances and stakeholders across five countries in East Africa (i.e., Burundi, Kenya, Rwanda, Tanzania, and Uganda). The survey included modified measures from the Readiness Assessment for the Prevention of Child Maltreatment (RAP-CM) short form, organizational size and funding, research capacity and priorities, and perceptions related to alcohol prevention and harm both locally and in the region. Analyses were computed based on 142 persons/organizations completing the survey. In terms of general readiness, the overall adjusted aggregate score for East Africa was 39.70% (ranging from 30.5% in Burundi to 47.0% in Kenya). Of the 10 domains assessed (on a 0-10 scale), across all countries, knowledge of alcohol prevention (8.43), institutional links and resources (6.15) and legislation, mandates and policies (5.46) received the highest scores. In contrast, measures pertaining to resources (i.e., material, human, technical, and informal) received the lowest score. Our results demonstrate substantial variability in the readiness to address alcohol-related harm across East Africa. The highest capacity was noted for knowledge towards alcohol prevention, institutional links, and legislative mandates and policies. However, important gaps were noted in terms of attitudes towards alcohol prevention, the will to address the problem, as well as material, human, and informal resources, which need to be urgently addressed to strengthen capacity for addressing and mitigating the significant toll of alcohol-related harm in the region.

Trends in alcohol intoxication among native and immigrant youth in Sweden, 1999-2017: A comparison across family structure and parental employment status.

Developing a better understanding of drinking patterns across immigrant generations and how these change over time is important for the development of effective alcohol polices. This study investigates the direction and rate of change in youth alcohol intoxication over time, based on immigrant status, and by family structure and parental employment status. The study is based on eight nationally representative school surveys conducted by the Swedish National Council for Crime Prevention between 1999 and 2017, with a combined sample of 50,657 adolescents. Group by time interactions were examined to compare rates of change of alcohol intoxication over time across immigrant generations. The results show a decreasing trend in alcohol intoxication among both first and second generation immigrant youth, and also among immigrant youth across different family structures and parental employment statuses. The results also show that the decrease in alcohol intoxication over time is greater for youths born abroad and for youths with two immigrant parents than for native Swedes, and that the decrease over time is greater for youths from intact families than for native Swedish youths from non-intact families and youths with one immigrant parent. Native and first- and second-generation immigrant youth may differ substantially from one another in many ways, and may therefore manifest different patterns of drinking behaviours. From a policy and prevention perspective, the data in this study imply that native youths and youths with one immigrant parent should be a central target group for alcohol prevention policy in Sweden.

Adolescents' Alcohol Use in Botellon and Attitudes towards Alcohol Use and Prevention Policies.

Alcohol is a common drug misused by young people worldwide. Previous studies have found that attitudes towards heavy consumption are stronger predictors than general norms concerning alcohol. This study aims to explore adolescents’ alcohol use and drunkenness, to understand adolescents’ attitudes towards alcohol use, drunkenness and prevention approaches, and to explore associations between attitudes and personal alcohol use and demographics. Methods: Cross-sectional face-to-face survey of 410 adolescents (61.2% women) who were socializing at night in the streets of Palma (Spain). Breath Alcohol Concentration (BrAC), self-reported measures of alcohol use and social variables were assessed. Results: 70.7% of respondents had a BrAC score higher than 0. The full sample reported having a mean of 3.9 drunk episodes in the last month, and a mean of 7.34 in Alcohol Use Disorders Identification Test (AUDIT). A total of 30.7% were under the minimum age limit for alcohol drinking in Spain and males showed higher BrAC than females. Bivariate analyses identified some differences in attitudes across participant demographics and personal alcohol use. In conclusion, we found high levels of alcohol use and drunkenness amongst adolescents, and adolescents’ attitudes towards drunkenness and prevention approaches were associated with their alcohol consumption as well as with age.

Nexus between drinking patterns, gender and life satisfaction: Some evidence from Indigenous Australians

AbstractExcessive alcohol consumption results in a broad range of health problems and other social issues, such as violence, social disorder and family breakdown. As such, alcohol consumption is considered as a critical social policy issue in Australia. In this study, we have used ordered logit models to estimate the probability of an Indigenous person consuming alcohol and to assess the impact of alcohol consumption on self‐perceived life satisfaction. A heteroscedasticity‐corrected ordered logit model is used to identify the gender difference in such effects. For this purpose, we use the latest National Aboriginal and Torres Strait Islander Social Survey (NATSISS) 2014/2015 data collected by the Australian Bureau of Statistics. The estimation results reveal that age, gender, employment status, income and the experience of unfair treatments significantly affect Indigenous people's (level of) alcohol consumption. The results also reveal that any level of alcohol consumption is linked with reduced overall life satisfaction, which is another reason why prevention of alcohol misuse should be a priority. A significant gender differences in the medium‐risk‐level alcohol consumption were also observed. These findings could be used as an alcohol prevention message in developing and implementing alcohol prevention strategies and policies.

Tendencias en el consumo de alcohol en adolescentes escolarizados en España (2010-2018)

ObjectiveTo analyze trends in beer, wine, and distilled spirits consumption, as well as drunkenness among school-aged adolescents in Spain from 2010 to 2018 by sex and age. MethodThe sample is composed of 35,310 adolescents aged 15 to 18. The data is representative of the adolescent school population in Spain in 2010, 2014, and 2018. The alcohol consumption questionnaire and the drunkenness questionnaire provided by the international team of the study were employed. Prevalence Ratios and 95% confidence intervals were estimated using Poisson regression models with robust variance. Resultsthe data show a general decrease in alcohol consumption (beer, wine, as well as distilled spirits) and in drunkenness, but the decrease mainly occurs between 2010 and 2014. Sex differences (higher consumption and drunkenness among boys) are found among adolescents aged 17-18 but not in the age group of 15-16 years old. Older adolescents show higher levels of consumption and drunkenness than younger adolescents. ConclusionThe results confirm the relevance of carrying out specific analyses in order to identify risk groups which are not detected through general analyses. This data highlights the need to maintain alcohol prevention and control policies due to the risk of stabilization in alcohol-related behaviours.

Long-term Trends in Death Rates from Alcohol-related Disease in South Korea.

Objectives: In this study, we examine long-term trends in death rates from alcohol-related disease in South Korea. Methods: We used cause-of-death statistics from Statistics Korea over the 1991- 2015 period. Specifically, using census data collected every 5 years, we analyzed 6,240,429 deaths in South Korea according to sex, age, and marital status. Results: Male death rates steadily declined from 1991 to 2015, but female death rates steadily increased. The growth rates of death for men and women in 1991 and 2015 were 138% and 700%, respectively, demonstrating a massive difference. The death rate from alcohol-related disease was highest in men aged 50-59 and wom- en aged 45-54. In addition, the death rates from alcohol-related disease among never-married and divorced people were higher than among those who were married or widowed. Conclusions: Male and female drinking behavior should be understood as having different characteristics, and alcohol prevention and treatment policies targeting women should be developed. In addition, preventive education and medical examinations should be conducted to prevent alcohol dependence or abuse arising from unemployment, divorce, disease, retirement, and so on.

An assessment of the effects of alcohol consumption and prevention policies on traffic fatality rates in the enlarged EU. Time for zero alcohol tolerance?

Some similarities can be seen in the drink driving policies of European Union (EU) countries but there are also some major differences. Although all member States are aware of the need to address the problem, there are considerable differences in aspects such as blood alcohol limits, alcohol prices and the enforcement of alcohol control laws. Considering that these policies are in place in specific economic and cultural contexts, we evaluate the effectiveness of the set of control policies implemented in the EU in terms of traffic fatality rates following the recent enlargement process. For this, we use a panel during the period 1999–2012 controlling for several explanatory economic, demographic and geographical attributes. We find that policies that may be effective for reducing alcohol consumption among young drivers may lead to improvements in road safety. Our results also show that zero approach maximum alcohol concentration rates do not seem to be a panacea for this problem, since the countries with the strictest limits do not achieve better road safety outcomes. Finally, the influence of alcohol consumption on traffic fatalities seems to be particularly relevant for the male population.

Readiness to Use Psychoactive Substances Among Second-Generation Adolescent Immigrants and Perceptions of Parental Immigration-Related Trauma

ABSTRACTObjectives: This research explores the relationship between parental immigration-related trauma and second-generation adolescent substance abuse. To examine this relationship, we focused on Ethiopian adolescents in Israel who are at risk for substance abuse. Many immigrants from Ethiopia experienced severe immigration trauma and research indicates the existence of transgenerational trauma transmission. The current research focuses on the connection between Ethiopian adolescents' perceptions of their parents' immigration trauma and their readiness to use psychoactive substances. Design: Five hundred and ten second-generation Ethiopian adolescents (Israeli-born children of Ethiopian immigrants) filled out questionnaires examining socio-demographic characteristics, immigration impact and readiness to consume alcoholic beverages and use illegal drugs. Results: Our findings show that readiness levels among Ethiopian adolescents to use psychoactive substances are relatively low, and that parental trauma only affects the readiness to consume alcohol. The levels of readiness to consume drugs were partially related to parental trauma. Conclusions/Importance: Transgenerational trauma transmission should be considered when implementing alcohol and substance abuse treatment and prevention policies among second generation immigrants. This should be done on all levels including personal, interpersonal and community levels.

From a target group towards interaction group: Alcohol prevention policy regarding young people in Germany

From a target group towards interaction group: Alcohol prevention policy regarding young people in Germany

Depressive symptoms and alcohol correlates among Brazilians aged 14 years and older: a cross-sectional study

BackgroundThe associations between depressive symptoms and alcohol-related disorders, drinking patterns and other characteristics of alcohol use are important public health issues worldwide. This study aims to study these associations in an upper middle-income country, Brazil, and search for related socio-demographic correlations in men and women.MethodsA cross-sectional study was conducted between November 2005 and April 2006. The sample of 3,007 participants, selected using a multistage probabilistic sampling method, represents the Brazilian population aged 14 and older. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale and alcohol dependence was assessed using the Composite International Diagnostic Interview. Associations assessed using bi-variate analysis were tested using Rao-Scott measures. Gender specific multinomial logistic regression models were developed.ResultsAmong the participants with alcohol dependence, 46% had depressive symptoms (17.2% mild/moderate and 28.8% major/severe; p < 0.01); 35.8% (p = 0.08) of those with alcohol abuse and 23.9% (p < 0.01) of those with a binge-drinking pattern also had depressive symptoms. Alcohol abstainers and infrequent drinkers had the highest prevalence of major/severe depressive symptoms, whereas frequent heavy drinkers had the lowest prevalence of major/severe depressive symptoms. In women, alcohol dependence and the presence of one or more problems related to alcohol consumption were associated with higher risks of major/severe depressive symptoms. Among men, alcohol dependence and being ≥45 years old were associated with higher risks of major/severe depressive symptoms.ConclusionsIn Brazil, the prevalence of depressive symptoms is strongly related to alcohol dependence; the strongest association was between major/severe depressive symptoms and alcohol dependence in women. This survey supports the possible association of biopsychosocial distress, alcohol consumption and the prevalence of depressive symptoms in Brazil. Investing in education, social programs, and care for those with alcohol dependence and major/severe depressive symptoms, especially for such women, and the development of alcohol prevention policies may be components of a strategic plan to reduce the prevalence of depression and alcohol problems in Brazil. Such a plan may also promote the socio-economic development of Brazil and other middle-income countries.

The Relationships Between the Impact of Alcoholic Beverage Control Policies, Selected Contextual Determinants, and Alcohol Drinking in Spain

Alcohol prevention policies alone neither cause nor explain changes in alcohol consumption, nor in related harm. Alcohol consumption in Spain throughout the period 1962–2008 was analyzed considering selected contextual factors and alcohol policies. Increased urbanization was found to be associated with higher consumption, especially of beer. Restrictive policies regulating purchase age, advertising, and licensing premises to sell alcohol were associated with decreased alcohol consumption, while lower blood alcohol concentration limits were followed by an increase. Study limitations are noted. Changes in the evolution of socioeconomic, sociodemographic, and cultural factors should be carefully analyzed to inform alcohol policy planning and evaluation.

A Comparative Review on National Alcohol Prevention Policies in Different Selected Countries

Alcohol, with its impact on both communicable and non-communicable diseases, is considered as the third global public health priority. Alcohol ranked third among causes of ill health and premature death, and ranked second in terms of cost among all the substances of abuse, after tobacco, even though nearly half the world’s population drinks alcohol. In most countries, where alcohol is considered as legal; governments facing the dilemma of dealing with alcohol, as they play the roles of the regulator, the wholesaler, and the retailer. In these countries, a broad unity of purpose and action has been emerged within the alcohol problems perspective, against diverse cultural, social and economic situations and experiences with alcohol at national level. The scientific basis for that perspective enrooted in a sustained global research effort. Many common features of these policies include monitoring of public health and safety impacts of policies, increased prevention programming (with a focus on children and youth and on modifying risky drinking behaviors), rigorous monitoring and enforcement of laws, enhancement of the addiction treatment and rehabilitation system, evaluation of prevention policies and programs and involvement of public health experts in the planning of future changes to alcohol policy. Many success stories has raised in reducing the alcohol problem in different countries, however, many challenges still exist. In this presentation policies of different countries on alcohol problem prevention were reviewed to provide a wealth of evidences to address the issues that policy makers are facing in terms of alcohol prevention program in Iran.

Process evaluation of European 'Healthy Stadia' program.

Healthy Stadia (HS) is a European public health pilot-program started in 2007 to support sports stadia in promoting the health of people who work and visit sports stadia, as well as inhabitants of the surrounding communities. The aim of this study is to describe the process evaluation of the program, from its beginning in July 2007 to December 2009, in order to assess the feasibility and sustainability of an HS network across Europe. The program involved nine associate partners involved in the coordination of activities at a local level, in the recruitment of stadia, in the development of specific program tasks and in the dissemination of the program at a national level. The activities of associate partners were evaluated through structured questionnaires administered every 6 months. The questionnaire response rate from associate partners was 77.8% for the first and third evaluations and 88.9% for the second and fourth evaluations. According to the evaluation's results, several good practices such as alcohol prevention policies and those supporting people with disabilities were implemented in stadia over the course of the program. Conversely, practices supporting mental health and green transport were generally not achieved. The implemented activities mainly involved staff and visitors. Lack of human and economic resources, especially toward the end of the program, was considered the principal challenge for program development. In conclusion, the process evaluation presented the feasibility of the HS program and the development of health promoting practices in sport stadia over time.

Adolescents and alcohol: an explorative audience segmentation analysis

BackgroundSo far, audience segmentation of adolescents with respect to alcohol has been carried out mainly on the basis of socio-demographic characteristics. In this study we examined whether it is possible to segment adolescents according to their values and attitudes towards alcohol to use as guidance for prevention programmes.MethodsA random sample of 7,000 adolescents aged 12 to 18 was drawn from the Municipal Basic Administration (MBA) of 29 Local Authorities in the province North-Brabant in the Netherlands. By means of an online questionnaire data were gathered on values and attitudes towards alcohol, alcohol consumption and socio-demographic characteristics.ResultsWe were able to distinguish a total of five segments on the basis of five attitude factors. Moreover, the five segments also differed in drinking behavior independently of socio-demographic variables.ConclusionsOur investigation was a first step in the search for possibilities of segmenting by factors other than socio-demographic characteristics. Further research is necessary in order to understand these results for alcohol prevention policy in concrete terms.

A step beyond — The relevance of depressed mood and mastery in the interplay between the number of social roles and alcohol use

Objectives The present study examines whether depressed mood and external control mediate or moderate the relationship between the number of social roles and alcohol use. Participants The analysis was based on a national representative sample of 25- to 45-year-old male and female drinkers in Switzerland. Method The influence of depressed mood and external control on the relationship between the number of social roles (parenthood, partnership, employment) and alcohol use was examined in linear structural equation models (mediation) and in multiple regressions (moderation) stratified by gender. All analyses were adjusted for age and education level. Results Holding more roles was associated with lower alcohol use, lower external control and lower depressed mood. The study did not find evidence of depressed mood or external control mediating the social roles–alcohol relationship. A moderation effect was identified among women only, whereby a protective effect of having more roles could not be found among those who scored high on external control. In general, a stronger link was observed between roles and alcohol use, while depressed mood and external control acted independently on drinking. With the exception of women with high external control, the study found no link between a higher number of social roles and greater alcohol use. Conclusion Our results indicate that drinking behaviours are more strongly linked to external control and depressed mood than they are to the number of social roles. The study also demonstrates that in any effective alcohol prevention policy, societal actions that enable individuals to combine more social roles play a central role.

Patterns of alcohol use among Brazilian adolescents

To describe patterns of alcohol consumption by adolescents in Brazil. From November 2005 to April 2006, a sample composed of 661 subjects aged between 14 to 17 years was rigorously selected in Brazil using a multistage probabilistic method to represent the profile of the adolescent Brazilian population. 34% of Brazilian adolescents drink alcoholic beverages. The mean age of drinking initiation was 14 years of age. Older adolescents, as well as those living in the southern part of Brazil, those who are not attending school and those who are working, and black individuals and those with personal income reported a higher frequency of drinking. Socio-demographic factors such as gender, income bracket, family income and student status do increase the amount of alcohol consumed. Males report a higher frequency of binge drinking than females. Moreover, more than half of the males that had drunk in the previous year reported having engaged in binge drinking on at least one occasion. Beer represents approximately half of all the drinks consumed by adolescents. There was no significant difference between genders in the kind of alcohol consumed. Among adolescents who drink, the consumption of several drinks is frequent. Alcohol consumption varies from region to region, social economic status (including self-generated income) and age. These findings are discussed in light of their importance for the development of alcohol prevention policies in Brazil.

Coaches’ Attitudes and Involvement in Alcohol Prevention Among High School Athletes

A total of 288 high school coaches completed a survey on their attitudes toward and involvement in alcohol prevention among male high school athletes. Results indicated that coaches felt alcohol use was less of a problem among high school student-athletes than high school students in general. Only one-third of coaches (39%) worked at a school requiring them to talk to their athletes about alcohol use. Coaches most likely to be involved in alcohol prevention were those who had attended an alcohol prevention class/workshop and those who worked for schools with strong alcohol prevention policies and schools that required them to talk with athletes about alcohol use.

HABERMAS’ MODELS OF DECISIONISM, TECHNOCRACY AND PRAGMATISM IN TIMES OF GOVERNANCE: THE RELATIONSHIP OF PUBLIC ADMINISTRATION, POLITICS AND SCIENCE IN THE ALCOHOL PREVENTION POLICIES OF THE SWISS MEMBER STATES

This article assesses the effects different constellations of science, administration and the political sphere display on the policy process in the field of alcohol prevention policy in the Swiss member states. First, it is argued that Habermas’ models of Decisionism, Technocracy, and Pragmatism can be interpreted as distinct modes of governance that take place in today’s policy‐making and implementation. Second, as for the effects of these different constellations of science, administration and politics, the findings from a written survey of the Swiss cantons reported here imply that a broad and adequate policy design is found in cantons with an alcohol prevention policy that is dominated by administrative actors. Output performance proves to be comparatively higher in cantons with a high influence either of scientific actors or of political actors. In an overall comparison, a combined model of administrative dominance with strong affiliation to the scientific community is shown to prevail against the other models considered.