Physical Availability Of Alcohol Research Articles

An assessment of federal alcohol policies in Canada and priority recommendations: Results from the 3rd Canadian Alcohol Policy Evaluation Project.

To systematically assess the Canadian federal government's current alcohol policies in relation to public health best practices. The 2022 Canadian Alcohol Policy Evaluation (CAPE) Project assessed federal alcohol policies across 10 domains. Policy domains were weighted according to evidence for their relative impact, including effectiveness and scope. A detailed scoring rubric of best practices was developed and externally reviewed by international experts. Policy data were collected between June and December 2022, using official legislation, government websites, and data sources identified from previous iterations of CAPE as sources. Contacts within relevant government departments provided any additional data sources, reviewed the accuracy and completeness of the data, and provided amendments as needed. Data were scored independently by members of the research team. Final policy scores were tabulated and presented as a weighted overall average score and as unweighted domain-specific scores. Compared to public health best practices, the federal government of Canada scored 37% overall. The three most impactful domains-(1) pricing and taxation, (2) marketing and advertising controls, and (3) impaired driving countermeasures-received some of the lowest scores (39%, 10%, and 40%, respectively). Domain-specific scores varied considerably from 0% for minimum legal age policies to 100% for controls on physical availability of alcohol. Many evidence-informed alcohol policies have not been adopted, or beenadopted only partially, by the Canadian federal government. Urgent adoption of the recommended policies is needed to prevent and reduce the enormous health, social, and economic costs of alcohol use in Canada.

Exploring the influence of local alcohol availability on drinking norms and practices: A qualitative scoping review.

High alcohol availability is related to increased alcohol consumption and harms. Existing quantitative research provides potential explanations for this relationship but there is little understanding of how people experience local alcohol availability. This is the first review to synthesise qualitative research exploring the relationship between alcohol availability and other factors in local alcohol environments. The scoping review includes qualitative studies exploring community-level alcohol availability and other factors, facilitating the purchase and consumption of alcohol. We included studies focusing on children and adolescents as well as adults. Study findings were brought together using thematic analysis and the socio-environmental context model, which explains how certain environments may facilitate drinking. The review includes 34 articles. The majority of studies were conducted since 2012. Most studies were conducted in the United Kingdom, Australia and South Africa. The physical availability of alcohol and proximity to local amenities and temporal aspects, like late night opening hours, may be linked to social factors, such as normalisation of drinking and permissive drinking environments. The review highlights the importance of social and cultural factors in shaping interactions with local alcohol environments. This qualitative scoping review advances understanding of the pathways linking alcohol availability and alcohol harms by showing that availability, accessibility and visibility of alcohol may contribute towards permissive drinking environments. Further research is needed to better understand how people experience alcohol availability in their local environment and how this can inform alcohol control policies.

Alcohol: No Ordinary Commodity-a summary of the third edition.

This article summarizes the findings and conclusions of the third edition of Alcohol: No Ordinary Commodity. The latest revision of this book is part of a series of monographs designed to provide a critical review of the scientific evidence related to alcohol control policy from a public health perspective. A narrative summary of the contents of the book according to five major issues. An extensive amount of epidemiological evidence shows that alcohol is a major contributor to the global burden of disease, disability and death in high-, middle- and low-income countries. Trends in alcohol products and marketing are described, indicating that a large part of the global industry has been consolidated into a small number of transnational corporations that are expanding their operations in Asia, Africa and Latin America. The main part of the book is devoted to a review of strategies and interventions designed to prevent or minimize alcohol-related harm. Overall, the most effective strategies to protect public health are taxation that decreases affordability and restrictions on the physical availability of alcohol. A total ban on alcohol marketing is also an effective strategy to reduce consumption. In addition, drink-driving counter-measures, brief interventions with at-risk drinkers and treatment of drinkers with alcohol dependence are effective in preventing harm in high-risk contexts and groups of hazardous drinkers. Alcohol policy is often the product of competing interests, values and ideologies, with the evidence suggesting that the conflicting interests between profit and health mean that working in partnership with the alcohol industry is likely to lead to ineffective policy. Opportunities for implementation of evidence-based alcohol policies that better serve the public good are clearer than ever before as a result of accumulating knowledge on which strategies work best.

Associations Between the Physical Availability of Alcohol and Alcohol Use: Regional Variation Across 15 Major Cities in Ontario, Canada.

Rates of alcohol use and alcohol-related harms increase with greater alcohol availability. However, regional differences in sociodemographic characteristics and built environment may affect this association. This study evaluated the association between off-premise alcohol availability and alcohol use in Ontario, Canada, and the degree to which this association varies between cities. This was a cross-sectional spatial analysis of urban neighborhoods in Ontario, Canada (n = 11,742). The primary exposure was off-premise alcohol availability, based on the drive time from a neighborhood to the closest off-premise outlets. The primary outcome was the neighborhood-level prevalence of high-volume alcohol use (>2 drinks/day [males], >1 drink/ day [females]) based on survey data from 2000 to 2014. The association between availability and use was assessed using Bayesian hierarchical spatial models to account for spatial autocorrelation. There was an overall positive association between alcohol availability and high-volume alcohol use (male coefficient estimate (β) = 0.19, 95% credible interval [CI] [0.16, 0.22]; female β = 0.17, 95% CI [0.13, 0.21]). However, the association was eliminated in models that allowed for this association to vary between cities via an interaction term (male β = -0.04, 95% CI [-0.26, 0.19]; female β = -0.04, 95% CI [-0.34, 0.26]). This was explained by variability in the association between cities, where some cities demonstrated a positive association between availability and use and others demonstrated a negative association. Although there is a province-wide positive association between off-premise alcohol availability and high-volume alcohol use, there is substantial regional variation in this association that may affect the local effectiveness of alcohol regulation policies.

Accessibility of alcohol as a risk factor contributing towards alcohol abuse amongst the youth of a selected rural community in Limpopo Province, South Africa

Alcohol abuse amongst the youth is one of the major problems the world is facing, especially in rural communities where the majority of young people are unemployed and have little to do with their time. This study sought to determine the accessibility of alcohol amongst the youth of a rural community in Limpopo province, South Africa. This was a qualitative study which employed the exploratory case study research design which allowed the researchers to explore the risk factors for youth alcohol abuse. Interviews were conducted to collect data which was analysed thematically. The Eco-systems theory was used as a guiding theory for this study. The study found that there were clear associations between physical availability of alcohol, its affordability and high density of liquor outlets in one area and youth alcohol abuse. This study concluded that alcohol and other substance abuse call for preventative and intervention measures in rural communities targeted at the youth. Issues such as educating parents and guardians on how to improve their parenting skills in relation to alcohol consumption and the dangers thereof proved to be of greater need in the rural communities.

The Road to the Alcohol Act 2018 in Finland: A conflict between public health objectives and neoliberal goals

Finnish alcohol policy has aimed for decades years to mitigate alcohol-related harm by using high taxation and restrictions on the physical availability of alcohol. The state monopoly on the retail of alcohol has played a central role in reducing the availability of alcohol. In 2011, preparations began for a comprehensive reform of the Alcohol Act 1994. Over time, the issue became highly politicised, lobbied and divisive. It took intense work of two consecutive governments to finalise the reform. The new Alcohol Act came into force in 2018. It expanded the rights of grocery stores to sell alcohol and reduced the administrative burden for on-premise sales. As a result, the state monopoly on the retail of alcohol was weakened, but it still has an important impact on the physical availability of alcohol. The Finnish public health community expected an increase in alcohol sales following the reform because of greater alcohol availability and expected price reductions related to greater competition of sales in grocery stores. However, prices decreased less than expected in 2018, partly due to a simultaneous increase in alcohol taxes. It is difficult to evaluate the impact of the reform at this early stage. However, after the reform, the 10-year (2008–2017) downward trend in the total per capita alcohol consumption was discontinued despite the tax increase. According to preliminary analyses, the change in the law may have slightly increased recorded alcohol sales but the effect was not statistically significant.

Community Approaches for Reducing Alcohol-Related Harms: an Overview of Intervention Strategies, Efficacy, and Considerations for Future Research

The study aims to provide an overview of the supply- and demand-side strategies used in community approaches for reducing alcohol-related harms, summarise key findings, and identify areas for consideration in future research. Whole-of-community interventions to reduce alcohol-related harms have largely used active population-level demand-reduction strategies, such as public-health messages, community outreach, and school-based education. Supply-side strategies (such as reducing physical availability of alcohol) and strategies targeted at high-risk populations (such as screening and brief intervention) are underutilised. Some small reductions in alcohol consumption indicators have been identified; however, evaluation is often via self-report and outcome reporting is poor, making appraisal difficult. Community approaches to reducing alcohol-related harm have largely relied upon active demand reduction strategies targeted at the whole population. A challenge for future research is to determine the optimal interaction between higher-level national responses—including changes in jurisdictional policies and legislative controls—and local-level action to maximise intervention reach and cost-effectiveness.

ALCOHOL RELATED PROBLEMS IN RUSSIA AND BELARUS: A COMPARATIVE ANALYSIS OF TRENDS

Goal: in present article comparative analysis of trends in alcohol-related problems rates (violent mortality, fatal alcohol poisonings, alcoholic psychoses), alcohol sales per capita, socioeconomic parameters in Russia and Belarus in soviet (1970-1991) and post-soviet (1992-2015) periods were analyzed.
 Materials and methods. As indicators of alcohol problems were used the mortality rate from external causes, the mortality rate from acute alcohol poisoning and the incidence of alcoholic psychoses. As an integral indicator characterizing the health status of the population was used the indicator of life expectancy at birth.
 Results: the results of correlation analysis suggest that alcohol sales is a statistically significant associated with alcohol-related problems rates in both countries during the Soviet period. However, there was no relationship between this variables during the post-Soviet period. The outcomes of this study indicate that psychosocial distress and macroeconomy were important determinants of fluctuations in alcohol-related problems rates in both countries. In the context of alcohol policy this mean that decrease in economic and physical availability of alcohol should be considered as a main priority.

Alcohol: is the evidence base guiding public policy?

Alcohol: is the evidence base guiding public policy?

Traffic Crashes and Alcohol Outlets in a Brazilian State Capital

Objective: Restricting alcohol outlets is being considered as a measure for preventing alcohol-related crashes. However, in many developing countries, alcohol availability is not regulated and its influence on motor vehicle traffic crashes is unknown. This study explores the association between traffic crashes and alcohol outlets in a Brazilian city. Method: Data were geocoded and exploratory analysis was conducted using the kernel density estimator. Two generalized additive models (GAMs) were implemented to predict the factors associated with alcohol-related crashes. Results: For 78 percent of the 3840 traffic crashes where the driver was a victim, there was at least one bar located within a 300-m radius. The median distances between an outlet were 124.4 and 130.7 m for a non-alcohol- and alcohol-related crashes, respectively (P =.13). The GAMs did not make evident any significant association between the outlet locations and alcohol-related crashes: the presence of at least one outlet was associated with alcohol-related crashes with an odds ratio (OR) of 0.94 (95% confidence interval [CI] = 0.75–1.17). Alcohol crashes are more likely to be observed among males (OR = 1.58; 95% CI = 1.21–2.06), young drivers vs. those aged 50 years+ (OR = 3.4; 95% CI = 1.79–6.43), and crashes with fatalities (OR = 1.73; 95% CI = 0.98–3.04). Conclusions: Density of alcohol outlets was high all over the city and both alcohol- and non-alcohol-related crashes occurred near an outlet. The study helps to better understand the relationship between alcohol availability and traffic crashes in a middle-income country where licensing/zoning is absent and suggests that measures for restricting the physical availability of alcohol are necessary, even though further studies are still needed.

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Alcohol and Public Policy Group: Alcohol: No ordinary commodity – a summary of the second edition This article summarizes the contents of Alcohol: No Ordinary Commodity (2nd edn). The first part of the book describes why alcohol is not an ordinary commodity, and reviews epidemiological data that establish alcohol as a major contributor to the global burden of disease, disability and death in high, middle and low income countries. This section also documents how international beer and spirits production has recently been consolidated by a small number of global corporations that are expanding their operations in Eastern Europe, Asia, Africa, and Latin America. In the second part of the book, the scientific evidence for strategies and interventions that can prevent or minimize alcohol-related harm is critically reviewed in seven key areas: pricing and taxation, regulating the physical availability of alcohol, modifying the drinking context, drink-driving countermeasures, restrictions on marketing, education and persuasion strategies, and treatment and early intervention services. Finally, the book addresses the policy making process at the local, national, and international levels and provides ratings of the effectiveness of strategies and interventions from a public health perspective. Overall, the strongest, most cost-effective strategies include taxation that increases prices, restrictions on the physical availability of alcohol, drink-driving countermeasures, brief interventions with at risk drinkers, and treatment of drinkers with alcohol dependence.

An Ecological Analysis of Alcohol-Outlet Density and Campus-Reported Violence at 32 U.S. Colleges

The purpose of this study was to assess the relationships among campus violence, student drinking levels, and the physical availability of alcohol at off-campus outlets in a multisite design. An ecological analysis of on-campus violence was conducted at 32 U.S. colleges. Dependent variables included campus-reported rates of rape, robbery, assault, and burglary obtained from a U.S. Department of Education online database for the years 2000-2004. Measures of student alcohol use and demographics were obtained from student surveys conducted for the Social Norms Marketing Research Project from 2000 to 2004. Measures of alcohol-outlet density within 3 miles of each campus were obtained from state alcohol-licensing authorities for 2004. Both on- and off-premise alcohol-outlet densities were associated with the campus rape-offense rate but not with the assault or robbery rates. Student drinking level was associated with both campus rape and assault rates but not with the campus robbery rate. The apparent effect of on-premise outlet density on campus rape-offense rates was reduced when student drinking level was included in the model, suggesting that the effect of on-premise outlet density may be mediated by student drinking level. Separate analyses revealed a similar mediational role for off-premise outlet density. These findings demonstrate that there is a campus-level association between sexual violence and the campus-community alcohol environment.

Should alcohol policies aim to reduce total alcohol consumption? New analyses of Canadian drinking patterns

We investigated whether high-risk drinking patterns are restricted to a few high-volume drinkers or are evenly distributed across the population to inform discussion regarding the optimal mix of targeted versus universal prevention strategies. Drinking patterns reported in the 2004 Canadian Addiction Survey (CAS, n = 13,909) were assessed against various low-risk drinking guidelines. Under-reporting was assessed against known alcohol sales for 2004. Non-response bias due to the low response rate (47%) was investigated through comparisons with the 2002 Canadian Community Health Survey (CCHS). Self-reported alcohol consumption for the past week and past year accounted for between 31.9% and 37.0%, respectively of official alcohol sales data. Comparisons with the 2002 CCHS suggested only limited non-response bias. Many more respondents regularly placed themselves at risk of short-term harm (20.6%) than exceeded guidelines for avoiding long-term health problems (3.9%). Ten percent of respondents consumed more than 50% of total self-reported consumption. Most alcohol (73.4%) consumed by the sample in the previous week was drunk in excess of Canadian low-risk drinking guidelines – for 19 to 24 year olds this figure was 89.4%. These data provide support both for universal prevention strategies (e.g. reducing economic and physical availability of alcohol) as well as targeted interventions for risky drinkers (e.g. screening and brief interventions in primary health care settings).

Alcohol outlet density, perceived availability and adolescent alcohol use: a multilevel structural equation model

Objectives:Perceived availability is commonly associated with adolescent alcohol use. Little is known about the factors which shape this perceived availability. The present study investigates (1) whether perceived alcohol availability is...

The Contextual Role of Alcohol Outlet Density in College Drinking

The objective of the study is to examine the relationship between the physical availability of off-campus alcohol and drinking outcomes among college students. A multilevel analysis of students (N = 17,051) nested within college campuses (N = 32) was conducted. Four problem-drinking-related outcomes (i.e., average number of drinks when partying, frequency of drunkenness in past 2 weeks, 30-day frequency of drinking, and greatest number of drinks in one sitting) along with individual level covariates of drinking were introduced at the student level. The physical availability of alcohol was assessed as the number of on-premise and off-premise alcohol outlets within 3 miles of campus per 1,000 students enrolled. Higher densities of on-premise alcohol outlets were strongly related to drinking outcomes even after controlling for individual predictors of college drinking. The association indicated that the campus means for the average number of drinks when partying and the number of drinking occasions in the past 30 days were, respectively, 1.13 drinks and 1.32 occasions greater when the outlet density was 2 SDs higher. Off-campus, on-premise outlet density is strongly associated with college-drinking outcomes. Given the limited number of modifiable factors that affect college drinking, on-premise outlet density represents a potential modifiable means of addressing the problem.

A safe, sensible and social AHRSE: New Labour* and alcohol policy

When the Labour government came to power in the UK in 1997, it took over high and rising levels of alcohol consumption and alcohol-related harm. Contrary to 'old Labour''s views on alcohol policy, New Labour did nothing to reverse this trend, and, if anything, exacerbated it. Since New Labour has been in power, alcohol has become 40% more affordable; consumption has increased by 14% and alcohol-related deaths have increased by over 40%. New Labour viewed alcohol-related harm as a question of individual responsibility and, as expressed in its long awaited 2004 alcohol harm reduction strategy (commonly known as AHRSE), viewed partnerships with the alcohol industry as the solution to reducing harm. Ten years on we have safe, sensible and social, the 3Ss, AHRSE's next steps. On first reading it would seem that the government has learnt nothing from its mistakes of the previous ten years, and in its approach to alcohol policy continues to disable the public interest. Nevertheless, there remain areas where science might inform policy, including health sector policy where there is an emphasis on early diagnosis and treatment, and transport policy, where reducing the legal blood alcohol level to the European Commission maximum recommended level of 0.5g/L is again on the agenda. The 3Ss propose an independent review of the evidence of the relationship between alcohol price, promotion and harm. However, unless this fully reviews the international evidence of the relationship between the economic and physical availability of alcohol, the marketing of alcohol and alcohol related harm, AHRSE and its successor will continue to be a recipe for ineffectiveness.

Udviklingen i Danskernes Holdninger til Alkoholforbrug og Alkoholpolitiske Spørgsmål

Danish alcohol policy is known to be liberal even if from the middle of the 1990s it has been going in a more restrictive direction. The most important Danish policy instrument has been education and information, where policymakers have attempted to change alcohol habits by changing public attitudes to alcohol consumption and possible regulations. The aim of this article is to examine whether Danish attitudes to governmental alcohol policy instruments and regulations have changed during the last 20 years – and if so, what directions these changes have taken. Five surveys on alcohol consumption and opinions on different alcohol policy instruments and regulations – from 1984, 1989, 1994, 1997/98 and 2002 – have been examined. All five surveys are cross-sectional studies with populations of representative samples of the Danish population age 18”70 yrs. Comparative analysis has been carried out on questions from the different surveys relating to opinions on: alcohol prices and taxation, alcohol and work, drinking alcohol in public places, compulsory treatment, experienced harms and inconveniences caused by intoxicated persons, and the physical availability of alcohol. The results show that Danish attitudes on alcohol policy instruments and regulation seems to go in two directions – when it comes to prising and taxation, drinking in public places, and availability, the changes in attitudes point in a more liberal direction, while when it comes to young peoples access to alcohol, compulsory treatment, and intoxication, changes in attitudes point in a more restrictive direction.

Is the physical availability of alcohol and illicit drugs related to neighborhood rates of child maltreatment?

Objective: This study examines how the availability of alcohol and illicit drugs (as measured by alcohol outlet density and police incidents of drug sales and possessions) is related to neighborhood rates of child abuse and neglect, controlling for other neighborhood demographic characteristics. Method: Data from substantiated reports of child abuse and neglect in 304 block groups in a northern California city were analyzed using spatial regression techniques. Results: This study found that higher concentration of bars ( B = 6.66, p < .05) and higher numbers of incidents of drug possession ( B = .53, p < .001) were positively related to rates of child maltreatment in neighborhoods when controlling for neighborhood demographic characteristics. Thus, areas with more bars and drug possession incidents per 1000 population have higher rates of child maltreatment. Conclusions: The presence of more bars per population may represent a lack of resources available to residents, may increase the stress on neighborhoods by “attracting” populations prone to participating in dangerous activities, or increase the frequency of alcohol use that then leads to maltreatment. Areas with more drug possession incidents may also contribute to the overall level of neighborhood stress and disorganization or act as a marker for drug use that leads to maltreatment. These results suggest that the neighborhood substance availability may deserve special attention when developing preventive interventions to reduce child abuse and neglect in neighborhood areas.

Neighbourhood deprivation and alcohol consumption: does the availability of alcohol play a role?

Previous studies suggest that the physical availability of alcohol may mediate the association between neighbourhood-level material deprivation and alcohol consumption. This study tests the relationships between neighbourhood-level deprivation, alcohol availability, and individual-level alcohol consumption using a multilevel analysis. Data are from cross-sectional surveys conducted between 1979 and 1990 as part of the Stanford Heart Disease Prevention Program (SHDPP). Women and men (n = 8197) living in four northern/central California cities and 82 neighbourhoods were linked to neighbourhood deprivation variables derived from the US census (e.g. unemployment, crowded housing) and to measures of alcohol availability (density of outlets in the respondent's neighbourhood, nearest distance to an outlet from the respondent's home, and number of outlets within a half mile radius of the respondent's home). Separate analyses were conducted for on- and off-sale outlets. The most deprived neighbourhoods had substantially higher levels of alcohol outlet density than the least deprived neighbourhoods (45.5% vs 14.8%, respectively). However, multilevel analyses showed that the least deprived neighbourhoods were associated with the heaviest alcohol consumption, even after adjusting for individual-level sociodemographic characteristics (OR 1.30, CI 1.08-1.56). Alcohol availability was not associated with heavy drinking and thus did not mediate the relationship between neighbourhood deprivation and heavy alcohol consumption. Although alcohol availability is concentrated in the most deprived neighbourhoods, women and men in least deprived neighbourhoods are most likely to be heavy drinkers. This mismatch between supply and demand may cause people in the most deprived neighbourhoods to disproportionately suffer the negative health consequences of living near alcohol outlets.

Physical availability: A firm base for building the next decade of Alcohol research, policy and practice. Comment on Chapter 7: Regulating the physical availability of Alcohol

Physical availability: A firm base for building the next decade of Alcohol research, policy and practice. Comment on Chapter 7: Regulating the physical availability of Alcohol