Rates Of Alcohol-related Harm Research Articles

Clarifying rural-urban disparities in alcohol-related emergency department visits and hospitalizations in Ontario, Canada: A spatial analysis.

Rates of alcohol-related harm are higher in rural versus urban Canada. This study characterized the spatial distribution and regional determinants of alcohol-related emergency department (ED) visits and hospitalizations in Ontario to better understand this rural-urban disparity. This was a cross-sectional spatial analysis of rates of alcohol-related ED visits and hospitalizations by Ministry of Health subregion (n = 76) in Ontario, Canada between 2016 and 2019. Regional hot- and cold-spots of alcohol-related harm were identified using spatial autocorrelation methods. Rurality was measured as the population weighted geographic remoteness of a subregion. The associations between rurality and rates of alcohol-related ED visits and hospitalizations were evaluated using hierarchical Bayesian spatial regression models. Rates of alcohol-related ED visits and hospitalizations varied substantially between subregions, with high rates clustering in Northern Ontario. Overall, increasing rurality was associated with higher subregion-level rates of alcohol-related ED visits (males adjusted relative rate [aRR]: 1.67, 95% credible interval [CI]: 1.49-1.87; females aRR: 1.78, 95% CI: 1.60-1.98) and hospitalizations (males aRR: 1.34, 95% CI: 1.24-1.45; females aRR: 1.59, 95% CI: 1.45-1.74). However, after the province was separated into Northern and Southern strata, this association only held in Northern subregions. In contrast, increasing rurality was associated with lower rates of alcohol-related ED visits in Southern subregions (males aRR: 0.87, 95% CI: 0.79-0.96; females aRR: 0.88, 95% CI: 0.81-0.97). There are regional differences in the association between rurality and alcohol-related health service use. This regional variation should be considered when developing health policies to minimize geographic disparities in alcohol-related harm.

The decline in youth drinking in England-is everyone drinking less? A quantile regression analysis.

Background and AimsYouth alcohol consumption has declined significantly during the past 15 years in many high‐income countries, which may have significant public health benefits. However, if the reductions in drinking occur mainly among lighter drinkers who are at lower risk, then rates of alcohol‐related harm among young people today and adults in future may not fall in line with consumption. There is conflicting evidence from Swedish school studies, with some suggesting that all young people are drinking less, while others suggest that alcohol consumption among heavier drinkers may be stable or rising while average consumption declines. This paper extends the geographical focus of previous research and examines whether the decline in youth drinking is consistent across the consumption distribution in England.DesignQuantile regression of 15 waves of repeat cross‐sectional survey data.SettingEngland, 2001–16.ParticipantsA total of 31 882 schoolchildren (50.7% male) aged 11–15 who responded to the Smoking Drinking and Drug Use among Young People surveys.MeasurementsPast‐week alcohol consumption in UK units at each fifth percentile of the consumption distribution.FindingsReductions in alcohol consumption occurred at all percentiles of the consumption distribution analysed between 2001 and 2016, but the magnitude of the decline differed across percentiles. The decline in consumption at the 90th percentile [β = −0.21, confidence interval (CI) = −0.24, −0.18] was significantly larger than among either lighter drinkers at the 50th percentile (β = −0.02, CI = −0.02, −0.01) or heavier drinkers at the 95th percentile (β = −0.16, CI = −0.18, −0.13).ConclusionsAlcohol consumption among young people in England appears to be declining across the consumption distribution, and peaks among heavy drinkers. The magnitude of this decline differs significantly between percentiles of the consumption distribution, with consumption falling proportionally less among the lightest, moderate and very heaviest youth drinkers.

Sexual orientation and alcohol-related harms in Canadian youth.

To determine associations between experiencing alcohol-related harm, sex, and sexual orientation among Canadian high school students. We used data from the 2012 Atlantic Student Drug Use Survey (ASDUS), including a comprehensive six-category measure of sexual orientation and nine different alcohol-related harms for analyses. Simple logistic regression was used to determine the association between experiencing any of the nine harms and each specific alcohol-related harm and sexual orientation, stratified by sex. Analysis was limited to those who indicated they had consumed alcohol in the year prior to the survey. High rates of having any alcohol-related harm were seen among both males (41.7%) and females (46.0%) attending Atlantic Canadian high schools. Mostly heterosexual males had a lower odds ratio for experiencing any alcohol-related harm compared to heterosexual males. Mostly heterosexual females and bisexual females had higher odds ratios for experiencing any alcohol-related harm than heterosexual females. High rates of alcohol-related harm in this population suggest that youth may benefit from a harm reduction approach to alcohol use. While we found that mostly heterosexual and bisexual female youth experience higher levels of alcohol-related harm than heterosexual females, further research is required to confirm this association and to determine its relevance to harm reduction strategies.

Of Course Sin Taxes are Regressive

There should be no debate about whether taxes on food, alcohol, tobacco and soft drinks (‘sin taxes’) are regressive. It can be easily demonstrated empirically, and countless studies have done so. As with most indirect taxes, they take a greater share of income from the poor than from the rich in all plausible scenarios. Sin taxes are regressive if we look at income groups and are even more regressive if we look at individual consumers. They are regressive in the short term and over the life-cycle. Alcohol taxes tend to be less regressive than tobacco and soft drink taxes as a result of high-income groups spending more money on alcoholic drinks, but they remain regressive in most countries. Some advocates for sin taxes claim that they produce health benefits that are progressive, i.e. they disproportionately benefit the poor. Decades of high taxes on tobacco and alcohol in many different countries suggest that this is not true. Despite very high rates of duty, smoking is much more common among low-income groups in Britain and whilst alcohol consumption is lower among these groups, rates of alcohol-related harm are considerably higher. Early evidence casts serious doubt on whether sugary drink taxes have ‘progressive’ health benefits either. Low-income consumers do not seem to have particularly elastic demand for sugary drinks. Even if they enjoyed disproportionate health gains from sin taxes, they would still suffer a net loss to their welfare and the tax would remain regressive in the traditional sense. Excise taxes raise significant sums of money and are relatively easy to collect. It is unrealistic to expect government to be entirely funded by taxes on the rich. Not every part of the tax system can be progressive, but advocates should be honest about the disproportionately high burden of sin taxes on low-income households.

Drinking Refusal Self-Efficacy and Intended Alcohol Consumption During a Mass-Attended Youth Event

ABSTRACTBackground: Mass-attended youth events represent a substantial public health challenge due to high levels of alcohol consumption and corresponding high rates of alcohol-related harm. Although previous research has documented the protective effect of high drinking refusal self-efficacy (DRSE) on alcohol consumption in general, there is a lack of research examining the role of DRSE in reducing consumption during mass-attended youth events and the factors associated with DRSE in these contexts. Objectives: This study aimed to identify potentially modifiable factors that influence DRSE and drinking intentions to inform interventions designed to reduce alcohol-related harm during mass-attended events. Methods: Australian secondary school students (n = 586; 70% female) in their final two years of high school completed an online survey assessing their alcohol consumption intentions for Schoolies, their perceived degree of DRSE, and other individual and environmental factors. Path analysis was used to assess a mediational model examining factors associated with DRSE and alcohol consumption intentions. Results: DRSE was found to be significantly associated with intended alcohol consumption during Schoolies. Specifically, leavers who believed they would not be able to refuse others' offers of alcoholic drinks reported significantly greater alcohol consumption intentions. Results also revealed that DRSE was enhanced in those respondents who believed there would be a variety of non-drinking activities and non-alcoholic beverages available to them during Schoolies. Conclusion: Results suggest the need to increase leavers' confidence in their ability to refuse unwanted alcoholic beverages and highlight the importance of providing celebration options that do not involve alcohol consumption.

Evaluating the impact of a multi-buy discount ban on off-trade alcohol sales: a natural experiment in Scotland, 2009-2012

Introduction Scotland has one of the highest rates of alcohol-related harm in western and central Europe. In October 2011, the Scottish Government implemented a ban on multi-buy discounts of off-trade alcohol. The aim of this study was to assess the impact of this legislation on alcohol sales, which provide the best indicator of population consumption. Methods We obtained weekly data on the volume of pure alcohol sold off-trade in Scotland and England & Wales between …

Harm Caused by Different Beverage Types—A Recurring Question

This publication is one of two thematic journal issues produced by the project Trouble per liter - The effects of policies favoring lighter beverages. The project's origins date back to March 2007, when Nordic and Russian alcohol researchers met up for a research-based alcohol policy conference in Moscow. During the meeting it became evident that, from a Russian point of view, the historic Nordic drinking trend away from a domination of distilled spirits towards a more mixed pattern, with beer playing a major role, could be interpreted as a successful result of a long-term alcohol policy strategy. Had a conscious steering of the overall consumption towards a preference of lighter-alcohol-content products indeed led to a more moderate and less harmful consumption style in the Nordic countries? The Nordic researchers were struck by the lack of evidence in this area. Could the claim of a successful policy be proven true or false - had larger shares of lighter beverages decreased overall rates of alcohol-related harm - even if the effect was measured, for example, per liter of ethanol consumed?To look into the matter, an international project group was established in 2009 with the support of the Nordic committee of senior civil servants of the social and health field.* At a scientific meeting in Copenhagen in the spring of 2011, results were presented from the separate inquiries. In this issue of Contemporary Drug Problems, five studies by members of the project group examine how consumption of different beverage types are connected to harm. While Ramstedt and Boman, Kerr and Ye, Makela, and Landberg frame their inquiries in a country-specific context, Room et al. investigate study material collected from 19 countries. Each addresses the same issue, i.e. the relationship between beverage choice and harm from drinking, but each from a different viewpoint and type of data. Kerr and Ye review United States studies that have conducted time-series analyses on the connection between per capita consumption of different beverages and various harm rates, and present a new such analysis for motor vehicle accident mortality. Landberg uses time-series data from Sweden to ask whether different beverages have had a different temporal correlation with harm rates, and whether spirits drinking has had an effect on harms over and above the effect of total consumption. Makela, using both aggregate-level and individual-level data, also takes a long-term view, but instead of studying beveragespecific consumption changes, she looks at the history as a test case of whether the change towards milder beverages has brought about the wished-for moderation of drinking patterns and a lowering of harms per liter of total alcohol consumption. Ramstedt and Boman use cross-sectional individual-level data from Sweden to study the interrelationships between beverage choice, drinking patterns, characteristics of drinkers, and harm from drinking. Room et al. present a cross-cultural comparison across a number of countries of the cross-sectional associations between beverage type and harms. On the basis of the results and discussions in the articles, conclusions have been drawn in a summary by Makela et al. at the end of the issue.As a group of studies, these articles illustrate the importance of posing beverage-specific questions in alcohol research. After all, we do not say that we will go out for a glass of alcohol, but rather for a glass of wine or a beer. Likewise, when policy decisions are made regarding taxation or availability restrictions, these are often made on particular beverage types, or groups of products, rather than expressed as restrictions on alcohol.There is a long-lived dream of a better order (Olsson, 1990, p. 193) in the Nordic countries, with the goal epitomized by the wine-drinking cultures of Southern Europe. According to this vision, alcohol plays a central role in such societies, but a less dramatic role, with fewer incidents of intoxication and alcohol-related violence. …

Recent trends in risky alcohol consumption and related harm among young people in Victoria, Australia

To examine recent trends in the proportion of young people who drink at risky levels and the rate of alcohol-related harms experienced by young people in Victoria, Australia. The study uses published data from a series of surveys that ask questions relating to alcohol consumption to ascertain whether the proportion of young people drinking at risky levels has increased over the time period in which data are available. Alcohol-caused hospital admissions and emergency department presentations for young people are also examined over recent years to assess trends in alcohol-related harms. The survey data shows mixed results, with no clear trend in the rate of risky drinking among young people. The harms data suggests that rates of alcohol-related harm, particularly acute intoxication, have increased dramatically over recent years. The relationship between survey-derived estimates of alcohol consumption and rates of alcohol-related harms is not as clear-cut as expected, and raise concerns about the sensitivity of population surveys in detecting changes in harmful drinking patterns. The current increasing trends in alcohol-related harms for young people in Victoria suggest the need for immediate public health interventions.

Upward Trends in Alcohol Consumption and Related Harm in Finland

Aim Our aim was to study whether the development in the rates of harm still follows the development in per capita alcohol consumption, and to clarify the relationship between alcohol consumption and related harms by paying attention to third factors affecting this relationship. Data Statistics on alcohol consumption and alcohol-related harm associated with the maintenance of public order and safety alcohol-related deaths and hospitalizations, and treatment for alcohol problems in the period 1990–2004. Analysis In the last 15 years, alcohol consumption in Finland first decreased during the economic recession of the early 1990s, and then increased almost constantly. Some harm series roughly followed these consumption trends, and for some others the connection with alcohol consumption became obvious when the effect of some third factor was taken into account. Harm rates also increased in 2004 when alcohol consumption increased by 10% after a decrease of alcohol excise duty rates of 33% on average. Conclusions In Finland changes in alcohol consumption are still today followed by changes in rates of alcohol-related harm.

Total versus hazardous per capita alcohol consumption as predictors of acute and chronic alcohol-related harm

This paper is a preliminary attempt to compare the power of different measures of alcohol consumption to predict variations in rates of alcohol-related harm across 130 adjacent geographical areas comprising the state of Western Australia (WA). It has been argued recently that there may be both scientific and political advantages to replacing, where possible, estimates of per capita total consumption of alcohol with estimates of hazardous consumption.' The arguments favoring this view include: (i) evidence that frequency of heavy drinking occasions predicts self-reported alcohol-related harm in population surveys to a greater degree than does average daily intake;2 (ii) evidence that prevention strategies that overtly target total population consumption are less well received by the voting public than those that target high-risk drinking or actual harm.3 To date this evidence has accumulated mainly from survey data. The present study attempts to examine the issue of predictive power in relation to rates of actual harm as indicated by traffic, health and police statistics for WA and of rates of alcohol consumption derived from both wholesale and survey data. Alcohol consumption is reported in a variety of ways to suit different purposes. For example, surveys frequently report the number of people whose average daily consumption exceeds levels considered to be harmful by Australia's peak medical research body' (e.g., 6% men and 3% women-). We are often told about per capita alcohol consumption-e.g., in 1993 the average Australian adult consumed 9.4 liters of absolute alcohol.6 What is not reported, however, is how much of this consumption is low risk or even beneficial (e.g., in terms of protecting the drinker against ischemic heart disease') and how much would be considered medium or high risk. A method for making such estimates from consumption survey data was described recently, which resulted in the calculation that almost one-third of all alcohol consumed in WA was at a harmful level.8 This method is adapted in this paper to calculate the proportion of total alcohol consumption in 130 regions of WA that is, to use a more conservative term, hazardous. Most other studies of drinking patterns have estimated these in terms of the frequency of heavy drinking occasions-e.g., drinking more than five standard drinks.2 The measure used here combines both frequency and the quantity consumed on such occasions and may thus combine the advantages of measures of both pattern and volume of drinking in one variable. This study is an early product of a research program entitled Measurement of Alcohol Problems for Policy (MAPP). This program brings together for the first time a number of statewide data sets that include measures or likely indicators of alcohol consumption and related harm. The relationships between these various measures and other sociodemographic variables have so far been explored for the financial year 1991-1992.9 The eventual aim of the MAPP project is to identify those indicators that are most sensitive to variations in consumption and harm across different geographical regions and over time. It is hoped this will enable prevention strategies to be better targeted, monitored and evaluated. In the road safety research area, a surrogate measure of alcohol-related crashes has been developed to overcome the problem of estimating alcohol-relatedness: single-vehicle nighttime accidents. These have been shown repeatedly to involve mostly drunk drivers and are now used routinely in the evaluation of major statewide prevention initiatives that target drinking and driving.'o It is likely that similar surrogate measures can be developed for other problem domains. For example, in a study of alcohol use and violence, Ireland and Thommeny reported that 91% of street offenses committed between 10 pm and 2 am involve prior consumption of alcohol. The first report of the MAPP project examined a number of potential harm indicators in the domains of road crashes, hospital morbidity data, drink driving, and assault offenses! …