Search

Background: Harmful alcohol consumption contributes to poorer health for all people. For Indigenous Peoples of Australia, Canada, and New Zealand alcohol impacts their wellbeing significantly, this is partially explained by both their experiences of colonisation and the resulting impact on structural and social determinants of health. Indigenous Peoples have a recognised right to self-determination, which includes their right to contribute to policy decisions that affect them. This right is based on international recognition and principles, and acknowledgement of historical culture and law. The aim of this narrative review is to examine the processes of inclusion of Indigenous Peoples in policy development processes for evidence of self-determination to inform alcohol policy development.Methods: Ninety-eight peer-reviewed journal articles were identified through four databases. Twenty papers describing the inclusion of Indigenous Peoples in policy development processes were included; one focusing on alcohol. Two authors reviewed and coded the papers by four domains of Indigenous inclusion in policy processes: Indigenous representation; method of inclusion; reasons for inclusion; and stage of inclusion.Results: There is no single model for the integration of self-determination into policy. However, the nature of participation is key in ensuring that Indigenous Peoples' self-determination is recognised. While all the papers reported Indigenous Peoples being included in processes, there was little evidence of self-determination.Conclusions: Self-determination is a right, and critical to effective policy and action. The inclusion of Indigenous Peoples in policy development alone is not self-determination; however, creating the conditions that ensures Indigenous Peoples have influence throughout policy processes is one integral component of self-determination. [ABSTRACT FROM AUTHOR]

Background: Unrecorded homemade alcohol consumption has been less examined in the literature. Previous studies of homemade alcohol in Russia have almost entirely focused upon the use of samogon (moonshine) attributed to the northern style of drinking. No systematic analysis is available regarding the production and consumption of homemade wine. This paper explores the drinking patterns demonstrated by consumers of samogon and homemade wine in Russia. The main factors affecting the consumption of these beverages are investigated.Methods: Data were collected from a 2014 nationwide survey of 14,986 respondents aged 15+ years. Beverage preferences, volume of consumed alcohol, drinking habits, and alcohol availability were the main measures reported. Demographic, socio-economic, spatial, and policy-related factors affecting homemade alcohol consumption are examined using logistic regression.Results: The percentages of samogon and homemade wine consumers were similar, although a greater volume of samogon in pure alcohol was consumed compared to homemade wine. The groups of samogon and homemade wine consumers showed very little overlap. Unlike homemade wine consumers, samogon drinkers consumed larger amounts of alcohol and were more engaged in frequent and excessive drinking, drinking without meals and drinking in marginal public settings. Gender, education, regional affiliation, and type of residence showed opposite associations with regard to the consumption of samogon and homemade wine. Availability of homemade alcohol in the neighbourhood was the most influential predictor due to respondents' own production, presence of homemade alcohol in friendship networks and at illegal market. The prices of manufactured alcohol and the consumption of homemade alcohol did not show significant relationships.Conclusion: Consumers of samogon and homemade wine demonstrate contrasting drinking patterns that are largely driven by different factors. Samogon is consumed in a more hazardous manner, whereas homemade wine is consumed in a more moderate and law-abiding way. Illegal commercial samogon should be a special concern for alcohol policy. [ABSTRACT FROM AUTHOR]

Background and Aims: There is little information on consumption patterns across the diverse range of cannabis product types. This paper examines trends in consumption patterns in Canada and the United States (US) between 2018-2020.Design: Repeat cross-sectional surveys were conducted as part of the International Cannabis Policy Study online survey in 2018 (n=27,024), 2019 (n=45,426), and 2020 (n=45,180).Setting: Respondents were recruited from commercial panels in Canada and US states that had and had not legalized non-medical cannabis (US 'legal' and 'illegal' states, respectively).Participants: Respondents were male and female participants aged 16-65 years.Measurements: Data on frequency and consumption amounts were collected for nine types of cannabis products, including dried flower and processed products (e.g., oils and concentrates). Consumers were also asked about mixing cannabis with tobacco. Socio-demographic information was collected.Findings: Dried flower was the most commonly used product, although use in the past 12 months declined between 2018 and 2020 in Canada (81% to 73%), US legal (78% to 72%) and illegal states (81% to 76%; p<0.05 for all). Prevalence of past 12-month use increased for virtually all other product forms, although prevalence of daily use remained stable across years. In 2020, edibles and vape oils were the most commonly used products after flower. Use of non-flower products was highest in US legal states, although similar trends were observed in all jurisdictions. Males were more likely to report using processed products, and vape oils were the most commonly processed product among 16-20-year-olds. Daily use of cannabis flower increased in US legal and illegal states, and average joint size increased across all jurisdictions over time.Conclusions: Dried flower remains the dominant product in Canada and the US; however, use of processed cannabis products has increased, with the largest increases observed in legal cannabis markets. [ABSTRACT FROM AUTHOR]

Background: Price-based policies are effective alcohol harm minimisation policy options. This paper examines public support for price-based policies based on patterns of consumption and expenditure, to determine if the extent to which an individual may be affected by a policy influences their support.Methods: The current study included 1,684 Australian residents (59.8% male, Mage 43.8 [SD=16.7]). Respondents who purchased and consumed alcohol in the past six months were asked about their support for potential changes in a series of price-based policies.Results: Increasing price was less likely to be supported than either implementing a minimum price or a tax-increase earmarked to pay for alcohol harms. Increasing price and taxing drinkers were more likely to be supported by older people and women. We found no relationship between income or perceived impact of price increases on purchasing and level of support.Conclusion: Contrary to the idea that public support might be partly influenced by ability to pay for alcohol, support for a minimum unit price was not related to price paid per drink or income, only amount consumed. Thus, heavier drinkers may be inherently unlikely to support price-based policies even when these policies would have little impact on their actual purchasing. [ABSTRACT FROM AUTHOR]

Background: Alcohol is a leading risk factor for death and disability globally. Due to the Islamic prohibition of alcohol consumption, alcohol policy is an under-studied and sensitive topic in Muslim majority countries (MMCs). In addition, drinkers in these countries may face barriers to treatment access due to stigma or the legal status of alcohol. Using Iran as a case study this paper explores how alcohol treatment is planned and delivered in the complex environment of an MMC.Method: We searched academic and grey literature, clinical manuals, guidelines and policy documents for information on the development and implementation of alcohol treatment policy in Iran. The search was conducted in English, Persian and Arabic. We conducted 6 consultations to verify information obtained. We analysed information based on the Walt & Gilson health policy analysis triangle, which identifies context, process, actors and content as key factors for understanding policy.Results: Iran initiated an alcohol-specific national strategy in 2011-2012 that aims to prevent, reduce and treat alcohol use disorders. This strategy has been designed to be implemented on a multi-sectoral level. Screening and prevention are mainly initiated in primary health care and cases are referred accordingly. Alcohol treatment is provided in specialised outpatient and inpatient settings. Due to contextual factors such as stigma, feasibility and affordability, alcohol outpatient units are planned to be integrated into existing public/ private drug addiction treatment facilities. However, the Ministry of Health has faced many challenges in implementing this pilot project. To date only small numbers of outpatient and inpatient units have formally commenced offering alcohol treatment.Conclusion: Implementing alcohol treatment has been challenging for Iran. Approval of new treatment programs may not be seen as a priority because of the low prevalence of alcohol use disorders in the country. Also, policy makers are implementing treatment services with caution due to the existing alcohol prohibition for the country's Muslim majority population. Barriers to treatment seeking need to be addressed at the micro and macro levels. Support from international agencies such as the WHO could assist MMCs to develop appropriate services that are feasible for their unique alcohol policy environment. [ABSTRACT FROM AUTHOR]