Search

Issues: Numerous studies have explored alcohol consumption in pregnancy, but less is known about women's drinking in the early parenting period (EPP, 0–5 years after childbirth). We synthesise research related to three questions: (i) How are women's drinking patterns and trajectories associated with socio‐demographic and domestic circumstances?; (ii) What theoretical approaches are used to explain changes in consumption?; (iii) What meanings have been given to mothers' drinking? Approach: Three databases (Ovid‐MEDLINE, Ovid‐PsycINFO and CINAHL) were systematically searched. Citation tracking was conducted in Web of Science Citation Index and Google Scholar. Eligible papers explored mothers' alcohol consumption during the EPP, focusing on general population rather than clinical samples. Studies were critically appraised and their characteristics, methods and key findings extracted. Thematic narrative synthesis of findings was conducted. Key Findings: Fourteen quantitative and six qualitative studies were identified. The (sub)samples ranged from n = 77,137 to n = 21 women. Mothers' consumption levels were associated with older age, being White and employed, not being in a partnered relationship, higher education and income. Three theoretical approaches were employed to explain these consumption differences: social role, role deprivation, social practice theories. By drinking alcohol, mothers expressed numerous aspects of their identity (e.g., autonomous women and responsible mothers). Implications and Conclusion: Alcohol‐related interventions and policies should consider demographic and cultural transformations of motherhood (e.g., delayed motherhood, changes in family structures). Mothers' drinking should be contextualised carefully in relation to socio‐economic circumstances and gender inequalities in unpaid labour. The focus on peer‐reviewed academic papers in English language may limit the evidence. [ABSTRACT FROM AUTHOR]

Issues: Globally, adolescent drinking is a major public health concern. Alcohol measurements are influenced by local consumption practices, patterns and perceptions of alcohol‐related harm. This is the first review to examine what tools are used to measure alcohol consumption, or screen for or assess harmful use in African adolescents, and how these tools take into account the local context. Approach: A systematic scoping review was conducted in line with the Arksey and O'Malley framework. A search in MEDLINE, CINAHL, Global Health and the Cochrane Database covered the period of 2000–2020. Key Findings: The search identified 121 papers across 25 African countries. A range of single‐ and multi‐item tools were identified. Very few adaptations of existing questions were specified, and this search identified no tools developed by local researchers that were fundamentally different from established tools often designed in the USA or Europe. Inconsistencies were found in the use of cut‐off scores; many studies used adult cut‐off scores. Implications and Conclusion: The possible impact of African drinking practices and culture on the accuracy of alcohol screening tools is currently unknown, but is also not taken into account by most research. This, in combination with a limited geographical distribution of alcohol‐related research across the continent and inconsistent use of age‐ and gender‐specific cut‐off scores, points towards probable inaccuracies in current data on adolescent alcohol use in Africa. [ABSTRACT FROM AUTHOR]

Issues: Meta‐analysis was used to estimate the effect of forming implementation intentions (i.e., if‐then plans) on weekly alcohol consumption and heavy episodic drinking (HED). Sample type, mode of delivery, intervention format and timeframe were tested as moderator variables. Approach: Cochrane, EThOS, Google Scholar, PsychArticles, PubMed and Web of Science were searched for relevant publications to 31 March 2021. Random‐effects meta‐analysis was used to estimate the effect size difference (d) between individuals forming versus not forming implementation intentions on weekly consumption and HED. Key Findings: Sixteen studies were included in meta‐analyses. The effect size difference for forming implementation intentions on weekly alcohol consumption was d+ = −0.14 confidence interval (CI) [−0.24; −0.03]. Moderator analyses highlighted stronger effects for: (i) community (d+ = −0.38, CI [−0.58; −0.18]) versus university (d+ = −0.04, CI [−0.13; 0.05]) samples; (ii) paper (d+ = −0.26, CI [−0.43; −0.09]) versus online (d+ = −0.04, CI [−0.14; 0.06]) mode of delivery; and (iii) volitional help sheet (d+ = −0.34, CI [−0.60; −0.07]) versus implementation intention format (d+ = −0.07, CI [−0.16; 0.02]). In addition, effects diminished over time (B = 0.02, SE = 0.01, CI [0.03; 0.01]). Forming implementation intentions had a null effect on HED, d+ = −0.01 CI [−0.10; 0.08]. Implications: Forming implementation intentions reduces weekly consumption but has no effect on HED. Conclusion: This review identifies boundary conditions on the effectiveness of implementation intentions to reduce alcohol consumption. Future research should focus on increasing the effectiveness of online‐delivered interventions and integrating implementation intention and motivational interventions. [ABSTRACT FROM AUTHOR]

Several initiatives have sought to increase the number of First Nations individuals with a higher degree in research (i.e., PhD or research masters)—in Australia and in similarly colonised countries. However, little has been written on day‐to‐day support structures and mechanisms that might help First Nations Australian candidates thrive in postgraduate research degrees and beyond. For sensitive research fields such as alcohol, emerging Aboriginal and Torres Strait Islander researchers must grapple with topics which are stigmatising and in some instances associated with traumatic associations. There is also a lack of studies internationally that describe optimal support for First Nations students undertaking a higher degree by research with a primary focus on alcohol. Here we discuss what we have learned from the support offered through the Centre of Research Excellence in Indigenous Health and Alcohol—from the perspective of academic staff, students, trainees and early career researchers. We consider what may be generalisable lessons from this experience. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol screening, brief advice and referral to treatment (SBIRT) in primary health care is an effective strategy to decrease alcohol consumption at population level. However, there is relatively scarce evidence regarding its economic returns in non‐high‐income countries. The current paper aims to estimate the return‐on‐investment of implementing a SBIRT program in Mexican primary health‐care settings. Methods: Empirical data was collected in a quasi‐experimental study, from 17 primary health‐care centres in Mexico City regarding alcohol screening delivered by 145 health‐care providers. This data was combined with data from a simulation study for a period of 10 years (2008 to 2017). Economic investments were calculated from a public sector health‐care perspective as clinical consultation costs (salary and material costs) and program costs (set‐up, adaptation, implementation strategies). Economic return was calculated as monetary gains in the public sector health‐care, estimated via simulated reductions in alcohol consumption, dependent on population coverage of alcohol interventions delivered to primary health‐care patients. Results: Results showed that scaling up a SBIRT program in Mexico over a 10‐year period would lead to positive return‐on‐investment values ranging between 21% in scenario 4 (confidence interval −8.6%, 79.5%) and 110% in scenario 5 (confidence interval 51.5%, 239.8%). Moreover, over the 10‐year period, up to 16,000 alcohol‐related deaths could be avoided as a result of implementing the program. Discussion and Conclusions: SBIRT implemented at national level in Mexico may lead to substantial financial gains from a public sector health‐care perspective. [ABSTRACT FROM AUTHOR]

Introduction: Evidence shows that price is an important policy lever in reducing consumption of alcohol and tobacco. However, there is little evidence of the cross‐price effect between alcohol and tobacco. Methods: This paper uses an econometric model which estimates participation and consumption elasticities, on data from the UK Living Costs and Food Survey 2006–2017 and extends the literature by, for the first time, estimating joint price elasticities for disaggregated alcohol and tobacco products. This paper presents new price elasticities and compares them to the existing literature. Results: The own‐price elasticity estimates are all negative for both participation and consumption. There is no pattern to the estimates of cross‐price elasticities. The elasticity estimates, when used in the Sheffield Tobacco and Alcohol Policy Model, produce bigger changes in consumption for the same change in price compared to other elasticity estimates in the existing literature. Discussion and Conclusions: Consumption of alcohol and tobacco are affected by the prices of one another. Policymakers should bear this in mind when devising alcohol or tobacco pricing policies. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion and Conclusions Reducing alcohol availability and restricting alcohol advertising are effective ways to reduce harm from alcohol. Implementation of public health policies involves collaboration between different stakeholders, and is influenced by public opinion. This paper explores public and professional stakeholders' perceptions of alcohol advertising and availability policies. It is the first to capture consensus and divergence in narratives of these stakeholders.We conducted semi‐structured interviews with 14 stakeholders from third sector organisations, government, public health and alcohol licensing in Scotland. We conducted 11 online focus groups with 45 participants, living in neighbourhoods in Scotland characterised by varying levels of urbanity, deprivation and retail density change. We gave participants a list of policies and discussed their views on acceptability, feasibility and likely success.Despite general consensus that regulation of alcohol advertising is an important priority, public stakeholders were concerned about the feasibility of advertising interventions and potential unintended consequences. While professional stakeholders were in favour of regulating alcohol availability, public stakeholders had misgivings about feasibility and effectiveness. When prompted to discuss specific interventions, similar views about protecting children and achieving cultural change emerged.This study highlights the importance of policy makers and other stakeholders to consider public stakeholders' opinions on alcohol policy and understanding that their views may be influenced by competing framings of alcohol problems. Attempts to increase support for alcohol control policies need to consider people's concerns about the effectiveness and potential unintended consequences of these policies, and the wider social context of alcohol consumption. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion and Conclusions This paper aims to produce a comprehensive estimate of alcohol's harm to others (AHTO) from strangers among Australia adults in 2021. This survey was undertaken during COVID‐19 and aims to compare AHTO results with those from 12 years before and identify differences across socio‐demographics.Cross‐sectional data of 2574 Australian adults were collected in November 2021 via two survey modes: random digit dialling and the Life in Australia™ panel. Questions pertained to harms from the drinking of known and unknown others (‘strangers’) in the previous 12 months. Multivariable logistic regression is used to analyse differences in the experience of AHTO from strangers across age, gender and other socio‐demographics.Under half of Australian adults reported experiencing AHTO from a stranger (42.2%) during the period of COVID‐19. Women were at significantly higher odds of reporting harm than men. Significantly higher percentages of participants aged 18–49 reported harm than those 65 and over. Rates of experience of harm from strangers' drinking varied between different Australian regions. Adults engaging in less frequent risky drinking (less than 4 days a month) reported significantly greater experiences of harm than those not engaging in risky drinking in the past year.The current study provides a national estimate of AHTO from strangers in Australia during the COVID‐19 pandemic. Finding greater risk of experiencing AHTO from strangers among women than men differs from previous AHTO literature, and further research is required to determine if this is an emerging trend. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol's harm to others (AHTO) refers to harms caused to those other than the drinker. The current paper estimates the prevalence of formal and informal supports sought due to AHTO and examines whether the type of support accessed varies by sociodemographic, economic and harm‐related characteristics. Methods: An Australian sample of 2574 people completed the 2021 AHTO survey, out of which 888 perceived they experienced harm from another's drinking. Prevalence of accessing services and supports was measured. Additionally, several sociodemographic factors, economic factors and harm‐related factors were included in multivariable logistic regression models predicting service/support use. Specifically, four models were constructed probing use of any service/support, use of police, use of counselling services and use of family/friend support. Results: Of the survey sample, 12.4% accessed any support/service. Seeking support from family and/or friends was most common, followed by police, counselling, healthcare services and being admitted to hospital. Women had higher odds of accessing counselling and family/friend support. Respondents with a higher education level and two or more financial stressors had higher odds of accessing police and counselling. Respondents harmed by a stranger had higher odds of accessing police, whereas respondents harmed by someone they know had higher odds of seeking support from family/friends. Experiencing more severe harm was associated with greater odds of accessing any support. Discussion and Conclusions: Several sociodemographic and economic factors were associated with accessing different supports. These findings may inform service development, interventions and policy changes for people affected by others' drinking. [ABSTRACT FROM AUTHOR]

Introduction: The current paper examines the proportion of drinking occasions and total alcohol consumed that takes place at off‐premise locations. Comparisons are made between high‐income countries: Australia, New Zealand, England and Scotland, and across drinker‐types: high‐risk and lower‐risk. Methods: Data were taken from the International Alcohol Control study in Australia (N = 1789), New Zealand (N = 1979), England (N = 2844) and Scotland (N = 1864). The cross‐national survey measures location and beverage‐specific alcohol consumption. The number of drinking occasions and mean consumption across on‐ and off‐premise locations and the proportion of drinking occasions that high‐ and lower‐risk drinkers had at on‐ and off‐premise locations was estimated for each country. Results: The majority of drinking occasions among high‐risk drinkers occurred at off‐premise locations across all four countries; Australia 80.1%, New Zealand 72.0%, England 61.7% and Scotland 60.7%. High‐risk drinkers in Australia had significantly larger proportions of drinking occasions occurring at off‐premise locations compared to England and Scotland. Across all countries, high‐risk drinkers and lower‐risk drinkers consumed significantly larger quantities of alcohol per occasion at off‐premise locations compared to on‐premises locations. Finally, the majority of total alcohol consumed occurred at off‐premise locations across all countries for high‐ and lower‐risk drinkers. Discussion and Conclusions: As the accessibility to alcohol outside of licensed premises continues to increase, particularly with the expansion of home delivery services, it is important to be mindful of the high proportion of heavy drinking occasions that occur off‐premise. [ABSTRACT FROM AUTHOR]

Introduction: Excessive alcohol use is associated with non‐communicable diseases and social problems, such as work absence, financial problems and family violence. Expenditure and expenditure shares on alcohol are valuable measures to monitor financial activities on this risk behaviour. The aim of this paper is to report trends in alcohol expenditure in Australia over the last two decades. Methods: Data are from six waves of Australian Household Expenditure Surveys from 1984 to 2015–2016. We explored trends of alcohol expenditure among Australians and in different socio‐demographic groups in the last 30 years. We further examined changes of expenditure on different on‐ and off‐premises beverages over time. Results: Absolute alcohol expenditure has remained the same between the 1980s and 2016, after accounting for inflation. However, a declining trend in relative alcohol expenditure as a proportion of total household expenditure was found across nearly all demographic groups (e.g., sex, age, employment, household income), except for women aged 45–54, who showed an increasing trend of alcohol expenditure after 1998–1999. Discussion and Conclusions: The current study shows declines in relative alcohol expenditure, which may reflect declines in alcohol's relative importance within the elements of the person's lifestyle they need to pay for and/or increased awareness of alcohol's health and social harms. Further longitudinal analysis should explore additional predictors of household expenditure on alcohol. Results suggest that current bi‐annual indexation increases in alcohol tax should account for increases in income to ensure the effectiveness of pricing. Moreover, attention is needed to address drinking among middle‐aged females. [ABSTRACT FROM AUTHOR]

Introduction: In 2015/2016 controversy followed the publication of a report on an anthropological study of Australian and New Zealand night‐time economies funded by a major alcohol producer. This paper explores the background, moments of public controversy and political uses of the report. Methods: Informed by the sociology of scientific controversies, we review the available relevant work of the author of the report, associated material such as press releases, newspaper articles (n = 18) and industry submissions to government (n = 12). Attention was paid to the ways in which claims were made about the relationship between alcohol and violence, and the ways in which credibility and legitimacy were constructed. Results: The author of the report has longstanding associations with alcohol industry organisations. Claims made regarding alcohol and violence have remained highly consistent over time, and appear oblivious to developments in the evidence. In the media, the story was largely framed as a contest of credibility between compromised parties. The report continues to be used in alcohol industry submissions to government. Discussion and Conclusions: This analysis suggests that this is a 'counterfeit scientific controversy'; in our assessment, the report has had value not as a contribution to the scientific literature, but as a resource in the claims‐making practices of the alcohol industry. Studies of the ways in which industry actors foster science‐related content conducted at significant social and conceptual distance from the core of the relevant research community will enhance understandings of the ways in which industry actors engage with science and policy. [ABSTRACT FROM AUTHOR]

Introduction: Before COVID‐19, Native Hawaiians/Pacific Islanders (NH/PI) endured a heavy burden of alcohol, tobacco and other drug (ATOD) use in prior US data. Responding to reports that many NH/PI communities experienced severe COVID‐19 disparities that could exacerbate their ATOD burden, we partnered with NH/PI communities to assess the substance use patterns and treatment needs of diverse NH/PIs during COVID‐19. Methods: Collaborating with NH/PI community organisations across five states with large NH/PI populations, we conducted a large‐scale investigation of NH/PI ATOD use, mental health and treatment need during COVID‐19. Between April and November 2021, NH/PI‐heritage research staff from our community partners collected data involving 306 NH/PI adults using several community‐based recruitment methods (e‐mail, telephone, in‐person) and two survey approaches: online and paper‐and‐pencil. Multivariate regressions were conducted to examine potential predictors of NH/PI alcohol use disorder and need for behavioural health treatment. Results: During COVID‐19, 47% and 22% of NH/PI adults reported current alcohol and cigarette use, while 35% reported lifetime illicit substance use (e.g., cannabis, opioid). Depression and anxiety were high, and alcohol use disorder, major depression and generalised anxiety disorder prevalence were 27%, 27% and 19%, respectively. One‐third of participants reported past‐year treatment need with lifetime illicit substance use, COVID‐19 distress and major depression respectively associating with 3.0, 1.2, and 5.3 times greater adjusted odds for needing treatment. Conclusions: NH/PI adults reported heavy ATOD use, depression, anxiety and treatment need during COVID‐19. Targeted research and treatment services may be warranted to mitigate COVID‐19's negative behavioural health impact on NH/PI communities. [ABSTRACT FROM AUTHOR]

A recent paper in Drug and Alcohol Review analysed the information on cancer disseminated by 27 alcohol industry funded organisations. The independent UK alcohol education charity Drinkaware was among the organisations whose information was studied, and based on the analysis claims were made of misrepresentation of evidence about the alcohol-related risk of cancer and alcohol industry influence. This commentary challenges the validity of these findings in respect to the evidence relating to the Drinkaware information, as the analysis is found to be misrepresenting the information by both disregarding the wider information content provided and the order and prominence with which alcohol-related cancer risk is presented. Furthermore, it is argued that the public has a right to be provided with relevant evidence-based information about cancer risk. It is critical that Drinkaware's important public health function is not compromised by unjustified allegations of inaccuracy and by unwarranted attacks on its independence and integrity. [ABSTRACT FROM AUTHOR]

Within the global context, Eastern Europe has been repeatedly identified as the area with the highest levels of alcohol-related health harms. Although the Berlin Wall fell in 1989, and the Soviet Union collapsed soon afterwards, alcohol-related mortality in Eastern Europe remains far higher than in Western Europe. However, despite the high burden of alcohol harm and mortality in Eastern Europe, with the partial exception of Russia, relatively little is known about the country-specific impact of alcohol on health and mortality and the various policy responses to it. In response to this, an international symposium was held in Vilnius, Lithuania in June 2017 entitled Persisting burden of alcohol in Central and Eastern Europe: recent evidence and measurement issues. This special section of Drug and Alcohol Review is based on a selection of the papers presented at this symposium, providing for the first time a broad overview of the problem of alcohol-related mortality in a diverse range of Eastern European countries linked to a description and analysis of alcohol control initiatives that have been developed. While there is strong evidence of the influence of history, culture and education across European countries having a profound and persistent effect on differences in drinking patterns and preferences, there is, nevertheless, evidence that effective policy responses have been mounted in a range of countries. [ABSTRACT FROM AUTHOR]

Introduction: As a result of COVID‐19 and associated lockdown restrictions, children may have been exposed to more home‐based alcohol consumption and parents' drinking practices. This paper explores Australian parents' perceptions of their children's awareness of drinking and their reflections on the impact of COVID‐19 on children's exposure and acquisition of alcohol‐related knowledge. Methods: In‐depth interviews were undertaken with 30 parents and carers of children aged four to 12 years from across Australia. Participants described their family lives, the role of alcohol, any changes in alcohol and family dynamics experienced because of COVID‐19 and their children's exposure and knowledge of alcohol before and during their experience of COVID‐19. Using social learning theory as a guiding framework, transcripts were analysed to identify relevant themes. Results: Pre‐COVID‐19 children were commonly thought to be aware of behavioural changes owing to alcohol consumption, made associations between people, beverages and activities and recognised boundaries around consumption. COVID‐19 was suggested to have impacted the environments in which children were exposed and the types of modelling and practices they were exposed to. It was more common for participants to describe COVID‐19 affecting other children's learning and knowledge of alcohol, rather than their own. Discussion and Conclusions: Participants were mindful of children's knowledge and the role they played in modelling consumption practices prior to and during the COVID‐19 lockdowns. There may be scope to use the insights provided here to support parents in modelling approaches and engaging with children about alcohol in ways that challenge or disrupt its prominence or acceptability. [ABSTRACT FROM AUTHOR]

Introduction: The closure of licensed venues during the COVID‐19 pandemic meant that most alcohol has been consumed at home during lockdown periods in the UK, a phenomenon that remains under‐researched despite the public health implications. Methods: This article draws on a study consisting of online semi‐structured interviews and focus groups with 20 UK drinkers, conducted between the first and second 2020 UK lockdowns. The study aimed to explore changing and enduring UK drinking practices within home spaces during the pandemic. Results: Our findings illuminate specific ways in which assemblages and contextual factors may come together to encourage or mitigate against the consumption of any (or excessive) volumes of alcohol at home during the lockdown. For example, the physical presence of alcohol bottles may both encourage consumption (e.g. compulsion to finish an open bottle of wine) and cue reflection on one's drinking (through the potentially confronting presence of empty bottles after domestic drinking). We also highlight the significance of the home as a space separate from—and different to—public drinking spaces. Discussion and Conclusions: With the increasing normalisation of domestic drinking during a global pandemic, this paper illuminates several factors that may encourage or curtail domestic alcohol consumption and invites us to consider the importance of assemblages, space and context. Such findings have wider applicability; for example, consideration of specific (and perhaps unique) push and pull factors of home spaces could inform future alcohol policy, health promotion messages and how guidance around 'moderation' or risky drinking is communicated. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Liquor permits were once used throughout Scandinavia and North America for managing alcohol, but largely disappeared in the late 20th century. Today, they are used in some Indigenous communities in Nunavut, Canada and the Northern Territory, Australia. This paper examines the extent to which liquor permits: (i) contribute to reducing alcohol-related harms in Indigenous communities; and (ii) offer a viable mechanism for managing alcohol in Indigenous communities.Design and Methods: The study draws on published and unpublished international literature on liquor permit systems in Indigenous communities, and on field visits to northern territory (NT) communities.Results: Apart from one anecdotal report, the study found no evidence that liquor permit systems in Nunavut communities have reduced alcohol-related problems. In the NT, they have reduced alcohol-related harms in some communities. However, management of liquor permit systems generates significant administrative demands in communities.Discussion and Conclusions: Effectiveness of liquor permit systems is a product of five factors: permits themselves; agencies and procedures for issuing and managing permits; agencies and procedures for supplying liquor; enforcement of permit conditions, and the presence of other agencies-legal and illegal-affecting supply and consumption of liquor. Liquor permits continue to be valued by some Indigenous communities for managing alcohol. This study suggests that they can do so provided: (i) agencies administering permits have adequate support; (ii) controls over non-legal purchasing and consumption of liquor are effective, and (iii) the permit system is viewed in the community as legitimate, equitable and transparent. [ABSTRACT FROM AUTHOR]

Introduction: Prison‐based drug and alcohol group treatment programs operate in all Australian jurisdictions. With more than two‐thirds of people in prison having a history of substance use prior to incarceration, such programs are needed. There have been few published papers on the impact of attending group treatment programs in Australian prisons, and the research published to date has been predominately quantitative. We aim to report the experiences of males in prison who completed and those who did not complete a group‐based drug and alcohol program, to gain insight into their strategies for reducing harm from drug and alcohol post‐release. Methods: Qualitative thematic analysis of in‐depth interviews with 12 males who completed or were about to complete and 10 males who discontinued a prison‐based group drug and alcohol treatment program. Results: Program completers were more likely to have well‐developed plans to reduce drug and alcohol harms and maintain abstinence upon return to the community, which included creating healthier social networks. They also showed stronger insights into the factors that led to offending. Those who did not complete the drug and alcohol program appeared to rely on self‐will as the main way to reduce drug and alcohol harms, with less awareness of options for support services to reduce or stop drug and alcohol use. Discussion and Conclusions: Prison‐based drug and alcohol program engagement imparted useful information for program completers. Controlled trials are needed to examine whether such differences equate to improved outcomes after release. [ABSTRACT FROM AUTHOR]

Introduction and Aims To review the results of five research projects commissioned to enhance alcohol treatment among Aboriginal Australians, and to highlight arising from them. Design and Methods Drafts of the papers were workshopped by project representatives, final papers reviewed and results summarised. Lessons arising were identified and described. Results While the impact of the projects varied, they highlight the feasibility of adapting mainstream interventions in Aboriginal Australian contexts. Outcomes include greater potential to: screen for those at risk; increase community awareness; build capacity and partnerships between organisations; and co-ordinate comprehensive referral networks and service provision. Discussion Results show a small investment can produce sustainable change and positive outcomes. However, to optimise and maintain investment, cultural difference needs to be recognised in both planning and delivery of alcohol interventions; resources and funding must be responsive to and realistic about the capacities of organisations; partnerships need to be formed voluntarily based on respect, equality and trust; and practices and procedures within organisations need to be formalised. Conclusions There is no simple way to reduce alcohol-related harm in Aboriginal communities. However, the papers reviewed show that with Aboriginal control, modest investment and respectful collaboration, service enhancements and improved outcomes can be achieved. Mainstream interventions need to be adapted to Aboriginal settings, not simply transferred. The lessons outlined provide important reflections for future research. [Gray D, Wilson M, Allsop S, Saggers S, Wilkes E, Ober C. Barriers and enablers to the provision of alcohol treatment among Aboriginal Australians: A thematic review of five research projects. Drug Alcohol Rev 2014;33:482-490] [ABSTRACT FROM AUTHOR]

Issues: Alcohol and other drug use among adolescents is a serious concern, and effective prevention is critical. Research indicates that expanding school-based prevention programs to include parenting components could increase prevention outcomes. This paper aims to identify and describe existing combined student- and parent-based programs for the prevention of alcohol and other drug use to evaluate the efficacy of existing programs.Approach: The PsycINFO, Medline, Central Register of Controlled trials and Cochrane databases were searched in April 2015 and additional articles were obtained from reference lists. Studies were included if they evaluated a combined universal intervention for students (aged 11-18 years old) and their parents designed to prevent alcohol and/or other drug use, and were delivered in a school-based setting. Risk of bias was assessed by two independent reviewers. Because of the heterogeneity of the included studies, it was not possible to conduct a meta-analysis and a qualitative description of the studies was provided.Key Findings: From a total of 1654 screened papers, 22 research papers met inclusion criteria, which included 13 trials of 10 programs. Of these, nine programs demonstrated significant intervention effects in terms of delaying or reducing adolescent alcohol and/or other drug use in at least one trial.Conclusion: This is the first review of combined student- and parent-based interventions to prevent and reduce alcohol and other drug use. Whilst existing combined student- and parent-based programs have shown promising results, key gaps in the literature have been identified and are discussed in the context of the development of future prevention programs. [Newton NC, Champion KE, Slade T, Chapman C, Stapinski L, Koning I, Tonks Z, Teesson M. A systematic review of combined student- and parent-based programs to prevent alcohol and other drug use among adolescents. Drug Alcohol Rev 2017;36:337-351]. [ABSTRACT FROM AUTHOR]

Objective. To review the findings of a paper that has often been cited as evidence-with potentially adverse public health consequences-that the demand for alcohol in Indigenous Australian communities is not responsive to price and that, in the face of increasing alcohol prices, expenditure is diverted from basic sustenance to the purchase of alcohol. Methods. The raw data on income and various items of expenditure from the original study were entered in a database, a trend variable was created, and trends in measures of interest were tested using appropriate cross-correlations. Results. Re-analysis of the data did not support the findings of the original study. Conclusions. The original study does not contradict the general findings of the national and international literature that the demand for alcohol is sensitive to increases in price and does not provide evidence for the assertion that, other factors being equal, price controls on the availability of alcohol in Indigenous communities are likely to be ineffective.[Dennis Gray. Is the demand for alcohol in Indigenous Australian communities 'price inelastic'? Drug Alcohol Rev 2012;31:818-822] [ABSTRACT FROM AUTHOR]

Introduction: Measuring self‐reported alcohol use is challenging in any population, including when episodic drinking may be common. Drinking among Indigenous Australians has been shown to vary greatly within and between communities. However, most survey methods assume 'regular' patterns of drinking. National estimates have also been shown to underestimate alcohol use among this group. This paper describes drinking patterns in two representative community samples (urban and remote). Methods: Indigenous Australians (aged 16+ years) in two South Australian sites were recruited to complete the Grog Survey App. The App is a validated, interactive tablet‐based survey tool, designed to help Indigenous Australians describe their drinking. Drinking patterns were described using medians and interquartile ranges; gender and remoteness were compared using Wilcoxon rank‐sum tests. Spearman correlations explored the relationship between drinking patterns and age. Logistic regressions tested if beverage or container preference differed by remoteness or gender. Results: Three‐quarters of participants (77.0%, n = 597/775) were current drinkers. Median standard drinks per occasion was 7.8 (78 g), 1.3 drinking occasions per month (median). Three‐quarters of current drinkers (73.7%) reported a period without drinking (median: 60 days). Remote drinkers were more likely to drink beer. Improvised containers were used by 40.5% of drinkers. Discussion and Conclusions: Episodic drinking with extended 'dry' periods and from non‐standard drinking containers was common in this representative sample of Indigenous Australians. The diversity of container use and beverage preference, by gender and remoteness, illustrates nuances in drinking patterns between communities. It shows the importance of community‐level data to inform local strategies addressing alcohol misuse. [ABSTRACT FROM AUTHOR]

Introduction: The positive impact of substance use treatment is well‐evidenced but there has been substantial disinvestment from publicly funded treatment services in England since 2013/2014. This paper examines whether this disinvestment from adult alcohol and drug treatment provision was associated with changes in treatment and health outcomes, including: treatment access, successful completions from treatment, alcohol‐specific hospital admissions, alcohol‐specific mortality and drug‐related deaths. Methods: Annual administrative data from 2013/2014 to 2018/2019 was matched at local government level and multi‐level time series analysis using linear mixed‐effect modelling conducted for 151 upper‐tier local authorities in England. Results: Between 2013/2014 and 2018/2019, £212.2 million was disinvested from alcohol and drug treatment services, representing a 27% decrease. Concurrently, 11% fewer people accessed, and 21% fewer successfully completed, treatment. On average, controlling for other potential explanatory factors, a £10 000 disinvestment from alcohol and drug treatment services was associated with reductions in all treatment outcomes, including 0.3 fewer adults in treatment (95% confidence interval 0.16–0.45) and 0.21 fewer adults successfully completing treatment (95% % confidence interval 0.12–0.29). A £10 000 disinvestment from alcohol treatment was not significantly associated with changes in alcohol‐specific hospital admissions or mortality, nor was disinvestment from drug treatment associated with the rate of drug‐related deaths. Discussion and Conclusions: Local authority spending cuts to alcohol and drug treatment services in England were associated with fewer people accessing and successfully completing alcohol and drug treatment but were not associated with changes in related hospital admissions and deaths. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, beverage composition of total alcohol consumption has changed substantially in Sweden. As beverage choice is strongly associated with drinking practices, our paper aims to analyse trends in beverage composition of alcohol consumption by age, period and cohort. Methods: Age‐period‐cohort (APC) analysis was conducted using monthly data from the Swedish Alcohol Monitoring Survey (2003–2018). The sample consisted of n = 260 633 respondents aged 16–80 years. APC analysis was conducted on drinkers only (n = 193 954; 96 211 males, 97 743 females). Beverage composition was defined as the beverage‐specific proportion of total intake in litre ethanol. Fractional multinomial logit regression was applied to estimate the independent effects of age, period and cohort on trends in beverage composition. Results: Regression models revealed statistically significant effects of age on all beverages except for medium‐strength beer and spirits in males. Controlling for age and cohort, decreasing trends were found over time for medium‐strength beer and spirits. The proportion of regular beer increased statistically significantly in males and the proportion of wine in females, whereas the trends for the opposite sex remained stable in each case. Predictions for cohorts showed statistically significant decreasing trends for medium‐strength beer in males, lower proportions for regular beer and higher proportions for spirits in the youngest cohorts. Discussion and Conclusions: The increasing proportion of wine drinking, which is associated with less risky drinking practices, may decrease alcohol‐related morbidity and mortality. Increasing proportions of spirits in the youngest cohorts raises concerns of a possible revival in spirits consumption among the youngest. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol poses a range of potential problems to people taking medications, but health professionals are usually not comfortable talking about drinking with patients. The Medicines and Alcohol Consultation aims to increase the capacity of pharmacists to conduct person‐centred reviews in which alcohol is regarded as another drug to be discussed alongside medications. This paper explores sensitivities in discussing alcohol and views on the legitimacy of the Medicines and Alcohol Consultation intervention concept at a pharmacy‐user intervention co‐design workshop. Methods: A co‐design workshop was held with 14 people recruited from UK community pharmacies who regularly drank alcohol and took medications for long‐term conditions. This formed one element of a broader, iterative, intervention co‐production process. Workshop discussions were audio‐recorded and analysed thematically. Results: The basic intervention concept resonated well, though not entirely unproblematically. Participants were interested in receiving information on how medications interact with alcohol and how this might affect their own conditions, with which to make their own informed choices. Linking alcohol use to medicines gave legitimacy to pharmacists to raise alcohol in medicines reviews. Sensitivity in talking about alcohol was linked to vulnerability to negative judgement. Discussion and Conclusions: Changing the framing of alcohol in medicines reviews, away from being regarded as a 'lifestyle issue' to being considered a drug directly linked to medicines use, safety and effectiveness, was welcomed by participants in this study. [ABSTRACT FROM AUTHOR]

Introduction and Aims This paper examined whether recall of childhood trauma was associated with adult alcohol consumption in a sample of Australians with low housing security. The secondary aim was to examine whether risky alcohol consumption predicted subsequent housing instability. Sociodemographic factors were examined as potential moderators of these associations. Design and Methods This paper utilised data collected through the Journeys Home Study, a longitudinal study of a representative sample of individuals who were homeless or at risk of homelessness. This paper focused on 1224 participants aged 18 years and over. Data on alcohol use, childhood trauma and sociodemographic characteristics were collected through interviews at baseline. Homeless status at 6- to 12-month follow-up was assessed via interview. Logistic regression modelling was used to examine associations of alcohol consumption with childhood abuse, sociodemographic factors and changes in homelessness status. Results Self-reported recall of childhood experiences of violence was more likely among current drinkers, risky or not, than among abstainers. Recall of childhood neglect was more common among abstainers than among risky drinkers. Discussion and Conclusions The relationships between recall of childhood trauma and adult alcohol consumption are likely to be complex. Risky consumption may contribute to continuing homelessness among adults with unstable housing. [Correction added on 29 December 2014, after first online publication: The Results, and Discussion and Conclusion sections in the abstract have been replaced.]. [Keane C, Magee CA, Lee JK. Childhood trauma and risky alcohol consumption: A study of Australian adults with low housing stability. Drug Alcohol Rev 2015;34:18-26] [ABSTRACT FROM AUTHOR]

Introduction And Aims There have been no previous quantitative analyses of the possible effects of industry funding on alcohol and health research. This study examines whether findings of alcohol's protective effects on cardiovascular disease may be biased by industry funding. Design and Methods Findings from a recent systematic review of prospective cohort studies were combined with public domain data on alcohol industry funding. The six outcomes evaluated were alcohol's effects on cardiovascular disease mortality, incident coronary heart disease, coronary heart disease mortality, incident stroke, stroke mortality and mortality from all causes. Results We find no evidence of possible funding effects for outcomes other than stroke. Whether studies find alcohol to be a risk factor or protective against incident stroke depends on whether or not there is possible industry funding [risk ratio (RR) 1.07 (0.97-1.17) for those without concern about industry funding compared with RR 0.88 (0.81-0.94)]. For stroke mortality, a similar difference is not statistically significant, most likely because there are too few studies. Discussion and Conclusions Dedicated high-quality studies of possible alcohol industry funding effects should be undertaken, and these should be broad in scope. They also need to investigate specific areas of concern, such as stroke, in greater depth. [McCambridge J, Hartwell G. Has industry funding biased studies of the protective effects of alcohol on cardiovascular disease? A preliminary investigation of prospective cohort studies. Drug Alcohol Rev 2015;34:58-66] [ABSTRACT FROM AUTHOR]

Introduction: This paper aimed to assess purchasing and drinking behaviour during the first COVID‐19 pandemic restrictions in New Zealand. Method: A convenience sample was collected via Facebook from 2173 New Zealanders 18+ years during pandemic restrictions April/May 2020. Measures included: the quantity typically consumed during a drinking occasion and heavier drinking (6+ drinks on a typical occasion) in the past week; place of purchase including online alcohol delivery. Descriptive statistics were generated, logistic and linear regression models predicted heavier drinking and typical occasion quantity, respectively. Weighting was not applied. Results: During pandemic restrictions, around 75% of respondents purchased from supermarkets, 40% used online alcohol delivery services (18% for the first time during COVID‐19). Purchasing online alcohol delivery during pandemic restrictions was associated with heavier drinking (75% higher odds) in the past week, while purchasing from supermarkets was not. About 58% of online purchasers under 25 reported no age checks. Sixteen percent of those purchasing online repeat ordered online to keep drinking after running out. Of respondents who had tried to buy alcohol and food online, 56% reported that alcohol was easier to get delivered than fresh food. Advertising for online alcohol delivery was seen by around 75% of the sample. Half of the sample reported drinking more alcohol during the restrictions. Discussion and Conclusions: Online alcohol delivery during the COVID‐19 pandemic restrictions was associated with heavier drinking in the past week. The rapid expansion of online alcohol delivery coupled with a lack of regulatory control requires public health policy attention. [ABSTRACT FROM AUTHOR]

Introduction and Aims: The collection of routine outcome measurement (ROM) data provides an opportunity for service providers to conduct benchmarking to inform quality assurance practices. To conduct comparative benchmarking, it is important that services have access to comparative data. This paper aims to establish effectiveness indicators for ROM data collected within the alcohol and other drug (AOD) sector.Design and Methods: ROM data were collected by specialist non-government AOD treatment services within the Network of Alcohol and other Drugs Agencies online database (i.e. NADAbase). All participants were attending treatment within New South Wales, Australia (N = 21 572). Effectiveness indicators were calculated by using effect sizes, standard error of measurement, and rates of reliable and clinically significant change. The study focused on quality of life (EUROHIS Quality of Life Scale), psychological distress (Kessler-10) and substance dependence (Substance Dependence Scale).Results: Since 2010, 21 572 unique people have completed at least one NADAbase Client Outcome Measure. Amphetamines (36%) and alcohol (32%) were the most commonly reported primary substances of concern. Effectiveness indicators were established for the total sample, as well as for people attending residential rehabilitation (n = 8161) and community-based (n = 10 306) treatment services. Standard error of measurement was the least stringent effectiveness indicator (i.e. a higher proportion of people demonstrated improvement), while the clinically significant change was the most stringent approach.Discussion and Conclusions: The study demonstrated the utility of the NADAbase to establish effectiveness indicators for benchmarking purposes. Recommendations are provided for the use of benchmarking to inform quality assurance activities in the sector. [ABSTRACT FROM AUTHOR]

Issues Serious educational games ( SEG) have been shown to be effective in educating young people about a range of topics, including languages and maths. This paper identifies the use of computerised SEGs in education about alcohol and other drugs and reviews their impact on the prevention of alcohol and drug use. Approach The Cochrane Library, EMBASE, MEDLINE, ERIC, Scopus, psychINFO, pubMED and DRUG databases were searched in February 2013. Additional publications were obtained from the reference lists of the relevant papers. Studies were included if they described an evaluation of a computerised SEG that targeted alcohol and/or other drugs and had been trialled with adolescents. Key Findings Eight SEGs were identified targeting tobacco, alcohol, cannabis, methamphetamine, ecstasy, inhalants, cocaine and opioids. Six reported positive outcomes in terms of increased content knowledge and two reported increased negative attitudes towards the targeted drugs. Only one reported a decrease in the frequency of drug use. Implications and Conclusion This is the first review of the efficacy of computerised SEGs for alcohol and other drugs for adolescents. Results suggest that SEGs can increase content knowledge of alcohol and other drugs. Evidence concerning impacts on negative attitudes and alcohol and drug use is limited, with few studies examining these outcomes. [ABSTRACT FROM AUTHOR]

Issues To review the burden of alcohol use in India, examine current policy initiatives and programs specific to India and provide a roadmap for future actions. Approach: A literature search was undertaken to review available published research papers, unpublished reports and anecdotal media information in the period 2000–2020 to assess the burden and pattern of alcohol use and appraise alcohol control policies in India. Key Findings: The per‐capita alcohol consumption among individuals aged 15+ years was 5.7 L, which increased over time. Prevalence of alcohol use varied across states with considerable impact on the nation. Regulatory policies and alcohol control programs vary across Indian states, with poor enforcement and implementation. Taxation and pricing policies are revenue oriented. Policies are needed to address the aggressive and innovative marketing strategies of the alcohol industry. The system for regular monitoring of alcohol burden and conducting alcohol policy analysis needs strengthening. Implications: Alcohol use and its public health impact would continue to increase in India in the absence of effective policy and programs; the country may not achieve its stated goal of relative reduction of alcohol use prevalence by 10% by 2025. Conclusion: The prevailing alcohol control policies and programs in India have been less than fully effective in controlling the burden of alcohol use and its associated impact. There is a need for comprehensive, evidence‐based and consensus‐driven national alcohol control policy to appropriately guide and support the Indian states in regulating alcohol and reducing the associated burden. Effective implementations of such policies are central to its success. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Restrictions introduced to reduce the spread of COVID‐19 have had major impacts on the living circumstances of Australians. This paper aims to provide insight into shifts in alcohol consumption and associated factors during the epidemic. Design and Methods: A cross‐sectional convenience sample of 2307 Australians aged 18 and over who drank at least monthly was recruited through social media. Respondents were asked about their alcohol consumption and purchasing in 2019 prior to the epidemic plus similar questions about their experiences in the month prior to being surveyed between 29 April and 16 May 2020. Results: Reports of average consumption before (3.53 drinks per day [3.36, 3.71 95% confidence interval]) and during (3.52 [3.34, 3.69]) the pandemic were stable. However, young men and those who drank more outside the home in 2019 reported decreased consumption during the pandemic, and people with high levels of stress and those who bulk‐bought alcohol when restrictions were announced reported an increase in consumption relative to those who did not. Discussion and Conclusions: A reported increase in consumption among those experiencing more stress suggests that some people may have been drinking to cope during the epidemic. Conversely, the reported decrease in consumption among those who drank more outside of their home in 2019 suggests that closing all on‐trade sales did not result in complete substitution of on‐premise drinking with home drinking in this group. Monitoring of relevant subgroups to assess long‐term changes in consumption in the aftermath of the epidemic is recommended. [ABSTRACT FROM AUTHOR]

Introduction and Aims: This paper examines the impact of an alcohol labelling intervention on recall of and support for standard drink (SD) labels, estimating the number of SDs in alcohol containers, and intended and unintended use of SD labels. Design and Methods: A quasi‐experimental study was conducted in Canada where labels with a cancer warning, national drinking guidelines and SD information were applied to alcohol containers in the single liquor store in the intervention site, while usual labelling continued in the two liquor stores in the comparison site. Three waves of surveys were conducted in both sites before and at two time‐points after the intervention with 2049 cohort participants. Generalised estimating equations were applied to estimate changes in all outcomes. Results: Participants in the intervention relative to the comparison site had greater odds of recalling [adjusted odds ratio (AOR) 5.69, 95% confidence interval (CI) 3.02, 10.71] and supporting SD labels (AOR 1.49, 95% CI 1.04, 2.12) and lower odds of reporting using SD labels to purchase high strength, low‐cost alcohol (AOR 0.65, 95% CI 0.45, 0.93). Exposure to the labels had negligible effects on accurately estimating the number of SDs (AOR 1.06, 95% CI 0.59, 1.93) and using SD labels to drink within guidelines (AOR 1.04, 95% CI 0.75, 1.46). Discussion and Conclusions: Evidence‐informed labels increased support for and decreased unintended use of SD labels. Such labels can improve accuracy in estimating the number of SDs in alcohol containers and adherence to drinking guidelines. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Alcohol use is a leading risk factor for death and disability, responsible for 3 million deaths in 2016. The alcohol industry is a powerful player in shaping trade and investment rules in ways that can constrain the ability of governments to regulate alcoholic beverages to reduce harm. This paper analyses publicly available submissions about alcohol in the context of Australia's free trade agreements to determine the key themes put forward by industry. Design and Methods: We searched for submissions made to the Department of Foreign Affairs and Trade by alcohol industry trade associations, alcohol manufacturers, distributors and retailers, general industry association, and government agencies with responsibilities for alcohol trade, about specific free trade agreements involving Australia. Thirty‐one submissions in relation to eight trade agreements were included for analysis. The analysis involved both descriptive content analysis and thematic analysis. Results: Findings suggest that industry is actively seeking to shape trade negotiations around alcohol. Priority issues for the industry include improving market access, harmonising regulation, improving clarity and transparency, reducing the burden of regulation and preventing monopolies on product names. Discussion and Conclusion: The alcohol industry and associated business and government organisations are actively working to influence trade agreement negotiations for industry economic gain, arguing for rules which may undermine public health goals. The analysis suggests that public health experts should pay attention to trade and investment agreements and develop counter frames to ensure agreements do not create barriers for coherent health policies. [ABSTRACT FROM AUTHOR]

The present text comments on Stockwell and colleagues' paper documenting the high burden of alcohol use in COVID-19 related mortality in the USA and Canada in North America and the absence of a control policy in several countries of the world. This comment adds information about the third country in North America, Mexico. It describes alcohol use during the COVID lockdown and its consequences, highlighting the control efforts through public health policies and ponders the weaknesses of the current response to the health crisis and opportunities in the aftermath. [ABSTRACT FROM AUTHOR]

Background and Aim: Belarus is among the countries that have very high alcohol consumption levels, and that suffer from a huge burden of excessive drinking. This paper aims to explore the peculiarities of the alcohol control policies implemented in Belarus, and to link these policies to the trends in alcohol consumption and mortality. Data and Methods: Our narrative review of alcohol policies and anti‐alcohol measures is based on the laws, directives and other official documents issued by Belarusian authorities since the early 1990s. The data on alcohol consumption and other relevant variables originate from official statistical books. Our analysis of mortality trends is based upon official statistical tables by causes of death. Results: Despite the large number of government policy initiatives that authorities claimed were controlling the problem, alcohol consumption in Belarus grew rapidly up to 2010, when it reached the highest level in the world. This negative trend can be largely attributed to inconsistent alcohol control policies. In particular, the implementation of excise taxes encouraged the manufacturing of inexpensive fortified fruit wines. Additionally, measures designed to raise the price of alcohol were inadequate, resulting in strong alcoholic drinks (e.g. vodka) becoming more affordable. However, the third anti‐alcohol campaign, which was launched in 2011, led to declines in both alcohol consumption and alcohol‐related mortality. Conclusions: Belarus has acquired the experience and the legislative foundation needed to implement effective alcohol control polices. To further reduce alcohol‐related harm in Belarus, a steady and consistent long‐term policy perspective is required. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Systematic monitoring of the parliamentary legislative processes, including voting of members of the Parliament (MPs) and factions, allows better understanding of the mechanisms for adoption of public health policies. The aim of this paper is to present a tool for monitoring voting on tobacco and alcohol control policies in the Lithuanian Parliament and consequent rating of MPs based on their voting. Design and Methods: MP rating included the collection of voting data, qualitative assessment of the proposed amendments based on their potentially positive or negative impact on public health, and finally quantitative analysis of voting by applying certain weight coefficients. Results: Analysis included 159 voting episodes. More than half (60%) of the MPs received low scores in the 2012–2016 Parliament′s term, and only a small proportion (3%) consistently supported evidence‐based alcohol and tobacco control policies. In contrast, only 26.5% MPs received low scores in the 2016–2018 half‐term. Significantly higher scores in the 2016–2018 half‐term reflect increased political support towards evidence‐based public health policies among the new political majority in Lithuania. Discussion and Conclusions: MP rating has a potential to become a valuable tool used by various stakeholders for more objective assessment of specific public health commitments of political parties and individual politicians. [ABSTRACT FROM AUTHOR]

Introduction and Aims. The purpose of this paper is to provide a per incident of crime cost measure for New South Wales that is suitable for the use within cost-effectiveness studies of interventions aimed at reducing the burden of alcohol. This paper seeks to quantify the individual cost of an assault, property damage, sexual offence and disorderly conduct in New South Wales. Design and Methods. Costs regarding the criminal act, police involvement, prosecution in criminal courts and incarceration are estimated and then using a four-stage probability analysis, the expected cost per incident is calculated. Results. It is found that expected cost per incident for assault, sexual offence, property damage and disorderly conduct (in 2006 dollar values) is $3982, $5976, $1166 and $501 respectively. Discussion and Conclusions. A large total cost figure is a powerful policy motivator; however, for the purpose of economic analysis it is often more useful to estimate the per incident cost. This research furthers the existing research on cost of crime estimates and facilitates future cost-effectiveness and other economic analysis of interventions that reduce alcohol-related crime.[Byrnes JM, Doran CM, Shakeshaft AP. Cost per incident of alcohol-related crime in New South Wales. Drug Alcohol Rev 2012;31:854-860] [ABSTRACT FROM AUTHOR]

Issues. To reduce the occurrence and costs related to substance use and associated harms it is important to intervene early. Although a number of international school-based prevention programs exist, the majority show minimal effects in reducing drug use and related harms. Given the emphasis on early intervention and prevention in Australia, it is timely to review the programs currently trialled in Australian schools. This paper reports the type and efficacy of Australian school-based prevention programs for alcohol and other drugs. Approach. Cochrane, PsychInfo and PubMed databases were searched. Additional materials were obtained from authors, websites and reference lists. Studies were selected if they described programs developed and trialled in Australia that address prevention of alcohol and other drug use in schools. Key Findings. Eight trials of seven intervention programs were identified. The programs targeted alcohol, cannabis and tobacco and most were based on social learning principles. All were universal. Five of the seven intervention programs achieved reductions in alcohol, cannabis and tobacco use at follow up. Conclusion. Existing school-based prevention programs have shown to be efficacious in the Australian context. However, there are only a few programs available, and these require further evaluative research. This is critical, given that substance use is such a significant public health problem. The findings challenge the commonly held view that school-based prevention programs are not effective.[Teesson M, Newton NC, Barrett EL. Australian school-based prevention programs for alcohol and other drugs: A systematic review. Drug Alcohol Rev 2012;31:731-736] [ABSTRACT FROM AUTHOR]

Introduction and Aims. This paper proposes an approach for evaluating the validity of alternative low-risk drinking guidelines. Design and Methods. Twenty-seven alternative guidelines were evaluated in terms of their ability to predict nine measures of concurrent and prospective alcohol-related harm, using longitudinal data from a nationally representative sample of US adults (n = 26 438 to 12 339 depending upon outcome). Parameters compared included sensitivity, specificity, adjusted odds ratios and measures of model fit. Results. Performance varied by harm. The guidelines that best predicted concurrent alcohol-related harm comprised daily-only limits of 4/3 drinks for men/women, but gender-invariant limits of 4/4 drinks also performed well. Adding weekly limits did little to improve the prediction of concurrent harm. The guidelines that best predicted prospective harm comprised daily limits of 4/4 drinks combined with weekly limits of 14 drinks for men and 7 drinks for women, with weekly limits of 14/14 drinks running second. When concurrent and incident harms were aggregated, daily-only limits of 4/3 drinks performed nearly on a par with the combination of 14/14 drinks per week and 4/3 drinks per day. Discussion and Conclusions. This paper supported gender-specific daily limits and suggested that optimal guidelines might take daily limits from analyses of concurrent harms and weekly limits from analyses of prospective harms. This paper illustrates a mechanism for validating the ability of low-risk drinking guidelines to accurately predict a range of alcohol-related harms, whereby countries could use their own data on consumption and its association with harm to evaluate their low-risk drinking guidelines.[Dawson DA, Smith SM, Pickering RP, Grant BF. An empirical approach to evaluating the validity of alternative low-risk drinking guidelines. Drug Alcohol Rev 2012;31:141-150] [ABSTRACT FROM AUTHOR]

This paper describes the development of the first set of national guidance focused on the prevention of alcohol problems in England. These guidelines were produced by the National Institute for Health and Clinical Excellence (NICE) working with a multidisciplinary program development group of scientists, practitioners and lay members. In this work, screening and brief alcohol interventions represent a key element of a comprehensive public health strategy to prevent alcohol-related risk and harm across the population. The first controlled trials of brief alcohol intervention were published in the mid to late 1980's and there are now around 60 published trials in this field. After 25 years of accumulated evidence in this field, brief alcohol interventions have yet to make a significant impact on routine clinical practice. While it is imperative to have good science to make the case for brief intervention delivery, this work is in vain if practitioners are unwilling or unable to use these interventions with their patients. Evidence from the alcohol field and other clinical areas indicates that national prioritisation of brief alcohol intervention activity, by a body, such as NICE, is likely to be a key driver of implementation by practitioners. This paper summarises a suite of complementary system-level and practice recommendations, which were published by NICE in June 2010, and considers their likely impact on screening and brief alcohol in England.[Kaner E. NICE work if you can get it: Development of national guidance incorporating screening and brief intervention to prevent hazardous and harmful drinking in England. Drug Alcohol Rev 2010;29;589-595] [ABSTRACT FROM AUTHOR]

In a recent analysis of the effect of the complete advertising ban on alcohol in Norway, I found that the ban led to a decrease in recorded alcohol sales. Jon Nelson offers comments on this study in two regards; my critical comments on his previous study of alcohol advertising bans and the time series analysis in my study. In this response to Nelson, I offer further explanation for my comments on Nelson's previous study and for the appropriateness of the analysis. [ABSTRACT FROM AUTHOR]

Issues. The last two or three decades have seen some valuable investment in workforce development. However, significant challenges remain in developing effective practice across various systems. Despite the relevance alcohol, tobacco and other drug use have for a range of staff across diverse organisations, adoption of cross-sector and collaborative effective practice is not widespread. The most common response involves a rather singular focus on strategies that develop practitioner knowledge and skills, with much less consideration given to the complex nature of the work environment and the belief systems of people who work in these environments. Approach. This paper explores the barriers to and facilitators of effective practice, extending beyond the common focus on education and training initiatives. A model of capacity building is explored as a template to inform workforce and organisational development strategies. Key Findings. Numerous barriers, outside education and training, must be considered in order to develop and maintain effective practice across various systems of prevention and treatment. The paper culminates with recommendations on how to overcome such challenges. Implications. Workforce and organisational development must extend beyond education and training initiatives. Along with a focus on organisational and system factors, we must also attend to the marginalisation of people affected by drug use and associated pejorative attitudes. Conclusion. Developing effective practice in the drug field involves changing the structures, and expected outcomes of these structures, in which people work, not just encouraging a few to use new ways of working in spite of the system.[Allsop SJ, Stevens CF. Evidence-based practice or imperfect seduction? Developing capacity to respond effectively to drug-related problems. Drug Alcohol Rev 2009;28:541–549] [ABSTRACT FROM AUTHOR]

Introduction: Aboriginal and Torres Strait Islander people are vastly over‐represented in Australian prisons. Many people in prison attribute in some way their offences to alcohol and/or other drug (AOD) use. This paper aims to understand AOD use before first and between terms in prison, among a group of Aboriginal men enrolled in a prison‐based AOD treatment program. It examines opportunities for prevention or treatment that might interrupt the cycle of alcohol consumption, offending and imprisonment. Methods: A thematic analysis of in‐depth interviews with 14 Aboriginal men in an urban prison. Results: Participants had low levels of formal education, none having completed high school and had spent limited or no time in the workforce. All 14 spoke of being negatively affected by AOD use within their families. First alcohol and cannabis use were around age 12–14 years, first amphetamines and/or heroin use was around age 15. As adults, they had unstable accommodation and when released from prison returned to the same situation they had been in previously. Most believed they would not have offended and subsequently imprisoned if they did not have a substance use disorder. Discussion and Conclusion: Without further support post‐prison, the men in this study are likely to return to the same situation and continue their AOD use. Further efforts are needed to support families with substance use disorders and to give young Aboriginal and Torres Strait Islander people better education and training opportunities. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Most official healthcare guidelines apply the precautionary principle by recommending that pregnant women abstain from any alcohol consumption. However, a number of women continue drinking alcohol while pregnant. The aim of this study was to investigate couples' experiences of the issue of alcohol consumption during pregnancy as a transitional process.Design and Methods: Thirty semi-directive joint interviews were conducted with couples expecting their first child in Switzerland. Interviews were analysed thematically with the help of ATLAS.ti.Results: Couples endorsed the imperative of changing drinking habits and all the women reduced their alcohol consumption, although some reported difficulties. First, we identified three themes describing how couples experienced the woman's change of drinking habits as a smooth transition: Internalisation of risk discourses, abstinence as a social norm and embodiment of alcohol aversion. Second, we emphasised four kinds of difficulties that couples encountered in their everyday lives: burden of risk discourses, conflicting advice, social occasions and desire for alcohol.Discussion and Conclusions: This paper makes a significant contribution by examining prenatal drinking change as a transition. In this conceptualisation, the change of alcohol consumption is a relational process that is shaped by multiple changes and social norms. Our findings have important implications for practice. First, health professionals should be aware of the difficulties women experience when they abstain from alcohol during pregnancy. Second, our findings suggest the importance of a patient-centred approach that considers the role of the partner in supporting a pregnant woman's change of alcohol consumption. [ABSTRACT FROM AUTHOR]

Evidence-based policy is promoted as the ideal in drug policy, yet public policy theorists suggest that policy-based evidence may be a more fitting analogy, where evidence is used selectively to support a predetermined policy direction. The following paper assesses the resonance of this notion to the development of the Illicit Drug Diversion Initiative (IDDI), an apparently pragmatic reform adopted in Australia in 1999 through the Federal Coalition 'Tough on Drugs' strategy. It utilises interviews with key informants from the Australian drug policy arena conducted in 2005 to assess the role of evidence in the design and implementation of the IDDI. The current paper shows that while policy-makers were generally supportive of the IDDI and viewed drug diversion as a more pragmatic response to drug users, they contend that implementation has suffered through a selective and variable emphasis upon evidence. Most notably, the IDDI is not premised upon best-practice objectives of reducing harm from drug use, but instead on 'Tough on Drugs' objectives of reducing drug use and crime. This paper contends that policy-based evidence may facilitate the adoption of pragmatic reforms, but reduce the capacity for effective reform. It therefore has both functional and dysfunctional elements. The paper concludes that greater attention is needed to understanding how to mesh political and pragmatic objectives, and hence to maximise the benefits from policy-based evidence. [Hughes CE. Evidence-based policy or policy-based evidence? The role of evidence in the development and implementation of the Illicit Drug Diversion Initiative. Drug Alcohol Rev 2007;26:363 - 368] [ABSTRACT FROM AUTHOR]

Diversion strategies aim to redirect drug-involved offenders away from the criminal justice system and into treatment. Despite the interest in diversionary practices, the emergence of an empirical evaluation literature has been slow. A methodological review of published outcome studies was conducted to investigate the current strength of evidence for the efficacy of diversion and aftercare practices for criminal offenders. Twenty outcome studies were identified for review: 19 on diversion and one on aftercare. The vast majority of studies were non-randomised evaluations, reflecting the paucity of rigorous evaluation work in this area. Although most studies were prospective, very few reported on long-term outcomes following treatment. Detail was lacking with regard to basic study characteristics, such as eligibility criteria and outcomes. Despite these methodological shortcomings, results provide some tentative evidence that diversion and aftercare programmes could be effective. Best practice elements of diversion and aftercare programmes are identified and feasible strategies to improve the methodological quality of future evaluations are considered. [Harvey E, Shakeshaft A, Hetherington K, Sannibale C, Mattick RP. The efficacy of diversion and aftercare strategies for adult drug-involved offenders: a summary and methodological review of the outcome literature. Drug Alcohol Rev 2007;26:379 - 387] [ABSTRACT FROM AUTHOR]

Introduction and Aims: Nigeria is composed of six geopolitical zones plus one Federal Capital Territory. Differences between zones can differentially influence the adoption of risk behaviours by adolescents. This paper aims to describe the knowledge, attitudes, beliefs, risk perception, skills and substance use among Nigerian secondary school students highlighting the differences by geopolitical zone.Design and Methods: The population size of each zone was taken into account in extracting the 32 schools for the survey. The characteristics of the social environment, tobacco, alcohol and substance use, knowledge, beliefs, risk perception, attitudes, personal skills and school climate were investigated through an anonymous questionnaire.Results: A total of 4078 adolescents participated in the survey: 5.1% reported they had smoked cigarettes at least once in their life, 33.6% drank alcohol, 13.1% experienced drunkenness, 7.5% used cannabis and 11.6% other drugs. The highest rates of alcohol use were observed in the South, whilst the use of tobacco, cannabis and other drugs was higher in the North. Knowledge about tobacco, alcohol and marijuana was quite low across all zones. Scores for self-esteem, decision-making and refusal skills, risk perception and beliefs were lower in the North.Discussion and Conclusions: This study shows a high prevalence of adolescent alcohol and substance use in Nigeria. There is a need for planning and implementing evidence-based drug education and prevention programs across the country. Prevention activities targeting adolescents could help to reduce the later life burden of disease related to use of tobacco, alcohol and other drugs. [ABSTRACT FROM AUTHOR]