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Introduction: This paper considers how harm from others' drinking is distributed across several economic and environmental factors., Method: Economic, environmental, demographic and drinking measures include: household income, financial disadvantage indicators, home spaciousness; neighbourhood socioeconomic status (SES), connections and safety; and respondent's gender, age group and risky drinking status. The paper explores interactions of these factors with harms from the drinking of others in a 2021 survey of 2574 Australian adults., Results: The home's degree of crowding (persons per bedroom) is related to harms from others in the household, while financial disadvantage is related to harm from drinkers outside the household, whether known or strangers. Perceived neighbourhood safety and knowing neighbours are negatively related to harms from the drinking of others outside the household. In multivariate analyses for harms from household members and from strangers, these findings are little affected by three individual factors related to harms from others' drinking: the respondent's gender, age group and risky drinking status., Discussion: Some economic and ecological factors play an important role in the occurrence of harms from others' drinking, but the relationship varies both between factors and by the category of other person involved.

Objective: The magnitude of caring for others because of excessive alcohol use is unclear in Australia and internationally. This study explores the prevalence, sociodemographic predictors, and consequences of informal care for others because of alcohol use., Method: A survey on harm from others' drinking was conducted among 2,574 Australian adults in November 2021 from national random digit dial and "Life in Australia" panel samples to elicit representative data. Respondents who indicated that they had "heavy drinker/s" in their lives ( n = 1,585) were asked about their experience of caring for these drinkers and their dependents in the last 12 months. Weighted logistic and linear regressions examined (a) sociodemographic factors associated with informal care because of others' drinking and (b) the impact of the caregiving burden on the caregiver's financial status, overall health, and quality of life., Results: Overall, 20% of participants reported caregiving responsibilities arising from others' drinking. Older age, unemployment, residing in capital cities, and reporting birth in a non-English-speaking background country were associated with a reduced likelihood of caregiving. In contrast, higher education and more frequent risky drinking were associated with an increased likelihood. Caregivers reported significantly higher financial disadvantage, a lower quality of life, and poorer overall health., Conclusions: One in five adults reported caring for drinkers in the previous 12 months, and this was associated with negative consequences for those providing care. Service providers, health promotion practitioners, and policymakers should focus on younger age groups, those who live in regional areas, and those born in Australia who are at greater risk of being burdened by caregiving because of others' alcohol use.

Objective: Few studies have investigated the persistence over time of experiences of harm from a known person's drinking. The aim of this study was to describe 1-year persistence and investigate its predictors at baseline. Potential predictors included the harmed person's sociodemographic factors, their own drinking habits, their relationship to the person causing harm, and the type of negative experience., Method: The sample included respondents who reported experiencing harm from a known person's drinking in a general population survey in 2013 and participated in a follow-up survey in 2014 ( n = 1,203). One-year persistence of experienced harm was defined as reporting any harm in both surveys. We investigated potential baseline predictors of persistence by estimating relative risks and 95% confidence intervals through modified binary Poisson regression analyses with robust error variance., Results: One-year persistence of experiencing any type of harm from a known person's drinking was seen in 52.5% of those reporting harm at baseline and was higher among women (56.7%) than men (43.3%). Reporting harm from a partner, parent, or other household member significantly predicted 1-year persistence, as did severity of overall perceived harm at baseline., Conclusions: In Sweden, 1-year persistence of experienced harm from a known person's drinking is common in most individuals. The risk of experiencing such harm is higher among women, when harm occurs within close relationships, and when it is experienced as severe at baseline. Support to individuals in these situations is crucial.

Objective: Drawing on a study of the range and magnitude of harms that alcohol caused to specific others in Australia, and on social and health agency statistics for collective costs, this article produces an analysis of the economic cost of alcohol's harm to others (AHTO) in Australia., Method: This study used a general population survey and routinely collected social response agencies' data to quantify different costs of AHTO, using methods consistent with International Guidelines for Estimating the Costs of Substance Abuse. This approach estimates costs for health care and social services, crime costs, costs of productivity loss, quality of life-year loss and other expenses, including both tangible costs (direct and indirect) and intangible costs of loss of quality of life (respondents' self-reported loss of health-related quality of life)., Results: The cost of AHTO in Australia was AUD$19.81 billion (95% CI [11.99, 28.34]), with tangible costs accounting for 58% of total costs ($11.45 billion, which is 0.68% of gross domestic product in 2016) and intangible costs of $8.36 billion. The costs to private individuals or households ($18.1 billion and 89% of total costs of AHTO) are greater than the costs to the government or society because of others' drinking in Australia., Conclusions: This study presents an estimation of the economic cost of harm from others' drinking. The economic costs from others' drinking are large and of much the same magnitude as the costs that drinkers impose on themselves, as found in previous studies. Preventing harm to others from drinking is important as a public health goal for both economic and humane reasons.

Objective: This article describes the origins and purposes of alcohol industry "social aspects organizations" as portrayed in internal tobacco industry documents., Method: We systematically searched the Truth Tobacco Documents Library for information regarding alcohol industry social aspects organizations. Using content provided by industry actors themselves, we identified a series of episodes in their evolution from the early 1950s to the early 1990s., Results: Hill and Knowlton, a public relations company, developed and managed the tobacco industry's scientific programs from the early 1950s onward. At the same time, the company performed a similar function for the U.S. distilled spirits industry, with research funding central to advancing what were conceived as public relations goals. They sought to persuade the public and policy makers that the cause of alcohol problems was the people who drank distilled spirits, rather than the product itself. Facing the existential threat posed by the developing population-level understanding of alcohol problems in the 1980s, national and international trade associations collaborated with the tobacco industry in various ways. The largest companies sought to bring together the different sectors of the alcohol industry to support a global network of national-level social aspects organizations., Conclusions: Alcohol industry social aspects organizations were developed to advance long-term public relations goals to manage both policy and science.

Objective: Drinking norms vary with the situation and the person's role in it. They may be located at a societal level or may be specific to subgroups in the society. This article compares norms about drinking at the societal level as reported in surveys in 12 countries, testing the degree of consensus on the norms by comparing answers of abstainers and heavy episodic drinkers in each society., Method: In national or regional general population samples of respondents ages 18-65 in Argentina, Australia, Costa Rica, India, Nicaragua, Nigeria, Peru, Sri Lanka, Sweden, Uganda, Uruguay, and the United States, endorsements of drinking norms across 10 situations are compared, across the 12 societies, and within each society by drinking pattern., Results: Substantial societal variation was found regarding the acceptance of drinking at all, and of heavier drinking in specific situations, although the societies shared a rough ordering of situations in terms of acceptability of drinking. In each society, abstainers and heavy episodic drinkers differed on norms, although the differences were smaller for "no drinking" in relatively "dry" situations than on accepting drinking at least "enough to feel the effects" in "wet" situations., Conclusions: Although societies vary in their acceptance of drinking and the drinking amount, there seems to be an approximately shared ordering of situations in terms of relative acceptability of drinking and heavier drinking. At the societal level, there is more consensus on where there should be no drinking than on where drinking enough to feel the effects is acceptable.

The emergent and growing body of research on alcohol's harm to others (AHTO), or secondhand effects of drinking, has important implications for prevention, intervention, and policy. Those victimized by other drinkers tend to favor effective alcohol policies more than their nonvictimized peers, but often a community's impulse will be to combat AHTO by targeting and stigmatizing individual heavy drinkers, rather than taking a public health approach to reducing harm. Here we discuss opportunities and challenges in selecting ways of reducing AHTO. We make a case for adopting joint public health and individual approaches to reduce AHTO., Competing Interests: The authors have no conflict of interest to report.

Objective: This study aims to ascertain and compare the prevalence and correlates of alcohol-related harms to children cross-nationally., Method: National and regional sample surveys of randomly selected households included 7,848 carers (4,223 women) from eight countries (Australia, Chile, Ireland, Lao People's Democratic Republic [PDR], Nigeria, Sri Lanka, Thailand, and Vietnam). Country response rates ranged from 35% to 99%. Face-to-face or telephone surveys asking about harm from others' drinking to children ages 0-17 years were conducted, including four specific harms: that because of others' drinking in the past year children had been (a) physically hurt, (b) verbally abused, (c) exposed to domestic violence, or (d) left unsupervised., Results: The prevalence of alcohol-related harms to children varied from a low of 4% in Lao PDR to 14% in Vietnam. Alcohol-related harms to children were reported by a substantial minority of families in most countries, with only Lao PDR and Nigeria reporting significantly lower levels of harm. Alcohol-related harms to children were dispersed sociodemographically and were concentrated in families with heavy drinkers., Conclusions: Family-level drinking patterns were consistently identified as correlates of harm to children because of others' drinking, whereas sociodemographic factors showed few obvious correlations.

Objective: The aim of this study was to examine where Australians in different demographic groups and drinker categories consume their alcohol., Method: Results were taken from the Australian arm of the International Alcohol Control study, a telephone survey of 2,020 Australian adults with an oversample of risky drinkers. The 1,789 respondents who reported consuming alcohol in the past 6 months were asked detailed questions about the location of their alcohol consumption and how much alcohol they consumed at each place., Results: Sixty-three percent of all alcohol consumption reported by respondents was consumed in the drinker's own home, with much less consumed at pubs, bars, and nightclubs (12%). This is driven primarily by the number of people who drink in the home and the frequency of these events, with the amount consumed per occasion at home no more than in other people's homes or pubs, and significantly less than at special events. The average consumption on a usual occasion at each of these locations was more than five Australian standard drinks (above the Australian low-risk guideline for episodic drinking). Short-term risky drinkers had the highest proportion of consumption in pubs (19%), but they still consumed 41% of their units in their own home., Conclusions: The majority of alcohol consumed in Australia is consumed in the drinker's own home. Efforts to reduce long-term harms from drinking need to address off-premise drinking and, in particular, drinking in the home.

Objective: The purpose of this study was to examine variation in reports of pressuring others to drink less, as a form of informal social control of drinking, across countries and different types of relationship to the respondent., Method: A cross-sectional survey was administered to 19,945 respondents ages 18-69 years in 14 countries included in the data set of the Gender, Alcohol and Culture: An International Study (GENACIS). Outcome variables were respondents' reports of pressuring others to drink less (yes/no) across a variety of relationships (their partners, other family members, workmates, or friends). Multilevel, multivariable logistic regression analysis was carried out on each outcome variable. The fixed-effects components included the Level 1 (individual) covariates of respondent age, gender, drinking status, and education level as well as the Level 2 (country level) covariates of percentage female drinkers and purchasing power parity. The random-effects components included country and current drinking status., Results: Respondents most frequently reported pressuring male friends to drink less (18%), followed by male family members (other than partners, 15%), partners (15%), work colleagues (12%), female friends (9%), female family members (other than partners, 6%), and children (5%). There was marked variation across countries, with pressuring frequently reported in Uganda, Costa Rica, and Nicaragua across most relationship types. Multivariable logistic regression revealed consistent effects of gender, with women more likely than men to report pressuring others to drink less across most relationship types. The patterns in relation to education status and age were less consistent and varied across relationship type., Conclusions: Informal social control of drinking varies dramatically according to whom is most likely to pressure whom to drink less as well as the country in which people live.

Objective: Alcohol can result in harm (including injury) not only to the drinker but also to others; however, little research exists on the additional proportion of violence-related injuries that can be attributed to the perpetrator., Method: Data are reported from emergency department studies in 14 countries on the prevalence of patients' self-report of drinking within the 6 hours before the violence-related injury event, patients' belief that the event would not have happened if they had not been drinking at the time, and patients' perception that the perpetrator had been drinking. Alcohol-attributable fraction was calculated based on the patients' perception that their own drinking was causally related to the event and on their perception that the perpetrator had been drinking., Results: Across all countries, 62.9% of the violence-related injuries involved alcohol use on the part of the victim, the perpetrator, or both. Rates of others definitely drinking, as perceived by the victim, ranged from 14% to 73% across countries and was positively associated with patients' own drinking in the event and with attributing a causal association between their drinking and the event. Estimates of alcohol-attributable fraction were 38.8% when the victim and perpetrator were considered together compared with 23.9% when only the patient was considered and varied by country-level drinking pattern., Conclusions: These findings suggest adjustments that could be made to global burden of disease estimates because of violence-related injury morbidity to better reflect alcohol-attributable fraction when drinking by others and country-level drinking patterns are taken into account.

Objective: European Union travelers' allowances for alcohol import to Denmark, Sweden, and Finland were abolished in 2004. In addition, excise taxes on alcohol were lowered in 2003 and 2005 in Denmark, and in 2004 in Finland. Using northern Sweden as a control site, this study examines whether levels of reported alcohol problems have changed in Denmark, Finland, and southern Sweden as a consequence of these policy changes., Method: Annual cross-sectional surveys were conducted in Denmark, Finland, and Sweden from 2003 to 2006. Five dependency items and seven extrinsic alcohol-related problems were examined. Changes were analyzed within each country/region with logistic regressions and tested for short- and long-term changes. Differential change was also tested between each country and the control site, northern Sweden., Results: Prevalence of alcohol problems decreased over the study period. Only in selected subgroups did problems increase. This mainly occurred in the samples for northern Sweden and Finland, and mostly among older age groups and men. In relation to the control site, however, no increases in problem prevalence were found., Conclusions: Our findings on a decline in reported alcohol problems largely agree with published reports on alcohol consumption over the same period in the study countries. They do not agree, however, with findings on changes in health and social statistics in Finland and Denmark, where some significant increases in alcohol-related harm have been found.

Objective: Self-reports of alcohol consumption among patients visiting an emergency department (ED) have been used extensively in the investigation of the relationship between drinking and injury. Little is known, however, about the associations between validity of self-reports with patient and injury characteristics and whether these relationships vary across regions or countries. Both of these issues are explored in this article., Method: In the construct of a multilevel logistical model, validity of self-reports was estimated as the probability of a positive self-report given a positive blood alcohol concentration (BAC). The setting included 44 EDs across 28 studies in 16 countries. Participants included 10,741 injury patients from the combined Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study of Alcohol and Injuries. Data were analyzed on self-reported drinking within 6 hours before injury compared with BAC results obtained from breath-analyzer readings in all but two studies, which used urine screens. Covariates included demographic, drinking, and injury characteristics and aggregate-level contextual variables., Results: At the individual level, a higher BAC measurement was associated with a higher probability of reporting drinking, as was heavy drinking and sustaining injuries in traffic accidents or violence-related events. At the study level, neither aggregate BAC nor other sociocultural variables affected the validity of self-reported drinking., Conclusions: This study provides further evidence of the validity of self-reported drinking measures in crossnational ED studies based on the objective criterion of BAC estimates.