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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]

In 2013, illegal drug use was responsible for 1.8% of years of life lost in the European Union, alcohol was responsible for 8.2% and tobacco for 18.2%, imposing economic burdens in excess of 2.5% of GDP. No single European country has optimal governance structures for reducing the harm done by nicotine, illegal drugs and alcohol, and existing ones are poorly designed, fragmented, and sometimes cause harm. Reporting the main science and policy conclusions of a transdisciplinary five-year analysis of the place of addictions in Europe, researchers from 67 scientific institutions addressed these problems by reframing an understanding of addictions.  A new paradigm needs to account for evolutionary evidence which suggests that humans are biologically predisposed to seek out drugs, and that, today, individuals face availability of high drug doses, consequently increasing the risk of harm.  New definitions need to acknowledge that the defining element of addictive drugs is 'heavy use over time', a concept that could replace the diagnostic artefact captured by the clinical term 'substance use disorder', thus opening the door for new substances to be considered such as sugar. Tools of quantitative risk assessment that recognize drugs as toxins could be further deployed to assess regulatory approaches to reducing harm. Re-designed governance of drugs requires embedding policy within a comprehensive societal well-being frame that encompasses a range of domains of well-being, including quality of life, material living conditions and sustainability over time; such a frame adds arguments to the inappropriateness of policies that criminalize individuals for using drugs and that continue to categorize certain drugs as illegal. A health footprint, modelled on the carbon footprint, and using quantitative measures such as years of life lost due to death or disability, could serve as the accountability tool that apportions responsibility for who and what causes drug-related harm.

Aims: To describe the range of effects experienced due to the drinking of people respondents know and analyze risk and protective factors for harm from the drinking of partners and household members, other relatives and friends and co‐workers. Design, setting and participants: Surveys of 2574 participants' experiences were obtained from two samples: 1000 people responded to random digitally dialled Australian mobile calls and 1574 participants responded from the Life in AustraliaTM panel survey. Measurements: Respondents were asked whether they had been negatively affected in the previous 12 months by the drinking of persons they knew who were 'a heavy drinker or drank a lot sometimes' and the nature of these harms. Weighted logistic regressions were used to analyze differences in rates of key negative outcomes from known others' drinking by gender, age and socio‐economic status. Findings Almost two thirds [60.2%; 95% confidence interval (CI) = 57.7%–62.7%] of participants reported having heavy drinkers in their lives and 21.8% (95% CI = 19.8%–23.9%) reported being negatively affected by the drinking of people they knew well in some way. Participants reported a gamut of effects, including, most commonly, adverse social effects: having to transport relatives and friends who had been drinking, role failure and faults, being emotionally hurt or neglected, serious arguments, family problems, having to care for drinkers and verbal abuse. Less commonly, respondents reported physical or sexual harm, property damage, financial stress and threats from others' drinking. Women (odds ratio = 1.49; 95% CI = 1.13–1.95), younger people, rural, Australian‐born (vs. respondents born overseas in non‐English speaking countries) and more frequent drinkers were more likely to report harm from a drinker they knew than their counterparts after adjusting for other variables in the model. Conclusions: Australians appear to be commonly adversely affected by the drinking of people they know. Harms from known drinkers are more likely to be experienced by women than men, particularly from the people they live with and other relatives. [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]

Purpose: The United Nations has adopted a set of 17 interlocking Sustainable Development Goals (SDGs) for 2015–2030. This commentary discusses how alcohol and other drugs have been dealt with and discussed in the context of the Goals, and issues raised by the relationship and history of how alcohol and other drug use and problems relate to development. Material and methods: A cross-section of discussions of alcohol and drugs in the context of the SDGs is considered, and evidence considered on the relationship and history of alcohol and drug use and problems to development. Results: While alcohol and narcotic drugs are mentioned in the SDG Targets, there has been little consideration of what effects attaining the goals may have on levels of alcohol and other drug consumption and problems. In cross-sectional comparisons, there are higher average levels of consumption of alcohol and controlled drugs in richer societies, and among richer than poorer individuals. But the harm per unit of use tends to be lower for richer individuals, and in richer societies. We consider how these two contrary trends may apply with socioeconomic development, given that development has often brought increases in substance use, and societal responses to limit the harms are often delayed by a generation or more, often resulting in 'long waves' of consumption and associated harms. Conclusions: To take alcohol and other drugs coherently into account in the Sustainable Development Goals, along with recognising that they are marketable and sometimes useful products, and thus involved to some extent in economic development, there needs to be action at national and international levels which recognises their double-sided nature—including market controls on commercial products to channel and limit availability and minimise harm. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol exposure is common in popular films, and research has demonstrated a link between alcohol exposure and use. The likelihood of implementing specific policies to reduce the amount of film exposure is dependent on the level of public support; however, evidence is currently lacking. This study investigated how supportive people are of film‐related alcohol policies and whether providing information about the amount of film exposure increased support. Methods: Australian adults (N = 252) first provided estimates of how much alcohol they thought were in popular films and then were randomised to either see an infographic about the amount of alcohol in films or not. All participants rated how supportive they were of eight policies. Results: The items 'alcoholic beverages and consumption should not be shown in G or PG rated films' (M = 3.54) and 'alcohol should not be glorified in films' (M = 3.49) were rated significantly higher than the scale's midpoint of 3 (p < 0.001). Participants who were older, female or reported lower alcohol use were more supportive of the policies. Only one policy item, 'information about alcohol sponsorship should be provided' received higher support from those who received the infographic compared to those who did not (M = 3.53 vs. M = 3.05; t(250) = −3.09, p = 0.002). Discussion and Conclusion: Participants were relatively supportive of film alcohol policies. However, providing information about the amount of alcohol in films did not make a difference on the level of support for most film alcohol policies. [ABSTRACT FROM AUTHOR]

Background and Aims: There have been few systematic attempts to examine how alcohol-related mortality has changed in Australia, and no studies that have explored cohort effects in alcohol-related mortality. This study uses more than 50 years of data to measure age, period and cohort trends in alcohol-related liver disease (ALD) mortality. Design, Setting and Cases: This was a retrospective age--period--cohort analysis of total Australian ALD mortality data from 1968 to 2020 in Australia. There was a total of 35 822 deaths--27 208 men (76%) and 8614 women (24%). Measurements: Deaths from ALD were grouped into 5-year age groups and periods (e.g. deaths for 20-24-year-olds between 1968 and 1972 were combined). Findings: ALD mortality peaked in the late 1970s and early 1980s for both men and women. In age--period--cohort models, mortality was highest for cohorts born 1915-30. For example, men born between 1923 and 1927 had a relative risk of 1.58 [95% confidence interval (CI) = 1.52, 1.64] compared with men born between 1948 and 1952. For women, there was an increase in risk for cohorts born in the 1960s [e.g. the 1963-67 cohort had a relative risk (RR) of 1.16 (95% CI = 1.07, 1.25) compared with women born in 1948-52]. For men, there was a broad decline in mortality over time [e.g. in 2020, the RR was 0.87 (95% CI = 0.82, 0.92) compared with the reference year of 2000]. For women, mortality declined until 2000 and has been stable since. Conclusions: Alcohol-related liver disease mortality has declined across the Australian population since the 1970s and 1980s partly due to cohort-specific shifts as the highest-risk birth cohorts age. For women, this decline had stalled by the year 2000, and cohorts of women born during the 1960s were at higher risk than earlier cohorts, suggesting the need for thoughtful interventions as this population enters its highest-risk years for ALD mortality. [ABSTRACT FROM AUTHOR]

Reducing the risks associated with drinking is an ongoing public health goal. Approximately two-fifths of Australian adults consume alcohol within low-risk guidelines, yet little is known about their drinking patterns or practices. In this paper, we use social practice theory to consider low-risk drinking at home as a routinised social practice with material, meaning and competence dimensions. We analysed open-text survey responses from 252 Australian adults (30–65, 89% female) who were considered low-risk drinkers. A low-risk drinking occasion was typically closely linked to other practices such as eating dinner or connecting with family or friends. Drinking alcohol, even in small amounts, was associated with enjoyment. Being attuned to bodily sensations and applying some self-imposed rules were competencies that allowed low-risk drinkers to avoid intoxication. Low-risk drinking practices entail some elements that can inform health promotion, including encouraging efforts to limit drinking to times of the day (e.g. during meals) and to attend to bodily feelings of sufficiency. The study also shows how low-risk drinking is entangled with gendered and age-related norms about drinking, and facilitated by rarely being in 'intoxigenic' environments. These factors are imbricated with individual decisions in our respondents' capacity to consume alcohol moderately. [ABSTRACT FROM AUTHOR]

Parental supply of alcohol to minors (i.e. those under the legal drinking age) is often perceived by parents as protective against harms from drinking, despite evidence linking it with adverse alcohol-related outcomes. This systematic review describes the prevalence of parental supply of alcohol, as reported in the international literature. The review was registered with PROSPERO (CRD42020218754). We searched seven online databases (Medline, Embase, PsycINFO, CINAHL, Scopus, Web of Science and Public Health Database) and grey literature from January 2011 to December 2022 and assessed the risk of bias with the JBI Critical Appraisal Checklist. Among 58 articles included in narrative synthesis from 29 unique datasets, there was substantial variation in the definition and measurement of parental supply of alcohol. Overall prevalence rates ranged from 7.0 to 60.0% for minor-report samples, and from 24.0 to 8.0% for parent-report samples. Data indicate that parental supply prevalence is generally proportionately higher for older minors or later-stage students, for girls, and has increased over time among minors who report drinking. Literature on the prevalence of parental supply of alcohol is robust in quantity but inconsistent in quality and reported prevalence. Greater consistency in defining and measuring parental supply is needed to better inform health promotion initiatives aimed at increasing parents' awareness. [ABSTRACT FROM AUTHOR]

Background and aims: Alcohol's harm to others (AHTO) has become a key driver of national and international alcohol policy. This study aimed to produce a contemporary, comprehensive estimate of the correlates and harms from others' drinking in 2021 in Australia. Design, setting, participants and measurements: Across Australia, 2574 adults (1380 women; 1172 men) were sampled via two cross‐sectional survey modes: a random‐digit dial mobile phone sample of 1000 people and 1574 people from the Life in Australia™ panel survey. In 2021 participants were asked about harms they had experienced from the drinking of family, friends, co‐workers and the public in the past year. Applying combined sample weights from each mode, bivariable and adjusted multivariable logistic regressions were used to analyse differences in rates of AHTO by participant gender, age, residence in rural or metropolitan regions, country of birth, education and employment. Findings: In 2021, 23.6% reported being negatively affected by strangers' drinking and 21.3% by the drinking of someone they knew, with 34.3% reporting being negatively affected a lot or a little by either; 42.4% of respondents reported specific harms from strangers' drinking. Thus, 48.1% of respondents reported any harm (negative effects or specific harms) from others' drinking. Women, younger people, Australian‐born and heavier episodic drinkers reported significantly higher rates of AHTO compared with other respondents. Smaller percentages (7.5%) of participants reported being harmed substantially by others' drinking, including by people they knew (5.8%) or strangers (2.3%). Stratified analyses showed that heavier drinking, furloughed, younger men who were born overseas in English‐speaking countries were affected by others' drinking, whereas women were affected regardless of these factors (apart from age). Conclusions: More than one‐third of Australian adults appear to have been negatively affected by others' drinking in 2021, with women, younger people and heavier drinkers at greater risk. Substantial harm appears to be more likely to arise from the drinking of people Australians know than from strangers' drinking. [ABSTRACT FROM AUTHOR]

Introduction: In Australia, cask wine is the cheapest alcoholic beverage available, offering the lowest price per standard drink. Despite this, there is little research on the contextual correlates of cask wine consumption. Therefore, the current study aims to describe how cask wine consumption has changed over the last decade. Then, through comparisons between cask and bottled wine, how prices, typical drinking locations, and patterns of consumption differ between the beverages. Methods: Cross‐sectional data was drawn from two sources. Four waves of the National Drug Strategy Household Survey were used (2010, 2013, 2016 and 2019) in order to examine consumption trends over time. The International Alcohol Control study (2013) in Australia was additionally used to explore pricing and consumption trends in greater detail. Results: Cask wine was considerably cheaper than other forms of wine at $0.54 per standard drink (95% confidence interval [CI] 0.45–0.62, p < 0.05). Consumption trends associated with cask wine differed from that of bottled wine, being consumed almost entirely at home and in significantly greater quantity (standard drinks per day 7.8, 95% CI 6.25–9.26, p < 0.05). Among the heaviest drinkers, 13% (95% CI 7.2–18.8, p < 0.05) consumed cask wine as their main drink, compared to 5% (95% CI 3.76–6.24, p < 0.05) consuming bottled wine. Conclusions: Cask wine drinkers are disproportionately more likely to consume higher amounts of alcohol, paying less per drink doing so compared to bottled wine drinkers. As all cask wine purchases were under $1.30, a minimum unit price may largely affect cask wine purchases, applying to a far smaller proportion of bottled wine. [ABSTRACT FROM AUTHOR]

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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]

The burden of caring for drinkers is seldom articulated as a social concern, or integrated in service planning or alcohol policy. This study aims to examine prevalence and predictors of informal caregiving due to others' drinking cross-nationally by surveying 20,728 respondents (18–64 years) in 11 countries. The outcome variable was respondent-reported informal caregiving due to others' drinking, analysed by socio-demographic factors and drinking pattern using logistic regression and meta-analysis. Estimated overall prevalence of informal caregiving due to others' drinking ranged from 9% in Nigeria to 47% in Thailand. In most countries, females reported a higher rate than males of caring for children and other dependents, but males reported a higher rate of driving family or friends somewhere or picking them up. Logistic regression analysis found differences between high-income countries and low- and middle-income countries in the relationship of caregiving with employment and household composition. Respondent's own drinking was positively correlated with the prevalence of caregiving in 10 out of 11 countries. In general, younger adults and those who are themselves risky drinkers are more likely to have had caring responsibilities. Although problematic drinking is concentrated in specific subpopulations, the burden of care for others' drinking extends widely across the population. [ABSTRACT FROM AUTHOR]

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

Introduction: 'Drinking occasions' are commonly used to capture quantities of alcohol consumed. Yet this standardised terminology brings with it numerous assumptions and epistemological limitations. We suggest that social changes brought on by COVID‐19 restrictions have influenced routines, patterns of time use and drinking practices, highlighting the need to re‐examine how we conceptualise drinking and 'drinking occasions' in alcohol research. Methods: This analysis draws on data gathered from 59 qualitative interviews conducted during the second half of 2020 with Australian drinkers aged 18 and over. The interviews explored how COVID‐19 restrictions impacted daily practices and alcohol consumption patterns. Findings: Participants spoke about their work, study and social routines changing, which influenced the times, timing and contexts of their drinking practices. We separated these shifts into four overarching themes: shifting of structures shaping drinking; the permeability of drinking boundaries; the extension of drinking occasions; and new contexts for drinking. Discussion and Conclusion: COVID‐19 restrictions have led to shifts in the temporal boundaries and contexts that would otherwise shape people's drinking, meaning drinking practices may be less bound by structures, norms, settings and rituals. The drinking occasions concept, although a simple tool for measuring how much people drink, has not been able to capture these complex developments. This is a timely consideration given that COVID‐19 may have enduring effects on people's lifestyles, work and drinking practices. It may be useful to examine drinking as practice, rather than just an occasion, in order to better contextualise epidemiological studies going forward. [ABSTRACT FROM AUTHOR]

Background and aims: Survey questions on usual quantity and frequency of alcohol consumption are regularly used in screening tools to identify drinkers requiring intervention. The aim of this study was to measure age‐based differences in quantity and frequency of alcohol consumption on the Alcohol Use Disorders Identification Test (AUDIT) and how this relates to the prediction of harmful or dependent drinking. Design: Cross‐sectional survey. Setting: Australia. Participants: Data were taken from 17 399 respondents who reported any alcohol consumption in the last year and were aged 18 and over from the 2016 National Drug Strategy Household Survey, a broadly representative cross‐sectional survey on substance use. Measurement Respondents were asked about their frequency of consumption, usual quantity per occasion and the other items of the AUDIT. Findings In older drinkers, quantity per occasion [β = 0.53, 95% confidence interval (CI) = 0.43, 0.64 in 43–47‐year‐olds as an example] was a stronger predictor of dependence than frequency per occasion (β = 0.24, 95% CI = 0.17, 0.31). In younger drinkers the reverse was true, with frequency a stronger predictor (β = 0.54, 95% CI = 0.39, 0.69 in 23–27‐year‐olds) than quantity (β = 0.26, 95% CI = 0.18, 0.34 in 23–27‐year‐olds). Frequency of consumption was not a significant predictor of dependence in respondents aged 73 years and over (β = −0.03, 95% CI = −0.08, 0.02). Similar patterns were found when predicting harmful drinking. Despite this, as frequency of consumption increased steadily with age, the question on frequency was responsible for at least 65% of AUDIT scores in drinkers aged 53 years and over. Conclusions: In younger drinkers, frequent drinking is more strongly linked to dependence and harmful drinking subscale scores on the Alcohol Use Disorders Identification Test (AUDIT) than quantity per occasion, yet quantity per occasion has a stronger influence on the overall AUDIT score in this group. In older drinkers, frequency of consumption is not always a significant predictor of the AUDIT dependence subscale and is a weak predictor of the harmful drinking subscale. [ABSTRACT FROM AUTHOR]

Background and Aims: The relationship between alcohol consumption and cirrhosis is well established. Policies that can influence population‐level use of alcohol should, in turn, impact cirrhosis. We examined the effect of population‐level alcohol control policies on cirrhosis mortality rates in Lithuania – a high‐income European Union country with high levels of alcohol consumption. Methods: Age‐standardized, monthly liver mortality data (deaths per 100,000 adults, aged 15+) from Lithuania were analysed from 2001 to 2018 (n = 216 months) while controlling for economic confounders (gross domestic product and inflation). An interrupted time‐series analysis was conducted to estimate the effect of three alcohol control policies implemented in 2008, 2017 and 2018 and the number of cirrhosis deaths averted. Results: There was a significant effect of the 2008 (P <.0001) and 2017 (P =.0003) alcohol control policies but a null effect of the 2018 policy (P =.40). Following the 2008 policy, the cirrhosis mortality rate dropped from 4.93 to 3.41 (95% CI: 3.02‐3.80) deaths per 100,000 adults, which equated to 493 deaths averted. Further, we found that following the 2017 policy, the mortality rate dropped from 2.85 to 2.01 (95% CI: 1.50‐2.52) deaths per 100,000 adults, corresponding to 245 deaths averted. Conclusions: Our findings support the hypothesis that alcohol control policies can have a significant, immediate effect on cirrhosis mortality. These policy measures are cost‐effective and aid in reducing the burden of liver disease. [ABSTRACT FROM AUTHOR]

Introduction: There is limited knowledge about how individual experiences of harm from others' drinking are influenced by heavy episodic drinking (HED) at the country level. The present study aimed to assess (1) the association between the country-level prevalence of HED and the risk of experiencing harm from others' drinking-related aggression and (2) if HED at the country level modifies the association between consumption of alcohol per capita (APC) and such harm. Methods: Outcome data from 32,576 participants from 19 European countries stem from the RARHA SEAS study. Self-reported harm from others' drinking included having been verbally abused, harmed physically, or having serious arguments. Data on country-level drinking patterns were derived from the World Health Organization. Associations between country-level prevalence of monthly HED and experiences of aggression (at least 1 of 3 studied harms) were derived through multilevel models – adjusted for country-level age structure and by including the respondent's own HED patterns as a mediator. Results: A 1% increase in the prevalence of monthly HED was associated with 5% higher odds (odds ratio [OR] 1.05) of experiencing others' alcohol-related aggression among men, and 6% (OR 1.06) among women. The results suggest that the association between APC and harm was stronger in countries with high prevalences of HED, but the modifying effect could not be confirmed. Discussion/Conclusion: Harm from others' drinking-related aggression depends not only on individual factors but is also influenced by the drinking patterns of the population. However, the country-level prevalence of HED only explains a small part of the variance of this type of harm. [ABSTRACT FROM AUTHOR]

The 'social worlds' concept has been underutilized in alcohol research. This is surprising given that drinking is primarily a social activity, often a secondary part of a sociable occasion in a social world whose members come together around something they have in common, such as an occupation, a hobby, or an identity. Social worlds which include drinking in their practices often entail encouragements or pressures to drink more, though they may also try to impose some limits on drinking or related behavior. Heavy drinking social worlds may be a useful target for public health interventions aimed at supporting less harmful drinking practices, and this paper moves beyond a theoretical discussion of social worlds and their utility to suggest how the concept might be applied in practical terms. We discuss the various influences and actors that potentially impact on heavy drinking social worlds, and suggest a pragmatic typology of social worlds in terms of five features: activity-based, identification-based, settings-based, worldview-based and social position-based. Most social worlds will be characterized by more than one feature, although it is likely that one will predominate in a given social world. Examples are discussed of changes in drinking norms in heavy-drinking social worlds primarily characterised in terms of each of the five features. Implications are considered for public health programming to reduce risky drinking in such social worlds. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine how gender, age and education, regional prevalence of male and female risky drinking and country-level economic gender equality are associated with harms from other people's drinking. 24,823 adults in 10 countries were surveyed about harms from drinking by people they know and strangers. Country-level economic gender equality and regional prevalence of risky drinking along with age and gender were entered as independent variables into three-level random intercept models predicting alcohol-related harm. At the individual level, younger respondents were consistently more likely to report harms from others' drinking, while, for women, higher education was associated with lower risk of harms from known drinkers but higher risk of harms from strangers. Regional rate of men's risky drinking was associated with known and stranger harm, while regional-level women's risky drinking was associated with harm from strangers. Gender equality was only associated with harms in models that did not include risky drinking. Youth and regional levels of men's drinking were consistently associated with harm from others attributable to alcohol. Policies that decrease the risky drinking of men would be likely to reduce harms attributable to the drinking of others. [ABSTRACT FROM AUTHOR]

Background and aims: Alcohol use has been identified as a major risk factor for burden of mortality and disease, particularly for countries in eastern Europe. During the past two decades, several countries in this region have implemented effective alcohol policy measures to combat this burden. The aim of the current study was to measure the association between Lithuania's alcohol control policies and adult all‐cause mortality. Design Interrupted time–series methodology by means of general additive models. Setting: Lithuania. Participants: Adult population of Lithuania, aged 20 years and older. Measurements Alcohol control policies were ascertained via a document review of relevant legislation materials. Policy effects were evaluated as follows: (1) slope changes in periods of legislative (non‐)activity with regard to alcohol control policy (analysis 1); (2) level changes of three interventions following recommendations of the World Health Organization (analysis 2); and (3) level changes of seven interventions judged a priori by an international panel of experts (analysis 3). Mortality was measured by sex‐stratified and total monthly age‐standardized rates of all‐cause mortality for the adult population. Findings During the period 2001–18, effective alcohol control policy measures were implemented on several occasions, and in those years the all‐cause mortality rate declined by approximately 3.2% more than in years without such policies. In particular, the implementation of increased taxation in 2017 was associated with reduced mortality over and above the general trend for men and in total for all analyses, which amounted to 1452 deaths avoided (95% confidence interval = −166 to –2739) in the year following the implementation of the policy. Conclusions: Alcohol control policies in Lithuania appear to have reduced the overall adult all‐cause mortality over and above secular trends. [ABSTRACT FROM AUTHOR]

Informed by literature on venue design and 'nudging' in the context of choice architecture, the purpose of this article is to investigate the physical design of, and practices enacted within, sports bars to provide some indication as to whether these venues are spaces that encourage risky drinking and betting. Our analysis draws on three arms of data collection: (i) website review of licensed venues in Victoria, Australia that promoted sports telecasting; (ii) observational data collection including site visits to 50 venues in Victoria that promoted sport telecasting, and more intensive sessions of observation during six sporting matches; and (iii) in situ interviews with 200 sports bar patrons. We identified three types of sports bars: (i) prototypical sports bars; (ii) venues that have a sports bar section; and (iii) venues that televise sport on occasion. Sports bar attendees reported moderately heavy drinking at sports bars and frequent engagement in sports betting. We identified two distinct groups of sports bettors. Prototypical sports bars and venues that televise sport on occasion attracted younger men who bet the least frequently but in the highest amounts, while venues that have a sports bar section attracted older men who bet more often but in smaller amounts. We identified several design elements across the three types of venues, each 'nudging' sports betting and drinking in different ways. Any focused public health work in relation to sports bars will need to consider the social and physical design elements of different sports betting environments. [ABSTRACT FROM AUTHOR]

This article proposes and discusses the text of a Framework Convention on Alcohol Control, which would serve public health and welfare interests. The history of alcohol's omission from current drug treaties is briefly discussed. The paper spells out what should be covered in the treaty, using text adapted primarily from the Framework Convention on Tobacco Control, but for the control of trade from the 1961 narcotic drugs treaty. While the draft provides for the treaty to be negotiated under the auspices of the World Health Organization, other auspices are possible. Excluding alcohol industry interests from the negotiation of the treaty is noted as an important precondition. The articles in the draft treaty and their purposes are briefly described, and the divergences from the tobacco treaty are described and justified. The text of the draft treaty is provided as Supplementary Material. Specification of concrete provisions in a draft convention points the way towards more effective global actions and agreements on alcohol control, whatever form they take. [ABSTRACT FROM AUTHOR]

Intervening in heavy drinking cultures within groups below the level of the population has been under-utilized as a means of reducing alcohol-associated harms. We argue that the concept of 'social worlds' is useful for the identification and investigation of heavy drinking cultures in collectivities at this level. The concept may also support investigations into other practices with health implications, such as other substance use or gambling. Social worlds are understood to be loosely bounded groups that change over time and any individual may be affiliated with many. Membership of a social world entails shared commitments, practices and norms generated and reiterated through interaction with other members, albeit not necessarily with all members participating together or at once. Social worlds of heavy alcohol consumption are also framed by the settings where people drink, products consumed and technologies used in doing so. As a tool to support public health efforts, we suggest that these social worlds should entail collective drinking, include sufficient members and involve a magnitude of harm to warrant public health investment and be accessible for research and intervention. Researchers can usefully consider how wider forces, including discourses about alcohol and the gendering of drinking practices, are enacted within particular social worlds. Although they may be explored through empirical research, social worlds of heavy drinking are analytic devices rather than perfect reflections of an objective reality. To see them as such allows us to define them strategically, looking for opportunities to modify cultures associated with harms. [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]

In light of the recent announcement from the Victorian (Australia) state government that they are moving to decriminalise public drunkenness and replace it with a 'health-based response', it is timely to reflect on a number of important considerations identified from the academic literature on this topic. We briefly review a number of models of health-care delivery that have been utilised in other jurisdictions, and suggest there are opportunities at a more principled level to respond more adequately to the decriminalisation of public drunkenness in Victoria (and elsewhere). First, embedding research and evaluation, particularly that draws on the needs, views and experiences of those who are deemed to be drunk in public, is essential from the outset, and must be ongoing to enable the continual refinement of models of care. Second, significant funding and intersectoral support are needed to ensure that the laws are not tokenistic and do not remain the responsibility of police. Third, there are opportunities to put policies and principles in place to ensure that police do not use more coercive powers to address concerns around public drunkenness. Most importantly, state-wide education and training efforts are needed alongside the repeal of the law to ensure that emergency services and health-care workers (as well as the community), have a good understanding of the contexts and needs of people who are considered drunk in public, and consequently treat them with care and respect. [ABSTRACT FROM AUTHOR]

We examined acceptability and feasibility of a tablet application ("App") to record self-reported alcohol consumption among Aboriginal and Torres Strait Islander Australians. Four communities (1 urban; 3 regional/remote) tested the App, with 246 adult participants (132 males, 114 females). The App collected (a) completion time; (b) participant feedback; (c) staff observations. Three research assistants were interviewed. Only six (1.4%) participants reported that the App was "hard" to use. Participants appeared to be engaged and to require minimal assistance; nearly half verbally reflected on their drinking or drinking of others. The App has potential for surveys, screening, or health promotion. [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]

This overview reviews the establishment and evolution of the Centre for Social Research on Alcohol and Drugs (SoRAD). It outlines its current organisation and updated research direction, and discusses SoRAD's future challenges and opportunities. SoRAD was established at Stockholm University to strengthen and support Swedish social science research on alcohol and drugs. It became active in 1999, and quickly grew in research efforts and reputation, while experiencing setbacks around 2006 and 2017. In 2018 SoRAD merged with the Centre for Health Equity Studies (CHESS), to form a new Department of Public Health Sciences. In its new suit, SoRAD acts as a research centre within the teaching department. The research activities on alcohol and other drugs and gambling behaviour and problems may be categorised into four main areas: social epidemiology; subcultures and social worlds of use and heavy use; policy formation, implementation and societal responses; and societal and other collective definitions of problems and solutions. The new arrangements, with an increased staff pool and close interplay with higher education, provide a more stable and long-term platform for achieving the main mission of promoting and developing social science research on addictive substances and behaviours and related problems. [ABSTRACT FROM AUTHOR]

Background and Aims: To reduce health and social inequities, it is important to understand how drinking patterns vary within and between Indigenous peoples. We aimed to assess variability in estimates of Indigenous Australian drinking patterns and to identify demographic and methodological factors associated with this. Design A three‐level meta‐analysis of Australian Aboriginal and Torres Strait Islander ('Indigenous') drinking patterns [International Prospective Register of Systematic Reviews (PROSPERO) no. CRD42018103209]. Setting: Australia. Participants: Indigenous Australians. Measurements The primary outcomes extracted were drinking status, single‐occasion risk and life‐time risk. Moderation analysis was performed to identify potential sources of heterogeneity. Moderators included gender, age, socio‐economic status, local alcohol restrictions, sample population, remoteness, Australian state or territory, publication year, Indigenous involvement in survey design or delivery and cultural adaptations. Findings A systematic review of the literature revealed 41 eligible studies. For all primary outcomes, considerable heterogeneity was identified within (I22 = 51.39–68.80%) and between (I32 = 29.27–47.36%) samples. The pooled proportions (P) of current drinkers [P = 0.59, 95% confidence interval (CI) = 0.53–0.65], single‐occasion (P = 0.34, 95% CI = 0.24–0.44) and life‐time (P = 0.21, 95% CI = 0.15–0.29) risk were all moderated by gender, age, remoteness and measurement tool. Reference period moderated proportions of participants at single‐occasion risk. Conclusions: Indigenous Australian drinking patterns vary within and between communities. Initiatives to reduce high‐risk drinking should take account of this variability. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the extent to which the association between recent alcohol consumption and risk of non‐traffic injury varies according to location at the time of the injury. Design Case–cross‐over design. Setting and participants: A total of 15 625 injury patients from 49 emergency departments (EDs) in 22 countries. Measurements Recent alcohol consumption and location at the time of the injury were assessed for when the injury occurred and for the same time 1 week prior to this. The confounding and interactive effects of location were examined by estimating the adjusted odds ratio (OR) of injury from alcohol consumption adjusting for location and then by examining the alcohol consumption × location interaction. Findings There were significant interactive effects of location and alcohol consumption on injury risk. For example, the ORs for volume 0.1–3.0 drinks and street/public place each were 3.0 and 14.2, respectively, whereas the OR for their joint effect was 44.1, suggesting a positive additive interaction [relative excess risk due to interaction (RERI) = 27.9, P < 0.05] and zero multiplicative interaction (OR = 1.0, P = 0.895). The interactions of alcohol consumption with drinking establishment location, work‐place and other locations were mostly additive and negative on the multiplicative scale (e.g. for interaction between volume 0.1–3.0 drinks and drinking establishment location: RERI = 1.19, P = 0.529; multiplicative interaction OR = 0.54, P < 0.05). Conclusions: Location appears to influence the relationship between alcohol consumption and risk of injury. The association between alcohol consumption and injury appears to be greater in locations such as streets and public places compared with private residences. [ABSTRACT FROM AUTHOR]