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Aims: To estimate the effect of national restrictions on late-night availability of alcohol on alcohol-related assault at a population level as indicated by (1) change in hospitalizations for weekend assaults and (2) change in the proportion of assaults documented by police that occur at night., Design: Evaluation of a natural experiment, involving: (1) pre-post comparisons of age-specific incidence rates, adjusted for seasonality and background trend using Poisson regression; and (2) interrupted time-series analyses, using seasonal autoregressive integrated moving average (SARIMA) models of national data with no control site., Setting: New Zealand., Participants: (1) Inpatients discharged from NZ hospitals following assault during the weekend (Friday-Sunday) from 2004 to 2016 (n = 14 996) and (2) cases of assault recorded by NZ Police from 2012 to 2018., Intervention: introduction of national maximum trading hours for all on-licence (8 a.m.-4 a.m.) and off-licence premises (7 a.m.-11 p.m.), abolishing existing 24-hour licences, on 18 December 2013., Measurements: (1) Age-specific incidence of hospitalization for assault on Friday, Saturday or Sunday from the national hospital discharge data set, excluding short-stay emergency department admissions and (2) proportion of weekly police-documented assaults occurring between 9 p.m. and 5.59 a.m., from NZ Police Demand and Activity data set., Findings: Following the restrictions, weekend hospitalized assaults declined by 11% [incidence rate ratio (IRR) = 0.89; 95% confidence interval (CI) = 0.84, 0.94], with the greatest reduction among 15-29-year-olds (IRR = 0.82; 95% CI = 0.76, 0.89). There was an absolute reduction (step change) of 1.8% (95% CI = 0.2, 3.5%) in the proportion of police-documented assaults occurring at night, equivalent to 9.70 (95% CI = 0.10, 19.30) fewer night-time assaults per week, out of 207.4., Conclusions: The 2013 implementation of national maximum trading hours for alcohol in NZ was followed by reductions in two complementary indicators of alcohol-related assault, consistent with beneficial effects of modest nation-wide restrictions on the late-night availability of alcohol., (© 2020 Society for the Study of Addiction.)

Introduction and Aims: In December 1999, New Zealand lowered the alcohol minimum purchasing age from 20 to 18 years. We tested hypotheses that this change was associated with long-term increases in traffic injury attributable to alcohol-impaired driving among 18- to 19-year-olds (target age group) and 15- to 17-year-olds (affected by 'trickle-down')., Design and Methods: We undertook a controlled before-and-after comparison of rates of fatal and non-fatal traffic injury to persons of any age attributable to impaired drivers aged 18-19 years and 15-17 years, versus 20- to 21-year-olds. Crash data including assessment of driver alcohol impairment were recorded by New Zealand Police. The pre-change period was 1996-1999. Post-change periods were 2000-2003, 2004-2007 and 2008-2010. Outcomes were population-based and vehicle travel-based rates., Results: Compared with the change in injury rates attributable to alcohol-impaired 20- to 21-year-old male drivers, injuries attributable to 18- to 19-year-old male drivers increased in all post-change periods and significantly so in the second post-change period (incidence rate ratio [IRR] 1.3, 95% confidence interval [CI] 1.1 to 1.5). For 15- to 17-year-old male drivers, rates increased in all post-change periods compared with 20- to 21-year-olds, and more so in the second (IRR 1.2, 95% CI 1.1 to 1.4) and third (IRR 1.2, 95% CI 1.1 to 1.4) periods. There was a short-term relative increase in harm attributable to 18- to 19-year-old female drivers (IRR 1.5; 1.1 to 2.0). Results were similar for vehicle travel-based rates., Discussion and Conclusions: Reducing the alcohol minimum purchasing age was followed by long-term increases in the incidence of traffic injury attributable to male 15- to 19-year-old alcohol-impaired drivers. [Kypri K, Davie G, McElduff P, Langley J, Connor J. Long-term effects of lowering the alcohol minimum purchasing age on traffic crash injury rates in New Zealand. Drug Alcohol Rev 2017;36:178-185]., (© 2016 Australasian Professional Society on Alcohol and other Drugs.)

Introduction and Aims: We examine the association between reducing the alcohol minimum purchasing age from 20 to 18 years in December 1999 and rates of weekend assault hospitalisation among young Māori in the following 12 years. Our previous work showed deleterious effects for young people overall. In keeping with Treaty of Waitangi principles, we sought to determine whether the policy was similarly detrimental for Māori., Design and Methods: We used Poisson regression to examine data from 1995 to 2011 on Māori hospitalised on Friday-Sunday following assault, separately by gender among 15- to 17-year-olds and 18- to 19-year-olds, versus 20- to 21-year-olds as a control for changes in economic and environmental factors., Results: There was no evidence to suggest weekend assault hospitalisations increased significantly more among 15- to 17-year-old or 18- to 19-year-old Māori males in the post-change periods (incidence rate ratios varied between 0.83 and 1.13; P values >0.25) compared with increases observed in 20- to 21-year-old Māori males. For Māori females, estimates were more variable, but overall, there was no evidence of the hypothesised effect (incidence rate ratios between 0.60 and 1.09; P values >0.07)., Discussion and Conclusions: Overall, we find no evidence that lowering the minimum alcohol purchasing age increased weekend hospitalised assaults among young Māori. Inferences are compromised by lack of statistical power which underlines the importance of planning for evaluation of important policies well before they are implemented, particularly with a view to meeting obligations to Māori arising from the Treaty of Waitangi., (© 2015 Australasian Professional Society on Alcohol and other Drugs.)

Objectives: We estimated the effects on assault rates of lowering the minimum alcohol purchasing age in New Zealand from 20 to 18 years. We hypothesized that the law change would increase assaults among young people aged 18 to 19 years (the target group) and those aged 15 to 17 years via illegal sales or alcohol supplied by older friends or family members., Methods: Using Poisson regression, we examined weekend assaults resulting in hospitalization from 1995 to 2011. Outcomes were assessed separately by gender among young people aged 15 to 17 years and those aged 18 to 19 years, with those aged 20 and 21 years included as a control group., Results: Relative to young men aged 20 to 21 years, assaults increased significantly among young men aged 18 to 19 years between 1995 and 1999 (the period before the law change), as well as the postchange periods 2003 to 2007 (incidence rate ratio [IRR] = 1.21; 95% confidence interval [CI] = 1.05, 1.39) and 2008 to 2011 (IRR = 1.20; 95% CI = 1.05, 1.37). Among boys aged 15 to 17 years, assaults increased during the postchange periods 1999 to 2003 (IRR = 1.28; 95% CI = 1.10, 1.49) and 2004 to 2007 (IRR = 1.25; 95% CI = 1.08, 1.45). There were no statistically significant effects among girls and young women., Conclusions: Lowering the minimum alcohol purchasing age increased weekend assaults resulting in hospitalization among young males 15 to 19 years of age.

Aim: To determine the extent to which ICD-10 alcohol intoxication codes are used for serious hospitalised injury and the distribution of these codes according to gender, age, injury mechanism and intent, severity of injury, and whether the patient was treated in an Intensive Care Unit., Design: Cross-sectional study., Setting: New Zealand., Participants: All injury hospital discharges in 2010 that met specified severity criteria., Measurements: Cases which had a measurement of BAC (Y90) coded, or only a subjective assessment of alcohol intoxication (F10.0)., Findings: 2.5% had a blood alcohol recorded (Y90) and a further 3% were coded as being intoxicated but there was no blood alcohol code. All factors investigated were shown to be independently associated with the assignation of codes. Notable findings were the elevated odds of an alcohol code for males, assault and the more severe injuries., Conclusions: Assessment of alcohol intoxication among seriously injured persons appears to be very uncommon. The development of a standardised instrument for clinical judgement of intoxication would be highly desirable., (Copyright © 2013. Published by Elsevier Ltd.)

Aim: To assess critically the face validity of the World Health Organization's (WHO's) International Guide for Monitoring Alcohol Consumption and Related Harm (MACRH) for deriving indicators, for the purposes of developing non-fatal alcohol-related injury indicators in New Zealand., Design: MACRH's five solutions for deriving indicators are: (i) use only alcohol-specific cases; (ii) identify subsets of events known to be highly alcohol-related; (iii) utilize control indicators that are rarely alcohol-related; (iv) estimate alcohol attributable fractions (AAFs) and adjust indicators accordingly; and (v) develop composite indicators. These were assessed in terms of their face validity with particular reference to New Zealand., Findings: There are significant face validity issues with each of the five options. Solution 4 offers the greatest promise, provided that: (i) valid AAFs can be derived and they are updated regularly; and (ii) appropriate adjustment is made for extraneous influences on the estimates of alcohol-related harm. To date, the latter has not been carried out., Conclusions: Most potential sources of data on alcohol-related harm are subject to extraneous influences, which vary over time and space. While the attempt by WHO to offer solutions to this problem is laudable, the solutions do not address the problem adequately. MACRH guidelines need to be revised to include criteria for a valid outcome indicator.