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Objective: Alcohol labels are one strategy for communicating health information to consumers. This study tested the extent to which consumers recalled alcohol labels with national drinking guidelines and examined the impact of labels on awareness and knowledge of the guidelines. Method: A quasi-experimental study was conducted in two jurisdictions in northern Canada examining the impact of labels on the following outcomes: unprompted and prompted recall of the drinking guideline label message, awareness of the drinking guidelines, and knowledge of the daily and weekly recommended drink limits. The intervention site applied labels with national drinking guidelines, a cancer warning, and standard drink information to alcohol containers in its liquor store, whereas the comparison site did not apply these labels. In total, 2,049 cohort participants in both sites were recruited to complete surveys before and at two time points after the intervention. Changes in outcomes were examined using generalized estimating equations. Results: After the intervention, unprompted and prompted recall of the drinking guideline label message increased more in the intervention versus comparison site (adjusted odds ratio [AOR] = 10.8, 95% CI [0.9, 127.6]; AOR = 7.0, 95% CI [3.3, 14.9], respectively). Awareness of the drinking guidelines increased 2.9 times more in the intervention versus comparison site (AOR = 2.9, 95% CI [2.0, 4.3]). In addition, knowledge of the daily and weekly drink limits increased 1.5 and 1.4 times more in the intervention versus comparison site, respectively (daily: AOR = 1.5, 95% CI [1.0, 2.1]; weekly: AOR = 1.4, 95% CI [1.0, 2.0]). Conclusions: Enhanced alcohol labels get noticed and may be an effective population-level strategy for increasing awareness and knowledge of national drinking guidelines.

Objective: This study tested the initial and continued effects of cancer warning labels on drinkers’ recall and knowledge that alcohol can cause cancer. Method: A quasi-experiment was conducted to examine changes in the intervention versus comparison site for three outcomes: unprompted and prompted recall of the cancer warning, and knowledge that alcohol can cause cancer. The intervention site applied cancer warning labels to alcohol containers in its liquor store for 1 month, and the two liquor stores in the comparison site did not apply cancer labels. In total, 2,049 unique cohort participants (1,056 male) were recruited at liquor stores in the intervention and comparison sites to participate in surveys 4 months before labels were applied and 2 and 6 months after the cancer label was halted because of alcohol industry interference. Generalized estimating equations tested differences in outcomes between sites over time adjusting for socio-demographics and other covariates. Results: Two months after the cancer label, unprompted (+24.2% vs. +0.6%; adjusted odds ratio [AOR] = 32.7, 95% CI [5.4, 197.7]) and prompted (+35.7% vs. +4.1%; AOR = 6.2, 95% CI [3.6, 10.9]) recall increased to a greater extent in the intervention versus comparison site. There was a 10% greater increase in knowledge (+12.1% vs. +11.6%; AOR = 1.1, 95% CI [0.7, 1.5]) 2 months after the cancer label in the intervention versus comparison site. Similar results were found 6 months after the cancer label for all three outcomes. Conclusions: In a real-world setting, cancer warning labels get noticed and increase knowledge that alcohol can cause cancer. Additional cancer label intervention studies are required that are not compromised by industry interference.

The aim of this study was to document the scope of violations of the Canadian Radio-television and Telecommunications Commission (CRTC) "Code for Broadcast Advertising of Alcoholic Beverages" (CRTC Code) by drinking venues posting alcohol-related content on social media platforms, and to assess whether CRTC Code violations by drinking venues relate to their popularity among university students and to students' drinking behaviours.In phase 1 of the study, a probability sample of 477 students from four Canadian university responded to a questionnaire about their drinking and preferred drinking venues. In phase 2, a probability sample of 78 students assessed the compliance of drinking venues' social media posts with the 17 CRTC Code guidelines. We pooled both datasets and linked them by drinking venues.Popular drinking venues were overwhelming posting alcohol-related content that contravenes the CRTC Code. Adjusted effect estimates show that a decrease in the mean level of compliance with the CRTC Code was significantly associated with a 1% increase in popularity score of drinking venues (t-test, p.001). With regard to drinking behaviours, a 1% increase in the overall mean level of compliance with the CRTC Code was associated with 0.458 fewer drinking days per week during a semester (t-test, p = .01), 0.294 fewer drinks per occasion (t-test, p = .048) and a lesser likelihood of consuming alcohol when attending a drinking venue (t-test, p = .001).The results of this study serve as a reminder to territorial and provincial regulatory agencies to review their practices to ensure that alcohol advertising guidelines are applied and enforced consistently. More importantly, these results call for the adoption of federal legislation with a public health mandate that would apply to all media, including print, television and radio, digital and social.Cette étude a pour but de documenter la portée des infractions au Code de la publicité radiodiffusée en faveur de boissons alcoolisées du Conseil de la radiodiffusion et des télécommunications canadiennes (CRTC) (Code du CRTC) commises par certains établissements servant de l’alcool qui publient du contenu lié à l’alcool sur des plateformes de médias sociaux et d’évaluer si ces infractions au Code du CRTC sont en lien avec la popularité de ces établissements auprès des étudiants universitaires et avec les comportements de ces derniers en matière de consommation d’alcool.Au cours de la phase 1 de l’étude, un échantillon aléatoire de 477 étudiants provenant de quatre universités canadiennes ont répondu à un questionnaire portant sur leurs habitudes de consommation d’alcool et sur les établissements servant de l’alcool qu’ils préféraient. Au cours de la phase 2, nous avons évalué, auprès d’un échantillon aléatoire de 78 étudiants, si les publications de ces établissements dans les médias sociaux étaient conformes aux 17 lignes directrices du Code du CRTC. Nous avons regroupé les deux ensembles de données et nous les avons jumelés au moyen de la liste des établissements servant de l’alcool.Les établissements populaires servant de l’alcool ont publié massivement des contenus liés à l’alcool contrevenant au Code du CRTC. Les estimations d’effet ajusté indiquent qu’une réduction du niveau moyen de conformité au Code du CRTC est associée de manière significative à une augmentation de 1 % du taux de popularité des établissements servant de l’alcool (test t, p0,001). En ce qui a trait aux comportements de consommation d’alcool, une augmentation de 1 % du niveau moyen global de conformité au Code du CRTC est significativement associée à une diminution de 0,458 jour de consommation par semaine pendant un semestre (test t, p = 0,01), une diminution de 0,294 consommation par occasion (test t, p = 0,048) et une probabilité plus faible que les étudiants consomment de l’alcool lorsqu’ils se trouvent dans un établissement servant de l’alcool (test t, p = 0,001).Les résultats de notre étude sont une invitation à ce que les agences de réglementation territoriales et provinciales réévaluent leurs pratiques, afin que les lignes directrices en matière de publicité sur l’alcool soient appliquées et respectées de manière uniforme. Au­delà, ces résultats justifient l’adoption d’une loi fédérale avec un mandat en santé publique applicable à tous les médias : médias imprimés, numériques et sociaux, télévision et radio.According to Canadian university students surveyed, popular drinking venues are overwhelmingly posting alcohol-related content on Facebook and Instagram that contravenes the CRTC "Code for Broadcast Advertising of Alcoholic Beverages" (CRTC Code). The heaviest drinkers tend to prefer drinking venues that post images that violate several CRTC Code guidelines. The current self-regulatory system fails Canadian youth by not taking action when a great number of alcohol portrayals and promotions support a culture of excessive drinking. The federal government should adopt new legislation that would apply to all media, include mandatory preclearance of alcohol advertisements and administrative and deterrence systems for infringements on marketing restrictions.Selon les étudiants universitaires canadiens sondés, les établissements populaires servant de l’alcool publient massivement du contenu lié à l’alcool sur Facebook et Instagram qui enfreint le Code de la publicité radiodiffusée en faveur de boissons alcoolisées du CRTC (Code du CRTC). Les grands consommateurs ont tendance à préférer les établissements qui publient des images enfreignant plusieurs lignes directrices du Code du CRTC. L’actuel système d’autoréglementation faillit à soutenir les jeunes Canadiens en n’agissant pas alors que de nombreuses images et promotions de l’alcool favorisent une culture de consommation excessive. Le gouvernement fédéral devrait adopter de nouvelles lois applicables à tous les médias, en particulier une approbation préalable obligatoire des publicités sur l’alcool, ainsi que des systèmes administratifs de dissuasion pour les infractions aux restrictions sur le marketing.

Knowledge that alcohol can cause cancer is low in Canada. Alcohol labels are one strategy for communicating alcohol-related harms, including cancer. Extending existing research observing an association between knowledge of the alcohol&ndash, cancer link and support for alcohol policies, this study examined whether increases in individual-level knowledge that alcohol is a carcinogen following an alcohol labelling intervention are associated with support for alcohol polices. Cancer warning labels were applied to alcohol containers at the intervention site, and the comparison site did not apply cancer labels. Pre-post surveys were conducted among liquor store patrons at both sites before and two-and six-months after the intervention was stopped due to alcohol industry interference. Limiting the data to participants that completed surveys both before and two-months after the cancer label stopped, logistic regression was used to examine the association between increases in knowledge and support for policies. Support for pricing and availability policies was low overall, however, increases in individual-level knowledge of the alcohol-cancer link was associated with higher levels of support for pricing policies, specifically, setting a minimum unit price per standard drink of alcohol (OR = 1.86, 95% CI: 1.11&ndash, 3.12). Improving knowledge that alcohol can cause cancer using labels may increase support for alcohol policies. International Registered Report Identifier (IRRID): RR2-10.2196/16320

OBJECTIVE: To test whether alcohol labels with a cancer warning and national drinking guidelines are an effective tool for supporting more informed and safer alcohol consumption among drinkers. METHODS: Using a quasi-experimental design, pre-post surveys were conducted with 1647 cohort participants systematically selected in liquor stores in two matched sites in Canada in 2017–2018. Enhanced labels designed according to best practices for effective product labels were applied to alcohol containers in the liquor store in the intervention site for one month, and usual practice continued in the comparison site. Generalized estimating equations tested the differences between sites over time in label salience and processing, and self-reported impact of the labels on drinking behaviours. RESULTS: After the intervention, recall of the cancer warning label increased to a greater extent in the intervention versus comparison site (adjusted odds ratio (AOR) = 32.2, 95% CI = 5.4, 191.1), but not the national drinking guideline label (AOR = 2.7, 95% CI = 0.2, 31.8). There were significant label effects in the intervention versus comparison site for reading (AOR = 1.8, 95% CI = 1.3, 2.5), thinking about (AOR = 2.0, 95% CI = 1.4, 2.9), and talking with others about (AOR = 2.1, 95% CI = 1.3, 3.6) the labels, as well as self-reported impact to cut down on drinking (AOR = 2.5, 95% CI = 1.3, 4.7) and to drink less (AOR = 2.4, 95% CI = 1.3, 4.3). CONCLUSIONS: Alcohol labels with a cancer warning and national drinking guidelines do a better job conveying risk information and promoting safer consumption than existing practices. Industry has a legal duty to adequately inform consumers about their products and should be mandated to include key information on alcohol containers. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.17269/s41997-020-00320-7) contains supplementary material, which is available to authorized users.

Alcohol labels are one strategy for raising consumer awareness about the negative consequences of alcohol, but evidence to inform labels is limited. This quasi-experimental study sought to test the real-world impact of strengthening health messages on alcohol container labels on consumer attention, message processing (reading, thinking, and talking with others about labels), and self-reported drinking. Alcohol labels with a cancer warning, national drinking guidelines, and standard drink information were implemented in the intervention site, and usual labelling practices continued in the comparison site. Changes in key indicators of label effectiveness were assessed among a cohort of adult drinkers in both the intervention and comparison sites using three waves of surveys conducted before and at two time-points after the alcohol label intervention. Generalized Estimating Equations with difference-in-difference terms were used to examine the impact of the label intervention on changes in outcomes. Strengthening health messages on alcohol container labels significantly increased consumer attention to [Adjusted Odds Ratio (AOR)=17.2, 95%CI:8.2,36.2] and processing of labels (e.g., reading labels: AOR=2.6, 95%CI:1.8,3.7), and consumer reports of drinking less due to the labels (AOR=3.7, 95%CI: 2.0,7.0). Strengthening health messages on alcohol containers can achieve their goal of attracting attention, deepening engagement, and enhancing motivation to reduce alcohol use. Strengthening alcohol labelling policies should be a priority for alcohol control globally.

On 1 March 2018, a 14‐year‐old girl was found lifeless in a stream behind her high school after having consumed FCKDUP—a beverage containing 11.9% alcohol and sold in 568 mL cans—during her lunch hour. Following her death, the Canadian government took actions at ministerial and parliamentary levels by seeking experts’ advice to better regulate highly sweetened alcoholic beverages, otherwise referred to as ‘alcopops’. We suggest that the Canadian government uses the work surrounding the alcopop tragedy as an opportunity to make significant amendments and revisions of federal alcohol regulations.

To characterize and compare sociodemographic profiles, game-play patterns, and level of addictive behaviors among adults who gamble online and those who do not, and to examine if, at the population level, online gambling is associated with more risky behaviors than offline gambling.Respondents were 8,456 offline gamblers and 111 online gamblers who participated in a population-based survey conducted in the province of Québec, in 2009. The study sample is representative of adult general population.There is an unequal distribution of online gambling in the population. A disproportionate number of men, young people, and students say they participate in online gambling. Poker players are overrepresented among online gamblers and gambling behaviors tend to be more excessive on the Internet. Compared with offline gamblers, online gamblers report more co-occurring risky behaviors, namely alcohol and cannabis use.Those who gamble online appear to be more at risk for gambling-related problems, but the present findings alone cannot be used as evidence for that conclusion. Future research designs could combine longitudinal data collection and multilevel analyses to provide more insight into the causal mechanisms associated with online gambling.

This study tests the hypothesis that the relationship between parenthood and heavy drinking is mediated by drinking locations. The analysis is based on a random sample of 4180 female and 3630 male Canadian drinkers aged between 18 and 55 years old. A multiple mediator model is tested. Results show that the parental role may be associated with variation in where people drink, and where people drink may be associated with variation in heavy drinking. For women, parenthood is related to a reduction in heavy drinking associated with a reduction of drinking occasions that occur at bars, offset to some extent by the fact that drinking in restaurants is also less common among mothers than non-mothers. For men, parenthood is related to a reduction in heavy drinking partly because fathers more often drink at friends' homes and the proportion of drinking occasions that occur at bars is smaller among fathers than non-fathers. The results of this study correspond with a refined version of the opportunity perspective. Given the nature of the processes by which parenthood is related to heavy drinking, alcohol consumption needs to be understood through a perspective that includes both individual and contextual factors.

OBJECTIVES: To describe gambling practices and trends in Quebec between 2009 and 2012 given that, in Canada, public funding allocation to address the risks associated with gambling practices should be based on valid prevalence data and knowledge of patterns and trends in vulnerable populations. METHODS: The study data were taken from the 2009 and 2012 cross-sectional waves of the Enquete sur les habitudes de jeu des Quebecois (ENHJEU-Quebec). The analytical sample consisted of 11,888 respondents in 2009 and 12,008 respondents in 2012. RESULTS: The prevalence of lifetime non-gamblers in the adult population of Quebec increased from 13.6% in 2009 to 16.4% in 2012, and past-year gambling participation decreased from 70.5% to 66.2%. Changes in gambling patterns were not contingent on demographic characteristics; gambling prevalence decreased in all subcategories. The proportion of problem and low-risk gamblers remained unchanged, whereas the prevalence of non-problem gamblers decreased significantly from 66.1% in 2009 to 61.5% in 2012. CONCLUSION: Gambling participation in Quebec is decreasing, though the proportion of problem gamblers remains stable. Given these findings, allocation of public resources for health care services should be maintained. Secondary and primary prevention efforts need to be initiated or maintained to prevent gambling harm.

Low-risk drinking guidelines have been developed independently in a number of jurisdictions resulting in different sets of advice with different definitions of 'low risk'. This paper discusses some of the fundamental issues addressed by an expert advisory panel during the course of developing national guidelines for Canadians and summarises key sets of evidence that were influential.The underlying reasoning and connection between the evidence and the guidelines is discussed in relation to: (i) how to minimise risk of long-term illnesses; (ii) how to minimise risk of short-term harms, for example injury; and (iii) alcohol use during pregnancy. Both absolute and relative risks were considered in the development of the guidelines.Meta-analyses of all-cause mortality were used to identify upper limits for usual drinking levels where potential benefits and risks were balanced for the average person in comparison with lifetime abstainers (10 standard drinks per week for women, 15 for men). Emergency room studies and situational risk factors were considered for advice on reducing short-term: (i) when not to drink at all; (ii) how to reduce intoxication; and (iii) upper limits for occasional daily consumption by adults aged 25 to 64 years (3 standard drinks for women, 4 for men). Shortcomings in the research data were highlighted.It was estimated that total compliance with these guidelines at a national level would result in substantially reduced per capita alcohol consumption and approximately 4600 fewer deaths per year.

The aim of this study was to assess whether the effect of parenthood on alcohol intake varies according to the context in which the drinking act occurs.The data were drawn from the Canadian Addiction Survey, a national telephone survey conducted in 2004. The analytical sample included 1,079 drinking occasions nested in 498 female drinkers and 926 drinking occasions nested in 403 male drinkers between 18 and 55 years of age. A multilevel linear statistical model was used to estimate the variance related to the drinking occasion (Level 1) and to the parental role (Level 2).Parenthood was not associated with alcohol intake per occasion. Drinking context variables brought great explanatory power to the study of alcohol intake, but, overall, the effect of parenthood on alcohol intake did not vary according to the context in which drinking occurs. Only one interaction between the parental role and contextual characteristics was found.Men's and women's alcohol intake within drinking contexts is more likely to be influenced by the immediate context in which drinking occurs than by their parental role. The explanation for alcohol behaviors within the general Canadian population may lie as much in the situation as in the person.

Objectives: To determine the way Canadians consume alcohol beyond drinking amounts and to verify if the drinking act is similar across provinces given that, in Canada, alcohol policies come under provincial jurisdiction. Methods: Subjects were 10,466 current drinkers (5,743 women and 4,723 men) aged 18 to 76 years, who participated in the GENACIS Canada study. Results: In Canada, there are three main patterns of consuming alcohol. Maritimers tend to drink more per occasion, report more binge drinking and largely prefer beer. In the Prairies, people tend to drink less, to drink less often during a meal and to favour spirits. Finally, drinkers from Quebec, Ontario and British Columbia drink more often, drink wine more often, drink spirits less often, and drink more often during a meal than drinkers from the other provinces. The same patterns are observed in both sexes, although the differences across provinces are less pronounced among women. Conclusion: Knowledge about these three drinking groups should be used to increase the legitimacy and effectiveness of alcohol policies in general. Key words: Culture; alcoholic beverages; Canada; gender

The inflammatory response to Pseudomonas aeruginosa is not properly regulated in the lungs of patients with cystic fibrosis (CF). In the lung epithelium of individuals with wild-type CF transmembrane conductance regulator, lipid rafts containing CF transmembrance conductance regulator are rapidly formed in response to P. aeruginosa infection, and this response is closely linked to resistance to infection and disease. We found these rafts also contained high levels of caveolin-1 and thus examined the sensitivity of cav1 knockout (KO) mice to P. aeruginosa challenge in both acute and chronic P. aeruginosa infection models. We found that cav1 KO mice had increased sensitivity to P. aeruginosa infection, as represented by an increased mortality rate, elevated bacterial burdens recovered from lungs and spleens, and elevated inflammatory responses. These findings correlated with the decreased ability of cav1-deficient neutrophils to phagocytose P. aeruginosa. In addition, P. aeruginosa colonized cav1 KO mice much better compared with the wild-type controls in a model of chronic infection, indicting an important contribution of Cav-1 to innate host immunity to P. aeruginosa infection in the setting of both acute pneumonia and chronic infection typical of CF.

To investigate the effect of lactoferrin or lactoferricin with or without penicillin G, light and transmission electron microscopy were performed on thin sections of two Staphylococcus aureus strains. Lactoferrin affected the ultrastructure of S. aureus and groups of undivided cells were observed after lactoferrin treatment with or without penicillin G. These results suggest that lactoferrin can affect staphylococcal cell separation and therefore prevent dissemination of daughter cells from spreading infection. After treatment with lactoferrin, S. aureus cells were less covered (P