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Objective: The objective of this study was to compare drink driving and related road safety issues in 2 urban areas of 6 countries and develop an equation for estimating the rate of crash underreporting to the police in urban areas of countries that lack this information. Methods: This study is a secondary analysis of 1 to 2 waves of surveys in pairs of matched medium-sized cities in Belgium, Brazil, China, Mexico, South Africa, and Ohio, United States; the surveys supported evaluation of local alcohol harm reduction efforts. Data were from 2017 to 2019 except 2023 for Mexico. Mailed surveys in Ohio and household interviews elsewhere of quota samples matched to census data yielded 23,240 completed interviews. Relevant questions covered drinking, driving under the influence of alcohol (DUI), DUI enforcement, and, except in South Africa, road crashes. GLM regression provided an equation for estimating police reporting rates of urban injury and no-injury crashes from a country's purchasing-power parity–adjusted gross domestic product (GDP) per capita. Results: The percentage of drivers driving unlicensed was 30% in Mexico and South Africa, 15% in Brazil, 8% in China, and <1% elsewhere. Among adults who both drove and drank, self-reported urban DUI rates ranged from 12% in China to 53% in South Africa, with 4 countries between 18% and 26%. Among those reporting DUI, the percentage stopped by police for doing so was 14% in Belgium, 15% in Brazil, 25% in China, 31% in Mexico, 45% in South Africa, and only 3% in Ohio. The surveys yielded data on 380 urban crashes. Past-year crash involvement was 2% to 3% in Belgium and China and 5% to 6% elsewhere. The 10% injury rate in Ohio crashes was significantly below the 24% to 35% rates elsewhere. Injury crashes were almost universally reported except in Brazil (60% reported). Only 49% to 56% of non-injury crashes were reported, except in Ohio (73%). Perceived alcohol-involved crash rates of 18% to 19% in Belgium and Ohio were significantly lower than the 32% reported in Brazil, 41% in China, and 57% in Mexico. In the regression, GDP per capita and injury involvement were positively associated with police crash reporting. Conclusions: Our equation more closely approximates urban police crash reporting rates than prior studies that assumed that they matched U.S. data. DUI enforcement is weak/ineffective in urban Ohio. With suggested adjustments, our survey questions should be usable in other international road safety and DUI studies. [ABSTRACT FROM AUTHOR]

Alcohol remains readily available to youth in most countries. We examined the associations between both the on- and off-premises commercial availability of alcohol to youth and their alcohol use, heavy episodic drinking, and alcohol-related harms. We conducted the study using data from a survey of a sample of 594 students in central Mexico between 12 and 17 years of age in 2016. Both the perceived availability of alcohol and the purchasing of alcohol at an off-premises establishment were positively related to past-30-day alcohol use and heavy episodic drinking, as well as to alcohol-related harms in the past year. Consumption at on-premises establishments was also positively associated with alcohol-related harms. Preventive efforts to reduce the availability of alcohol at off- and on-premises establishments, by such strategies as mystery shopper and responsible beverage service programs, are imperative.

We report the results of a quasi-experimental evaluation of a mystery shopper intervention in Zacatecas and Guadalupe, Mexico. Underage youth attempted to purchase beer at 50 Modelorama stores and 32 Oxxo stores (intervention groups), and at 19 comparison convenience stores in March, July, and August 2018. After each attempt, intervention store operators were informed if a sale was made. Modelorama operators also received training and were warned that repeated sales to minors could jeopardize their franchise. Average sales rates to minors were 63.8% at Modeloramas, 86.5% at Oxxo stores, and 98.2% at comparison stores. The findings suggest that mystery shopper interventions with training, feedback to store operators, and sanctions after repeated sales to underage youth may reduce sales to minors in low- and middle-income countries.

Despite high rates of youth drinking in Mexico, little is known about the availability and consumption of specific types of alcoholic beverages within this population or the contexts in which alcohol is consumed. Objectives: This descriptive study examined alcohol consumption, perceived availability, and purchase of different types of alcoholic beverages (i.e., beer, wine, tequila, other spirits, pre-mixed cocktails, alcohol energy drinks, homemade alcohol), and drinking contexts. Methods: The sample comprised 594 students aged 12-17 in three cities in central Northeastern Mexico, where the legal drinking age is 18. Results: Over half had consumed alcohol in the past year. Of past-year drinkers, almost 57% had consumed alcohol in the past 30 days. Over half of these students reported that they or their friends had purchased alcohol at an off-premise establishment for their personal consumption, and 40% had consumed it at an on-premise establishment. Beer, which almost 60% of the study's adolescents thought was either fairly or very easy to get, was the most commonly consumed type of alcoholic beverage in the past 30 days. The majority of youth (70%) reported that their last drinking location was at home, someone else's home, or a public place. Importantly, however, 39% of young drinkers reported that the last time they consumed alcohol was at an on-premise establishment, and most of these youth (90%) did so in the absence of their parents. Conclusions/Importance: The findings suggest the need to implement and enforce measures to decrease retail and social alcohol availability to Mexican youth. [ABSTRACT FROM AUTHOR]

Introduction: Low- and middle-income countries bear disproportionate burdens from excessive alcohol consumption, yet have fewer resources to identify and intervene with risky drinkers. Low-cost screening and brief intervention (SBI) models offer a tool for addressing this health problem and reducing disparities., Methods: In this mixed-methods study, trained pseudo-patients visited health clinics in Zacatecas, Mexico, where a novel SBI model was used with trained nonmedical health educators (HEs) conducting SBI in waiting areas. Pseudo-patients, who provided responses to the AUDIT-C screening items designed to trigger a brief intervention (BI), waited for HEs to engage them in an SBI encounter. Data on HEs' behaviors, SBI components provided, and contextual characteristics were coded from audio recordings of the encounters using an SBI checklist and from pseudo-patient interviews., Results: Quantitative analyses examined the consistency in pseudo-patients' targeted AUDIT-C scores and those documented by HEs as well as the frequency of delivery of SBI components. Across 71 interactions, kappas between HEs' scores and the targeted AUDIT-C scores ranged from 0.33 to 0.45 across AUDIT-C items; it was 0.16 for the total AUDIT-C. In 41% of interactions, the HEs recorded total AUDIT-C scores that accurately reflected the targeted scores, 45% were below, and 14% exceeded them. Analyses of checklist items and transcripts showed that HEs demonstrated desired interpersonal skills (attentive, empathetic, professional) and provided general information regarding risks and recommendations about reducing consumption. In contrast, personalized BI components (exploring pseudo-patients' personal challenges and concerns about reducing drinking; making a plan) occurred much less frequently. Pseudo-patient interviews revealed contextual factors (noise, lack of privacy) that may have negatively affected SBI interactions., Discussion: Using trained nonmedical persons to administer SBI holds promise to increase its reach. However, ongoing training and monitoring, prioritizing comprehensive BIs, eliminating contextual barriers, and electronic delivery of screening may help ensure high quality delivery., Competing Interests: Deborah A. Fisher, Joel W. Grube, Liz Lilliott-González, Christopher L. Ringwalt, Ted R. Miller, Marissa Elias, and Robert Sturm have received funding from the AB InBev Foundation to conduct an independent evaluation of the Global Smart Drinking Goals initiative. Tom Achoki, Elena Cardenas Vargas, and Angela Rizzo are affiliated with the AB InBev Foundation., (Copyright © 2024 Fisher, Grube, Lilliott-González, Elias, Sturm, Ringwalt, Miller, Cardenas Vargas, Achoki and Rizzo.)

Background: Research on the effects of restricting bar opening hours and alcohol sales in middle-income countries is very limited. We assessed compliance with and possible effects of a law enacted in Zacatecas, Mexico on December 30, 2017 and implemented in 2018 and 2019 that established a 2 AM bar closing time and 10 PM cut-off for alcohol sales by off-premises stores., Methods: Monthly observations of bars and off-premises stores and alcohol mystery shopping visits from 2018 to early 2020 were conducted to assess compliance with the law. Breath tests were conducted in 2018 and 2019 with samples of pedestrians in the nighttime entertainment districts of Zacatecas and a comparison city (Aguascalientes). Surveys of bar owners/managers and staff, emergency medical personnel (EMP), and police officers were conducted in Zacatecas in 2018 and 2019 to assess awareness and support of the law and possible effects of the law on alcohol-related problems such as violence and injuries., Results: Monthly observations indicated that a substantial percentage of bars and off-premises package stores did not comply with the law. Pedestrian breath tests in 2018 and 2019 indicated significant reductions in blood alcohol concentration and heavy drinking among pedestrians in Zacatecas from 11 PM to 2 AM compared to Aguascalientes, but not after 2 AM. Surveys of bar owners/managers indicated that most were aware and supportive of the law. EMP surveys indicated reductions in incidents of physical fighting and drunk or injured customers during the annual September fair in Zacatecas., Conclusions: This study suggests that restricting bar opening hours and alcohol sales may not result in full compliance by bars and off-premises stores, but may help to reduce excessive alcohol use and related harms in a middle-income country. A more rigorous evaluation with pre-intervention data is needed, however, to fully address this latter question., (Copyright © 2021. Published by Elsevier B.V.)