Search

Introduction: Alcohol remains a significant contributor to mortality and morbidity in Finland and the Baltic countries, particularly among men. This study aimed to assess alcohol policy restrictiveness in this region from 1995 to 2019 using a modified version of the Bridging the Gap (BtG-M) policy scale and examine its association with alcohol-related disease burden., Methods: The study utilised national laws to score policy restrictiveness (higher BtG-M scores mean stricter policies) and age-standardised rates of disability-adjusted life years (DALY), years of life lost, years lived with disability and deaths per 100,000 from the 2019 Global Burden of Disease Study (GBD). Spearman correlation tests and panel data regression models were applied to assess the association between policy score and burden of disease., Results: Finland maintained a high BtG-M score, while the Baltic countries experienced recent increases from initially lower scores. Alcohol-related disease burden showed an inverse association with policy changes in these countries. Strongest association was seen between the BtG-M score and DALY rates attributed to injuries. Premature mortality among men constituted the largest proportion of disease burden., Discussion and Conclusions: Despite challenges in accessing and comparing policy data over time, we showed a strong association between alcohol policy and alcohol-related harm in Finland and the Baltic countries. This study is one of the first to use the BtG-M scale to monitor changes in alcohol policies over time and their relationship to alcohol-related harm using GBD methodology. The study highlights the effects of national alcohol policies on levels of alcohol-related harm., (© 2024 The Author(s). Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Competing Interests: Competing interests: Associate Professor NC is a board member of the Foundation for Alcohol Research and Education and has received a research grant from the Australian Research Council Linkage Project with the Foundation for Alcohol Research and Education as Partner Organisation.

Background: There is a well-published literature on the effectiveness and stringency of alcohol control policies, but not many studies focus on policy implementation, where policies transform into impact. The objective of this study is to create a composite index that measures the capacity for implementing effective alcohol control policies across all provinces in Thailand., Methods: Based on the international literature, we developed a list of key indicators for tracking the implementation of alcohol policies at the subnational level. To ensure these indicators were relevant to the Thai context, we obtained feedback from Thai experts. We collected primary data according to the developed indicators using questionnaires filled in by key informants at the implementing agencies and gathered secondary data at the provincial level. On this basis, we developed indices that reflect the status of alcohol control policy implementation. We then investigated the association between the indices and the prevalence and pattern of alcohol consumption and alcohol-related harms while adjusting for potential confounders using multiple linear regression and negative binomial regression, respectively., Results: Scores on the Provincial Alcohol Policy Implementation Capacity (PAPIC) Index ranged between 39 and 79. We found that each 1-point increase in PAPIC score was associated with a 1.98 % reduction in the quantity of alcohol consumed in grams per day (coefficient: -0.02; 95 %CI: -0.03, -0.00; p-value<0.05; e -0.02 = 0.9802). We also found that for each 1-point increase in PAPIC score, the proportion of regular drinkers reduced by 0.30 per cent (coefficient: -0.30; 95 %CI: -0.55, -0.05; p-value<0.05). However, we did not find any association between the indices and alcohol-related harms., Conclusion: The level of implementation of alcohol control policy at the sub-national level is associated with alcohol consumption levels. The findings suggest the value of allocating resources to the implementation of alcohol control policy., Competing Interests: Declaration of competing interest The authors declare they have no known competing financial interests or personal relationships that could appear to have influenced the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Objective: To systematically assess the Canadian federal government's current alcohol policies in relation to public health best practices., Methods: The 2022 Canadian Alcohol Policy Evaluation (CAPE) Project assessed federal alcohol policies across 10 domains. Policy domains were weighted according to evidence for their relative impact, including effectiveness and scope. A detailed scoring rubric of best practices was developed and externally reviewed by international experts. Policy data were collected between June and December 2022, using official legislation, government websites, and data sources identified from previous iterations of CAPE as sources. Contacts within relevant government departments provided any additional data sources, reviewed the accuracy and completeness of the data, and provided amendments as needed. Data were scored independently by members of the research team. Final policy scores were tabulated and presented as a weighted overall average score and as unweighted domain-specific scores., Results: Compared to public health best practices, the federal government of Canada scored 37% overall. The three most impactful domains-(1) pricing and taxation, (2) marketing and advertising controls, and (3) impaired driving countermeasures-received some of the lowest scores (39%, 10%, and 40%, respectively). Domain-specific scores varied considerably from 0% for minimum legal age policies to 100% for controls on physical availability of alcohol., Conclusion: Many evidence-informed alcohol policies have not been adopted, or been adopted only partially, by the Canadian federal government. Urgent adoption of the recommended policies is needed to prevent and reduce the enormous health, social, and economic costs of alcohol use in Canada., (© 2024. The Author(s).)

Introduction: Alcohol use is involved in a large proportion of homicides and suicides each year in the U.S., but there is limited evidence on how policies targeting alcohol influence violence in the U.S., Context: Extant studies generally focus on individual policies in isolation of each other. This study examines the impacts of changes in states' alcohol policy restrictions on overall homicide and suicide rates and firearm-related homicide and suicide rates using a holistic measure of states' alcohol policy environments., Methods: Using a composite measure of state-level alcohol policies (Alcohol Policy Scale) and data from the National Vital Statistics System from 2002 to 2018, this study applied a Bayesian time series model to estimate the impacts of alcohol policy changes on overall and firearm-involved homicide and suicide rates. The analysis was performed in 2023 and 2024., Results: A 1 SD change in the Alcohol Policy Scale was associated with a 6% decline in homicide rates both overall (incident rate ratio=0.94; 95% credible interval = 0.89, 1.00) and for firearm homicides specifically (incident rate ratio=0.94, 95% CI=0.88, 1.01). There was no clear association of alcohol policy with suicides. The model predicts that a nationwide increase in alcohol restrictions equivalent to a shift from the 25 th to 75 th percentile of the scale's distribution would result in almost 1,200 fewer homicides annually., Conclusions: Increases in the restrictiveness of state-level alcohol policies are associated with reductions in homicides. More restrictive alcohol policy environments may offer an opportunity to reduce homicides., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Alcohol imposes a significant burden on health, social and economic systems in Sri Lanka. In the present economic crisis taxes on alcohol provides necessary revenue increases. Yet, the perception of the public on alcohol policies in Sri Lanka is not well explored., Objectives: This opinion survey was conducted with the aim to understand the public's awareness on alcohol harm, alcohol industry influences, barriers and facilitators for implementing alcohol control policies in Sri Lanka, and the level of public support for alcohol policies, particularly taxes on alcohol products., Methods: A street intercept survey among 997 participants (with a ratio of 2:1 for males and females) selected through a cluster sampling method responded to an interviewer administered questionnaire. Bivariate and multivariate analyses were conducted to determine associations and a p  < 0.05 was considered significant., Results: Among the respondents, 36.1% have consumed alcohol at least once in their lifetime and 29.1% have consumed alcohol during the past 12 months with a significant gender difference (females - 2.8%; males- 43.4%; p  < 0.001). Significant proportions of both men (81.4%) and women (71.8%); p  < 0.017 agreed that policy measures to reduce alcohol consumption would benefit the government including a significant proportion (73.8%, p  < 0.008) of alcohol users. The vast majority -72.8%- agreed that increasing alcohol prices would help address the alcohol consumption problem in Sri Lanka. Moreover, only 30.8% of men and 44.3% of women agreed that the government's alcohol laws are currently strong enough to protect people from alcohol harm. The regression analysis revealed that men are 2.43 times more in agreement with the statement that "policy measures aimed at reducing alcohol consumption can benefit the public" as compared to women. However, individuals aged 50-64 years are 40% less likely to agree with this statement as compared to 18-33 years., Conclusion: The majority of the public, including people who consume alcohol, are supportive of improving alcohol related policies, including taxes, and acknowledge negative impact of alcohol consumption on the country. This presents a clear opportunity for Sri Lanka to strengthen and enforce the alcohol related policies to protect and improve public health., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chandraratne, Negi, Siyambalapitiya, De Seram, Selladurai, Pieris, Rothenstein-Henry and Murukutla.)

Background: The European region has the highest daily alcohol consumption per capita and a high alcohol-related burden of disease. Policymaking at the European Union level is open to participation by interest groups, from public health organizations to alcohol industry representatives. This study aimed to map the interest groups present in the alcohol taxation and cross-border regulation initiatives and identify which arguments were used to support positions in favor or against them., Methods: We used qualitative content analysis on the comments submitted on the official European Commission website during the 2017, 2018, 2020, and 2022 participation periods. Interest groups were characterized considering their positioning, and arguments were identified and compared by position and type of initiative., Results: Opponents of changes to the structures of alcohol excise duties and cross-border regulations were mostly representatives of the alcohol and agricultural industries, and the proponents were mostly health-related nongovernmental organizations. Opponents of these initiatives used a wide variety of arguments, from economic and trade to health arguments, while proponents focused mainly on health arguments, such as the effectiveness of alcohol taxation in preventing alcohol-related morbidity and mortality., Conclusion: This study highlights the wide range of arguments used by opponents around alcohol control policies, contrasting with the health-centered arguments of proponents. It further shows that there is a lobbying network at the European Union level, combining national and international representatives of industry and non-governmental organizations. These findings provide an opportunity for better preparation for upcoming discussions on alcohol control at national and regional levels., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Parental monitoring behaviors are negatively associated with adolescent substance use. Yet, the processes explaining these associations are still unclear. The current study examined adolescents' knowledge of minimum legal drinking age laws and their perceived acceptability of underage drinking as potential mediators of the links between parental monitoring behaviors and youth alcohol use. The sample included 1154 Belgian adolescents (M age  = 16.34, SD = 1.33; 71% girls), who were recruited in Wallonia (54.9%) and in Flanders (45.1%). Path analyses revealed that higher parental rule setting, but not solicitation, was related to lower alcohol use. Acceptability of underage drinking mediated this link, but not knowledge of the laws. Results suggest that beyond laws regulating the minimum legal drinking age, alcohol use prevention programs should consider the importance of parental rule setting and youth's perceived acceptability of underage drinking., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: Complementing the extensive research literature demonstrating that increased alcohol outlet density is associated with excessive alcohol consumption and related harms, this article synthesizes information on the types of alcohol outlet density restrictions in US state-level laws., Design: Statutes and regulations related to alcohol outlet density in all 50 states and the District of Columbia in effect as of January 1, 2022, were collected using Westlaw. State-level density restrictions were coded according to 4 variables and overlaid with existing research on state-specific local authority to regulate outlet density. Alcohol outlet density laws in Michigan and Massachusetts were analyzed in detail as case studies., Setting: United States., Main Outcome Measure: US state-level licensing laws restricting alcohol outlet density., Results: Thirty-three states and the District of Columbia have state-level licensing laws that limit alcohol outlet density. Of those, 25 have population-based restrictions, 8 have distance-based restrictions, 7 have quotas, and 6 require the licensing agency to consider density-related factors. Within the same group of 34 jurisdictions, 22 apply restrictions to both on- and off-premises outlets, 5 apply them only to on-premises outlets, and 7 apply them only to off-premises outlets. Among the 32 states where localities lack authority to license alcohol outlets, two-thirds have state-level laws restricting outlet density. State-level density restrictions also exist in approximately two-thirds of the states where localities have licensing authority. Case studies of Michigan and Massachusetts highlight how state-level density restrictions operate in practice., Conclusions: Two-thirds of jurisdictions have state-level alcohol outlet density restrictions, with population-based restrictions being the most common. In addition, outlet density restrictions may exist regardless of limits on local control and whether localities with authority to enact density restrictions have done so. Policymakers and others can reference this assessment to identify examples and opportunities to strengthen the alcohol policy environment in any given state., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: During COVID-19, hospitality businesses (e.g. bars, restaurants) were closed/restricted whilst off-sales of alcohol increased, with health consequences. Post-covid, governments face lobbying to support such businesses, but many health services remain under pressure. We appraised 'sweetspot' policy options: those with potential to benefit public services and health, whilst avoiding or minimising negative impact on the hospitality sector., Methods: We conducted rapid non-systematic evidence reviews using index papers, citation searches and team knowledge to summarise the literature relating to four possible 'sweetspot' policy areas: pricing interventions (9 systematic reviews (SR); 14 papers/reports); regulation of online sales (1 SR; 1 paper); place-shaping (2 SRs; 18 papers/reports); and violence reduction initiatives (9 SRs; 24 papers/reports); and led two expert workshops (n = 11)., Results: Interventions that raise the price of cheaper shop-bought alcohol appear promising as 'sweetspot' policies; any impact on hospitality is likely small and potentially positive. Restrictions on online sales such as speed or timing of delivery may reduce harm and diversion of consumption from on-trade to home settings. Place-shaping is not well-supported by evidence and experts were sceptical. Reduced late-night trading hours likely reduce violence; evidence of impact on hospitality is scant. Other violence reduction initiatives may modestly reduce harms whilst supporting hospitality, but require resources to deliver multiple measures simultaneously in partnership., Conclusions: Available evidence and expert views point to regulation of pricing and online sales as having greatest potential as 'sweetspot' alcohol policies, reducing alcohol harm whilst minimising negative impact on hospitality businesses., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: N.F. declares that she has received fees for serving as an expert witness for the Government of Ireland in a challenge to pandemic-related restrictions on licensed premises. T.S. declares receipt of fees for serving as an expert witness on behalf of (i) the Ontario Public Service Employees Union in a challenge to 7/11′s applications for liquor licences in their many corner stores and gas stations; (ii) individuals seeking damages for injuries caused by accidents involving intoxicated people. He also declares receiving research funds, travel expenses and personal fees from government alcohol monopolies for research on alcohol and public health policy in Sweden, Finland and Canada. R.O., I.U., J.M., M.C., K.G., K.H., K.H., C.W., E.M., P.M., J.R., Z.Q. and C.A. declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background: Individuals with alcohol-related disorders often encounter barriers to accessing treatment. One potential barrier is the state alcohol exclusion laws (AELs) that allow insurers to deny coverage for injuries or illnesses caused by alcohol intoxication. Several states have repealed AELs by prohibiting them completely, including banning exclusions in health and accident insurance policies, limiting their scope, or creating exemptions., Objectives: To examine whether prohibiting alcohol exclusions in health and accident insurance policies is associated with alcohol-related treatment admissions., Design: We used the 2002 to 2017 Treatment Episode Data Set and obtained data from several sources to control for state-level factors. We employed a heterogeneous difference-in-differences method and an event study to compare the treatment admissions in Colorado and Illinois, two states that uniquely repealed AELs, with control states that allowed or had no AELs., Main Measures: We used aggregated alcohol treatment admission for adults by healthcare referral: (i) with alcohol as the primary substance and (ii) with alcohol as the primary, secondary, or tertiary substance., Key Results: We found a significant relationship between AEL repeal and increased referrals. AEL repeal in Colorado and Illinois was associated with higher treatment admissions from 2008 to 2011 (average treatment effect on the treated: 2008 = 653, 2009 = 1161, 2010 = 1388, and 2011 = 2020). We also found that a longer duration of exposure to AEL repeal was associated with higher treatment admissions, but this effect faded after the fourth year post-treatment., Conclusions: Our study reveals a potential positive association between the repeal and prohibition of AELs and increased alcohol-related treatment admissions. These findings suggest that states could enhance treatment opportunities for alcohol-related disorders by reconsidering their stance on AELs. While our study highlights the possible public health benefits of repealing AELs, it also paves the way for additional studies in this domain., (© 2023. The Author(s).)

Objective: Most research on alcohol control policies in the United States has focused on the state level. In this study, we assessed both local and state policy prevalence and restrictiveness in a nationwide sample of cities., Method: We conducted original legal research to assess prevalence of local-level policies across 374 cities (48 states) in 2019 for the following seven policy areas: (a) drink specials; (b) beverage service training; (c) minimum age for on-premise servers and bartenders; (d) minimum age for off-premise sellers; (e) prohibitions against hosting underage drinking parties (i.e., social host provisions); (f) bans on off-premise Sunday sales; and (g) keg registration. We obtained parallel state-level policies from the Alcohol Policy Information System. We assessed the restrictiveness of existing policies and how these compared across local and state levels., Results: We found that for six of the seven policy areas, the majority of cities (53% to 83%) had only a state-level policy. Few cities (0% to 8% across policy areas) had only a local-level policy. The percentage of cities that had an alcohol policy at both the local and state levels ranged from less than 1% to 19% across policy areas, and the policies were mostly equally restrictive at both levels., Conclusions: The lack of local policies may point to areas where these localities could strengthen their alcohol policy environments. Additional research is needed to understand how the prevalence and restrictiveness of local and state policies are associated with public health harms such as traffic crashes.

Objectives: The World Health Organization advocates measures regulating alcohol advertising content, as illustrated by the French Évin law. However, how people react to such regulation has been under-investigated. The research reported here has two objectives: to analyze how different advertising contents (regulated or not) affect the persuasion process from attention to behavioural responses, and whether young people are protected; to examine how alcohol warnings perform depending on their salience and the advertising content displayed (regulated or not)., Materials and Methods: This study surveyed French people aged 15-30 using a mixed-methods design. In-depth interviews were conducted on 26 respondents to understand how non-regulated (NRA) and regulated (RA) alcohol advertising influence the persuasion process. An experiment on 696 people assessed the influence of RA vs. NRA on intentions to buy and drink alcohol, and whether less vs. more salient warnings displayed in the RA or NRA setting have differential effects on behavioural responses., Results: NRA (vs. RA) had a greater influence on young people's desire to buy and drink alcohol, which we explain by different psychological processes. NRA appeared to trigger a heuristic process that involves affective reactions (e.g. image, symbolism) and product-oriented responses (e.g. quality), whereas RA appeared to trigger a more systematic process that had less influence. The protective effect of content regulations was strong for the youngest participants but fades as age increases, reaching its limits at age 22 years. Salience of the warnings had no influence on desire to buy and drink alcohol, whatever the ad content., Conclusion: Advertising content regulations need to be implemented to protect young people, particularly the youngest. Our results on alcohol health warnings highlighted that text-only labels similar to those adopted in many countries are ineffective at decreasing young people's intentions to buy and drink alcohol., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: Some evidence suggests that cannabis may be a safer substitute for other drugs. Historically, sober living houses (SLHs) have been abstinence-based environments designed for individuals in recovery to live with others in recovery. However, the evolving legal landscape around cannabis use has left SLH operators and managers in a difficult position regarding policies related to cannabis use among residents. The primary aim of this study was to examine how cannabis use relates to alcohol use, other drug use, and related problems among SLH residents., Methods: Baseline (N = 557), 6-month (n = 462), and 12-month (n = 457) data came from SLH residents living in 48 houses in Los Angeles, CA from 2018 to 2021. Longitudinal generalized estimating equation models tested associations between any past six-month cannabis use and alcohol and non-cannabis drug outcomes: any use, number of days of use, and any alcohol- or drug-related problems. Final models adjusted for baseline age, sex, race-and-ethnicity, inpatient substance use treatment, and alcohol/drug use days, and time-varying 12-step attendance and percent of social network using drugs/alcohol heavily., Results: At baseline, 107 (19.2 %) residents reported cannabis use in the past six months. At 12 months, 80 (17.5 %) residents reported cannabis use in the past six months. Across all timepoints, any vs. no past six-month cannabis use was related to significantly (P < 0.05) higher odds of past-month alcohol use (OR = 3.85, 95 % CI: 2.65, 5.59); more drinking days in the past six months (IRR = 1.76, 95 % CI: 1.40, 2.21); higher odds of alcohol problems (OR = 2.74, 95 % CI: 1.99, 3.76); higher odds of past-month drug use (OR = 10.41, 95 % CI: 6.37, 17.00); more drug use days in the past six months (IRR = 1.86, 95 % CI: 1.40, 2.49); and higher odds of drug problems (OR = 14.99, 95 % CI: 9.91, 22.68)., Conclusions: During each assessment period, almost one-fifth of individuals residing in sample of California sober living houses report using cannabis in the past six months. Cannabis does not appear to work as a substitute for alcohol or other drugs in this population because cannabis use is related to increased risk of alcohol and other drug use and problems. SLH managers and operators should consider potential harm that could result from house policies that fail to address cannabis use., Competing Interests: Declaration of competing interest The authors report no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The purpose of this study was to define the alcohol consumption norms and attitudes toward alcohol regulation policies among citizens of Seoul and the relationships between such norms and the favored regulatory policies. The study population consisted of 1001 adults aged 19-80 years living in Seoul. We collected demographic data and data on health behaviors, attitudes towards drinking, and preferred alcohol regulation policies. The correlations between drinking and the favored regulatory policies were analyzed. Male, as well as being employed, aged 19-39 years, single, a smoker, and a current or heavy episodic drinker were associated with more positive attitudes toward drinking (all p < 0.001) and less desire for alcohol regulation policies (all p < 0.001). We found a significant negative correlation between attitudes toward drinking and preferred alcohol regulation policies ( p < 0.001). Participants who favored reduced or no alcohol consumption and a reduction in alcohol-related harm were more accepting of restrictive alcohol consumption policies. To establish alcohol control polices, differences in drinking norms within populations should be considered. Furthermore, for a successful alcohol control policy, efforts should be made to change drinking norms, as well as consider differences in regulatory policy preferences between population groups.

Background: The IAC Policy Index was developed to allow comparison in alcohol policy between countries and within countries over time including in low resource settings. It measures four effective alcohol policies and takes into account stringency of regulation and the actual impact on the alcohol environment, such as trading hours and prices paid. This framework was used to assess policy in Aotearoa New Zealand in a time period covering two relevant legislative changes. This is the first study to use an alcohol policy index to assess and describe legislative change within country., Methods: Data to calculate the IAC Policy Index was collected for 2013 and 2022. Stringency of policy was assessed from legislative statutes and impacts of policy on the alcohol environment from administrative data and specifically designed data collection., Results: The overall IAC Policy Index score improved over the time period. The scores for the separate policy areas reflected the legislative changes as hypothesised, but also independent changes in impact, given ecological changes including reduced enforcement of drink driving countermeasures and increased exposure to marketing in digital channels. The IAC Policy index reflects the changes in policy status observed in Aotearoa, NZ., Discussion: The IAC Policy Index provided a useful framework to assess and describe change in alcohol legislation contextualised by other influences on policy impact over time within a country. The results indicated the value of assessing stringency and impact separately as these moved independently., Conclusions: The IAC Alcohol Policy Index, measuring both stringency and actual impact on the alcohol environment with a focus on only the most effective alcohol policies provides meaningful insights into within-country policy strength over time. The IAC Policy Index used over time can communicate to policy makers successes and gaps in alcohol policy., (© 2024. The Author(s).)

Objective: To examine the strategies employed by opponents of the Queensland Government's policy to restrict unhealthy food and alcohol advertising on publicly owned assets and identify which of the opposing arguments appeared to influence the policy outcomes., Methods: Retrospective qualitative policy analysis case study informed by the Policy Dystopia Model of corporate political activity. We used qualitative content analysis to examine data from stakeholder submissions to the 'Advertising content on Queensland Government advertising spaces' policies (v1 and 2), and Minister for Health's diaries., Results: Stakeholders from the food, beverage, alcohol and advertising industries and several not-for-profit health organisations opposed the policy. Industry actors used discursive strategies, coalition management (including co-option of not-for-profit health organisations), information management and direct involvement with policy makers to communicate their arguments against the policy. The second version of the policy was weaker regarding scope and key policy provisions, reflecting the arguments of industry actors., Conclusions: Influence from industries with a clear conflict of interest should be minimised throughout policy development to ensure public health is prioritised over corporate gain., Implications for Public Health: Our findings can support other jurisdictions to prepare for industry opposition when designing policies to restrict unhealthy food and alcohol marketing., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Importance: It is well established that alcohol outlets (ie, places that sell alcohol) attract crime, particularly during late-night hours., Objective: To evaluate the association of Maryland Senate Bill 571 (SB571), which reduced the hours of sale for bars/taverns in 1 Baltimore neighborhood from 6 am to 2 am to 9 am to 10 pm, with violent crime within that neighborhood., Design, Setting, and Participants: This controlled interrupted time series analysis compared the change in violent crime density within an 800-ft buffer around bars/taverns in the treatment neighborhood (ie, subject to SB571) and 2 control areas with a similar mean baseline crime rate, alcohol outlet density, and neighborhood disadvantage score in the City of Baltimore between May 1, 2018, and December 31, 2022. The interrupted time series using Poisson regression with overdispersion adjustment tested whether the violent crime density differed before vs after the policy change in the treatment neighborhood and whether this difference was localized to the treatment neighborhood., Exposure: Statutory reduction of bar/tavern selling hours from 20 to 13 hours per day in the treatment neighborhood., Main Outcomes and Measures: The primary outcome was all violent crime, including homicide, robbery, aggravated and common assault, and forcible rape. Secondary outcomes were homicides and assaults. All violent crime measures summed the monthly incidents within 800 ft of bars/taverns from 8 pm to 4 am. For each outcome, a level change estimated the immediate change (first month after implementation), and a slope change estimated the sustained change after implementation (percent reduction after the first month). These level and slope changes were then compared between the treatment and control neighborhoods., Results: The treatment neighborhood included 26 bars/taverns (mean [SD] population, 524.6 [234.6] residents), and the control neighborhoods included 41 bars/taverns (mean [SD] population per census block, 570.4 [217.4] residents). There was no immediate level change in density of all violent crimes the month after implementation of SB571; however, compared with the control neighborhoods, the slope of all violent crime density decreased by 23% per year in the treatment neighborhood after SB571 implementation (annualized incidence rate ratio, 0.77; 95% CI, 0.60-0.98; P = .04). Similar results were seen for homicides and assaults. Several sensitivity analyses supported the robustness of these results., Conclusions and Relevance: This study's findings suggest that alcohol policies that reduce hours of sale could be associated with a reduction in violent crimes. Given these findings, SB571 may serve as a model for other cities looking to create safer neighborhoods.

Introduction: Previous research has found that policies specifically focused on pregnant people's alcohol use are largely ineffective. Therefore, the purpose of this study is to analyze the relationships between general population policies regulating alcohol physical availability and outcomes related to pregnant people's alcohol use, specifically infant morbidities and injuries., Methods: Outcome data were obtained from Merative MarketScan, a longitudinal commercial insurance claims data set. Policy data were obtained from the National Institute on Alcohol Abuse and Alcoholism's Alcohol Policy Information System, the National Alcohol Beverage Control Association, and Liquor Handbooks and merged using policies in effect during the estimated year of conception. Relationships between state-level policies regulating sites, days/hours, and government monopoly of liquor sales and infant morbidities and injuries were examined. Analyses used logistic regression with individual controls, fixed effects for state and year, state-specific time trends, and SEs clustered by state. The study analysis was conducted from 2021 to 2023., Results: The analytic sample included 1,432,979 infant-birthing person pairs, specifically people aged 25-50 years who gave birth to a singleton between 2006 and 2019. A total of 3.1% of infants had a morbidity and 2.1% of infants had an injury. State government monopoly on liquor sales was associated with reduced odds of infant morbidities and injuries, whereas gas station liquor sales were associated with increased odds of infant morbidities and injuries. Allowing liquor sales after 10PM was associated with increased odds for infant injuries. No effect was found for allowing liquor sales in grocery stores or on Sundays., Conclusions: Findings suggest that limiting alcohol availability for the general population may help reduce adverse infant outcomes related to pregnant people's alcohol use., (Copyright © 2024 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

In 2011, China implemented tougher driving-under-the-influence laws, which criminalized driving under the influence of alcohol for the first time and increased penalties. This paper provides the first comprehensive analysis of the effects of stricter drinking policies on men's smoking behavior by using data from the 2010 and 2012 waves of the China Family Panel Studies. The results show that stricter drinking policies reduced smoking initiation and the number of cigarettes smoked per day among men by reducing the frequency and quantity of alcohol consumption. Heterogeneity analyses show that the impact of the policy is more pronounced not only for men aged 41-55, but also for men who have higher educational qualifications, who are employed, or who are not members of the Communist Party., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

In Wisconsin, many alcohol policies are regulated at the local level. To examine the relationship between local policies, alcohol use and health outcomes, our team developed a database to collect local alcohol policies. Initial results highlight differences in how policies are defined, enforced, and made available to the public.

Background: Accelerating progress to implement effective alcohol policies is necessary to achieve multiple targets within the WHO global strategy to reduce the harmful use of alcohol and the Sustainable Development Goals. However, the alcohol industry's role in shaping alcohol policy through international avenues, such as trade fora, is poorly understood. We investigate whether the World Trade Organization (WTO) is a forum for alcohol industry influence over alcohol policy., Methods: In this qualitative analysis, we studied discussions on alcohol health warning labelling policies that occurred at the WTO's Technical Barriers to Trade (TBT) Committee meetings. Using the WTO Documents Online archive, we searched the written minutes of all TBT Committee meetings available from Jan 1, 1995, to Dec 31, 2019, to identify minutes and referenced documents pertaining to discussions on health warning labelling policies. We specifically sought WTO member statements on health warning labelling policies. We identified instances in which WTO member representatives indicated that their statements represented industry. We further developed and applied a taxonomy of industry rhetoric to identify whether WTO member statements advanced arguments made by industry in domestic forums., Findings: Among 83 documents, comprising TBT Committee minutes, notifications to the WTO of the policy proposal, and written comments by WTO members, WTO members made 212 statements (between March 24, 2010, and Nov 15, 2019) on ten alcohol labelling policies proposed by Thailand, Kenya, the Dominican Republic, Israel, Turkey, Mexico, India, South Africa, Ireland, and South Korea. WTO members stated that their claims represented industry in seven (3·3%) of 212 statements, and 117 (55·2%) statements featured industry arguments. Member statements featured many arguments used by industry in domestic policy forums to stall alcohol policy. Arguments focused on descaling and reframing the nature and causes of alcohol-related problems, promoting alternative policies such as information campaigns, promoting industry partnerships, questioning the evidence, and emphasising manufacturing and wider economic costs and harms., Interpretation: WTO discussions at TBT Committee meetings on alcohol health warnings advanced arguments used by the alcohol industry in domestic settings to prevent potentially effective alcohol policies. WTO members appeared to be influenced by alcohol industry interests, although only a minority of challenges explicitly referenced industry demands. Increased transparency about vested interests might be needed to overcome industry influence., Funding: None., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Objective: To assess how different bans on serving alcohol in Norwegian bars and restaurants were related to the detection of SARS-CoV-2 in bartenders and waiters and in persons in any occupation., Methods: In 25 392 bartenders and waiters and 1 496 328 persons with other occupations (mean (SD) age 42.0 (12.9) years and 51.8% men), we examined the weekly rates of workers tested and detected with SARS-CoV-2, 1-10 weeks before and 1-5 weeks after implementation of different degrees of bans on serving alcohol in pubs and restaurants, across 102 Norwegian municipalities with: (1) full blanket ban, (2) partial ban with hourly restrictions (eg, from 22:00 hours) or (3) no ban, adjusted for age, sex, testing behaviour and population size., Results: By 4 weeks after the implementation of ban, COVID-19 infection among bartenders and waiters had been reduced by 60% (from 2.8 (95% CI 2.0 to 3.6) to 1.1 (95% CI 0.5 to 1.6) per 1000) in municipalities introducing full ban, and by almost 50% (from 2.5 (95% CI 1.5 to 3.5) to 1.3 (95% CI 0.4 to 2.2) per 1000) in municipalities introducing partial ban. A similar reduction within 4 weeks was also observed for workers in all occupations, both in municipalities with full (from 1.3 (95% CI 1.3 to 1.4) to 0.9 (95% CI 0.9 to 1.0)) and partial bans (from 1.2 (95% CI 1.1 to 1.3) to 0.5 (95% CI 0.5 to 0.6))., Conclusion: Partial bans on serving alcohol in bars and restaurants may be similarly associated with declines in confirmed COVID-19 infection as full bans., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Aims: Alcohol-associated liver disease (ALD) is the leading cause of liver-related mortality in Latin America, yet the impact of public health policies (PHP) on liver disease is unknown. We aimed to assess the association between alcohol PHP and deaths due to ALD in Latin American countries., Approach and Results: We performed an ecological multinational study including 20 countries in Latin America (628,466,088 inhabitants). We obtained country-level sociodemographic information from the World Bank Open Data source. Alcohol-related PHP data for countries were obtained from the World Health Organization Global Information System of Alcohol and Health. We constructed generalized linear models to assess the association between the number of PHP (in 2010) and health outcomes (in 2016). In Latin America, the prevalence of obesity was 27% and 26.1% among male and female populations, respectively. The estimated alcohol per capita consumption among the population at 15 years old or older was 6.8 L of pure alcohol (5.6 recorded and 1.2 unrecorded). The overall prevalence of alcohol use disorders (AUD) was 4.9%. ALD was the main cause of cirrhosis in 64.7% of male and 40.0% of female populations. A total of 19 (95%) countries have at least one alcohol-related PHP on alcohol. The most frequent PHP were limiting drinking age (95%), tax regulations (90%), drunk-driving policies and countermeasures (90%), and government monitoring systems and community support (90%). A higher number of PHP was associated with a lower ALD mortality (PR, 0.76; 95% CI, 0.61-0.93; P = 0.009), lower AUD prevalence (PR, 0.80; 95% CI, 0.65-0.99; P = 0.045), and lower alcohol-attributable road traffic deaths (PR, 0.81; 95% CI, 0.65-1.00; P = 0.051)., Conclusions: Our study indicates that in Latin America, countries with higher number of PHP have lower mortality due to ALD, lower prevalence of AUD, and lower alcohol-attributable road traffic mortality., (© 2021 by the American Association for the Study of Liver Diseases.)

Alcohol and cannabis use as a contraindication to organ transplantation is a controversial issue. Until recently, patients in Canada with alcohol-associated liver disease were required to demonstrate abstinence for 6 mo to receive a liver transplant. There is no equivalent rule that is applied consistently for cannabis use. There is some evidence that alcohol and cannabis use disorder pretransplant could be associated with worse outcomes posttransplantation. However, early liver transplantation for patients with alcohol-associated liver disease in France and in the United States has led to challenges of the 6-mo abstinence rule in Canada in the media. It has also resulted in several legal challenges arguing that the rule violates human rights laws regarding discrimination in the provision of medical services and that the rule is also unconstitutional (this challenge is still before the court). Recent legalization of cannabis use for adults in Canada has led to questions about the appropriateness of limiting transplant access based on cannabis use. The ethics committee of the Canadian Society of Transplantation was asked to provide an ethical analysis of cannabis and alcohol abstinence policies. Our conclusions were as follows: neither cannabis use nor the 6-mo abstinence rule for alcohol use should be an absolute contraindication to transplantation, and transplant could be offered to selected patients, further research should be conducted to ensure evidence-based policies; and the transplant community has a duty not to perpetuate stigma associated with alcohol and cannabis use disorders., Competing Interests: The authors declare no funding or conflicts of interest., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)

Evidence for effective government policies to reduce exposure to alcohol's carcinogenic and hepatoxic effects has strengthened in recent decades. Policies with the strongest evidence involve reducing the affordability, availability and cultural acceptability of alcohol. However, policies that reduce population consumption compete with powerful commercial vested interests. This paper draws on the Canadian Alcohol Policy Evaluation (CAPE), a formal assessment of effective government action on alcohol across Canadian jurisdictions. It also draws on alcohol policy case studies elsewhere involving attempts to introduce minimum unit pricing and cancer warning labels on alcohol containers. Canadian governments collectively received a failing grade (F) for alcohol policy implementation during the most recent CAPE assessment in 2017. However, had the best practices observed in any one jurisdiction been implemented consistently, Canada would have received an A grade. Resistance to effective alcohol policies is due to (1) lack of public awareness of both need and effectiveness, (2) a lack of government regulatory mechanisms to implement effective policies, (3) alcohol industry lobbying, and (4) a failure from the public health community to promote specific and feasible actions as opposed to general principles, e.g., 'increased prices' or 'reduced affordability'. There is enormous untapped potential in most countries for the implementation of proven strategies to reduce alcohol-related harm. While alcohol policies have weakened in many countries during the COVID-19 pandemic, societies may now also be more accepting of public health-inspired policies with proven effectiveness and potential economic benefits.

Alcohol consumption is a major risk factor for premature mortality. Although alcohol control policies are known to impact all-cause mortality rates, the effect that policies have on specific age groups is an important area of research. This study investigates the effect of alcohol control policies implemented in 2009 and 2017 in Lithuania on all-cause mortality rates. All-cause mortality rates (deaths per 100,000 people) were obtained for 2001-2018 by 10-year age groups (20-29, 30-39, 40-49 years, etc.). All-cause mortality rates, independent of macro-level secular trends (e.g., economic trends) were examined. Following a joinpoint analysis to control for secular trends, an interrupted time series analysis showed that alcohol control policies had a significant effect on all-cause mortality rates (p = .018), with the most significant impact occurring among young adults (20-29 and 30-39 years of age). For these age groups, their mortality rate decreased during the 12 months following policy implementation (following the policy in 2009 for those 20-29 years of age, p = .0026, and following the policy in 2017 for those 30-39 years of age, p = .011). The results indicate that alcohol control policy can impact all-cause mortality rates, above and beyond secular trends, and that the impact is significant among young adults., (© 2021. The Author(s).)

Background: Coronavirus disease-19 (COVID-19) restrictions, particularly relating to the sale of alcohol and hours of curfew, have had a marked effect on the temporal pattern of unnatural deaths in South Africa. Methods. Death data were collected over 68 weeks from January 2020 to April 2021, together with information on the nature of restrictions (if any) on the sale of alcohol, and hours of curfew. Data were analysed using a simple ordinary least square (OLS) regression model to estimate the relative contribution of restrictions on the sale of alcohol and hours of curfew to the pattern of excess unnatural deaths. Results. The complete restriction on the sale of alcohol resulted in a statistically significant reduction in unnatural deaths regardless of the length of curfew. To the contrary, periods where no or limited restrictions on alcohol were in force had no significant effect, or resulted in significantly increased unnatural deaths. Conclusions. The present study highlights an association between alcohol availability and the number of unnatural deaths and demonstrates the extent to which those deaths might be averted by disrupting the alcohol supply. While this is not a long-term solution to addressing alcohol-related harm, it further raises the importance of implementing evidence-based alcohol control measures.

Introduction and Aims: In July 2016, the Queensland government introduced the Tackling Alcohol-Fuelled Violence policy, with some amendments over the subsequent 12 months. Key measures included restricting alcohol sales to 3 am in safe night precincts (SNPs), limiting the annual number of extended trading permits (i.e. trading until 5 am) and introducing mandatory networked identification scanners. We examined the policy impact on the number of serious assaults across all combined SNPs and in five major SNPs: Fortitude Valley, Cairns, Surfers Paradise, Toowoomba and Townsville., Design and Methods: Using police data (July 2009-June 2019), we examined the impact of the policy on serious assaults during high-alcohol hours (high-alcohol hours; 8 pm-6 am, Friday and Saturday), employing time series methods., Results: Across all SNPs there was no significant change in the number of serious assaults during overall high-alcohol hours, but a significant 49% decrease in the monthly number of serious assaults between 3 am and 6 am on Friday/Saturday. A significant decrease in the monthly count of serious assaults during high-alcohol hours and specifically 3 am-6 am on Friday/Saturday was evident in Fortitude Valley SNP (52%), and during high-alcohol hours in Toowoomba SNP (43%)., Discussion and Conclusions: Although results were mixed, there was evidence of some promising reductions in alcohol-related violence in SNPs. It is likely that factors such as extended trading permits (venues not closing at 3 am), continued drinking in some venues and 24-h trading in casinos have reduced the potential impacts seen elsewhere., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)

Aim: Kingdon [(2014) Agendas, Alternatives, and Public Policies. Essex. United Kingdom: Pearson Education Limited] argues that windows of opportunity to pass policies emerge when problems, solutions and policy support co-occur. This study aims to identify a set of alcohol policies with the potential to reduce alcohol-related disparities given high levels of support from marginalized groups, such as racial/ethnic minorities and lower-income groups., Methods: This study used data from five US National Alcohol Surveys, which were based on household probability samples of adults in 1995 (n = 4243), 2000 (n = 5736), 2005 (n = 1445), 2010 (n = 4164) and 2015 (n = 4041). We used multiple logistic regression to determine the odds of policy support by racial/ethnic group and income level, considering price, place and marketing policies as well as individual-level interventions., Results: Overall a majority of Americans supported banning alcohol sales in corner stores (59.4%), banning alcohol advertisements on television (55.5%), and establishing universal health coverage for alcohol treatment (80.0%). Support was particularly high among Blacks, Hispanics/Latinos and lower-income persons. Multivariate models showed that compared with White people, foreign-born Hispanics/Latinos had the most robust levels of support, including raising alcohol taxes (aOR = 2.40, 95% CI: 2.00, 2.88, P < 0.0001), banning alcohol sales in corner stores (aOR = 2.85, 95% CI: 2.22, 3.65, P < 0.0001) and reducing retail sales hours (aOR = 2.91, 95% CI: 2.38, 3.55, P < 0.0001)., Conclusion: Of the policies examined, banning alcohol sales at corner stores is most likely to be in a "window of opportunity" for reducing alcohol-related disparities. By simultaneously reducing population-level consumption and harms from others' drinking, place-based policies have the potential to reduce harms experienced by marginalized groups., (© The Author(s) 2020. Medical Council on Alcohol and Oxford University Press. All rights reserved.)

Aims: Venue capacity has been proposed as a factor associated with increased number of violent incidents on-premises, though no specific research has demonstrated this association, and instead has tended to focus on the relationship between crowding and aggression. The aim of current paper is to investigate the association between venue capacity and the number of violent incidents on-premises., Methods: Venue capacity data (the maximum capacity listed on the liquor license) were obtained for all venues in central Melbourne from 2010 until 2016. These data were then matched with police-recorded on-premises assaults that occurred within high-alcohol hours (Friday and Saturday 8 pm-6 am) inside the venue., Results: Analyses were conducted on 5729 venue-years (yearly assault counts per venue, per year) across central Melbourne. Compared with venues that have a maximum capacity of between 0 and 100 patrons, venues with higher capacities have increasingly more recorded assaults. Venues with maximum capacities between 501 and 1000 are 6.1 times more likely to have an assault recorded compared with venues with a maximum capacity between 0 and 100. Further, each additional high-alcohol hour that a venue can be open for is associated with a 72% increase in the number of recorded assaults., Conclusions: Greater venue capacity was found to be strongly associated with an increased risk of violent incidents for any given venue. This was further exacerbated by late-night trading which substantially adds to the risk of assaults inside the venue., (© 2021 by the Research Society on Alcoholism.)

Background : Policy support research identifies demographic profiles of those who support policies, but community organizers aim to mobilize groups with an existing structure. Thus, identifying established groups that support alcohol policies may aid organizing efforts. Objective : This paper calculates prevalence and odds of policy support among three potential constituency groups (i.e., religious affiliation, persons harmed by others' drinking, and persons in recovery from alcohol) for three policies: alcohol tax increases, banning alcohol in corner stores, and universal coverage for alcohol treatment. Methods : Using the 2014-15 National Alcohol Survey (n = 3,444; 1,457 male, 1,987 female) and logistic regression, this study explores associations between constituency groups and policy support. Results : Support was higher for the individual-level strategy of alcohol treatment (80.8%) than raising taxes (27.5%) and banning sales in corner stores (52.2%). Support for taxes was higher among persons who valued religion highly (vs not; aOR = 1.46, p < .01), persons harmed by others' drinking (vs not; aOR = 1.71, p < .001), and persons in recovery (vs. not; aOR = 1.76, p = .02); Catholics had lower odds of support for taxes (vs no denomination; aOR = 0.63, p = .01). Persons who valued religion highly (aOR = 1.53, p < .001), Protestants (aOR = 1.63, p < .01), Catholics (aOR = 1.46, p = .03), and persons with other religious denominations (aOR = 2.17, p = .02) had higher odds of supporting bans in corner stores. Only those in recovery showed greater support for treatment (aOR = 3.20, p < .001). Conclusion : Overall, support was lower for population-wide approaches, but results revealed constituency groups that supported these policies. These groups may be allies to organizers who seek to reduce population-level alcohol consumption and harms.

Many young adults in the United States (U.S.) moved from college accommodations to live with their parents/family during the Spring 2020 semester due to the COVID-19 pandemic. While alcohol consumption fluctuates during a typical semester among students, the impact of the sudden changes stemming from the pandemic on students' alcohol consumption patterns is unclear. To examine the impact of the COVID-19 pandemic on college student alcohol consumption while accounting for legal drinking age and living situation. Data were collected from students (n = 302) at a large, northeastern U.S. university at the beginning and end of the of the 2019 and 2020 Spring semesters via an online survey that assessed socio-demographic characteristics (age, gender, race/ethnicity, living situation) and alcohol consumption using the daily drinking questionnaire. Data were analyzed using a 2 (cohort group: COVID-19 vs. normal) × 2 (age group: above 21 vs. under 21) × 2 (time: beginning vs. end of the semester) mixed model ANOVA. There was a significant three-way interaction. Students over the legal drinking age impacted by the pandemic demonstrated a drastic decrease in alcohol consumption by the end of the semester compared to those under normal circumstances. Change in living situation as a result of the pandemic drastically impacted the alcohol consumption patterns of students over the legal drinking age. Suggestions for future research on the continuing effects of the pandemic on students are discussed., (© Society of Behavioral Medicine 2021. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: In Thailand, alcohol is consumed in social setting. The Thai government introduced a ban on alcohol sales and other measures at the beginning of COVID-19 lockdown with gradual lifts. However, drinking behaviors, behaviors of community members, and alcohol marketing activities during the ban and lifts have not been described., Methods: We contracted a survey research firm to conduct four phone-based cross-sectional surveys between April and July 2020 (n = 6239 participants in total). Participants were recruited from all regions and Bangkok. We also summarized alcohol control measures as reported by multiple sources. We analyzed data from Waves 1 thru 4 using descriptive statistics with adjustment for sampling weight., Results: A total of 6239 persons participated in the 4 waves of surveys. Among survey respondents who were drinkers, half did not drink alcohol during the alcohol sale ban while one-third reported drinking less than usual in the past 30 days. Almost no participant reported drinking more than usual. During the ban (Wave 1), one-sixth of respondents noticed social drinking in their areas while less than 6 percent reported witnessing alcohol sale. Online parties were the predominant alcohol marketing activity, but became less common during Wave 3 compared to Wave 2., Discussion and Conclusions: Ever drinkers either abstained from alcohol or drank less than usual during the ban on alcohol sale. However, social drinking and alcohol sale persisted despite the ban., (Copyright © 2021 Elsevier B.V. All rights reserved.)

This article provides an evaluation of the long-term effectiveness of the Alcohol Ignition Interlock Programme (AIIP) on recidivism. A retrospective cohort design was used to compare the known reoffending behaviour of 1676 AIIP participants with that of 907 persons in a control group, consisting of offenders who committed an AIIP-worthy driving-under-the-influence (DUI) offence that was not reported to the Dutch driving license authority. Persons in the control group were not sanctioned with an AIIP, but had their case settled in the criminal court. Our outcome measure was the percentage of offenders who committed at least one new DUI offence within the follow-up period. Results indicate that the percentage of repeat offenders in the AIIP group was lower than in the control group. Additional analyses indicate that were an AIIP to be imposed alongside a criminal settlement, a recidivism reduction of 4 percentage points (4 % versus 8 %) could be expected. This would translate to a relative decrease of 54 %. Explanations for these findings are discussed., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: International drink-driving policy research generally focuses on aggregate outcomes (e.g., rates of crashes, fatalities) without emphasizing secondhand alcohol-related vehicular harms. In contrast, we investigate associations between drink-driving policies and harms involving another driver's impairment., Methods: Alcohol's harms to others (AHTO) survey data from 12 countries (analytic N = 29,616) were linked to national alcohol policy data from the World Health Organization. We examined separately associations of two 12-month driving-related AHTOs (passenger with an impaired driver; vehicular crash involving someone else's drink driving) with 3 national drinking-driving policies-legal blood alcohol concentration (BAC) limits, use of random breath testing, use of sobriety checkpoints, and comprehensive penalties for drink-driving (community service, detention, fines, ignition interlocks, license suspension/revocation, mandatory alcohol treatment, vehicle impoundment, and penalty point system), plus 2 alcohol tax variables (having excise taxes and value-added tax [VAT] rate). Multilevel logistic regression addressed clustering of individuals within countries and subnational regions, while adjusting for individuals' gender, age, marital status, risky drinking, and regional drinking culture (% male risky drinkers in sub-national region)., Results: Controlling for national-, regional-, and individual-level covariates, comprehensive penalties were significantly and negatively associated with both outcomes; other vehicular policy variables were not significantly associated with either outcome. A society's VAT rate was negatively associated with riding with a drunk driver. Regional male drinking culture was positively associated with riding with an impaired driver, but was not significantly associated with being in a vehicular crash due to someone else's drinking. In both models, being male, being younger, and engaging in risky drinking oneself each were positively associated with vehicular harms due to someone else's drinking., Conclusions: Although results are associational and not causal, comprehensive penalties may be promising policies for mitigating driving-related harms due to another drinker. Higher VAT rate might reduce riding with a drunk driver., (© 2020 by the Research Society on Alcoholism.)

Background: Sudden alcohol prohibition in India during the COVID-19 pandemic presented an opportunity to test whether Google Trends data could indicate population responses and the public health impact of alcohol policy. We hypothesized, following prohibition: there would be a significant change in the relative search volumes (RSV) of alcohol-related queries; that temporal analysis of the trends would reflect a public response to policy changes; and that geospatial analysis of RSV would correlate with the prevalence of alcohol use., Methods: Three different search periods were used to test the hypotheses. The search inputs were based on potential public response to alcohol prohibition, as evidenced by the literature, newspaper articles, and consensus. We used RSV as the unit of analysis. Mean RSV of search queries, pre-post implementation of prohibition, were compared. Smoothing of scatter plots examined the temporal association of trends with policy measures. Multiple linear regression tested the relationship of state-wise RSV and alcohol use prevalence., Results: Post-implementation of prohibition, a significant increase in the RSV was observed for searches related to alcohol withdrawal (p<0.001), how to extract alcohol from sanitizer (p = 0.002), alcohol home delivery online (p<0.001), alcohol home delivery (p<0.001), and sleeping pills (p = 0.006). The trends suggested a decrease in general interest in alcohol but increased demand, and a possible connection with changes in policy measures. State-level RSV and alcohol use prevalence did not reveal a significant relationship., Conclusion: Google trend is a potential source of rapid feedback to policymakers about population responses to an abrupt change in alcohol policies., Competing Interests: Declaration of Interests None., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: The professions of physician and dentist are associated with multiple health risks. The aim of this study was to identify the medical conditions that caused limitation or suspension of the professional license of Polish physicians and dentists, and to assess their return to professional activities., Methods: We analyzed documentation of Regional Medical Registers concerning the procedure for suspending medical licences or limiting certain medical activities, and decisions of Regional Medical Councils in 1990-2014., Results: The data on 65 decisions suspending the professional license, 8 decisions limiting the license and 1 revoking the right to practice have been obtained from 8 Councils. The most frequent cause of limiting or suspending the professional license was drug and alcohol dependence (54.1%). There was no correlation between the underlying medical condition and gender or profession (physician/dentist). Among doctors aged 42-57 and 58-67 whose licence had been suspended or limited, more than 60% suffered from substance use disorder (SUD). In the group of doctors aged 41 and younger, no such case was found. Among doctors older than 67, addiction was the cause of 37.5% of decisions suspending or limiting the professional license. In no case the medical condition causing limitation or suspension of the licence was an occupational disease. SUD was more frequent in surgical than nonsurgical specialties (76.5% vs. 46.9%, p < 0.05). The doctors suffering from addictions were more likely to return to their practice (57.5%) than those suffering from other illnesses (20.5%, p < 0.05)., Conclusions: The most common medical ground for limiting or suspending the professional licence was substance abuse. Number of decisions suspending or limiting the licence is relatively small and indicates a need for more efficient procedures for identification of doctors and dentists incapable of practicing due to health problems and assessment of the capacity to practice in the case of individuals who do not undertake treatment themselves and therefore are unable to assure sufficient quality of care to their patients. Moreover, although few decisions were issued, there is a need for an active addiction prevention, particularly among surgical specialists.

Background and Aims: In February 2014, pubs and bars in Kings Cross (KX) and the central business district (CBD) of Sydney, Australia were required to stop serving alcohol by 3 a.m. and operate a 'lockout' from 1.30 a.m. We studied changes in the incidence of assault during the following 5 years, including possible displacement., Design: Controlled before-and-after ecological study., Setting: Sydney, Australia., Participants/cases: Assaults in specified areas in which police apprehended at least one person., Measurements: We compared change in non-domestic assault in KX and the CBD with adjacent areas, other city areas, and outer suburbs, adjusting for the trend in the rest of the state during three periods: 6 p.m.-1.29 a.m. ('pre-lockout'), 1.30 a.m.-2.59 a.m. ('lockout') and 3 a.m.-6 a.m. ('after last-drinks'). We constructed interrupted time-series models with terms for secular trend and season, producing incidence rate ratios (IRR) for step and slope parameters. We performed sensitivity analyses on impacts of missing location data., Findings: After the intervention, assaults fell 38% in KX (IRR for step change = 0.62, 95% CI = 0.49, 0.79) and 10% in the CBD (IRR = 0.90, 95% CI = 0.80, 0.99). Assaults continued declining in KX (IRR for slope = 0.990, 95% CI = 0.982, 0.998) and later increased in adjacent areas (IRR for slope = 1.006, 95% CI = 1.001, 1.011) and earlier in the evenings in both KX and the adjacent areas. The net reduction was 627 assaults over 60 months post-intervention, i.e. 10 fewer per month. Estimates were robust to extreme assumptions about missing data., Conclusions: The 2014 alcohol supply restrictions for pubs and bars in Kings Cross (KX) and the central business district (CBD) of Sydney, Australia were followed by a substantial reduction in the incidence of assault in KX and to a lesser extent in the CBD, possibly displacing some cases to adjacent areas and earlier in the evening., (© 2020 Society for the Study of Addiction.)