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1.
Soc Sci Med ; 348: 116875, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38613870

RESUMO

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.


Assuntos
Consumo de Bebidas Alcoólicas , Fumar , Humanos , Masculino , China/epidemiologia , Adulto , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Pessoa de Meia-Idade , Fumar/epidemiologia , Fumar/legislação & jurisprudência , Fumar/psicologia , Adulto Jovem , Adolescente , Dirigir sob a Influência/estatística & dados numéricos , Dirigir sob a Influência/legislação & jurisprudência , Política Pública
2.
Rev. méd. Urug ; 38(1): e38104, 2022.
Artigo em Espanhol | LILACS, UY-BNMED, BNUY | ID: biblio-1389671

RESUMO

Resumen: Introducción: apuntando a la prevención y disminución de la siniestralidad vial, se promulgó la Ley 19360 "de alcohol cero" que modifica la tolerancia de alcohol en sangre para conductores, bajándola de 0,3 g/l a 0,0 g/l, con probados resultados de disminución de siniestros fatales en el corto plazo. Objetivo: analizar el impacto de dicha norma en la venta declarada de alcohol y sobre los usuarios de vías siniestrados por tipo de vehículo y región. Metodología: estudio inferencial, de impacto de intervención. Se analizaron series de tiempo de distintas fuentes, para medir si hubo cambios significativos en éstas mediante la modelización ARIMA, comparando antes y después de la sanción de la Ley 19360. Resultados: el consumo de alcohol declarado no sufrió modificaciones importantes a pesar de la ley cero, mientras que la cantidad de motociclistas fallecidos y heridos de gravedad caen de manera significativa a partir de la sanción de la Ley 19360. Conclusiones: los motociclistas son los más beneficiados con esta legislación, con numerosas vidas salvadas. Los datos sugieren un posible cambio de comportamiento de los conductores de vehículos respecto al consumo de alcohol antes y durante el manejo. La mejora continua de la información disponible para la ciudadanía es clave para comprender mejor estos fenómenos.


Summary: Introduction: law 19360 of "Zero blood alcohol concentration" was passed to prevent and reduce road accidents by modifying the tolerance to blood alcohol concentration for drivers. It lowered it from 0.3 g/l to 0.0 g/l and results proved the reduction of fatal crashes in the short term. Objective: to analyze the impact of the new law on the official alcohol sales and on drivers by type of vehicle and region. Method: inferential study, impact of intervention. Time-series analyses for different sources were performed to find out whether there were meaningful changes using the ARIMA model, comparing figures corresponding to the periods before and after Law 19360 was passed. Resultados: declared consumption of alcohol did not evidence important modifications despite the zero law, whereas the number of dead motorcyclists and severely wounded significantly dropped after Law 19360 was passed. Conclusions: motorcyclists are those who benefit the most with the law, since a great number of deaths were saved. Data suggest there might be a change in the behaviour of vehicle drivers in regards to alcohol consumption before and after driving. The steady improvement of information available for citizens is essential to better understand these phenomena.


Resumo: Introdução: visando a prevenção e redução dos acidentes de trânsito, foi promulgada a Lei 19360 "de tolerância zero ao álcool", que modifica a tolerância ao álcool no sangue para motoristas, baixando-a de 0,3 g/l para 0,0 g/l, com resultados comprovados de redução de sinistros fatais no curto prazo. Objetivo: analisar o impacto do referido regulamento na venda declarada de álcool e nos usuários das estradas afetados por tipo de veículo e região. Metodologia: estudo inferencial, de impacto da intervenção. Séries temporais de diferentes fontes foram analisadas para medir se houve mudanças significativas nestes por meio de modelagem ARIMA, comparando antes e depois da promulgação da Lei 19360. Resultados: o consumo declarado de álcool não sofreu modificações importantes apesar da lei de tolerância zero ao álcool, enquanto o número de motociclistas falecidos e gravemente feridos caiu significativamente após a promulgação da Lei 19.360. Conclusões: os motociclistas são os que mais se beneficiam com essa legislação, com muitas vidas salvas. Os dados sugerem uma possível mudança no comportamento dos condutores de veículos em relação ao consumo de álcool antes e durante a condução. O aprimoramento contínuo das informações disponibilizadas ao público é fundamental para um melhor entendimento desses fenômenos.


Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Acidentes de Trânsito/estatística & dados numéricos , Mudança Social
3.
Nutrients ; 13(8)2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34445006

RESUMO

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.


Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Bebidas Alcoólicas/legislação & jurisprudência , Política de Saúde , Saúde Pública , Consumo de Bebidas Alcoólicas/efeitos adversos , Bebidas Alcoólicas/economia , COVID-19/epidemiologia , Canadá , Comércio/economia , Comércio/normas , Custos e Análise de Custo , Programas Governamentais , Regulamentação Governamental , Humanos , Pandemias , Rotulagem de Produtos/legislação & jurisprudência , Política Pública , SARS-CoV-2/isolamento & purificação
4.
Transplantation ; 105(9): 1957-1964, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-33587429

RESUMO

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.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Política de Saúde , Fumar Maconha/efeitos adversos , Transplante de Órgãos/normas , Obtenção de Tecidos e Órgãos/normas , Abstinência de Álcool , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Canadá , Tomada de Decisão Clínica , Consenso , Contraindicações de Procedimentos , Medicina Baseada em Evidências/normas , Regulamentação Governamental , Política de Saúde/legislação & jurisprudência , Humanos , Fumar Maconha/legislação & jurisprudência , Transplante de Órgãos/efeitos adversos , Transplante de Órgãos/ética , Transplante de Órgãos/legislação & jurisprudência , Seleção de Pacientes , Formulação de Políticas , Medição de Risco , Fatores de Risco , Obtenção de Tecidos e Órgãos/ética , Obtenção de Tecidos e Órgãos/legislação & jurisprudência
5.
Hawaii J Health Soc Welf ; 79(6 Suppl 2): 10-12, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32596671

RESUMO

The heavy burden of non-communicable diseases (NCD) in Yap State, Federated States of Micronesia overwhelms the resources of this small population. Traditional cultural practices strongly influence all aspects of life, especially in the remote outer islands. The traditional Chiefs must grant permission to perform any type of health outreach or services for about one-third of the population. One key cultural practice promotes tobacco and alcohol use. The Yap Comprehensive Cancer Control Program, in collaboration with other entities in public health, systematically engaged the traditional Chiefs, resulting in a landmark policy that paved the way for other system and environmental interventions to reduce the risks of developing NCD.


Assuntos
Política de Saúde/tendências , Formulação de Políticas , Prática de Saúde Pública/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Assistência à Saúde Culturalmente Competente/métodos , Política de Saúde/legislação & jurisprudência , Humanos , Micronésia/epidemiologia , Doenças não Transmissíveis/epidemiologia , Política Pública , Produtos do Tabaco/efeitos adversos , Produtos do Tabaco/legislação & jurisprudência
6.
J Stud Alcohol Drugs ; 81(2): 284-292, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32359059

RESUMO

OBJECTIVE: Although the World Health Organization (WHO) declared alcohol a Class 1 carcinogen 30 years ago, few governments have communicated this fact to the public. We illustrate how alcohol industry groups seek to keep their customers in the dark about alcohol-related cancer risks. In Canada, a federally funded scientific study examining the introduction of cancer warning labels on containers was shut down following industry interference. We show that the industry complaints about the study had no legal merit. Of 47 WHO member countries with alcohol warning labels, only South Korea requires cancer warnings on alcohol containers. However, industry complaints, supported by sympathetic governments, helped weaken the warning labels' implementation. Ireland has legislated for cancer warnings but faces continuing legal opposition expressed through regional and global bodies. Cancer societies and the public health community have failed to counter industry pressures to minimize consumer awareness of alcohol's cancer risks. Placing cancer warnings on alcohol containers could make a pivotal difference in motivating both drinkers to consume less and regulators to introduce more effective policies to reduce the serious harms of alcohol consumption.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Bebidas Alcoólicas/efeitos adversos , Informação de Saúde ao Consumidor/normas , Governo , Indústrias/normas , Rotulagem de Produtos/normas , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Bebidas Alcoólicas/legislação & jurisprudência , Informação de Saúde ao Consumidor/legislação & jurisprudência , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Indústrias/legislação & jurisprudência , Irlanda/epidemiologia , Rotulagem de Produtos/legislação & jurisprudência , Saúde Pública/legislação & jurisprudência , Saúde Pública/normas , República da Coreia/epidemiologia , Fatores de Risco , Comportamento Social , Organização Mundial da Saúde , Yukon/epidemiologia
7.
BMC Med ; 17(1): 213, 2019 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-31771596

RESUMO

BACKGROUND: Although long-term alcohol and tobacco use have widely been recognised as important risk factors for cancer, the impacts of alcohol and tobacco health policies on cancer mortality have not been examined in previous studies. This study aims to estimate the association of key alcohol and tobacco policy or events in Australia with changes in overall and five specific types of cancer mortality between the 1950s and 2013. METHODS: Annual population-based time-series data between 1911 and 2013 on per capita alcohol and tobacco consumption and head and neck (lip, oral cavity, pharynx, larynx and oesophagus), lung, breast, colorectum and anus, liver and total cancer mortality data from the 1950s to 2013 were collected from the Australian Bureau of Statistics and Cancer Council Victoria, the WHO Cancer Mortality Database and the Australian Institute of Health and Welfare. The policies with significant relations to changes in alcohol and tobacco consumption were identified in an initial model. Intervention dummies with estimated lags were then developed based on these key alcohol and tobacco policies and events and inserted into time-series models to estimate the relation of the particular policy changes with cancer mortality. RESULTS: Liquor licence liberalisation in the 1960s was significantly associated with increases in the level of population drinking and thereafter of male cancer mortality. The introduction of random breath testing programs in Australia after 1976 was associated with a reduction in population drinking and thereafter in cancer mortality for both men and women. Meanwhile, the release of UK and US public health reports on tobacco in 1962 and 1964 and the ban on cigarette ads on TV and radio in 1976 were found to have been associated with a reduction in Australian tobacco consumption and thereafter a reduction in mortality from all cancer types except liver cancer. Policy changes on alcohol and tobacco during the 1960s-1980s were associated with greater changes for men than for women, particularly for head and neck, lung and colorectum cancer sites. CONCLUSION: This study provides evidence that some changes to public health policies in Australia in the twentieth century were related to the changes in the population consumption of alcohol and tobacco, and in subsequent mortality from various cancers over the following 20 years.


Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Política de Saúde , Neoplasias/epidemiologia , Uso de Tabaco/legislação & jurisprudência , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Austrália/epidemiologia , Epidemias , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Neoplasias/mortalidade , Neoplasias/prevenção & controle , Saúde Pública , Fatores de Risco , Nicotiana , Uso de Tabaco/efeitos adversos , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-31752119

RESUMO

The influence of the alcohol industry, also known as "corporate political activity" (CPA), is documented as one of the main barriers in implementing effective alcohol control policies. In Portugal, despite an alcohol consumption above the European average, alcohol control does not feature in the current National Health Plan. The present research aimed to identify and describe the CPA of the alcohol industry in Portugal. Publicly-available data published between January 2018 and April 2019 was extracted from the main websites and social media accounts of alcohol industry trade associations, charities funded by the industry, government, and media. A "Policy Dystopia" framework, used to describe the CPA strategies of the tobacco industry, was adapted and used to perform a qualitative thematic analysis. Both instrumental and discursive strategies were found. The industry works in partnership with health authorities, belonging to the national task force responsible for planning alcohol control policies. Additionally, it emphasizes the role alcohol plays in Portuguese culture as a way to disregard evidence on control policies from other countries. This paper presents the first description of CPA by the alcohol industry in Portugal and provides evidence for the adoption of stricter control policies in the country.


Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Indústria Alimentícia/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Política , Política Pública/legislação & jurisprudência , Portugal
10.
PLoS One ; 14(2): e0212938, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30811520

RESUMO

The increased mortality rate among the Acoli people of northern Uganda is anecdotally blamed on excessive consumption of cheap and widely available sachet-packaged alcohol in the region. In this paper, we quantify this perceived association by determining statistically the health risks associated with ingesting 20 heavy metals in 17 popular spirits products consumed in Acoli. Thirteen of these products were industrially packaged in sachets (locally known as 'sachet,' waragi, arege or moo lyec) and four were locally produced Lira-Lira spirits from Bolo, Awere and Teso Bar in the region and Nsambya in southern Uganda. A Scottish whisky purchased in San Diego (USA) was our reference. Risk assessment was performed according to standardized protocols developed by the United States Environmental Protection Agency (US EPA). Our results show that a strong correlation indeed exists between health risks and ingestion of spirits in Acoli. At >2.5 sachets/day for 240 day/year over a lifetime for example, the risk of developing cancer due to exposure to As, Pb and Cr alone is 1 in 102,041. This estimate excludes ethanol, a known carcinogen, and 17 heavy metals also studied due to lack of their cancer slope factors. The primary non-cancer related health risk factor in all samples tested is ethanol with unacceptably high health index of four. The Lira-Lira spirits, with 100-6000% copper above the US EPA limit for intake by oral ingestion in water, would be the 'cleanest' without copper and at par with the Scottish whisky. Collectively, we find that no amount of alcohol consumed in Acoli is safe. Preventive measures are therefore recommended to reduce mortality in Acoli in particular, and in Uganda in general. These measures should include public education, better public policies, creating productive economic activities other than brewing alcohol, and social activities that engage people away from drinking.


Assuntos
Consumo de Bebidas Alcoólicas/mortalidade , Álcoois/análise , Metais Pesados/análise , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Álcoois/toxicidade , Monitoramento Ambiental , Feminino , Política de Saúde , Humanos , Masculino , Metais Pesados/toxicidade , Medição de Risco , Uganda
11.
Int J Health Policy Manag ; 7(8): 696-698, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-30078289

RESUMO

As taxation is one of the key public policy domains influencing population health, and as there is a legal, strategic, and programmatic basis for health impact assessment (HIA) in Finland, we analyzed all 235 government bills on tax legislation over the years 2007-2014 to see whether the health impacts of the tax bills had been assessed. We found that health impacts had been assessed for 13 bills, bills dealing with tobacco, alcohol, confectionery, and energy legislation and that four of these impact assessments included impacts on health inequalities between social classes. Based on our theoretical classification, the health impacts of 40 other tax bills should have been evaluated.


Assuntos
Comércio/legislação & jurisprudência , Regulamentação Governamental , Governo , Avaliação do Impacto na Saúde , Política de Saúde , Promoção da Saúde/métodos , Impostos , Consumo de Bebidas Alcoólicas/economia , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Finlândia , Indústria Alimentícia/economia , Indústria Alimentícia/legislação & jurisprudência , Equidade em Saúde , Humanos , Saúde da População , Produtos do Tabaco/economia , Produtos do Tabaco/legislação & jurisprudência
12.
Drug Alcohol Rev ; 37(5): 563-564, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29873133

RESUMO

Alcohol consumption is behind only smoking and obesity among leading contributors to the burden of disease in Australia. For the first time in over a decade, Australian governments are developing a National Alcohol Strategy, and plan to finalise it in 2018. The draft contains evidence-based recommendations but lacks a framework for accountability, and the Commonwealth Minister of Health recently suggested that the alcohol industry help devise the final version. We recommend that the Government rely on advice from health experts for health policy, pre-specify outcome indicators, commit to modest activities initially, to develop momentum; and commission independent evaluation after 3 years.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/prevenção & controle , Efeitos Psicossociais da Doença , Política de Saúde , Saúde Pública/métodos , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Austrália/epidemiologia , Humanos , Saúde Pública/legislação & jurisprudência
13.
Curr Opin Psychiatry ; 31(4): 342-347, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29746422

RESUMO

PURPOSE OF REVIEW: This review is a critical reflection on the effectiveness of evidence-based alcohol policies and their implementation, based on studies and observations that have arisen in recent years. RECENT FINDINGS: This article covers themes in recent literature of: the relationship between alcohol consumption and harm, the variability of country contextual factors and the interactions of both country contexts and alcohol policies on changes in alcohol consumption and harm. SUMMARY: These recent observations imply that alcoholic beverage policies and programmes should focus on contextual determinants in each country and community, and address targeted problems (like problem drinking) and harm (such as liver cirrhosis, cancer and road accidents), rather than consumption per se.


Assuntos
Consumo de Bebidas Alcoólicas , Bebidas Alcoólicas/efeitos adversos , Política Pública/legislação & jurisprudência , Controle Social Formal/métodos , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/prevenção & controle , Humanos , Avaliação de Programas e Projetos de Saúde
14.
Am J Public Health ; 108(6): 748-753, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29672146

RESUMO

OBJECTIVES: To evaluate US state regulations regarding marijuana, tobacco, and alcohol to determine the extent to which states attempt to govern these substances in early care and education (ECE) settings. METHODS: Two independent reviewers assessed regulations enacted by December 2016 for all states and the District of Columbia. Reviewers compared regulations to national standards on the possession or use of marijuana, tobacco, and alcohol in ECE settings. RESULTS: Fewer states regulated marijuana than tobacco or alcohol in ECE settings. More states restricted the use of these 3 substances than they restricted the possession of them. CONCLUSIONS: Most states address alcohol or tobacco possession or use in their regulations but should consider updating these provisions to align with national standards. Public Health Implications. Updating and strengthening state childcare regulations regarding marijuana, tobacco, and alcohol possession and use may help protect children in ECE settings, where many children spend a substantial portion of time. As more states legalize marijuana, they may consider updating their regulations and including precise language to better protect children from unintended pediatric marijuana exposure or impaired childcare providers.


Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Cuidadores/legislação & jurisprudência , Creches/legislação & jurisprudência , Fumar Maconha/legislação & jurisprudência , Fumar Tabaco/legislação & jurisprudência , Adulto , Pré-Escolar , Humanos , Estados Unidos
15.
Am J Drug Alcohol Abuse ; 44(4): 413-417, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29672179

RESUMO

In the US, underage drinkers often consume supersized alcopop - a high-alcohol-content, ready-to-drink flavored alcoholic beverage that is currently regulated as beer. However, calculations in this paper illustrate how the high alcohol by volume and low price of supersized alcopops suggest that they rely on a larger proportion of additives for their alcohol content than permitted to meet the legal definition for beer. From a public safety perspective, it is urgently important that the Alcohol and Tobacco Tax and Trade Bureau assess the formulation of supersized alcopops - specifically, the percent of alcohol in the finished product that is derived from additives. Appropriate reclassification of supersized alcopops as distilled spirits would reduce youth access by resulting in increased price and reduced availability at the retail locations where youth most often obtain alcohol.


Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Bebidas Alcoólicas/classificação , Marketing , Saúde Pública , Humanos
16.
Alcohol Alcohol ; 53(3): 333-336, 2018 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-29346576

RESUMO

Like the tobacco industry, the alcohol industry, with the support of governments in alcohol exporting nations, is looking to international trade and investment law as a means to oppose health warning labels on alcohol. The threat of such litigation, let alone its commencement, has the potential to deter all but the most resolute governments from implementing health warning labeling.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Bebidas Alcoólicas/efeitos adversos , Conhecimentos, Atitudes e Prática em Saúde , Direito Internacional , Rotulagem de Produtos/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/tendências , Humanos , Rotulagem de Produtos/tendências
17.
Cad. Saúde Pública (Online) ; 34(8): e00122117, 2018. tab, graf
Artigo em Português | LILACS | ID: biblio-952447

RESUMO

Resumo: O objetivo foi analisar o impacto do Código de Trânsito Brasileiro (CTB) e da Lei Seca na mortalidade por acidentes de trânsito no Estado do Paraná, Brasil, no período de 1980 a 2014. Estudo ecológico de séries temporais das taxas de mortalidade por acidentes de trânsito de residentes de 15 a 49 anos por sexo, idade e categorias das vítimas, com dados do Sistema de Informações sobre Mortalidade. O estudo da tendência foi realizado por meio do modelo de regressão linear segmentada e pelo procedimento iterativo de Cochrane-Orcutt. O pressuposto de independência dos resíduos foi verificado por correlogramas e teste de Box-Pierce. Em todo o período, as maiores taxas de mortalidade foram observadas para sexo masculino, motociclistas e faixa etária de 20 a 29 anos de idade. Após a implantação do CTB, houve redução de 9,69 óbitos, por ano, para todas as categorias de acidentes de trânsito (p < 0,001), de 6,90 para pedestres (p = 0,001) e de 1,96 para ocupantes de veículo (p < 0,001). Quanto à faixa de etária, o maior impacto na mortalidade foi observado de 15 a 19 anos para pedestres (p < 0,001) e entre 20 a 29 anos para todas as categorias (p < 0,001). Após a Lei Seca, os dados apresentaram variabilidade e as tendências não foram significativas. Entretanto, houve diminuição da mortalidade para a categoria geral e pedestre. Para as categorias de motociclista e veículo, houve estabilização das taxas. Os resultados mostram impacto nas taxas de mortalidade por acidentes de trânsito após a implantação do CTB e da Lei Seca, com posterior aumento destas. Evidencia-se a demanda por efetividade na fiscalização das leis e avanço nas políticas públicas para que não haja retrocesso no já realizado.


Abstract: The objective was to analyze the impact of the Brazilian Traffic Code and the Law Against Drinking and Driving on mortality from traffic accidents in the State of Paraná, Brazil, from 1980 to 2014. This was an ecological time series study on mortality from traffic accidents in residents 15 to 49 years of age, stratified by the sex, age, and categories of victims, with data from the Mortality Information System. The time trend study used a segmented linear regression model and the Cochrane-Orcutt iterative procedure. The assumption of independence of residuals was verified by correlograms and the Box-Pierce test. The highest mortality rates during the period were in males 20 to 29 years of age. After enactment of the Brazilian Traffic Code, there was a decrease of 9.69 deaths/100,000 inhabitants per year for all categories of traffic accidents (p < 0.001), 6.90 for pedestrians (p = 0.001), and 1.96 for vehicle occupants (p < 0.001). As for age bracket, the greatest impact on mortality was in pedestrians 15 to 19 years of age (p < 0.001) and all victims 20 to 29 years of age (p < 0.001). Following enactment of the Drinking and Driving Law, the data displayed variability and the trends were not significant. However, there was a decrease in overall and pedestrian mortality. The rates for motorcyclists and vehicle occupants stabilized. The results showed an impact on traffic accident mortality after enactment of the new Brazilian Traffic Code and Drinking and Driving Law, followed by an increase in the rates. The study evidenced the need for more effective enforcement and progress with public policies in order to avoid a reversal of the gains achieved.


Resumen: El objetivo fue analizar el impacto del Código de Tráfico Brasileño (CTB) y la Ley Seca en la mortalidad por accidentes de tráfico, en el Estado de Paraná, Brasil, durante el período de 1980 a 2014. Se trata de un estudio ecológico de series temporales sobre las tasas de mortalidad por accidentes de tráfico, de residentes de 15 a 49 años, por sexo, edad y categorías de las víctimas, con datos del Sistema de Informaciones sobre Mortalidad. El estudio de la tendencia se realizó mediante un modelo de regresión lineal segmentada y por el procedimiento interactivo de Cochrane-Orcutt. El presupuesto de independencia de los residuos se verificó mediante correlogramas y el test de Box-Pierce. Durante todo el período, las mayores tasas de mortalidad se observaron para el sexo masculino, motociclistas y una franja de edad de 20 a 29 años de edad. Tras la implantación del CTB, hubo una reducción de 9,69 óbitos por año, en todas las categorías de accidentes de tráfico (p < 0,001), de 6,90 en peatones (p = 0,001) y de 1,96 en ocupantes de vehículo (p < 0,001). En cuanto a la franja de edad, el mayor impacto en la mortalidad se observó desde los 15 a los 19 años en peatones (p < 0,001) y entre 20 a 29 años en todas las categorías (p < 0,001). Tras la Ley Seca, los datos presentaron variabilidad y las tendencias no fueron significativas. No obstante, hubo una disminución de la mortalidad en la categoría general y peatones. En las categorías de motociclista y vehículo, hubo una estabilización de las tasas. Los resultados muestran impacto en las tasas de mortalidad por accidentes de tráfico, tras la implantación del CTB y la Ley Seca, con un posterior aumento de las mismas. Se evidencia una demanda de efectividad en la fiscalización de las leyes y el avance en las políticas públicas para que no haya retroceso en lo ya realizado.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Motocicletas/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Acidentes de Trânsito/mortalidade , Dirigir sob a Influência/legislação & jurisprudência , Brasil/epidemiologia , Sistemas de Informação , Modelos Lineares , Fatores de Risco , Pedestres
18.
BMJ Open ; 7(12): e017837, 2017 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-29229655

RESUMO

OBJECTIVES: Reducing smoking in young adults, particularly young Maori and Pacific, is vital for reducing tobacco harm and health inequalities in New Zealand (NZ). We investigated how NZ policy experts appraised the feasibility and likely effectiveness of interventions designed to reduce smoking prevalence among 18-24 year olds. DESIGN: We used a qualitative design, conducting semistructured interviews and applying thematic analysis. PARTICIPANTS: We interviewed 15 key informants, including politicians, senior policy analysts and leading tobacco control advocates. Participant selection was based on seniority and expertise and ensuring diverse perspectives were represented. INTERVENTIONS: We examined nine interventions that could either promote greater mindfulness or introduce barriers impeding smoking uptake: smoke-free outdoor dining and bars; no tobacco sales where alcohol is sold; social marketing campaigns; real life stories (testimonials); life skills training; raise purchase age to 21; tobacco-free generation; smokers' licence; make tobacco retail premises R18. RESULTS: The policies perceived as more effective denormalised tobacco; made it less convenient to access and use; highlighted immediate disadvantages (eg, impact on fitness); aligned with young people's values; and addressed the underlying causes of smoking (eg, stress). Participants highlighted some political barriers and noted concerns that some interventions might widen ethnic disparities. Exceptions were social marketing campaigns and extending smoke-free regulations to include outdoor areas of cafes and bars, which participants saw as politically feasible and likely to be effective. CONCLUSIONS: Our findings suggest the merit of an approach that combines social marketing with regulation that makes accessing and using tobacco less convenient for young adults; however, political barriers may limit the regulatory options available in the short term. Strategies to support self-determination and address the underlying causes of smoking in young people warrant further investigation. Determining policy acceptability to Maori and Pacific, and likely effectiveness for these populations, should be key priorities.


Assuntos
Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar/legislação & jurisprudência , Fumar/legislação & jurisprudência , Marketing Social , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Estudos de Viabilidade , Humanos , Entrevistas como Assunto , Havaiano Nativo ou Outro Ilhéu do Pacífico , Nova Zelândia , Pesquisa Qualitativa , Indústria do Tabaco/legislação & jurisprudência , Adulto Jovem
20.
Int J Oral Maxillofac Surg ; 46(6): 740-745, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28254401

RESUMO

The aim of this study was to determine whether the regional implementation of prohibitive liquor legislation, introduced in order to limit the sale of and access to alcohol, can lead to a sustained reduction in the incidence of assault occasioning facial injury, as seen in patients presenting to a level 1 trauma hospital. A retrospective observational cohort study was conducted to document patients who were identified as an acute hospital presentation of assault occasioning facial injury. The period of study was 2003-2015; this ensured a similar period of time before and after the implementation of the legislation in 2008. A statistical analysis was undertaken to assess the rates of change in oral and maxillofacial (OMF) assault admissions pre and post legislation. The study found that pre-legislation numbers of OMF assaults increased at a rate of 14% per annum and then decreased at a rate of 21% per annum post legislation (31% relative rate ratio reduction). Similar trends were seen for all males, males aged 18-35 years, and males where alcohol was recorded at clinical presentation. The introduction of 'last drinks' and 'lock out' legislation has led to a significant and sustained reduction in assaultive alcohol-related facial injury in Newcastle.


Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Comércio/legislação & jurisprudência , Traumatismos Faciais/epidemiologia , Traumatismos Faciais/prevenção & controle , Adolescente , Adulto , Feminino , Humanos , Masculino , New South Wales/epidemiologia , Estudos Retrospectivos , Fatores de Risco
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