Seven-years of alcohol consumption in Australia by wastewater analysis: Exploring patterns by remoteness and socioeconomic factors.

BACKGROUND: Wastewater analysis provides a complementary measure of alcohol use in whole communities. We assessed absolute differences and temporal trends in alcohol consumption by degree of remoteness and socioeconomics indicators in Australia from 2016 to 2023. METHODS: Alcohol consumption estimates from 50 wastewater treatment plants (WWTP) in the Australian National Wastewater Drug Monitoring Program were used. Trends were analysed based on 1) site remoteness: Major Cities, Inner Regional and a combined remoteness category of Outer Regional and Remote, and 2) using two socioeconomic indexes from the Australian Bureau of Statistics (ABS) relating to advantage and disadvantage for Income, education, occupation, and housing. RESULTS: Consumption estimates were similar for Major Cities and Inner Regional areas (14.3 and 14.4L/day/1000 people), but significantly higher in Outer Regional and Remote sites (18.6L/day/1000 people). Consumption was decreasing in Major cities by 4.5% annually, Inner Regional by 2.4%, and 3.5% in the combined Outer Regional and Remote category. Consumption estimates were higher in socioeconomically advantaged quartiles than those of lower advantage (0%-25% mean = 13.0, 75%-100% mean = 17.4). Consumption in all quartiles decreased significantly over the 7 year period with annual rates of decrease of 0.9%, 3.7%, 3.6%, and 3.0% for the lowest to highest quartile, respectively. CONCLUSIONS: Declines in Australian alcohol consumption have been steeper in large urban areas than regional and remote areas. There were smaller annual decreases in the most socioeconomically disadvantaged areas. If continued, these trends may increase Australian health inequalities. Policy and prevention work should be appropriately targeted to produce more equitable long-term outcomes.

Evolving Disparities in Cannabis Use Among Youth by Demographics and Tobacco and Alcohol Use in the U.S.: 2013-2021.

INTRODUCTION: This study investigated the prevalence of past 30-day cannabis use among U.S. youth by cigarette use, alcohol use, demographics, and state-of-residence cannabis legal status in 2021 and examined whether changes in cannabis use prevalence were modified by these factors from 2013 to 2021. METHODS: Data were drawn from the 24 states that collected cannabis use data participating in the Youth Risk Behavior Surveillance System from 2013 to 2021. Logistic regression analyses estimated past 30-day cannabis prevalence in 2021 and produced AORs by current cigarette, alcohol, and state-of-residence cannabis legal status. The same method was used with year as the exposure, adjusting for sex, race, and ethnicity, to assess trends in prevalence from 2013 to 2021. RESULTS: In 2021, cannabis use was more common among female youth (16.75% vs 13.83% [AOR=1.26, 95% CI=1.16, 1.37]) and non-Hispanic Black and Hispanic youth than among non-Hispanic White youth (17.19%, 16.14% vs 14.60% [AOR=1.25, 95% CI=1.12, 1.39 and AOR=1.16, 95% CI=1.04, 1.29, respectively]). Cannabis use was much more common among youth who reported any past 30-day cigarette or alcohol use (44.90% vs 6.48% [AOR=11.80, 95% CI=10.57, 13.18]). Declines in cannabis use were observed independent of state-level cannabis law from 2013 to 2021, and cannabis use prevalence did not differ significantly by state-of-residence cannabis legal status among the 24 participating states in 2021. CONCLUSIONS: Public health officials should carefully consider the potential impact of expanding commercialization of cannabis as a wellness product on youth cannabis use, especially with regard to minoritized populations and co-use with tobacco and alcohol. National and state-level public health education on cannabis use and youth-oriented prevention of cannabis uptake are long overdue.

Canada's Alcohol Deficit, 2007-2020: Social Cost, Public Revenue, Magnitudes of Alcohol Use, and the Per-Drink Net Deficit for a Fourteen-Year Period.

OBJECTIVE: Governments generate substantial revenue from the distribution and sale of alcoholic beverages. However, the use of this alcohol results in considerable public costs for health care, criminal justice, and economic loss of production. Because comparisons of these two sides of the same coin are limited, this study aims to estimate this net alcohol surplus or deficit in Canada and each province/territory for a 14-year study period. METHOD: Net government revenue from alcohol sales and net social costs of alcohol use were estimated for Canada and each province/territory for all years of study from 2007 to 2020, and all dollar figures were Consumer Price Index-adjusted to 2020 Canadian dollars (CAD). The net alcohol surplus/deficit was estimated as the difference. Per capita recorded alcohol sold was from administrative sources and used as proxy to calculate alcohol used by adding an estimate of unrecorded use and converting to Canadian standard drinks (CSDs). The per-drink net deficit was the net deficit divided by CSDs. RESULTS: In Canada in 2020, governments generated CAD $13.3 billion in revenue from alcohol sales, but this was offset by $19.7 billion in social costs attributable to alcohol use. This "alcohol deficit" increased by 122.0% in real-dollar terms over the study period and reached a high of $6.4 billion in 2020. In 2020, the magnitude of the alcohol used in Canada was 16.8 billion CSDs. Each of these drinks resulted in a public net deficit of $0.379. CONCLUSIONS: Both alcohol use and the resulting public alcohol deficit are high in Canada. To mitigate these losses to the well-being of Canadians and their economy, government planners, regulators, and policymakers must urgently deploy evidence-based alcohol policies toward reducing the magnitude of alcohol used in Canada.

Combinations of Drinking Occasion Characteristics Associated with Units of Alcohol Consumed among British Adults: An Event-Level Decision Tree Modeling Study.

BACKGROUND: Alcohol consumption is influenced by the characteristics of drinking occasions, for example, location, timing, or the composition of the drinking group. However, the relative importance of occasion characteristics is not yet well understood. This study aims to identify which characteristics, and combinations of characteristics, are associated with units consumed within drinking occasions. It also tests whether accounting for occasion characteristics improves the prediction of consumption compared to using demographic information only. METHODS: The data come from a cross-sectional, nationally representative, online market research survey. Our sample includes 18,409 British drinkers aged 18 + who recorded the characteristics of 46,072 drinking occasions using 7-day retrospective drinking diaries in 2018. We used decision tree modeling and nested linear regression to predict units consumed in occasions using information on drinking location/venue, occasion timing, company, occasion type (e.g., a quiet night in), occasion motivation, drink type and packaging, food eaten and entertainment/ other activities during the occasion. We estimated models separately for 6 age-sex groups and controlled for usual drinking frequency, and social grade in nested linear regression models. Open Science Framework preregistration: https://osf.io/42epd. RESULTS: Our 6 final models accounted for between 55% and 71% of the variance in drinking occasion alcohol consumption. Beyond demographic characteristics (1 to 9%) and occasion duration (24 to 60%), further occasion characteristics and combinations of characteristics accounted for 31 to 70% of the total explained variance. The characteristics most strongly associated with heavy alcohol consumption were long occasion duration, drinking spirits as doubles, and drinking wine. Spirits were also consumed in light occasions, but as singles. This suggests that the serving size is an important differentiator of light and heavy occasions. CONCLUSIONS: Combinations of occasion duration and drink type are strongly predictive of alcohol consumption in adults' drinking occasions. Accounting for characteristics of drinking occasions, both individually and in combination, substantially improves the prediction of alcohol consumption.

The impact of a minimum unit price on wholesale alcohol supply trends in the Northern Territory, Australia.

OBJECTIVE: The Northern Territory (NT) Government introduced a minimum unit price (MUP) of $1.30 per standard drink (10g pure alcohol) explicitly aimed at reducing the consumption of cheap wine products from October 2018. We aimed to assess the impact of the NT MUP on estimates of beverage-specific population-adjusted alcohol consumption using wholesale alcohol supply data. METHODS: Interrupted time series analyses were conducted to examine MUP effects on trends in estimated per capita alcohol consumption (PCAC) for cask wine, total wine and total alcohol, across the NT and in the Darwin/Palmerston region. RESULTS: Significant step decreases were found for cask wine and total wine PCAC in Darwin/Palmerston and across the Northern Territory. PCAC of cask wine decreased by 50.6% in the NT, and by 48.8% in Darwin/Palmerston compared to the prior year. PCAC for other beverages (e.g. beer) were largely unaffected by MUP. Overall, PCAC across the Territory declined, but not in Darwin/Palmerston. CONCLUSION: With minimal implementation costs, the Northern Territory Government's MUP policy successfully targeted and reduced cask wine and total wine consumption. Cask wine, in particular, almost halved in Darwin/Palmerston where the impact of the MUP was able to be determined and considering other interventions. Implications for public health: Implementation of a minimum unit price for retail alcohol sales is a cost-effective way to reduce the consumption of high alcohol content and high-risk products, such as cheap cask wine.

Alcohol in Greenland 1950-2018: consumption, drinking patterns, and consequences.

Alcohol is the single most important public health challenge in Greenland. We provide an overview of alcohol consumption, drinking patterns, and consequences of excessive use of alcohol in Greenland since 1950 through a synthesis of published results and analyses of population-based interview surveys. The import of alcohol fluctuated over the last 70 years with a peak in the 1980s at 22 litres 100% alcohol per person per year. In 1950 and 2015, the import of alcohol was similar at 8 litres. Several explanations have been put forward to explain the changes including restrictions, increased tax, demographic changes, treatment of alcohol disorders, and public health interventions. The proportion of abstainers increased from 1993 to 2018 while the proportion of participants with regular consumption decreased. About half of the population reported binge drinking at least monthly. Compared with Denmark, there were more abstainers and binge drinkers in Greenland, and fewer had a regular consumption. Although genetics may play a role for drinking patterns, social and cultural conditions are more important. Exposure to domestic alcohol problems and sexual abuse in childhood parallel the recorded import of alcohol and is a likely cause of transgenerational consequences such as youth suicides and alcohol problems.

Alcohol Consumption among Samoan Adults in 2010: Patterns, Correlates and Health Implications.

AIMS: We aim to describe alcohol consumption and related problems from a nationwide survey in 2010 in Samoa in association with sociodemographic variables as part of an intervention development. METHODS: The sample consisted of 3463 adults, 25-65 years of age. Participants self-reported alcohol consumption in the previous 12 months, patterns of drinking and alcohol-related psychosocial problems. Data about age, census region of residence, highest attained education level, employment, marital status, household assets score and current smoking status were gathered. RESULTS: More than one-third of men, 36.1%, and 4.1% of women consumed alcohol in the past year. There were greater proportions of alcohol users among younger adults, <45 years, in both men and women. Among men, being unemployed and residing outside of rural Savai'i and smoking cigarettes were associated with current alcohol use. Among women, tertiary education and cigarette smoking were strongly associated with alcohol use. Among alcohol consumers, almost 75% of both men and women reported being drunk more than once in the prior month, and 58% of men and 81% of women drank heavily, consuming >4 drinks for women and >5 drinks for men at least once per episode in the prior week. More men than women, 51% versus 26%, felt that alcohol consumption had interfered with their daily life. CONCLUSION: Our analyses identified correlates of alcohol consumption and associated problems that can help guide the development of targeted interventions for different sex and age groups to mitigate the social and physiological harms of alcohol misuse.

Trends in U.S. women's binge drinking in middle adulthood by socioeconomic status, 2006-2018.

BACKGROUND: Binge drinking causes injury and illness. Prevalence of binge drinking doubled in 2006-2018 for women in middle adulthood (ages 30 s and 40 s); these are the first cohorts for whom attaining higher education and income (both associated with increased alcohol use) are highly prevalent. It is unknown whether recent trends in binge drinking among US women aged 30-49 differ by socio-economic status (SES). METHODS: We examined trends in binge drinking using nationally-representative National Health Interview Surveys (2006-2018) for women age 30-49 (N = 63,426), by education (college) and family income (<100 %, 100-199 %, 200-399 %, and >400 % of poverty line), controlling for age and race. RESULTS: The odds of binge drinking increased among all women approximately 7 % annually from 2006 to 2018. The magnitude of the change increased with education; the predicted probability of binge drinking among women at lowest levels of education increased from 10 % to 13 % from 2006 to 2018 (adjusted OR [AOR] 1.02, 95 % CI 0.99, 1.04), and those with the highest education from 13%-32% (AOR 1.10, 95 % CI 1.08-1.12). Women at the lowest income increased binge drinking from 12 % to 16 % (AOR 1.03, 95 % CI 1.01-1.05) and highest income from 17 % to 36 % (AOR 1.09, 95 % CI 1.07-1.10). Interactions between education (F8554, p < 0.001) and income (F8573, p < 0.001) with time confirmed slope differences. CONCLUSIONS: Nationally, women at all levels of SES increased binge drinking, but increases were most pronounced among high SES women.

Cross-sectional surveys of financial harm associated with others' drinking in 15 countries: Unequal effects on women?

INTRODUCTION AND AIMS: That physical, emotional and social problems occur not only to drinkers, but also to others they connect with, is increasingly acknowledged. Financial harms from others' drinking have been seldom studied at the population level, particularly in low- and middle-income countries. Whether financial harm and costs from others' drinking inequitably affect women is little known. The study's aim is to compare estimates and correlates of alcohol's financial harm to others than the drinker in 15 countries. METHODS AND MATERIALS: Cross-sectional surveys of Alcohol's Harm To Others (AHTO) were conducted in Australia, Brazil, Chile, Denmark, India, Ireland, Lao PDR, New Zealand, Nigeria, Sri Lanka, Sweden, Switzerland, Thailand, the US and Vietnam. PARTICIPANTS: 17,670 men and 20,947 women. MEASUREMENT: The prevalence of financial harm in the last year was assessed as financial trouble and/or less money available for household expenses because of someone else's drinking. ANALYSIS: Meta-analysis and country-level logistic regression of financial harm (vs. none), adjusted for gender, age, education, rurality and participant drinking. RESULTS: Under 3.2 % of respondents in most high-income countries reported financial harm due to others' drinking, whereas 12-22 % did in Thailand, Sri Lanka and India. Financial harm from others' drinking was significantly more common among women than men in nine countries. Among men and women, financial harm was significantly more prevalent in low- and middle- than in high-income countries. CONCLUSIONS: Reports of financial harm from others' drinking are more common among women than among men, and in low- and middle-income than in high-income countries.

Alcohol Harms over a Period of Alcohol Policy Reform: Surveys of New Zealand College Residents in 2004 and 2014.

Background: We estimated the change in the prevalence of harms attributed by students to their drinking and to others' drinking, over a decade of concerted effort by university authorities to reduce antisocial behaviour and improve student safety. Interventions included a security and liaison service, a stricter code of conduct, challenges to liquor license applications near campus, and a ban on alcohol advertising. Methods: We used a pre-post design adjusting for population changes. We invited all students residing in colleges of a New Zealand University to complete web surveys in 2004 and 2014, using identical methods. We estimated change in the 4-week prevalence of 15 problems and harms among drinkers, and nine harms from others' drinking among all respondents. We adjusted for differences in sample sociodemographic characteristics between surveys. Results: Among drinkers there were reductions in several harms, the largest being in acts of vandalism (7.1% to 2.7%), theft (11% to 4.5%), and physical aggression (10% to 5.3%). Among all respondents (including non-drinkers), there were reductions in unwanted sexual advances (14% to 8.9%) and being the victim of sexual assault (1.0% to 0.4%). Conclusion: Alcohol-related harm, including the most serious outcomes, decreased substantially among college residents in this period of alcohol policy reform. In conjunction with evidence of reduced drinking to intoxication in this population, the findings suggest that strategies to reduce the availability and promotion of alcohol on and near campus can substantially reduce the incidence of health and social harms.

Examining beverage-specific trends in youth drinking in Australia before and after the implementation of the alcopops tax.

INTRODUCTION AND AIMS: Alcohol consumption among young Australians has declined markedly since the early 2000s. As yet, there has been no data on how this decline has been spread across different beverages and instead high-level survey data with significant potential for recall and other bias has been used. Trends in beverage choice among young people following an increase in the 'alcopops' tax have also not received much attention. DESIGN AND METHODS: Data on 'yesterday' drinking occasions were obtained from five waves (2004, 2007, 2010, 2013, 2016) of the National Drug Strategy Household Survey. A total of 23 536 respondents aged 14-29 years were included in this study. Descriptive and regression analyses were conducted to explore trends in alcohol consumption and changes in beverage preferences. RESULTS: Youth drinking declined by 45% across the study period, with declines of 66% in premix, 48% in spirits, 46% in beer and 33% in wine. Consumption of premix was significantly lower in 2013 and 2016 compared to 2007 amongst the overall sample, males, females, respondents aged 14-21 and 22-29 years, light and heavy drinkers. Significant reductions were also observed in the consumption of premix immediately following the tax (2010) for the younger age group, males and light drinkers. DISCUSSION AND CONCLUSIONS: Youth consumption of alcohol has declined during the study period with significant variation across beverage types. We found some evidence of a separate impact for the alcopops tax, although for some groups, declines in premix consumption occurred well after the implementation of the tax.

Factors associated with the suicide rates in Korea.

The suicide rate in the Republic of Korea remains among the highest in the world, which needs to be examined in various aspects. This study investigated factors associated with the suicide rates in Korea. The suicide rates of 251 districts in Korea in 2015 and their relationships with the prevalence of heavy drinking, health care provision, and religion as well as demographic characteristics were examined with a Pearson correlations and a multiple linear regression analysis. The suicide rate in Korea was 26.5 per 100,000 persons in 2015. The regression analysis showed that the income level of the region, as represented by the average national health insurance premium, had a negative association with the suicide rate and that the prevalence of heavy drinking and the percentage of the population aged 65 and above had positive associations with the suicide rate. While the unemployment rate and the proportion of Catholics showed negative relationships with the suicide rate in the correlation matrix, the association was statistically insignificant in the regression analysis. Special attention should be given to excessive drinking and socio-economically disadvantaged conditions in taking measures to prevent suicide.

Psychometric Validation of the Brief Alcohol Social Density Assessment in an Adult Community Sample.

BACKGROUND: Individuals' social networks exert a strong influence on alcohol use, but valid assessment of network drinking behavior is typically lengthy and high in participant burden. The aim of this study was to validate the Brief Alcohol Social Density Assessment (BASDA), an efficient measure of perceived alcohol use within a person's social network, in a sample of adult drinkers from the general community. Specifically, the convergent, criterion-related, incremental validity and internal validity were investigated by examining the BASDA in relation to other established measures of drinking motives, weekly drinking level, and severity of involvement. METHODS: Participants were 903 (56% female) adults who reported drinking in the last year and who completed the BASDA, the Drinking Motives Questionnaire, the Daily Drinking Questionnaire, and the Alcohol Use Disorders Identification Test (AUDIT). RESULTS: Significant positive correlations were found between the BASDA and drinking motives, drinking quantity, and the AUDIT (rs = 0.21 to 0.51, ps < 0.001), providing support for convergent validity. There was a significantly higher BASDA score for those scoring at or above an AUDIT cutoff for hazardous drinking (p < 0.001), providing support for criterion-related validity. Finally, beyond motives and covariates, the BASDA was significantly associated with total AUDIT score (ΔR2  = 0.09, p < 0.001), indicating its additive contribution and providing support for incremental validity. Confirmatory factor analysis revealed excellent fit, and all items significantly loaded onto a single factor (p < 0.0001), providing evidence of internal validity. The resulting alcohol social density latent variable was significantly and robustly associated with drinks per week and AUDIT total score. CONCLUSIONS: These findings provide further support for the BASDA as a valid and efficient measure of social network alcohol density for understanding social influences on alcohol misuse.

Are Trends in Alcohol Consumption and Cause-Specific Mortality in Russia Between 1990 and 2017 the Result of Alcohol Policy Measures?

OBJECTIVE: The purpose of this study was to analyze trends in alcohol consumption and mortality and their association with alcohol control measures in Russia between 1990 and 2017. METHOD: Analysis of trends for all-cause mortality and alcohol-related mortality, life expectancy, and total adult per capita alcohol consumption and their relationship were conducted. A narrative literature review of alcohol control policies since 1990 was done. RESULTS: Corresponding trends of alcohol consumption and all-cause mortality and cause-specific mortality were observed for the analyzed period. Steep increases in consumption and mortality occurred in 1991-1994 and in 1998-2002, and a continuous decline was observed since 2003. Trends in alcohol consumption were also closely mirrored by trends in life expectancy. These dynamics seem to be affected by economic trends and alcohol control policies, which were increasingly implemented over the observation period, even though some measures remained vague. CONCLUSIONS: A combination of several factors seems to be at play to explain alcohol consumption and mortality trends: the general economic situation, the availability and affordability of alcohol, and the changing patterns of alcohol consumption. Alcohol control measures seem to have had a positive impact on decreasing alcohol consumption and mortality insofar as they have reinforced the existing economic trends.

Trends in inequalities of alcohol-related harms among Thai households: 2007-2017.

BACKGROUND: To estimate and compare the socio-economic inequities in alcohol-related harms among households in Thailand between 2007 and 2017 adjusted for socioeconomic status with the proportions of current and binge drinkers in each household. METHODS: A secondary data analysis of the 2007 and 2017 National Cigarette and Alcohol Consumption Survey was conducted. The unit of analysis was household-level. Concentration index (CI) was used to measure household income-based inequalities in alcohol-related harms (i.e., workplace, domestic, non-domestic, financial, and drinking-and-driving) in the previous 12 months. RESULTS: Based on data from two waves of survey (n = 66,776 in 2007 and 39,630 in 2017), the prevalence of households that had at least one member who had an alcohol-related harm event was 21.8% and 26.2% in 2007 and 2017, respectively. The highest prevalence was the drinking-and-driving domain (about 20%). The prevalence increased between 2007 and 2017 with an annual rate of change ranged from 1.2 to 4.4%. All of the CI values were negative for both survey waves, except the drink-and-driving domain in 2007. The CI values for all domains in 2017 had a larger magnitude than in 2007, except the domestic domain. For any alcohol-related harm, the CI value was not significant at +0.002 (Standard error [SE] 0.004) in 2007, but significant at -0.014 (SE 0.004) in 2017. So, the index changed around -0.016. CONCLUSIONS: The poor households had a slightly greater tendency to incur harms from alcohol and there existed more inequality in the prevalence of harms in 2017 compared with 2007.

[Nutrition and gastronomy in the community of La Rioja. Evolution of the food model, gastronomic identity and nutritional evaluation of the diet]. / Nutrición y gastronomía en la comunidad autónoma de La Rioja. Evolución del modelo alimentario, de la identidad gastronómica y de la valoración nutricional de la dieta.

INTRODUCTION: Objectives: the nutritional status of a population is one of the factors that most affect its health and quality of life. The gastronomy of a region as well as being an immaterial cultural asset of its inhabitants' conditions the food model of the same. Determining the evolution of the food model of the Community of La Rioja and its adaptation to the recommendations, assessing the influence that gastronomy has on it and defining the nutritional profile of the people of La Rioja has been the basis of this review. Methods: data provided by the Mapama Food Consumption Panel. Bibliographic searches on the topics described. Results: a decrease in the consumption of fresh fruits, vegetables, bread, vegetables and fresh vegetables is observed. Olive oil consumption is high. Gastronomy in La Rioja is simple but laborious, limiting the preparation of traditional dishes. The consumption of distilled drinks has increased. It has been estimated a low intake of carbohydrates and high fat. Calcium. Zinc, vitamin D and folates are nutrients that are deficient in the diet of the people of La Rioja. Conclusions: the decrease in the consumption of food of vegetable origin distances the food model from the Mediterranean diet while the high consumption of olive oil keeps it within it. The increase in the consumption of spirits with a higher content of ethanol, ethanol and ethyl carbamate is worrying. The intake of fatty acids, especially saturated fatty acids, should be moderated and a higher intake of carbohydrates from fruits, vegetables and legumes should be considered.

INTRODUCCIÓN: Objetivos: el estado nutricional de una población es uno de los factores que más inciden en su salud y en su calidad de vida. La gastronomía de una región, además de ser un bien cultural inmaterial de sus habitantes, condiciona su modelo alimentario. Determinar la evolución del modelo alimentario de la comunidad de La Rioja y su adecuación a las recomendaciones, valorar la influencia que la gastronomía tiene en el mismo y definir el perfil nutricional de los riojanos ha sido el fundamento de la presente revisión. Métodos: datos ofrecidos por el Panel de Consumo Alimentario del Mapama. Búsquedas bibliográficas sobre los temas descritos. Resultados: se observa un descenso en el consumo de fruta fresca, legumbres, pan, hortalizas y verduras frescas. El consumo de aceite de oliva es elevado. La gastronomía riojana es sencilla pero laboriosa, hecho que limita la preparación de platos tradicionales. El consumo de bebidas destiladas ha aumentado. Se ha estimado una baja ingesta de hidratos de carbono y alta en grasa. Calcio, Zinc, vitamina D y folatos son nutrientes deficitarios en la dieta de los riojanos. Conclusiones: el descenso en el consumo de alimentos de origen vegetal aleja al modelo alimentario de la dieta mediterránea, mientras que el elevado consumo de aceite de oliva lo mantiene dentro de ella. Es preocupante el incremento en el consumo de bebidas espirituosas con mayor contenido en etanol, etanal y carbamato de etilo. Debe moderarse la ingesta de ácidos grasos, y en especial de ácidos grasos saturados, y plantear una mayor ingesta de hidratos de carbono a partir de frutas, verduras y leguminosas.

Effects of changes to the taxation of beer on alcohol consumption and government revenue in Australia.

BACKGROUND: In 1988, the Australian government introduced a single nominal rate of tax on all beer products calculated on alcohol content. However, in 2000/01, varying nominal rates of tax were introduced for beer products according to three alcohol content levels (low-/mid-/high-strength) and container type (on-/off-premises). Little is known about the effect of the different tax policies on alcohol consumption and government revenue. METHODS: We undertake time series analysis over 1989-2016 to examine the effect of beer tax policies in two sub-periods (before/after 2000/01) on category-level beer consumption per capita and government revenue. We also test if the policy changes in 2000/01 had immediate or long-term effects on total (all beer category) consumption over 1989-2016. Data includes monthly domestic beer sales volumes by category (in litres of alcohol), monthly government revenue from beer tax (AUD$), and inflation-adjusted tax rates (AUD$ per litre of alcohol). RESULTS: Before 2000/01, the single nominal tax rate had a significant positive effect on revenue, but no significant effect on consumption. After 2000/01, the relatively higher nominal tax rates for two beer categories (mid- and high-strength off-premises) had a significant negative effect on their consumption, and a significant negative effect on revenue in one category (mid-strength off-premises). However, across the full period examined (1989-2016), the level and slope of total beer consumption was not significantly affected by the tax policy changes in 2000/01. CONCLUSION: Raising alcohol taxes has the potential to reduce consumption and increase government revenue, but has been underutilised for these public health and public finance objectives in Australia.

Equity in household spending on alcoholic beverages in South Africa: assessing changes between 1995 and 2011.

BACKGROUND: Globally, alcohol consumption accounts for a substantial burden of disease, which translates into high social and economic costs. To address this burden, several policies (e.g. age and trading hour restrictions, increasing alcohol taxation) were implemented. Despite the existence of these policies evidence shows that alcohol misuse and alcohol-related harms have increased in South Africa over recent years. The objective of this paper is to assess progressivity and the changes in progressivity of alcohol expenditure at the household level in South Africa using datasets that span 15 years. METHODS: Data come from the 1995, 2000, 2005/06 and 2010/11 South Africa Income Expenditure Survey. Distribution of spending on alcoholic beverages were analyzed using standard methodologies. Changes in progressivity between 1995 and 2000, and between 2005/06 and 2010/11 were also assessed using the Kakwani index. RESULTS: Alcohol spending was regressive between 1995 and 2011 as the fraction of poorer households' expenditure spent on alcohol beverage exceeds that for the richest households. Also, the difference in Kakwani indexes of progressivity indicates that spending on alcoholic beverages has become less regressive between the same time periods. CONCLUSION: The results show no evidence that alcohol policy including taxation increased regressivity. Thus, there is an opportunity to further reduce the regressivity using coherent alcohol policies. This paper concludes that there is a need for further research to unpack why alcohol spending became less regressive over the years that goes beyond just looking at changes in the distribution of alcohol expenditure.

Trends in alcohol consumption and expenditure: Analysis of household data from nationally representative sample from India.

BACKGROUND: Alcohol consumption in India has been rising at an increasing rate. A better understanding of current trends of consumption and expenditure is necessary for tackling future challenges. AIMS: To determine association between household income and amount of alcohol consumed, type of beverage consumed, and expenditure on alcohol in Indian households across different income-groups for rural and urban areas. METHOD: Secondary analysis of cross-sectional data from the Consumption Expenditure Survey by National Sample Survey Organization for 2011-12 in a nationally representative sample of over 65,000 households. We used estimates of average household Monthly Per Capita Consumer Expenditure (MPCE) including distribution of households and persons over the MPCE range, break-up of average MPCE by commodity group. RESULTS AND CONCLUSION: Households in India, on average, consumed 0.18 L of all alcoholic beverages per month (0.22 L in rural areas; 0.10 L in urban areas). The absolute quantity of alcohol consumed was higher among higher income-groups in both rural and urban areas. Country liquor was used by a majority across India; was used seven times more than toddy and beer, and 3.5 times more than Indian Made Foreign Liquor. Households' expenditure on alcohol was Rs.16.46 (US$0.26) per month, which was 0.98% of average total household MPCE. Fraction of average total household MPCE on alcohol in rural areas (1.14%) was almost double that of urban areas (0.62%). It increased steadily from lowest (0.5%) to highest (1.7%) income group in rural areas whereas in urban areas, it varied a little (0.5-0.8%) across income groups.