A natural experiment: Assessment of Danish high-school students' alcohol drinking patterns from 2014 and 2019 after the introduction of a common alcohol policy.

AIM: In this study, using national survey data from 2014 and 2019, we tested the hypothesis that students at schools who introduced a common alcohol policy in 2017 drank less than students at schools without a common policy. METHODS: We used survey data from 41 high schools that participated in the Danish National Youth Study in 2014 and 2019. We perceived the introduction of a common high-school alcohol policy in 2017 among local groups of high schools as a natural experiment and assessed it using difference-in-difference analyses. We assessed drinking patterns from 2014 and 2019 among students at schools with and without a common alcohol policy combined and stratified by sex in negative binominal regression and logistic regression models. Drinking patterns were measured as average weekly alcohol use, average alcohol intake at last school party, proportion of non-drinkers and frequent binge drinkers. RESULTS: Drinking patterns were similar among students in schools with and without a common alcohol policy. For example, among students at schools with a common alcohol policy, the average alcohol intake at the last school party among drinkers was 8.7 units in 2014 and 8.5 units in 2019, whereas average alcohol intake among students at schools without a common alcohol policy was 8.8 units in 2014 and 8.9 units in 2019 (p=0.413). CONCLUSIONS: No statistically significant effects were observed following the introduction of a common alcohol policy on students' drinking patterns, and alcohol consumption among high-school students was stable and remained high in 2014 and in 2019.

College Students' Underestimation of Blood Alcohol Concentration from Hypothetical Consumption of Supersized Alcopops: Results from a Cluster-Randomized Classroom Study.

BACKGROUND: Supersized alcopops are a class of single-serving beverages popular among underage drinkers. These products contain large quantities of alcohol. This study examines the extent to which young adults recognize how intoxicated they would become from consuming these products. METHODS: The study sample included 309 undergraduates who had consumed alcohol within the past year. Thirty-two sections of a college English course were randomized to 1 of 2 survey conditions, based on hypothetical consumption of supersized alcopops or beer of comparable liquid volume. Students were provided an empty can of 1 of the 2 beverages to help them answer the survey questions. Equation-calculated blood alcohol concentrations (BACs)-based on body weight and sex-were compared to the students' self-estimated BACs for consuming 1, 2, and 3 cans of the beverage provided to them. RESULTS: In adjusted regression models, students randomized to the supersized alcopop group greatly underestimated their BAC, whereas students randomized to the beer group overestimated it. The supersized alcopop group underestimated their BAC by 0.04 (95% confidence interval [CI]: 0.034, 0.053), 0.09 (95% CI: 0.067, 0.107), and 0.13 g/dl (95% CI: 0.097, 0.163) compared to the beer group. When asked how much alcohol they could consume before it would be unsafe to drive, students in the supersized alcopop group had 7 times the odds of estimating consumption that would generate a calculated BAC of at least 0.08 g/dl, compared to those making estimates based on beer consumption (95% CI: 3.734, 13.025). CONCLUSIONS: Students underestimated the intoxication they would experience from consuming supersized alcopops. Revised product warning labels are urgently needed to clearly identify the number of standard drinks contained in a supersized alcopop can. Moreover, regulations are needed to limit alcohol content of single-serving products.

Perceived parental alcohol problems and drinking patterns in youth: A cross-sectional study of 69,030 secondary education students in Denmark.

The aim of the study was to examine whether young people with parental alcohol problems have different drinking patterns than those without parental alcohol problems. Further, we examined whether the association between parental alcohol problems and young people's drinking patterns differed depending on the gender of the child and the parent, and whether more severe parental alcohol problems and cohabitation with the parent with alcohol problems was associated with earlier and heavier drinking patterns. Data came from the Danish National Youth Study 2014, a web-based national survey. 75,025 high school and vocational school students (15-25years) participated. Drinking patterns were investigated by the following outcomes: non-drinking, weekly alcohol consumption, frequent binge drinking, and early intoxication debut age. The main predictor variables were perceived parental alcohol problems, gender of the parent with alcohol problems, cohabitation with a parent with alcohol problems and severity of the parents' alcohol problems. Young people with parental alcohol problems had a higher weekly alcohol consumption (boys: 15.2 vs. 13.9 drinks per week; girls: 11.6 vs. 10.2 drinks per week), higher odds of early intoxication debut age (boys: OR=1.68 [95% CI 1.50-1.89]; girls: OR 1.95 [95% CI 1.79-2.14]), and more frequent binge drinking (boys, OR=1.16 [95% CI 1.04-1.29]; girls, OR=1.21 [95% CI 1.11-1.32]) compared to young people without parental alcohol problems. In conclusion, this study shows that young people with perceived parental alcohol problems have an earlier intoxication debut age, binge drink more frequently, and drink larger quantities per week than young people without perceived parental alcohol problems.

Adolescent Drinking Risks Associated with Specific Drinking Contexts.

BACKGROUND: To identify drinking contexts toward which prevention efforts should be directed, associations of context-specific alcohol use (past-year frequency of drinking and heavier drinking in the context) with a range of alcohol-related problems were examined in a population sample of adolescents. METHODS: A sample of youths (ages 15 to 18) residing in 50 medium-to-large California cities (n = 473 drinkers) was obtained. Respondents provided information about 7 past-year alcohol-related problems in 3 domains (physiological consequences, alcohol-related violence, and conflict/trouble) and the number of times in the past year they used 6 distinct drinking contexts (parties, restaurants/bars, parking lots/street corners, beaches/parks, respondent's home without parents, and someone else's home without parents). Context-specific dose-response model was estimated for each context using censored Tobit models with heteroskedasticity corrections. RESULTS: Physiological problems were associated with more frequent drinking in 5 of 6 contexts. Heavier drinking in restaurants/bars/nightclubs (b = 0.22, SE = 0.10) and someone else's home without parents (b = 0.14, SE = 0.06) was associated with greater risk of violence. Conflict/trouble was associated with more frequent drinking in parking lots/street corners, declining at higher levels of drinking. CONCLUSIONS: Certain drinking contexts are related to problems among youths, some because they are associated with frequent alcohol consumption and others because they are associated with heavier drinking. Identifying which drinking contexts are related to specific alcohol-related problems and why is an essential component of developing effective preventive interventions.

Does the decline in Swedish adolescent drinking persist into early adulthood?

BACKGROUND AND AIMS: Sweden has experienced a substantial decrease in adolescent drinking over the past decades. Whether the reduction persists into early adulthood remains unclear. Using survey data, the present study aimed to determine whether reductions in indicators of alcohol use observed among adolescents remain in early adulthood and whether changes in alcohol intake are consistent among light/moderate and heavy drinkers. DESIGN: Data from the Swedish monthly Alcohol Monitoring Survey (2001-20) were used to construct five 5-year birth cohorts (1978-82, 1983-87, 1988-92, 1993-97 and 1998-2002). SETTING: Sweden. PARTICIPANTS: A total of n = 52 847 respondents (48% females) aged 16 and 30 years were included in this study. MEASUREMENTS: For both males and females, temporal changes in the prevalence of any drinking, the prevalence of heavy episodic drinking (HED) and total alcohol intake in the past 30 days in centilitres were analysed. FINDINGS: The prevalence of any drinking in more recent cohorts remained low until young people came into their early (females) and mid- (males) 20s. Male cohorts differed in the prevalence of HED across age, with the later cohorts showing lower odds than earlier cohorts (odds ratios between 0.54 and 0.66). Among females, no systematic differences between cohorts across age could be observed. Later male birth cohorts in light/moderate drinkers had lower alcohol intake than earlier cohorts (correlation coefficients between -0.09 and -0.54). No statistically significant cohort effects were found for male heavy drinkers. Although differences in alcohol intake among females diminished as age increased, the cohorts did not differ systematically in their level of alcohol intake. CONCLUSIONS: In Sweden, the reduced uptake of drinking in adolescents appears to fade as people move into adulthood. Observed reductions in alcohol intake among light and moderate drinkers appear to persist into adulthood. More recent male cohorts show a lower prevalence rate of heavy episodic drinking.

Trends in alcohol-related harm among Swedish youth: Do in-patient care registry data match drinking trends?

INTRODUCTION: Youth drinking has been declining in Sweden since the year 2000. There is a paucity of studies examining trends in alcohol-related harm during this period. The overall aim of the present study is to examine how trends in alcohol-related harm match trends in drinking among Swedish youths during 2000-2021. METHODS: Measures of alcohol use were obtained from national school surveys. Prevalence rates of any alcohol use and heavy episodic drinking were used. Alcohol-related harm indicators were obtained from registry information from the National Board of Health and Welfare. Annual trends in harm indicators were tested with linear regression models and correlations between alcohol use and alcohol-related harm indicators were assessed using Pearson's correlation on annual data. RESULTS: Statistically significant negative trends were observed for all alcohol-related harm indicators for the period 2000-2021. Significant correlations were found for both measures of alcohol use and all alcohol-related harm indicators. DISCUSSION AND CONCLUSIONS: The levels of alcohol-related harm have declined among youths in Sweden during the period 2000-2021. The trends in harm seem to reflect the decline in youth drinking that has occurred during the same period.

Tax policy, adult binge drinking, and youth alcohol consumption in the United States.

BACKGROUND: Prior research attributed youth alcohol consumption to the attitudes and drinking patterns among adults. Yet at a population level, few have examined the relationship between state-level adult binge drinking prevalence and youth drinking behaviors, or whether tax policy plays a role in this relationship. METHODS: We analyzed 6 biennial surveys (1999 to 2009) of individual-level youth alcohol use and related behaviors from state-based Youth Risk Behavior Surveys and corresponding years of state-level adult binge drinking prevalence from the Behavioral Risk Factor Surveillance System. We employed logistic regression with generalized estimating equations method to assess the extent to which state adult binge drinking predicted individual-level youth drinking outcomes and examined the role of alcohol taxes in that relationship. RESULTS: Population-aggregate analyses based on 194 state-year strata showed a positive correlation between state adult binge drinking and youth binge drinking (Pearson r = 0.40, p < 0.01). For individual-level youth drinking outcomes, a 5 percentage point increase in binge drinking prevalence among adults was associated with a 12% relative increase in the odds of alcohol use (adjusted OR = 1.12, 95% CI: 1.08, 1.16). Taxes were strongly inversely related with adult and youth drinking measures, and the effect of tax on youth drinking was attenuated after controlling for adult binge drinking. CONCLUSIONS: Both tax and adult binge drinking are strong predictors of youth drinking. Tax may affect youth drinking through its effect on adult alcohol consumption. Implementing effective alcohol policies to reduce excessive drinking in the general population is an important strategy to reduce youth drinking.

Who are Australia's young heavy drinkers? a cross-sectional population study.

OBJECTIVE: In light of the recent declines in youth drinking, the socio-demographic correlates of (1) annual total alcohol consumption (volume) and (2) monthly single occasion risky drinking among underage young people (14-17-year-olds) and young adults (18-24-year-olds) were examined. METHODS: Cross-sectional data were drawn from the 2019 National Drug Strategy Household Survey (n=1,547). Multivariable negative binomial regression analyses identified the socio-demographic correlates of total annual volume and monthly risky drinking. RESULTS: Those who spoke English as first language reported higher total volume and rates of monthly risky drinking. Not being in school predicted total volume for 14-17-year-olds, as did having a certificate/diploma for 18-24-year-olds. Living in affluent areas predicted a greater total volume for both age groups, and risky drinking for 18-24-year-olds. Young men in regional areas and working in labour and logistics reported higher total volume than young women in the same groups. CONCLUSIONS: There are important differences among young heavy drinkers related to gender, cultural background, socio-economic status, education, regionality and work industry. IMPLICATIONS FOR PUBLIC HEALTH: Prevention strategies that are sensitively tailored towards high risk groups (e.g. young men in regional areas and working in trade and logistics) may be of public health benefit.

Decline in youth drinking in high-income settings: Implications for public health in low-income countries.

Declining drinking among youth in many high-income countries has attracted scholarly attention and debates. Still, researchers are yet to globalize such research or examine its public health implications for low-resource settings. This commentary has two interrelated purposes. First, using evidence from Nigeria, it highlights how declining youth drinking in high-income countries may impact public health in low-income countries. Second, it highlights the necessity for research to examine youth drinking behaviours simultaneously worldwide. The declining drinking trends among young people in high-income countries have occurred simultaneously with global alcohol corporations being more aggressive in low-income countries like Nigeria. Relatedly, alcohol corporations may employ evidence regarding declines in drinking to argue against implementing stringent policies or other effective interventions in Nigeria (and other low-income settings), claiming their apparent success in the falling drinking trends in high-income settings. The article argues that research on the drinking decline among young people should be globalized because without commensurate attempts to examine their drinking behaviours/trends worldwide simultaneously, public and/or global health may be harmed for the reasons explored in this article.

Are changes in parenting related to the decline in youth drinking? Evidence from a comparison of Sweden and Denmark.

Introduction: The aim of this study was to replicate earlier studies suggesting that changes in parenting have contributed to the recent decline in youth drinking by comparing parenting in a country experiencing a sharp decline in youth drinking (Sweden) with a country with only a small decline (Denmark). Data and analysis: Data stem from self-reported information from 15-16-year-old children in the Swedish and Danish subsamples of ESPAD. Youth drinking was measured by prevalence and frequency of drinking over the past year. Parenting was measured in terms of the extent the child reported that: (1) parents' attitudes towards offspring drinking are restrictive, (2) parents set up general rules for what their children are allowed to do, and (3) parents have high level of knowledge about where and with whom their children spend time. The association between these indicators of parenting and youth drinking was first estimated with logistic regressions. Second, changes in parenting between 1999 and 2015 were compared between Denmark and Sweden across the study period. Results: Restrictive parental attitudes were associated with a lower likelihood of past-year drinking and frequent drinking in both Sweden and Denmark. This attitude was more common in Sweden, where it also became more prevalent between 2003 and 2015 in contrast to in Denmark. The association between strict parental rule-setting and youth drinking was weak in both countries. A high parental knowledge of the child's whereabouts was linked to a lower likelihood of past-year drinking in Sweden and a lower frequency of drinking in both countries. Parental knowledge of offspring's whereabouts did not develop differently in Sweden and Denmark, with a high and stable proportion in both countries. Conclusion: More restrictive parental attitudes towards youth drinking may have contributed to the decline in youth drinking, whereas the importance of general parental rule-setting and parental knowledge of offspring's whereabouts was not supported.

Mapping the complex causal mechanisms of drinking and driving behaviors among adolescents and young adults.

BACKGROUND: The proportion of motor vehicle crash fatalities involving alcohol-impaired drivers declined substantially between 1982 and 1997, but progress stopped after 1997. The systemic complexity of alcohol-impaired driving contributes to the persistence of this problem. This study aims to identify and map key feedback mechanisms that affect alcohol-impaired driving among adolescents and young adults in the U.S. METHODS: We apply the system dynamics approach to the problem of alcohol-impaired driving and bring a feedback perspective for understanding drivers and inhibitors of the problem. The causal loop diagram (i.e., map of dynamic hypotheses about the structure of the system producing observed behaviors over time) developed in this study is based on the output of two group model building sessions conducted with multidisciplinary subject-matter experts bolstered with extensive literature review. RESULTS: The causal loop diagram depicts diverse influences on youth impaired driving including parents, peers, policies, law enforcement, and the alcohol industry. Embedded in these feedback loops are the physical flow of youth between the categories of abstainers, drinkers who do not drive after drinking, and drinkers who drive after drinking. We identify key inertial factors, discuss how delay and feedback processes affect observed behaviors over time, and suggest strategies to reduce youth impaired driving. CONCLUSION: This review presents the first causal loop diagram of alcohol-impaired driving among adolescents and it is a vital first step toward quantitative simulation modeling of the problem. Through continued research, this model could provide a powerful tool for understanding the systemic complexity of impaired driving among adolescents, and identifying effective prevention practices and policies to reduce youth impaired driving.

Changes in Alcoholic Beverage Choice and Risky Drinking among Adolescents in Europe 1999-2019.

This paper explores trends in beverage preference in adolescents, identifies related regional differences, and examines cluster differences in key drinking measures. Data were obtained from the European School Survey Project on Alcohol and Other Drugs (ESPAD), covering 24 European countries between 1999 and 2019. Trends in the distribution of alcoholic beverages on the participants' most recent drinking occasion were analysed by sex and country using fractional multinomial logit regression. Clusters of countries based on trends and predicted beverage proportions were compared regarding the prevalence of drinkers, mean alcohol volume and prevalence of heavy drinking. Four distinct clusters each among girls and boys emerged. Among girls, there was not one type of beverage that was preferred across clusters, but the proportion of cider/alcopops strongly increased over time in most clusters. Among boys, the proportion of beer decreased, but was dominant across time in all clusters. Only northern European countries formed a geographically defined region with the highest prevalence of heavy drinking and average alcohol volume in both genders. Adolescent beverage preferences are associated with mean alcohol volume and heavy drinking at a country-level. Future approaches to drinking cultures need to take subpopulations such as adolescents into account.

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.

Patterns of alcohol consumption in 16 cohorts of Australian young adults aged 15-24 between 2001 and 2016.

BACKGROUND AND AIMS: Repeated cross-sectional surveys have identified substantial declines in adolescent drinking in Australia and some other countries in recent years. There is debate about whether these declines will be maintained as the cohort ages. This study modelled alcohol consumption over time to check for cohort effects reflecting a decrease in youth consumption, and then used this model to predict how decreases in youth drinking will be sustained through to adulthood. DESIGN: Longitudinal study using data from the Household Income and Labour Dynamics in Australia (HILDA) survey from 2001 to 2016. Piecewise latent growth models were estimated to assess consumption trajectories for each birth cohort from ages 15-18 and 18-24 years. SETTING: Australia. PARTICIPANTS: This study focused on 5320 (51.9% female) respondents aged between 15 and 22 in wave 1 (2001) to those aged between 17 and 24 in wave 16 (2016). MEASUREMENT: Annual volume of alcohol consumption was calculated as the product of the quantity per occasion and the frequency of drinking expanded to represent drinking occasions per year. FINDINGS: The model with best fit suggested that consumption increased rapidly [b = 0.667, standard error (SE) = 0.046, P < 0.001] until the legal drinking age of 18 and then plateaued (b = -0.027, SE = 0.016, P = 0.088). More recent cohorts start with significantly lower levels of consumption (b = -0.145, SE = 0.010; P < 0.001) but increase at a faster rate (b = 0.022, SE = 0.003, P < 0.001) between 15 and 18; however, not enough to catch up to earlier cohorts. CONCLUSION: Recent decreases in adolescent drinking in Australia may, at least in part, be attributed to lower consumption in recent cohorts of younger drinkers. Results indicate that this group may continue to drink less than previous cohorts as they age into their twenties.

The decline in youth drinking in England-is everyone drinking less? A quantile regression analysis.

BACKGROUND AND AIMS: Youth alcohol consumption has declined significantly during the past 15 years in many high-income countries, which may have significant public health benefits. However, if the reductions in drinking occur mainly among lighter drinkers who are at lower risk, then rates of alcohol-related harm among young people today and adults in future may not fall in line with consumption. There is conflicting evidence from Swedish school studies, with some suggesting that all young people are drinking less, while others suggest that alcohol consumption among heavier drinkers may be stable or rising while average consumption declines. This paper extends the geographical focus of previous research and examines whether the decline in youth drinking is consistent across the consumption distribution in England. DESIGN: Quantile regression of 15 waves of repeat cross-sectional survey data. SETTING: England, 2001-16. PARTICIPANTS: A total of 31 882 schoolchildren (50.7% male) aged 11-15 who responded to the Smoking Drinking and Drug Use among Young People surveys. MEASUREMENTS: Past-week alcohol consumption in UK units at each fifth percentile of the consumption distribution. FINDINGS: Reductions in alcohol consumption occurred at all percentiles of the consumption distribution analysed between 2001 and 2016, but the magnitude of the decline differed across percentiles. The decline in consumption at the 90th percentile [ß = -0.21, confidence interval (CI) = -0.24, -0.18] was significantly larger than among either lighter drinkers at the 50th percentile (ß = -0.02, CI = -0.02, -0.01) or heavier drinkers at the 95th percentile (ß = -0.16, CI = -0.18, -0.13). CONCLUSIONS: Alcohol consumption among young people in England appears to be declining across the consumption distribution, and peaks among heavy drinkers. The magnitude of this decline differs significantly between percentiles of the consumption distribution, with consumption falling proportionally less among the lightest, moderate and very heaviest youth drinkers.

Young cohorts of Russians drink less: age-period-cohort modelling of alcohol use prevalence 1994-2016.

BACKGROUND AND AIMS: Young Russians have been drinking less alcohol, and fewer strong spirits in particular, in recent years. This study aimed to disentangle age, period and birth cohort effects for the first time in Russia to improve our understanding of these trends. DESIGN: Age, period and cohort analysis of annual nationally representative repeated cross-sectional surveys [Russian Longitudinal Monitoring Survey- Higher School of Economics (RLMS-HSE)] using separate logistic models for each gender. SETTING: Russia 1994-2016. PARTICIPANTS: A total of 195 234 respondents aged 14-85 years. MEASUREMENTS: Age (14 groups: 14-17 to 76+ years), period (21 years: 1994-2016) and birth cohorts (17 groups: 1920-24 to 2000-02). Outcome measures were 30-day overall and beverage-specific alcohol use prevalence accounting for vodka, moonshine, beer and wine. Controls were per capita income, education, marital status, ethnicity, residence type and regional climate. FINDINGS: Controlling for age and period effects, the most recent cohorts had lower rates of participation than older cohorts. Findings were valid for females born in 1995-2002 (P = 0.000) and males born in 1990-94 (P = 0.002) and 1995-2002 (P = 0.000). The period effects were strong in 1994-2003 due to intensive substitution of beer in place of vodka. Period effects were also important in determining a decline of prevalence in 2008-15 due to restrictive alcohol policy. Age effects showed an inverse U-shaped trend in both genders, except for moonshine and wine. Overall, drinking profiles were beverage-specific. Models indicated diverse beverage-specific effects of income, ethnicity, education, marital status and residence on the prevalence of alcohol use. CONCLUSION: The recent downward trend in alcohol use in Russia appears to be attributable to reduced participation rates among younger cohorts born after 1990.

Communities mobilizing for change on alcohol (CMCA): secondary analyses of a randomized controlled trial showing effects of community organizing on alcohol acquisition by youth in the Cherokee nation.

AIMS: We evaluated the effects of a community organizing intervention, Communities Mobilizing for Change on Alcohol (CMCA), on the propensity of retail alcohol outlets to sell alcohol to young buyers without age identification and on alcohol acquisition behaviors of underage youth. DESIGN: Random assignment of community to treatment (n = 3) or control (n = 2). Student surveys were conducted four times per year for 3 years; the cohort was in 9th and 10th grades in the 2012-13 academic year. Alcohol purchase attempts were conducted every 4 weeks at alcohol retailers in each community (31 repeated waves). SETTING: The Cherokee Nation, located in northeastern Oklahoma, USA. PARTICIPANTS: A total of 1399 high school students (50% male; 45% American Indian) and 113 stores licensed to sell alcohol across five study communities. INTERVENTION: Local community organizers formed independent citizen action teams to advance policies, procedures and practices of local institutions in ways to reduce youth access to alcohol and foster community norms opposed to teen drinking. MEASUREMENTS: Perceptions regarding police enforcement and perceived difficulty of and self-reported actual acquisition of alcohol from parents, adults, peers and stores. FINDINGS: Alcohol purchases by young-appearing buyers declined significantly, an 18 [95% confidence interval (CI) = 3, 33] percentage-point reduction over the intervention period. Student survey results show statistically significant differences in the trajectory of perceived police enforcement, increasing 7 (4, 10) percentage points, alcohol acquisition from parents, decreasing 4 (0.1, 8) percentage points, acquisition from 21+ adults, decreasing 6 (0.04, 11) percentage points, from < 21 peers decreasing 8 (3, 13) percentage points and acquisition from stores decreasing 5 (1, 9) percentage points. CONCLUSIONS: A community organizing intervention, Communities Mobilizing for Change on Alcohol (CMCA), is effective in reducing the availability of alcohol to underage youth in the United states. Furthermore, results indicate that the previously reported significant effects of CMCA on teen drinking operate, at least in part, through effects on alcohol access.

Purchases by heavier drinking young people concentrated in lower priced beverages: Implications for policy.

INTRODUCTION AND AIMS: Alcohol is an increasingly important risk factor in the global burden of disease. The acute harms experienced and persistence of drinking patterns established in adolescence motivate investigating influences on youth drinking. The aim is to examine association between heavier drinking in young people and their choice of beverage type, purchase outlet and price. DESIGN AND METHODS: A nationally representative sample of New Zealand drinkers (N = 1056) aged 16-19 years recruited using random digit dialling was surveyed in 2012 as part of the International Alcohol Control study. Typical quantities consumed and frequency of alcohol consumption categorised respondents into lower, medium and heavier consumption groups. Beverage choice, prices paid and on or off-premise purchase were related to consumption using univariate analysis. Logistic analysis was used to examine multivariate factors predicting membership of consumption groups. RESULTS: Twenty percent of the sample consumed six or more drinks at least once a week, increasing to 1 in 4 for those 18 years and older. Heavier drinkers consumed more alcohol in the form of ready to drinks (RTD) especially high-potency RTDs. Lower consumers drank greater proportion of wine. Heavier drinkers paid less than medium consumers who paid less than lower consumers. High-potency RTDs were cheaper per unit of alcohol than other beverages and chosen by heavier drinkers resulting in lower prices. DISCUSSION AND CONCLUSIONS: Heavy consumption of alcohol remains common in New Zealand young drinkers. Heavier drinkers paid less to purchase alcohol and consumed more alcohol in the form of high-potency RTDs. [Wall M, Casswell S, Yeh L-C. Purchases by heavier drinking young people concentrated in lower priced beverages: Implications for policy. Drug Alcohol Rev 2017;36:352-358].

Understanding trends in Australian alcohol consumption-an age-period-cohort model.

AIMS: To decompose Australian trends in alcohol consumption into their age, period (survey year) and cohort (birth year/generation) components. In particular, we aimed to test whether recent declines in overall consumption have been influenced by reductions in drinking among recently born cohorts. DESIGN: Seven cross-sectional waves of the Australian National Drug Strategy Household Survey (1995-2013). Age, period and cohort effects were estimated using a linear and logistic cross-classified random-effects models (CCREMs). SETTING: Australia PARTICIPANTS: A total of 124 440 Australians (69 193 females and 55 257 males), aged 14-79 years. MEASUREMENTS: Whether or not respondents consumed alcohol in the 12 months prior to the survey and, for those who did, the estimated volume of pure alcohol consumed, derived using standard quantity-frequency survey questions. FINDINGS: Controlling for age and period effects, there was significant variation in drinking participation and drinking volume by birth cohort. In particular, male cohorts born between the 1965 and 1974 and female cohorts born between 1955 and 1974 reported higher rates of drinking participation (P < 0.05), while the most recent cohorts (born in the 1990s) had lower rates of participation (P < 0.01). Among drinkers, the most recently born cohort also had sharply lower average consumption volumes than older cohorts for both men and women (P < 0.01). CONCLUSION: Recent birth cohorts (born between 1995 and 1999) in Australia report significantly lower rates of both drinking participation and drinking volume than previous cohorts, controlling for their age distribution and overall changes in population drinking. These findings suggest that the recent decline in alcohol consumption in Australia has been driven by declines in drinking among these recently born cohorts. These trends are consistent with international shifts in youth drinking.