Should tobacco sales be restricted to state-run alcohol outlets? Perspectives from 10 US alcohol control states.

BACKGROUND AND AIMS: The ubiquity of tobacco retailers helps to sustain the tobacco epidemic. A tobacco retail reduction approach that has not been tried is transitioning tobacco sales to state-controlled alcohol stores (TTS), which are limited in number and operate under some restrictions, e.g. regarding opening hours or marketing materials. This study summarizes policy experts' and advocates' views of TTS, including (1) advantages and disadvantages; (2) feasibility; and (3) potential implementation obstacles. DESIGN: This study was a qualitative content analysis of semi-structured interviews. SETTING: Ten US states with alcoholic beverage control systems were included. PARTICIPANTS: The participants comprised a total of 103 tobacco control advocates and professionals, public health officials, alcohol policy experts and alcohol control system representatives, including two tribal community representatives. MEASUREMENTS: Interviewees' perspectives on their state's alcoholic beverage control agency (ABC, the agency that oversees or operates a state alcohol monopoly) and on TTS were assessed. FINDINGS: Interviewees thought TTS offered potential advantages, including reduced access to tobacco products, less exposure to tobacco advertising and a greater likelihood of successful smoking cessation. Some saw potential long-term health benefits for communities of color, due to the smaller number of state alcohol stores in those communities. Interviewees also raised concerns regarding TTS, including ABCs' limited focus on public health and emphasis on revenue generation, which could conflict with tobacco use reduction efforts. Some interviewees thought TTS could enhance the power of the tobacco and alcohol industries, increase calls for alcohol system privatization or create difficulties for those in recovery. CONCLUSIONS: In the United States, transitioning tobacco sales to state-controlled alcohol stores (TTS) could have a positive public health impact by reducing tobacco availability, marketing exposure and, ultimately, tobacco use. However, tensions exist between alcohol control system goals of providing revenue to the state and protecting public health. Should a state decide to pursue TTS, several guardrails should be established, including building into the legislation an explicit goal of reducing tobacco consumption.

What are the impacts of alcohol supply reduction measures on police-recorded adult domestic and family violence in the Northern Territory of Australia?

BACKGROUND: During 2017-18, the Northern Territory (NT) introduced a Banned Drinker Register (BDR) and Minimum Unit Price (MUP) NT-wide; Police Auxiliary Liquor Inspectors (PALIs) in three regional towns; and restrictions on daily purchases/opening hours (DPOH) in one regional town. The BDR is an individual-level alcohol ban; MUP is a pricing policy; and PALIs enforce bans on restricted areas at takeaway outlets. This study examines the impact of these policies on adult domestic and family violence (DFV). METHODS: We examined DFV assaults and breaches of violence orders from January 2014 - February 2020 using interrupted time series models for NT, Greater Darwin, Katherine, Tennant Creek, and Alice Springs. To account for increasing numbers of individuals on the BDR we tested two timepoints (Sept 2017, March 2018). FINDINGS: Following DPOH, assaults (78 %) and alcohol-involved assaults (92 %) decreased in Tennant Creek. After PALIs, assaults (79 %) in Tennant Creek, and breaches (39 %) and alcohol-involved breaches (58 %) in Katherine decreased. After MUP, assaults (11 %), alcohol-involved assaults (21 %) and alcohol-involved breaches (21%) decreased NT wide. After MUP/PALIs in Alice Springs, alcohol-involved assaults (33 %), breaches (42 %), and alcohol-involved breaches (57 %) decreased. BDR (Sept 2017) found increases in assaults (44 %) and alcohol-involved assaults (39 %) in Katherine and assaults (10%) and alcohol-involved assaults NT-wide (17 %). There were increases of 21 %-45 % in breaches NT-wide, in Darwin, Katherine, and Alice Springs. Following March 2018 found increases in assaults (33 %) and alcohol-involved assaults (48 %) in Katherine. There were increases - from 20 % to 56 % - in breaches in NT-wide, Katherine, and Alice Springs. CONCLUSION: PALIs and DPOH were associated with some reductions in DFV; the BDR was associated with some increases. The upward trend commences prior to the BDR, so it is also plausible that the BDR had no effect on DFV outcomes. Although MUP was associated with reductions in the NT-wide model, there were no changes in sites without cooccurring PALIs.

Is alcohol outlet availability associated with binge drinking in Canadian young adults? Findings from British Columbia and Quebec.

OBJECTIVES: Alcohol availability is associated with alcohol consumption and related harms, but there is less evidence on associations with heavy episodic drinking (HED), a drinking pattern prevalent among young adults. This study aimed to assess the associations between alcohol availability and HED among young Canadians. METHODS: We used a population-based sample of Canadian urban-dwelling young adult drinkers (18‒29 years) from the cross-sectional Canadian Community Health Survey (CCHS; cycles 2015‒2019). We linked data from CCHS respondents in British Columbia and Quebec with two measures of alcohol availability for both offsite and onsite outlets: density (AOD) and accessibility (SAI) within dissemination areas (N = 1,067,747). We used logistic regression to estimate the associations between alcohol availability and monthly HED, adjusting for covariates. RESULTS: The associations between availability and HED differed by province, and availability measure. In British Columbia, offsite and onsite accessibility using SAI was inversely associated with HED. For example, living in neighbourhoods with medium alcohol accessibility (as compared to low) was significantly associated with reduced odds of HED (offsite OR = 0.33, 95% CI 0.17‒0.64; onsite OR = 0.49, 95% CI 0.27‒0.89). In Quebec, offsite availability was positively associated with HED using SAI (although not statistically significant) while no clear trend was seen for onsite availability. CONCLUSION: Results were consistent with previous evidence. Restricting spatial availability of alcohol remains an important public health strategy for decreasing the ease/convenience of access. Understanding why patterns of availability and drinking differ across regions could inform regionally tailored policies.

RéSUMé: OBJECTIFS: La disponibilité des points de vente d'alcool (PVA) dans les quartiers est associée à la consommation d'alcool et aux méfaits qui y sont reliés, mais il y a encore peu de données probantes sur les associations avec la forte consommation épisodique, un mode de consommation d'alcool répandu chez les jeunes adultes. Cette étude visait à évaluer les associations entre la disponibilité des PVA et la forte consommation épisodique d'alcool chez les jeunes adultes canadiens. MéTHODES: Nous avons analysé les données de jeunes adultes (18 à 29 ans) ayant participé à l'Enquête sur la santé dans les collectivités canadiennes (ESCC; cycles 2015‒2019) et vivant en milieu urbain en Colombie-Britannique et au Québec. Nous avons couplé ces données à deux mesures de disponibilité des PVA : la densité et l'accessibilité calculées à l'échelle des aires de diffusion (N = 1 067 747). Nous avons estimé les associations entre la disponibilité des PVA, en distinguant les PVA à consommer sur place (p. ex., bars) et pour emporter (p. ex., dépanneurs), et la forte consommation épisodique d'alcool à l'aide de modèles de régression logistique ajustés pour les variables de confusion potentielle. RéSULTATS: Les associations entre la disponibilité des PVA et la forte consommation épisodique différaient selon la province et la mesure de disponibilité choisie. En Colombie-Britannique, l'accessibilité aux PVA à consommer sur place et à emporter était inversement associée à une forte consommation épisodique d'alcool. Par exemple, le fait de vivre dans des quartiers où l'accessibilité à l'alcool était moyenne (comparativement à faible) était significativement associé à une plus faible probabilité de forte consommation épisodique (RC PVA à consommer sur place = 0,49, IC à 95% : 0,27‒0,89; RC PVA pour emporter = 0,33, IC à 95% : 0,17‒0,64). Au Québec, l'accessibilité aux PVA pour emporter était associée positivement à la forte consommation épisodique (bien que l'association n'était pas statistiquement significative), tandis qu'aucune tendance claire n'a été observée pour la disponibilité des PVA à consommer sur place. CONCLUSION: Nos résultats concordent avec les données probantes antérieures. Restreindre la disponibilité des points de vente d'alcool dans les quartiers demeure une stratégie de santé publique intéressante pour réduire la facilité d'accès à l'alcool. Une exploration plus en profondeur des raisons pour lesquelles les associations entre disponibilité et consommation d'alcool diffèrent entre provinces servirait à énoncer des politiques publiques adaptées aux régions.

The Association of Alcohol Outlet Density With Alcohol Intake: The Multiethnic Cohort.

OBJECTIVE: Neighborhood characteristics have been shown to influence lifestyle behaviors. Here we characterized alcohol outlet density in Los Angeles County, CA, and Hawaii and assessed the association of alcohol outlet density with self-reported alcohol intake in the Multiethnic Cohort. METHOD: Participants (n = 178,977) had their addresses geocoded at cohort entry (1993-1996) and appended to block group-level alcohol outlet densities (on- and off-premises). Multinomial logistic regression was performed to assess the association between self-reported alcohol intake and on- and off-premise alcohol outlet densities by each state. Stratified analysis was conducted by sex, race, and ethnicity. RESULTS: Overall, we did not find associations between alcohol outlet density and self-reported alcohol intake in Los Angeles County, but we found that on-premise alcohol outlets were associated with 59% (odds ratio [OR] = 1.59, 95% CI [1.29, 1.96]) increased odds of consuming more than two drinks per day in Hawaii. Women living in neighborhoods with a high density of on-premise alcohol outlets (Los Angeles County: OR = 1.15, 95% CI [0.95, 1.40]; Hawaii: OR = 2.07, 95% CI [1.43, 3.01]) had an increased odds of more than two drinks per day. CONCLUSIONS: This study suggests that neighborhood factors are associated with individual-level behaviors and that multilevel interventions may be needed.

Notas sobre la prevención del alcoholismo y la dependencia de drogas / Notes about alcoholism and drug dependence prevention

Se hace un análisis crítico de la prevención en materias de alcoholismo y dependencia de drogas, ofreciéndose los modelos conceptuales que debe inspirar los programas preventivos, señalándose los factores de riesgo que es necesario controlar y subrayándose la necesidad, dada la complejidad de la materia, de llevar a cabo acciones multidisciplinarias, multiproesionales comprensivas y adecuadamente coordinadas. Igualmente, se señalan los riesgos de las políticas preventivas y se hace mención de las que han fracasado. Se ofrece el modelo de salud pública como organizador de las acciones preventivas a realizar, ordenándose como centradas en la oferta y en la demanda de drogas y alcohol y en el medio psico-socio-cultural, que serían las más centrales y que nunca debieran estar ausentes en las políticas y programas de prevención. Se termina insistiendo en la comprensividad de éstas

Cómo prevenir la depresión en momentos de aislamiento 6 [infografía]

Evita el consumo de alcohol y outras sustancias. El alcohol es un depresor del sistema nervioso central, y el sonsumo de esta sustancia puede hacerte sentir menos útil, más cansado, menos activo y emocionalmente más triste. Otras sustancias como la marihuana pueden ocasionar sensación de tristeza y un mayor riesgo biológico de experimentar depresión.