Reducing high-risk drinking by young Americans south of the border: the impact of a partial ban on sales of alcohol

OBJECTIVE: Determine the effect of a partial sales ban on cross border drinking in Mexico. METHOD: On weekend evenings, thousands of youths (younger than 21 years) and young adults (21 to 25 years) residing in communities along the U.S. border cross over into Mexico to patronize all-night bars where the drinking age is 18 rather than 21 years and where the price of alcohol is considerably less than in the United States. On January 1, 1999, Juárez, Mexico, across the border from El Paso, Texas, implemented a 2 AM bar closing policy replacing the previous 5 AM closing time. Breath alcohol tests of pedestrians at the Juárez/El Paso border before and after the policy change were compared with a similar sample of pedestrians at the Tijuana, Mexico/San Diego, California border. RESULTS: At the Juárez/El Paso border, the total number of youths with positive BACs returning from Juárez after 3 AM when the bars were closed was reduced 89%, whereas the number returning between midnight and 3 AM remained unchanged. There was no change in either period at the Tijuana/San Diego comparison site. CONCLUSIONS: Early closing of the bars in Juárez reduced the number of youths returning after 3 AM to the United States with positive BACs.     

Legal cannabis market shares during Canada's first year of recreational legalisation

BackgroundThis study estimated legal products’ share of Canada's total cannabis consumption during the first year of recreational legalisation, October 2018 to September 2019.MethodsGovernment data was used to estimate monthly recreational sales in dollars per capita, grams per user, and percentage share of kilograms or litres consumed. As explanatory factors, the analysis considered provincial differences in retail pricing (percentage mark-ups) and store density (stores per million users), as well as national monthly production of dry cannabis (kilograms) and cannabis oil (litres) finished products.ResultsLegal recreational products’ share of Canada's overall cannabis consumption began at 7.8% in October 2018 and grew to 23.7% by September 2019, with an average of 14.5% over the first 12 months. Sales growth was delayed by shortages of both dry cannabis products and licensed stores, but not cannabis oils. Across the 10 provinces, legal recreational shares in September 2019 varied from 13% to 70%; differences in store densities and retail prices partly explained the variation. Prince Edward Island's large 70% share seemed due to it having minimal product shortages, high store densities, and low prices.ConclusionsLegal recreational products captured market share to the extent they were available, accessible, and low-priced. Problems with those factors slowed the initial expansion of legal product sales but also suggested ways to gradually increase their market share.     

Assessing the Validity of On-Premise Alcohol License Data in Six Communities in California: Operating Characteristics and Outlet Densities

This study evaluated State of California alcohol license records as a measure of businesses selling alcohol for consumption on premise. In 2008, researchers attempted to visit all 799 licensed restaurants, bars, and pubs in six medium-sized cities near San Francisco. Surveys collected detailed business characteristics for a subsample of 151 bars or restaurants that included a separate bar area. Results suggest inaccuracies of official records regarding license locations and types (bar/pub vs. restaurant). Analyses also indicate that establishment characteristics are related to local alcohol outlet densities. Study implications and limitations are discussed.     

Compliance checks for underage cigarette and alcohol purchase attempts and associated factors in retail outlets in Hawaii

Aims: Tobacco use remains the leading cause of preventable death, and alcohol is the most commonly used and abused drug among youth. Adolescents acquire cigarettes and alcohol through the retail environment. This paper investigates the relationships between underage cigarette and alcohol sales resulting from compliance checks and associated factors in Hawaii. Methods: Four hundred and two retail establishments were inspected by minors for compliance to underage cigarette and alcohol age restrictions. Findings: The overall compliance rate for selling cigarettes to a minor was 93% and alcohol was 84% from April 2012 to March 2013. There were 5.7% of stores that sold cigarettes only, 14.4% that sold alcohol only, 1.7% that sold both and 78.1% that did not sell any. No similarities between the gender of the minor or the gender of the clerk were found. Selling cigarettes and alcohol to a minor was significantly associated with whether identification or age was asked of the minor. Selling alcohol to a minor was significantly associated with smaller stores, having alcohol advertisements and correct wording on warning signs. Conclusions: Results are useful for future compliance education and enforcement and to further understand what factors may be contributing to, or preventing, underage cigarette and alcohol sales.     

Cannabis sales increases during COVID-19: Findings from Alaska,Colorado, Oregon,and Washington

Background and aimsFollowing emergency declarations related to COVID-19 in the United States, many states issued stay-at-home orders and designated essential business categories. Most states allowed medical and/or non-medical adult-use cannabis retailers to remain open. This study assesses changes in cannabis sales across Alaska, Colorado, Oregon, and Washington before and during the pandemic.MethodsPre-tax sales data from cannabis marketplaces in four states were analyzed to identify trends from January 2018–December 2020. Mean monthly sales and relative percent change in mean monthly sales were compared by state from April–December (coinciding with the pandemic) in 2018, 2019, and 2020. Differences were assessed using the nonparametric Mann-Whitney-U test.ResultsMean monthly cannabis sales in all four states were higher during the pandemic period in 2020 compared to the same period in 2019. Sales reached a three-year peak in Washington in May 2020 and in Alaska, Colorado, and Oregon in July 2020. From April–December, the percent change in mean monthly sales from 2019 to 2020 was significantly higher than 2018–2019 in all four states, though Alaska saw similar increases between 2018–2019 and 2019–2020.ConclusionTo date, cannabis sales in Alaska, Colorado, Oregon, and Washington have increased more during the COVID-19 pandemic than in the previous two years. In light of these increases, data monitoring by states and CDC is warranted to understand how patterns of use are changing, which populations are demonstrating changes in use, and how such changes may affect substance use and related public health outcomes.     

2017—2019年天津市津南医院第二类精神药品使用情况分析

目的 分析天津市津南医院第二类精神药品的使用情况和变化趋势,为促进临床合理应用第二类精神药品提供依据。方法 对2017—2019年天津市津南医院第二类精神药品的销售量、销售金额、用药频度（DDDs）、日均药费（DDC）、药品排序比（B/A）进行统计和分析。结果 2017—2019年第二类精神药品的销售总金额呈现先下降后上升趋势。地佐辛注射液的销售金额始终居首位,2018—2019年佐匹克隆片、艾司唑仑片和咪达唑仑注射液的销售金额保持在前3位。2018—2019年,佐匹克隆片、艾司唑仑片和右佐匹克隆片的DDDs始终排名前3位。地佐辛注射液的DDC值较大,居首位。第二类精神药品的B/A基本均接近于1.00,同步性较好。结论 天津市津南医院第二类精神药品的使用基本合理,但个别药品存在不合理现象。     

Sales to apparently alcohol-intoxicated customers and online responsible vendor training in recreational cannabis stores in a randomized trial

BackgroundIn some U.S. states, laws prohibit sales of recreational marijuana to intoxicated customers to prevent associated harms. In alcohol markets, training in responsible sales practices is one intervention to help reduce such sales to intoxicated customers. Similar training may be beneficial in the recreational cannabis market.MethodsAn online responsible marijuana vendor (RMV) training was developed. Among its five modules, learning elements taught store personnel to recognize signs of alcohol impairment and intoxication, refuse sales, and understand the risks of driving under the influence of cannabis. A sample of n = 150 recreational cannabis stores in Colorado, Oregon, and Washington State, USA were enrolled in a randomized controlled trial, half of which were randomly assigned to use the RMV training. Stores were posttested using a pseudo-customer protocol in which confederate buyers feigned obvious signs of alcohol intoxication.ResultsDeterrence of sales to intoxicated customers does not seem to exist, regardless of whether the states’ laws prohibit it. Only 16 of 146 stores (11.0%; 4 Oregon stores were eliminated that were not in business) refused sales. There was no difference in refusal rates between intervention (11.6% [3.9%]) and control stores (7.6% [3.1%], F = 0.71, p = 0.401 [1-tailed]) or between stores that used the RMV training (6.3% [4.0%]) or not (12.0% [5.7%], F = 0.91, p = 0.343 [2-tailed]). In 11 visits, store personnel commented on the buyers’ behavior, or expressed concern/suspicion about buyers, but sold to them anyway.ConclusionsTraining in responsible sales practices alone did not appear to reduce sales to apparently alcohol-intoxicated customers. Legal deterrence from making these sales may be insufficient or nonexistent for store management to support adherence to this responsible sales practice. Regulatory and policy actions may be needed to increase perceived risk with such sales (i.e., clear policy and swift, severe, and certain penalties) to achieve training's benefits.     

A partial ban on sales to reduce high-risk drinking South of the border: seven years later

OBJECTIVE: On weekend evenings, thousands of youths (ages 20 and younger) and young adults (ages 21-25) residing in communities along the U.S. border cross into Mexico to patronize all-night bars where the drinking age is 18, rather than 21, and where the price of alcohol is considerably less than in the United States. On January 1, 1999, Juárez, Mexico, implemented a 2 AM (instead of 5 AM) bar-closing policy. The number of crossers and their blood alcohol concentration levels on return were reduced in the year following this policy change. The present study's objective was to determine the long-term (7-year) effect of the earlier-closing bar policy on cross-border drinking in Mexico. METHOD: Analyzed data (1998 to August 2005) were from quarterly breath-test surveys at the El Paso (Texas)/Juárez (Mexico) border, bar observations in Juárez, and trauma data in El Paso. RESULTS: Bar surveys in Juárez show that the 2 AM closing policy, initiated 7 years ago, continues to be enforced, as has the reduction (89%) in youthful crossers returning after 3 AM. The number of underage youths returning earlier in the evening (before 3 AM), however, unchanged for 2 years after the policy change, has doubled recently. CONCLUSIONS: The early closing of bars in Juárez has a continuing positive impact on the reduction of the number of those returning after 3 AM. Although initially there appeared to be no displacement of the late returnees into the early hours (before 3 AM), the number of bar visitors crossing and returning earlier has been steadily increasing. Suggestions for reducing cross-border heavy episodic drinking are described.     

Hallucinogens in the United States: A Diagnostic Evaluation

Abstract

It is not known whether the American public accepts smokefree bars and restaurants. Anticipating public displeasure with these ordinances, tobacco, liquor and restaurant industry trade associations have helped to stall efforts to pass laws curbing bar and restaurant smoking in the expectation that diminished patronage would inevitably result. This cross-sectional trend study uses data from the May 1993 and January 1999 Current Population Surveys, Tobacco Use Supplements to compare tobacco-control attitudes among American bar and restaurant workers, all other workers, smokers and nonsmokers (total n = 90,661). It was found that by 1999, smokefree workplaces were widely accepted by two-thirds of adults, with half favoring completely smokefree restaurants. Completely smokefree bars remained less popular, with nearly equal numbers (about 30%) preferring them or favoring unrestricted bar smoking. Even among bar and restaurant industry workers less than 10% favored unrestricted restaurant smoking. Greater acceptances of smokefree bars are now taking hold, especially in places like California, where acceptance rose 15% in six years. and 45% preferred them. Opponents to smokefree bars and restaurants may have underestimated the levels of support and growing acceptance of smokefree living areas now taking hold among the general public.     

Event-level analyses of energy drink consumption and alcohol intoxication in bar patrons

Aim

To assess event-level associations between energy drink consumption, alcohol intoxication, and intention to drive a motor vehicle in patrons exiting bars at night.

Method

Alcohol field study. Data collected in a U.S. college bar district from 802 randomly selected and self-selected patrons. Anonymous interview and survey data were obtained as well as breath alcohol concentration (BrAC) readings.

Results

Results from logistic regression models revealed that patrons who had consumed alcohol mixed with energy drinks were at a 3-fold increased risk of leaving a bar highly intoxicated (BrAC ≥ 0.08 g/210 L), as well as a 4-fold increased risk of intending to drive upon leaving the bar district, compared to other drinking patrons who did not consume alcoholic beverages mixed with energy drinks.

Discussion

These event-level associations provide additional evidence that energy drink consumption by young adults at bars is a marker for elevated involvement in nighttime risk-taking behavior. Further field research is needed to develop sound regulatory policy on alcohol/energy drink sales practices of on-premise establishments.     

我院生殖与泌尿男科门诊用药分析

目的 分析我院生殖与泌尿男科门诊的用药情况,为药物利用综合评价及临床合理用药提供参考。方法 采用回顾性调查方法,对我院2018—2019年生殖与泌尿男科门诊用药情况按药理分类、销售金额和用药频度（DDDs）及用药循证依据等进行统计分析。结果 2018年、2019年药品销售排前三位类别分别是：中成药（78.42%、69.74%）、心血管系统用药（9.09%、18.6%）、促性腺激素类（6.45%、7.25%）,以上三类占据男科用药主导地位,其销售合计占比分别为93.96%、95.59%;各类药品销售金额排序相对稳定,用药频度排序部分发生变化。生精片、龙鹿丸、胰激肽原酶肠溶片在2年内销售均列单品前三位。用药频次前三位：2018年为来曲唑片、生精片、胰激肽原酶肠溶片;2019年为胰激肽原酶肠溶片、龙鹿丸、四维葡锌胶丸。结论 山大生殖医院男性不育症致孕率居国内领先,其中药物的辅助治疗发挥了积极作用,用药评价分析表明整体用药结构基本符合我院生殖与泌尿男科临床诊疗方向,但中成药治疗周期较长、疗效尚缺乏高级别循证依据,有待于进一步的综合评价与临床研究。此外,尚需加强辅助用药的临床监管、提高合理用药水平。     

DUI pre-arrest alcohol purchases: a survey of Sonoma County drunk drivers.

Based on a sample of 1,052 drunk drivers in northern California, less than 1% (0.80%) of those arrested for DUI had purchased and consumed alcohol prior to arrest from a convenience/gas store (gasmart). Data from both "on-sale" (on-premises consumption) and "off-sale" (off-premises consumption) alcohol outlets were compared. When off-sale outlets were compared only 2% of the DUI offenders had purchased and consumed alcohol from gasmarts prior to the arrest event. Gasmarts were the least frequent source of DUI-offender alcohol purchases. This report also describes the distribution of alcohol outlets for Sonoma and San Diego counties with respect to type of license and activity. Convenience stores that sold gas and alcohol concurrently were not overrepresented in either county.     

Changes in characteristics of drug overdose death trends during the COVID-19 pandemic

BackgroundReports analyzing drug overdose (OD) mortality data during the COVID-19 pandemic are limited. Outcomes across states are heterogenous, necessitating assessments of associations between COVID-19 and OD deaths on a state-by-state level. This report aims to analyze trends in OD deaths in Massachusetts during COVID-19.MethodsAnalyzing 3,924 death records, we characterize opioid-, cocaine-, and amphetamine-involved OD mortality and substance co-presence trends from March 24-November 8 in 2020 as compared to 2018 and 2019.ResultsOD deaths involving amphetamines increased by 85% from 2019 to 2020 (61 vs. 113; P<0.001) but were steady from 2018 to 2019. Heroin's presence continued to decrease (341 in 2018, 247 in 2019, 157 in 2020; P<0.001); however, fentanyl was present in more than 85% of all OD deaths across all periods. Among OD deaths, alcohol involvement consistently increased, present in 250 deaths in 2018, 299 in 2019 (P=0.02), and 350 in 2020 (P=0.04). In 2019, 78% of OD decedents were White and 7% were Black, versus 73% and 10% in 2020 (P=0.02).ConclusionIncreased deaths involving stimulants, alcohol, and fentanyl reflect concerning trends in the era of COVID-19. Rising OD death rates among Black residents underscore that interventions focused on racial equity are necessary.     

2018—2020年天津市津南医院抗脑血管病药的使用情况分析

目的 调查分析2018—2020年天津市津南医院抗脑血管病药的应用情况及趋势,为医院抗脑血管病药的科学管理和合理应用提供参考.方法 采用数据回顾性方法,对天津市津南医院抗脑血管病药的用药总金额、用药总数量及构成比、限定日计量(DDD)值、用药频度(DDDs)及日均费用(DDC)等数据进行统计与分析.结果 天津市津南医院...     

A cognitive analysis of server intervention policies: perceptions of bar owners and servers

OBJECTIVE: The present study examined the underlying psychological variables relevant to alcohol server intervention policies. The focus of the research was the theoretical examination of college bar owners' and servers' attitudes and beliefs about server intervention policies. METHOD: Owners (n = 185) and servers (n = 185) of college bars were asked about their attitudes and perceived cognitive outcomes regarding server intervention policies. RESULTS: Although the findings revealed no statistical differences between owners and servers on their attitudes toward the different server intervention policies, statistical differences were found between the different policies (p < .05). Favorable policies focused on providing services to customers, whereas unfavorable policies focused on limiting the sales of alcohol. Finally, structural equation modeling revealed perceived cognitive outcomes related to the attitudes toward different server intervention policies. CONCLUSIONS: According to the present study's theoretical orientation, the attitudes are likely to have a direct influence on the adoption of policies or, on the part of the server, compliance with the policies. These attitudes toward the policies were found to be a function of the perceived hassle of implementing the policies and how effective the policy was in preventing driving under the influence.     

2018—2022年中国科学院合肥肿瘤医院新型抗肿瘤药应用分析

目的 评价中国科学院合肥肿瘤医院新型抗肿瘤药的临床使用情况和用药趋势，为促进临床合理用药提供依据。方法 采用回顾性的方法分析2018-2022年中国科学院合肥肿瘤医院临床使用的新型抗肿瘤药的消耗量、销售金额、用药频度（DDDs）、限定日费用（DDC）及药品销售金额排序（B）/DDDs排序（A）情况。结果 2018-2022年，医院新型抗肿瘤药物的品种数和销售金额呈逐年增长趋势，品种数从2018年的11种增加到2022年的49种，销售金额从2018年的270.34万元增长至2022年的2 543.00万元。2018-2019年，甲磺酸阿帕替尼片的销售金额及其DDDs排序均居第1位；2020-2021年，注射用卡瑞利珠单抗的销售金额排序居第1位，其DDDs 2021年居第1位。2022年，贝伐珠单抗注射液的销售金额排序居第1位，其DDDs排序居第3位。吉非替尼片销售金额不断下降，但其DDDs在2018-2021年均居前3位。2018-2022年，中国科学院合肥肿瘤医院大部分新型抗肿瘤药各品种的DDC处于逐年降低趋势。2020年卡瑞利珠单抗B/A<1，患者经济负担较重，2021年入围国家医保谈判品种后，价格大幅度下降，B/A达到1，2022年B/A>1；重组人血管内皮抑制素、贝伐珠单抗的B/A均<1，可能与其近年来销售金额增加有关；厄洛替尼、埃克替尼的B/A均>1，说明其价格更低、使用频率更高，大部分药品的DDC相对稳定，B/A接近于1，提示其销售金额与DDDs的同步性总体较好。结论 中国科学院合肥肿瘤医院新型抗肿瘤药的临床使用相对合理，需要加强抗肿瘤药物临床应用管理，建立相关考核指标体系并纳入绩效考核，从而确保临床使用新型抗肿瘤药物安全、有效、经济。     

Outlets,drinking and driving: a multilevel analysis of availability

OBJECTIVE: This study examines the degree to which the physical availability of alcohol as measured by outlet densities is related to self-reported individual drinking patterns, preferred drinking location, as well as both driving after drinking (DAD) and driving while intoxicated (DWI). METHOD: Data from 7,826 drinkers were obtained from a general-population telephone survey of 1,353 zip code areas in California. Measures of individual alcohol consumption included drinking frequency, drinks per occasion and variance in quantities consumed per occasion. Preferred drinking locations included bars, restaurants and the homes of drinkers and of their friends. DAD was defined as driving a motor vehicle within 4 hours of having one or more alcoholic drinks, and DWI was defined as driving after having too much to drink and drive safely. Geographic measures of outlet densities were obtained for bars, restaurants and off-premises establishments, using zip codes as geographic units of analysis. Hierarchical linear modeling was used to relate outlet densities within and surrounding respondents' area of residence to respondents' drinking and to respondents' drinking and driving. RESULTS: Whereas restaurant densities were directly related to greater drinking frequencies and DAD, bar densities were inversely related to DAD. There were no direct effects of drinking patterns on drinking and driving. Drinking and driving was strongly related to drinking location preference (e.g., bars and restaurants) only when considered simultaneously with individual drinking patterns, particularly drinking frequency. CONCLUSIONS: Increased restaurant density is strongly related to higher rates of both self-reported driving after drinking and drinking frequency. The strongest influence on both driving after drinking and driving while intoxicated is preferred drinking location considered together with individual drinking patterns. Outlet density and preferred drinking location when considered together with individual drinking patterns support driving after drinking and thereby increase the potential for alcohol-related accidents.     

Retailers’ views of tobacco policy and law enforcement

Aims: Tobacco retailers are in a unique position to implement policies that can influence sales and ultimately tobacco use, so the present survey explored retailers’ tobacco policies, involvement and problems with law enforcement, and pessimism about whether youth will obtain tobacco products.

Methods: 144 randomly selected tobacco retailers (30.1% return rate) in Mississippi, USA, completed a 2-page questionnaire about their store tobacco policies.

Findings: Present retailers, on average, endorsed fewer than half of eight commonly-adopted tobacco access policies. Significantly fewer anti-tobacco policies were complied with when those responding (a) were owners rather than managers, (b) worked at convenience stores rather than grocery stores, (c) had no law-enforcement involvement rather than some, and (d) had 18+ years of retail experience rather than less. Policy correlated significantly with law-enforcement involvement, but not significantly with tobacco-enforcement problems or pessimism about youth tobacco sales.

Conclusions: By their own self-report, there is considerable room for improvement in retailers’ youth tobacco access policies. Individually-owned, convenience stores, where the owner has lots of retail experience, have few tobacco policies. They may be a particularly appropriate targets for educational efforts.     

Challenges to implementing and enforcing California's Smoke-Free Workplace Act in bars

California's 1995 Smoke-Free Workplace Act—Assembly Bill 13 (AB 13)—was extended to bars in 1998. This paper examines the challenges faced by officials responsible for implementing and enforcing the law. As part of a series of studies evaluating AB 13 in bars, researchers conducted confidential in-depth interviews with 35 state, county and municipal authorities and representatives of non-governmental agencies. The interviews were recorded, transcribed, coded and analyzed by themes and respondent categories. Data from structured observations in sampled bars and interviews with bar staff and patrons offer contextual information. Analyses indicated the following challenges: (1) an ineffective administrative structure; (2) problems associated with the complaint-driven system used to enforce the law; (3) lack of funding for enforcement; (4) low prioritization of enforcement; and (5) the minimal deterrence effect of the sanctioning penalties. The findings indicate why indoor smoking may continue in some bars despite the state law prohibiting smoking in workplaces. Many municipalities, states and countries may be considering restricting smoking in workplaces including bars, and our findings show that clear delineation of procedures and enforcement criteria, as well as funding and substantive penalties, should be considered in drafting these laws.