Europe. An Analysis of Changes in the Consumption of Alcoholic Beverages: The Interaction Among Consumption,Related Harms,Contextual Factors and Alcoholic Beverage Control Policies

This AMPHORA study's aim was to investigate selected factors potentially affecting changes in consumption of alcoholic beverages in 12 European countries during the 1960s–2008 (an average increase in beer, decreases in wine and spirits, total alcohol drinking decrease). Both time series and artificial neural networks-based analyses were used. Results indicated that selected socio-demographic and economic factors showed an overall major impact on consumption changes; particularly urbanization, increased income, and older mothers’ age at their childbirths were significantly associated with consumption increase or decrease, depending on the country. Alcoholic beverage control policies showed an overall minor impact on consumption changes: among them, permissive availability measures were significantly associated with consumption increases, while drinking and driving limits and availability restrictions were correlated with consumption decreases, and alcohol taxation and prices of the alcoholic beverages were not significantly correlated with consumption. Population ageing, older mother's age at childbirths, increased income and increases in female employment, as well as drink driving limitations were associated with the decrease of transport mortality. Study's limitations are noted.     

Effects of Alcoholic Beverage Control Policies and Contextual Factors on Alcohol Consumption and its Related Harms in France From 1960 to 2000

Important social changes such as urbanization, increases in female education and employment, and increased incomes have occurred in France from 1960 to 2000 along with a major decrease in alcoholic beverage consumption (from 25 L pure alcohol per inhabitant 15 years and old to 13 L); especially due to wine consumption decrease. These changes in drinking patterns are associated with significant decreases in alcohol consumption-related harms (liver disease mortality and transport accident mortality). Several alcoholic beverage consumption control policy measures were also created during this period. This study explores the impact of these policies measure on alcohol consumption and alcohol consumption-related harms, adjusted with selected social changes. France's control policy has been associated, partially, with regressive effects on alcohol consumption but not on alcohol consumption-related harms. Study limitations are noted.     

Alcoholic Beverage Preferences and Self-Reported Problems in Switzerland

The study identifies changes in selected (“unplanned”) socio-demographic and economic factors as well as in (planned) political measures that are most strongly correlated with changes in alcohol consumption and alcohol consumption-related harm between 1961 and 2006 in Austria. During the period of investigation consumption increased until the early 1970s, dropped during the next decade and have leveled off since. Increasing urbanization, female employment and average age of mothers at their child births are associated with the best time series model for the interpretation of consumption changes. The results regarding alcohol control policies and their impact on consumption were paradoxical. Study limitations were noted pointing up the necessity to improve indicators and concepts.     

The effects of real price and a change in the distribution system on alcohol consumption

Time-series analysis of alcohol consumption data has shown an impact of real price on alcohol consumption in NZ in the decade 1984-96. Beer consumption was reduced by real price increases and wine consumption was increased by real price decreases. By contrast, during this period spirits were price inelastic. A further influence on alcohol consumption was the introduction of wine into grocery stores, which led to a sudden permanent increase in wine consumption 3 months after the legislation came into force. Beer and spirits were not introduced into supermarkets at this time and while there was no effect on beer consumption there was a significant decrease in spirits consumption.     

Contextual Factors and Alcohol Consumption Control Policy Measures: The AMPHORA Study Background

Drinking alcoholic beverages is deeply rooted in European cultural and economic history, and European consumption trends have varied over time during the decades following WW II. How and why such consumption patterns have changed, and what are the roles that societies’ transformations play in these changes are the AMPHORA project's focus. Preventive alcohol consumption control policies have been developed for a long time; during different eras, in different ways and in different countries. How have and do formal policies affect such changes? These questions stimulated a group of 40 researchers from 12 European countries and 14 institutions to investigate the interactions between selected socio-demographic and economic factors, alcohol control policy measures, alcohol consumption and alcohol consumption-related harm that occurred in 12 European countries between 1960 and 2008.     

Contextual determinants of alcohol consumption changes and preventive alcohol policies: a 12-country European study in progress

Beginning with France in the 1950s, alcohol consumption has decreased in Southern European countries with few or no preventive alcohol policy measures being implemented, while alcohol consumption has been increasing in Northern European countries where historically more restrictive alcohol control policies were in place, even though more recently they were loosened. At the same time, Central and Eastern Europe have shown an intermediate behavior. We propose that country-specific changes in alcohol consumption between 1960 and 2008 are explained by a combination of a number of factors: (1) preventive alcohol policies and (2) social, cultural, economic, and demographic determinants. This article describes the methodology of a research study designed to understand the complex interactions that have occurred throughout Europe over the past five decades. These include changes in alcohol consumption, drinking patterns and alcohol-related harm, and the actual determinants of such changes.     

Contextual Determinants of Alcohol Consumption Changes and Preventive Alcohol Policies: A 12-Country European Study in Progress

Beginning with France in the 1950s, alcohol consumption has decreased in Southern European countries with few or no preventive alcohol policy measures being implemented, while alcohol consumption has been increasing in Northern European countries where historically more restrictive alcohol control policies were in place, even though more recently they were loosened. At the same time, Central and Eastern Europe have shown an intermediate behavior. We propose that country-specific changes in alcohol consumption between 1960 and are explained by a combination of a number of factors: (1) preventive alcohol policies and (2) social, cultural, economic, and demographic determinants. This article describes the methodology of a research study designed to understand the complex interactions that have occurred throughout Europe over the past five decades. These include changes in alcohol consumption, drinking patterns and alcohol-related harm, and the actual determinants of such changes.     

Alcohol consumption and attributable harm in middle-income South-East Asian countries: Epidemiology and policy options

Background Factors and policies which potentially explain the changes in alcohol consumption and related harms from 2010 to 2017 in 11 middle-income countries in the South-East Asian region (Cambodia, Lao PDR, Indonesia, the Philippines, Malaysia, Maldives, Myanmar, Sri Lanka, Thailand, Timor-Leste, and Vietnam) were examined.Methods Using secondary data from UN agencies, we analyzed trends in alcohol consumption, alcohol-attributable deaths and the burden of disease.Results Starting from a level of consumption significantly below the global average—especially among the Muslim-majority countries (Maldives, Indonesia, and Malaysia)—the majority of the countries in this region had markedly increased their alcohol consumption along with the economic development they experienced between 2010 and 2017. In fact, five middle-income countries in this region (Vietnam, Lao PDR, Cambodia, Myanmar, and Timor-Leste) were in the top 12 countries globally based on absolute increases in adult alcohol per capita consumption (APC). The Philippines and Malaysia were the exceptions, as they had reduced their APC over this period. The majority of South-East Asian countries had parallel increasing trends in the age-standardized alcohol-attributable deaths and DALYs since 2010, in contrast to global trends. While all countries put some alcohol control policies in place, there were differences in the number and strength of the policies applied, commensurate with trends in consumption. In particular, three of the countries which were most successful in reducing consumption and harm (Malaysia, Philippines, and Sri Lanka) applied more effective tax methods based on specific taxation alone or in combination with another taxation method, applying higher taxation rates and regularly increasing them over time.Conclusion To achieve the global target and the Sustainable Development Goal in reducing alcohol consumption worldwide, middle-income countries, especially lower-middle-income countries, should employ stricter alcohol control policies, and apply an appropriate excise tax on alcohol products with regular increases to reflect inflation.     

Differences in drinking patterns associated with migration from a Greek island to Melbourne, Australia: a study of sibships

Siblings (and their families) who have migrated from the Greek island of Levkada to Melbourne, Australia reported markedly lower alcohol consumption (n aged 25-74 = 846, reported consumption 16 g/d for men, 2 g/d for women) when compared with the siblings (and their family members) who stayed on the island (n = 498, 54 g/d for men, 16 g/d for women). Median time since migration exceeded 20 years. Of nonmigrants, 73% drank wine and 88% of these produced all they consumed. They drank wine regularly with the two main meals each day. Some migrants managed a kind of self-sufficiency by home-pressing bulk-purchased grapes, but commoner responses were to purchase beer or wine or to cease drinking alcohol. Migrants who drank wine consumed less than half as much as comparable nonmigrants. The prevalence of drinking on special occasions was not lower in migrants, nor were the amounts drunk. Drinking contexts continued to be those traditional within Greek culture. Among nonmigrant men self-rated health was positively associated with alcohol consumption. In this culture, which has traditionally made heavy use of alcohol and used it primarily as a food, the level and pattern of use changed markedly under changed circumstances--such as the loss of true self-sufficiency and an altered temporal pattern of daily life.     

Not Your Typical Alcohol Accord: The Long-Term Impact of a Voluntary Liquor Agreement in a Small Australian Town

Background: The town of Norseman introduced a Voluntary Liquor Agreement (voluntary restrictions on alcohol sales) in 2008, to reduce problematic drinking. This study examined its long-term impact. Methods: Quantitative data on alcohol (cask wine, fortified wine, spirits) wholesale sales, hospital emergency visits and alcohol related offenses were compared from before to after the introduction of the restrictions. Qualitative interview data were collected from 10 key informants and from focus groups with Indigenous residents. Results: Consumption of cask wine declined in the short and long term. Fortified wine consumption did not change in the short term, but declined in the long term. Spirit consumption did not change in the short term, but increased in the long term. Total beverage consumption did not change at any time. There was no change in hospital emergency visits. There was a decline in Indigenous and non-Indigenous burglary and assault offenses, and a decline in Indigenous domestic violence. Police tasking (callouts) declined. Key informants and focus group participants indicated the behavior of drinkers, alcohol consumption, alcohol harms and community climate had all improved. Conclusions: These findings indicate that alcohol restrictions, backed by the community, can have a long-term impact on local alcohol problems.     

Drinking cultures and the position of women in nine European countries 1

Nine European countries involved in the Biomed Project “Alcohol Consumption and Alcohol Problems Among Women in European Countries”; are described in relation to sociodemographic characteristics and drinking patterns. The populations of the nine countries, especially women, have become much older during the period 1950–1995. Also, women tend to have fewer children, and at an older age, so that the percentage of the younger age groups is decreasing. If we connect this to the fact that women now are more a part of the labor force than before, we might infer that the observed decrease in gender difference in alcohol use is to be explained in relation to economic factors. In terms of drinking patterns, a broad division can be made between two wide regions: (a) the northern dry area, where beer is the leading beverage, consumed on weekends and outside mealtimes; and (b) the southern, or Mediterranean, wet area, where wine is the main beverage, usually drunk at meals. However, the dispersion in alcohol consumption found among the study countries in 1961 declined considerably by 1997. In this respect, European countries are getting more similar, so that we may consider this phenomenon a “convergence”; of alcohol drinking in Europe. More generally, changes from a more traditional drinking pattern to a novel one from another country may be due to several factors, one of which is the increasing relevance of women in the drinking context. On the treatment side, such a relevance is nowadays visible through the better availability of both health services and nonstatutory organizations to take care of women affected with alcohol‐related problems.     

Sociodemographic determinants of Malaysian household’s use of and expenditure on alcohol: a regional comparison

Abstract

Aims: Alcohol consumption has become a serious public health concern. The objective of the present study is to investigate sociodemographic factors associated with alcohol consumption across regions of Malaysia.

Methods: Data are obtained from the Malaysian Household Expenditure Survey 2014, which contains 10,665 observations. Double-hurdle model is used to examine the consumption decision and amount decision of alcohol among households. Analyses are stratified by regions (Northern, East coast, Central and Southern).

Findings: Results show that age, household size, gender, ethnicity, marital status, education, employment status, location of residence and tobacco consumption are independently associated with alcohol consumption. Households headed by males and well-educated individuals are more likely to consume alcohol and also spend more compared with households headed by females and less-educated individuals. Being employed, non-Bumiputera and tobacco consumption seem to increase the likelihood of consuming alcohol. Household size is negatively associated with the amount spent on alcohol.

Conclusion: In conclusion, sociodemographic factors play an important role in determining alcohol consumption. It appears that factors associated with alcohol consumption vary across regions. Hence, policies that address regional differences in the sociodemographic factors associated with alcohol consumption are needed.     

The effect of a moderate level of white wine consumption on the hypothalamic-pituitary-adrenal axis before and after a meal.

The nutritional status of the individual at the time of alcohol consumption may mediate the rate of alcohol absorption and metabolism, thus influencing the systemic effect of alcohol on the body. The aim in the present investigation was to assess the effect of moderate white wine consumption on the hypothalamic-pituitary-adrenal (HPA) axis under variable nutritional conditions. Seven males aged between 19 and 22 years participated in all aspects of the current investigation. The experimental procedure for the fasting trial required participants to ingest either 4 standard units of alcohol (40 g) or the equivalent amount of placebo over a 135-min period before consuming food for 45 min. Alternatively, in the feeding trial, food was consumed for 45 min prior to participants ingesting either 4 standard units of alcohol (40 g) or the equivalent amount of placebo over a 135-min period. Blood alcohol, salivary cortisol, and salivary dehydroepiandrosterone sulfate (DHEAS) levels were assessed at 45-min intervals during the 180-min experimental periods. The results demonstrated a significant alcohol-induced decrease in salivary cortisol irrespective of nutritional status and a significant decrease in salivary DHEAS when alcohol is consumed alone under fasting conditions only. It was concluded that moderate white wine consumption may promote a transient alteration in the functioning of the HPA axis.     

Alcohol availability and consumption: Iowa sales data revisited.

Recent changes in Iowa liquor control laws ended the 51-year-old state alcohol monopoly distribution system and turned the sales of bottled wine and spirits over to the private sector. The resulting increase in the availability of these beverages provided a unique opportunity to study the relationship between increased wine and spirits availability and changes in their consumption. Time series analyses of monthly sales (apparent consumption) trends showed that the increased availability had no lasting impact on consumption.     

我国饮酒现状及相关问题

近年来,中国的酒消耗量及相关危害增加明显,自2002,中国的啤酒产量成为全球第一。成人人均饮酒量为每年5·4L纯酒精。根据一项WHO资助的研究,15a以上男性、女性三个月饮酒率分别为63·8%和18·3%,整体三个月饮酒者比例为43·5%。饮酒主要表现为急性酒中毒相关的问题,包括暴力、犯罪、经济问题、家庭问题等。饮酒相关的远期问题主要表现为躯体精神问题,公共卫生问题以及社会问题。目前,我国颁布了有关法律、管理条例,以降低酒相关危害,但目前还没有针对酒滥用的预防项目与计划等,这是今后需要急切解决的问题。     

Drinking Habits among High School Students in Perugia,Italy, in 1981 and 1988: Time Trends and Correlates

The prevalence of alcohol consumption among 9th (14–15 years old) and 13th grade (18–19 years old) high school students in Perugia, Italy, was investigated in 1981 and 1988. Wine was the most popular beverage, although its use declined in the 7-year period. Beer consumption remained stable, but it was at a lower level than wine. Overall, alcohol consumption showed a slight decline among both 9th and 13th graders. However, the proportion of excessive drinkers increased, and a growing phenomenon of drunkenness among students was observed. Alcohol consumption was positively associated with sex and smoking and negatively associated with father's education and knowledge of the health hazards of alcohol abuse by multivariate analysis.     

The effect of self-discrepancy and discrepancy salience on alcohol consumption

The effect of self-discrepancy magnitude and salience on alcohol consumption was examined in an ad lib drinking study in order to evaluate the utility of the self-inflation component of the myopia model for better understanding drinking practices. Participants were 33 males and 27 females recruited on a university campus. It was predicted that participants with relatively large real self/ideal self discrepancies on dimensions important to their self-concept would consume the greatest amount of alcohol in a wine tasting test. Moreover, this effect was expected to be enhanced when self-discrepancies were made salient. The results of hierarchical regression analyses showed a main effect of gender and a significant interaction between self-discrepancy magnitude and salience condition. However, the interaction was such that wine consumption tended to decrease as discrepancy magnitude increased in the condition in which self-discrepancies were made salient, with the opposite relationship in the control condition. Three possible reasons for the unexpected findings are discussed: (a) The salience manipulation did not perform as expected: (b) the sample had little to gain from self-inflation: and (c) typically, self-inflation does not significantly motivate alcohol consumption.     

The more you know,the better you drink: The new drinking culture in Italian wine production areas

Introduction: The paper complements an epidemiological analysis of secondary data that compared levels of consumption, alcohol-related mortality and morbidity in territories in Piedmont (N-W Italy), characterized by a different involvement with wine culture, and which showed lower alcohol-related risks in areas of production. Aims: The main aim is to shed light on these epidemiological results through qualitative methods, focusing on meanings attributed to drinking and on mechanisms of regulation that could explain why in wine-producing areas alcohol-related risks appear to be lower. Methods: Eighty-one in-depth individual interviews have been conducted. The sample consisted of males and females, from three cohorts (aged 18–25; 45–52; 70–77 years) and covering two areas (with higher versus lower vineyard acreage). Results: In areas characterized by wine production the traditional alcohol socialization process within the family is more persistent. In these areas, the traditional drinking culture has been not only valued, but also renewed, by emphasising the importance of proper drinking and the knowledge related to it. Conclusions: The alcohol socialisation process and the emphasis on wine as a cultural product seem to be the most relevant protective factors, contributing to the lower alcohol consumption and counteracting the widespread risk of alcohol consumption patterns.     

Is long-term heavy alcohol consumption toxic for brain serotonergic neurons? Relationship between years of excessive alcohol consumption and serotonergic neurotransmission.

The relationship between years of excessive alcohol consumption and central serotonergic neurotransmission, as assessed by the prolactin (PRL) response to D-fenfluramine, was investigated in 22 male alcohol-dependent subjects. A negative correlation was obtained, that is, the longer duration of excessive alcohol consumption the lower PRL response to D-fenfluramine. It is therefore suggested that long duration of excessive alcohol consumption in alcohol-dependent subjects causes a reduction in central serotonergic neurotransmission, possibly by a toxic effect of alcohol on serotonin neurons. The relationship between depressive and anxiety symptoms during on-going drinking and the PRL response to D-fenfluramine was also investigated. No such correlations were obtained, suggesting that reduction in central serotonergic neurotransmission does not pre-dispose to the development of depressive and anxiety symptoms, at least in relation to on-going drinking in alcohol-dependent subjects.     

Drinking-driving fatalities and consumption of beer, wine and spirits

Drinking-driving is a leading cause of preventable morbidity and mortality in Canada. The purpose of this paper was to examine factors that influenced drinking driver deaths in Ontario. We examined the impact of per capita consumption of total alcohol, and of beer, wine and spirits separately, on drinking-driving deaths in Ontario from 1962 to 1996, as well as the impact of the introduction of Canada's per se law and the founding of People to Reduce Impaired Driving Everywhere - Mothers Against Drunk Driving (PRIDE - MADD) Canada. We utilised time-series analyses with autoregressive integrated moving average (ARIMA) modelling. As total alcohol consumption increased, drinking driving fatalities increased. The introduction of Canada's per se law, and of PRIDE-MADD Canada, acted to reduce drinking driving death rates. Among the specific beverage types, only consumption of beer had a significant impact on drinking driver deaths. Several factors were identified that acted to increase and decrease drinking driver death rates. Of particular interest was the observation of the impact of beer consumption on these death rates. In North America, beer is taxed at a lower rate than other alcoholic beverages. The role of taxation policies as determinants of drinking-driving deaths is discussed. [Mann RE, Zalcman RF, Asbridge M, Suurvali H, Giesbrecht N. Drinking-driving fatalities and consumption of beer, wine and spirits. Drug Alcohol Rev 2006;25:321 - 325]