Alcohol sales and fatal alcohol poisonings: a time-series analysis

Aims To discover whether the number of fatal alcohol peaks during festivities characterized by unrestrained drinking and relates to sales of alcoholic beverages. Design Time‐series and cross‐sectional. Data Fatal alcohol poisonings and retail alcohol sales in Finland in 1983–99. Findings Fatal alcohol poisonings were found to peak during weekends and in the May Day, Midsummer Day and Christmas celebrations. Regression analysis of quarterly series lead to a model showing that 1% increase in the sales of spirits increases the number of fatal alcohol poisonings by 0.4%. Conclusions At the population level, increases in the sales of spirits and periods of hard drinking seem to increase deaths from alcohol poisoning. The findings could be of use in efforts to decrease hard drinking.     

Changes in per capita alcohol sales during the partial privatization of British Columbia's retail alcohol monopoly 2003–2008: a multi-level local area analysis

Aim   To investigate the independent effects on liquor sales of an increase in (a) the density of liquor outlets and (b) the proportion of liquor stores in private rather than government ownership in British Columbia between 2003/4 and 2007/8.
Design   The British Columbia Liquor Distribution Branch provided data on litres of ethanol sold through different types of outlets in 89 local health areas of the province by beverage type. Multi-level regression models were used to examine the relationship between per capita alcohol sales and outlet densities for different types of liquor outlet after adjusting for potential confounding social, economic and demographic factors as well as spatial and temporal autocorrelation.
Setting   Liquor outlets in 89 local health areas of British Columbia, Canada.
Findings   The number of private stores per 10 000 residents was associated significantly and positively with per capita sales of ethanol in beer, coolers, spirits and wine, while the reverse held for government liquor stores. Significant positive effects were also identified for the number of bars and restaurants per head of population. The percentage of liquor stores in private versus government ownership was also associated significantly with per capita alcohol sales when controlling for density of liquor stores and of on-premise outlets ( P  < 0.01).
Conclusion   The trend towards privatisation of liquor outlets between 2003/04 and 2007/08 in British Columbia has contributed to increased per capita sales of alcohol and hence possibly also to increased alcohol-related harm.     

Impact of a levy on sales of sugar-sweetened beverages within a national chain of restaurants: interrupted time-series analysis

BackgroundConsumption of sugar-sweetened beverages (SSBs) is associated with type 2 diabetes, weight gain, and dental caries. Taxes and levies on these beverages have been proposed as a way to reduce their consumption. However, only limited evidence exists for the effectiveness of taxes and levies where implemented. We aimed to assess the impact of a levy of £0·10 per drink on sales of SSBs delivered nationally in the UK within a restaurant setting using electronic point of sale data.MethodsPoint of sale data for non-alcoholic drinks were obtained from all eligible restaurants (n=37) in one restaurant chain between June 23, 2014, and Feb 28, 2016. We conducted an interrupted time-series analysis using linear mixed-models with restaurant as a random effect to assess whether there was a step-change in sales per customer of levy-eligible SSBs at 12 weeks and 6 months after implementation. We assessed effects on non-levied drinks (other soft drinks, juices, bottled waters, and diet cola) to explore substitution effects. Analyses also adjusted for seasonality and clustering. We stratified analyses by sales area (London, the North of the UK, the South of the UK) to assess regional effects.FindingsOverall, compared with the preintervention period, sales per customer of levy-eligible SSBs declined by 11·7% (p=0·002) at 12 weeks and 9·8% (p=0·004) at 6 months. For non-levy drinks, sales per customer of fruit juice (main menu) increased at 12 weeks (+3·3%, p=0·051) and 6 months (+19·7%, p<0·0001). At 6 months, there was a decrease in sales per customer of diet cola (−7·6%, p=0·002) and bottled waters (−6·7%, p=0·009), whereas sales of other non-levied soft drinks increased (+14·6%, p<0·001). We found marked regional variations, with declines in sales of levy-eligible SSBs in London (−14·2%, p<0·001) and the South (−13·8%, p<0·001), but no change in the North.InterpretationTo our knowledge, this is the first study to assess the impact on sales of a levy on SSBs delivered at scale in a national chain of restaurants. We found evidence of substantial declines in sales of levy-eligible SSBs, with the greatest effects seen in London and the South. A levy on SSBs within restaurant settings has the potential to reduce sales and therefore consumption of these beverages.FundingNational Institute for Health Research.     

Potential consequences of replacing a retail alcohol monopoly with a private licence system: results from Sweden

Aim To examine the potential effects of replacing the Swedish alcohol retail system with a private licensing system on alcohol consumption and alcohol‐related harm. Design Two possible scenarios were analysed: (1) replacing the current alcohol retail monopoly with private licensed stores that specialize in alcohol sales or (2) making all alcohol available in grocery stores. We utilized a multiplicative model that projected effects of changes in a set of key factors including hours of sale, retail prices, promotion and advertising and outlet density. Next, we estimated the effect of the projected consumption increase on a set of harm indicators. Values for the model parameters were obtained from the research literature. Measurements Measures of alcohol‐related harm included explicitly alcohol‐related mortality, accident mortality, suicide, homicide, assaults, drinking driving and sickness absence. Findings According to the projections, scenario 1 yields a consumption increase of 17% (1.4 litres/capita), which in turn would cause an additional 770 deaths, 8500 assaults, 2700 drinking driving offences and 4.5 million sick days per year. The corresponding figures for scenario 2 are a consumption increase of 37.4% (3.1 litres/capita) leading to an additional annual toll of 2000 deaths, 20 000 assaults, 6600 drinking driving offences and 11.1 million days of sick leave. Conclusions Projections based on the research literature suggest that privatization of the Swedish alcohol retail market would significantly increase alcohol consumption and alcohol‐related harm.     

Alcohol and violence: use of possible confounders in a time-series analysis

AIMS: To assess the aggregate association between alcohol consumption and violence, while controlling for potential confounders. DESIGN AND MEASUREMENTS: The data comprise aggregate time-series for Norway in the period 1880-2003 and 1911-2003 on criminal violence rates and per capita alcohol consumption. Possible confounders comprise annual rates of unemployment, divorce, marriage, total fertility rate, gross national product, public assistance/social care and the proportion of the population aged between 15 and 25. Autoregressive integrated moving average (ARIMA) analyses were performed on differenced data. Both semilogarithmic and linear models were estimated. FINDINGS: Alcohol consumption was associated significantly with violence, and an increase in alcohol consumption of 1 litre per year per inhabitant predicted a change of approximately 8% in the violence rate. The parameter estimate for the alcohol variable remained unaltered after including the covariates both in the semilogarithmic and the linear models. Of the seven covariates included in the models, only divorce was associated significantly with violence rate. CONCLUSIONS: The results suggest that alcohol consumption has an independent effect on violence rates when other factors are controlled for. The results support the assumption of a causal effect of alcohol consumption on violence, and it appears that alcohol consumption is an important factor when we wish to explain changes in violence rates over time.     

Effects of the history of conduct disorder on the Iowa Gambling Tasks

BACKGROUND: Recent research conducted with the Iowa Gambling Task (GT) suggests decision-making impairments in substance dependence, as well as behavior disorders such as conduct disorder and attention-deficit/hyperactivity disorder. However, little is known about the past history of conduct disorder on decision making. The purpose of this study was to test the possible effect of past history of conduct disorder on GT performance and how this factor could contribute to the performance on GT in alcohol-dependent patients. METHODS: Four subject groups were tested: (1) alcohol-dependent patients with (n = 28) and (2) alcohol-dependent patients without (n = 28), a history of conduct disorder and (3) normal controls with (n = 10) and (4) normal controls without (n = 30) a history of conduct disorder. Demographic and alcohol-related variables were evaluated, and a decision-making task, "Iowa GT," both original and variant version, were applied. RESULTS: As a whole, normal controls with a history of conduct disorder and alcohol-dependent patients with or without a history of conduct disorder show impaired decision making because of hypersensitivity to reward and hyposensitivity to punishment. However, no significant differences were noted between alcohol-dependent patients either with or without a history of conduct disorder on gambling performance. CONCLUSIONS: These results indicate that the history of conduct disorder may contribute to impaired decision making on GT. Furthermore, this kind of decision-making pattern may represent one of common underlying mechanisms in both conduct disorder and alcohol dependence.     

An investigation of the effect of privatization of retail sales of alcohol on consumption and traffic accidents in Alberta, Canada

AIMS: Privatization of the retail sale of alcohol in Alberta took place primarily between the end of the 1980s and the beginning of the 1990s. The aim of this study was to evaluate the effects of this privatization on alcohol sales and on the incidence of fatal motor vehicle traffic accidents in the province. DATA AND METHOD: Interrupted time-series analysis (ARIMA) with a quasi-experimental control area design was used, and all series were differenced to remove long-term trends. Canada, with the exception of Alberta, was the control area. The effects of privatization were measured by means of created privatization variables. In the analyses of the effects of privatization on alcohol sales, the inhabitants' disposable income and alcohol prices were used as control variables. The study period was 1950-2000. When effects on the number of fatal motor vehicle traffic accidents were analysed the number of road motor vehicle registrations was used as a control variable, and the study period was 1950-98. FINDINGS: Privatization had a significant permanent effect on the sale of spirits, but the effect was not large enough to affect total sales. The effect on wine and beer sales was not significant. There was no significant effect on the number of fatal motor vehicle traffic accidents. CONCLUSION: The fact that sales on the wholesale level continued to be monopolized, along with the fact that alcohol sales were never allowed in ordinary grocery stores, may explain the lack of any larger effects of privatization on alcohol sales in Alberta.     

Effects of alcohol use and gender on the dynamics of EKG time-series data

Hurst analysis of EKG data obtained from a population of alcoholic (n = 13) and nonalcoholic (n = 48) subjects was undertaken. Potential subjects (n = 120) were screened using the Schedule for Affective Disorders and Schizophrenia and Structured Clinical Interview for DSM-III instruments. Data from subjects with a diagnosis of current alcohol dependence were analyzed. Subjects with diagnoses such as major depression, bipolar disorder or schizophrenia (Axis I diagnoses), or personality disorders (Axis II diagnoses) were excluded from analysis. Subjects undergoing testing were free of alcohol and illicit drugs. Alcoholic subjects had no clinical evidence of alcohol withdrawal symptoms at the time of testing. EKG data were obtained with eyes open or with eyes closed. Approximately 3.5 min of data were obtained for each condition. Alcoholic subjects had less complex heart rate dynamics as evidenced by higher values of H = 0.18 +/- 0.05 (mean +/- SEM), compared with healthy comparison subjects with H = 0.09 +/- 0.02, p < 0.014 for the eyes closed condition, and H = 0.17 +/- 0.05 (mean +/- SEM) compared with healthy comparison subjects with H = 0.07 +/- 0.02,p < 0.011 for the eyes open condition. A gender effect was seen, with female subjects showing evidence of more complex heart rate dynamics than male subjects.     

Alcohol tax cuts and increase in alcohol-positive sudden deaths: a time-series intervention analysis

AIMS: The impact of alcohol regulation changes in Finland during 2004 on alcohol-positive sudden deaths was analysed, focusing on: (1) removal of traveller's allowance quotas on alcohol imports from other European Union (EU) countries, (2) lowering of Finnish alcohol excise duty rates and (3) Estonia joining the EU. DESIGN: The impact of these changes was estimated using an autoregressive integrated moving average (ARIMA) analytical technique. Post-mortem forensic toxicology data were analysed over a 15-year period to account for seasonal and long-term variation. In all, the data comprised a weekly series of 33,782 alcohol-positive cases (at least 0.20 mg/g alcohol in blood) and a control series of 37,617 alcohol-negative cases. SETTING: Finland in 1990-2004. FINDINGS: The liberation of traveller's allowances had no material impact on alcohol-positive sudden deaths, but the impact of alcohol tax cuts in March 2004 was significant, resulting in an estimated eight additional alcohol-positive deaths per week, which is a 17% increase compared with the weekly average of 2003. The impact associated with Estonia joining the EU was not statistically significant. In the models applied to the control series of alcohol-negative deaths, none of the impact coefficients was statistically significant. CONCLUSIONS: Alcohol tax cuts were associated with an increase in the number of sudden deaths involving alcohol. This parallels the reported increases in alcohol consumption and alcohol-related causes of death in 2004 in Finland.     

Alcohol and all-cause mortality in Europe 1982-1990: a pooled cross-section time-series analysis

Aim. To test the relationship between alcohol consumption and all-cause mortality. Design. Data: Yearly mortality rates and per capita consumption from 25 European countries between 1982 and 1990. Statistical models. This paper employs time-series cross-sectional data to model the relationships between alcohol consumption and all-cause mortality. The data are derived from 25 European countries in the 1980s. The statistical analyses controlling cross-sectional correlation and timewise autoregression were used to implement the econometric modelling. Findings. Increases (decreases) in the per capita consumption of 1 litre of pure alcohol were associated with increases (decreases) of 1.3% in all-cause mortality rates. The beverage-specific analyses indicated a significant relationship between consumption of beer and all-cause mortality only. Conclusion. The data show that per capita alcohol consumption, according to reported levels in Europe, is related to all-cause mortality and is thus of relevance to public health.     

四川省消除丝虫病的费用与经济效益分析

目的 分析投入消除丝虫病的费用与经济效益的关系。方法 防治费用按各县(市、区)直接投入经费统计和核定丝防各项投入的消耗单价估算费用；认定如不开展防治，丝虫病人相对稳定在防治前水平；将微丝蚴血症者治愈，淋巴管结炎和淋巴液肿患者流火发作减少，所避免损失的劳动收益货币量及节省的诊疗费用及减少开支的货币量作为产出，计算出丝防工作的经济效益；对费用和效益采取贴现，用费用与效益之比进行分析。结果 贴现后防治直接投入总费用为ll069366元，按丝防各项投入消耗估算总费用经贴现后为13071136元，总效益为63296594元。结论 投入费用—效益比值：直接和估算投入比值分别为1：5．72、1：4．84，即每投入1元，可分别获5．72元、4．84元的效益。     

贵州省黔南州供碘20年碘缺乏病病情动态监测分析

目的了解贵州省黔南州碘缺乏病防治进展,评价防治效果,探讨其影响因素,为防治决策提供依据。方法设置病情监测点,观察供应碘盐以来境内两所农村学校7-14岁儿童甲状腺肿大率(甲肿率)、尿碘水平与家庭食用盐含碘量的变化。结果①甲肿率:1984-1992年为20．11％,1993-1999年为13．03％, 2000-2004年为10．16％;②尿碘:1984-1992年为132．29μg／L,1993-1999年为382．81μg／L,2000-2004年为324．67μg／L;③盐碘:1984-1992年为9．59 mg／kg,1993-1999年为38．11 mg／kg,2000-2004年为28．66 mg／kg,碘盐合格率逐年上升。结论碘盐合格率升高,人群尿碘水平稳定,儿童甲肿率逐年下降。