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Present by :Wittaya Wisutruangdaj

Sopit Nasueb

Alcohol control policies and al cohol consumption by youth:

A - multi national study

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INTRODUCTION• M any countries to implement policies restricting alc

ohol availability in order to reduce consumption and related harm among young people.

• Example - S etting a minimum legal purchase or drinking age. - R estricting the types of alcoholic beverages sold in stores.- R estricting the density of stores selling alcoholic

beverages in a given area.- R estricting the hours of business when alcohol can be

sold. - M andatory training of alcoholic beverage servers and increasing the price of alcohol.

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• Alcohol policies may affect consumption by youth di rectly and indirectly through their effects on consu

mption and drinking norms in the general population.

• Most previous research on the effects of alcohol poli cies on drinking behavior is based on analysis of dat

a within single countries. So d iscourse about alcoho l policies and consumption is often framed in intern

ational terms, and for most countries alcohol policy i s set at a national level.

• They adopt an ecological design examining statistic al associations between alcohol policy ratings and d

rinking behavior in 30 Organization for Economic Co operation and Development (OECD) countries.

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• I - n part Cross national studies of alcohol policy and a lcohol consumption are rare, because of the difficult

y of quantifying such policies across different countr ies. Recently, however, the Alcohol Policy Index (API

) was developed to rate the relative comprehensive ness and strength of alcohol control policies and has been applied to 30 countries. The API comprises 5

domains(16 policy topics).– C orresponding to alcohol availability– D rinking context– Pr i ce– Advertising– M otor vehicles

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• Weights of API scoring were assigned to each domai n based on the potential effectiveness of the regulato ry 16 policy. API score ranging from 0 to 100 with a

higher score indicating The validity of the API was su pported through

1( ) A sensitivity analysis in which several methodolo gical assumptions were varied

(2) C orrelation and regression analysis showing an in verse association between API score and 2003 per ca

pita alcohol consumption in litres of ethanol [ r -= 0.5 7, P - 0001 010 95= . , b = . , % confide

nce interval]• T he API does not capture the level of policy enforcem

ent, which may vary considerably across policy topic s, domains and geographic areas within each country

. Additionally, the API does not reflect research on th e effectiveness of regulatory policies since 2003, and

thus may weight some of the policy topics incorrectly.

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• None the less, the API provides an opportunity to ex amine possible relationships between alcohol contr

ol policies and national estimates of adolescent alco hol consumption. Such prevalence estimates are pr

ovided by the 2003 European School Survey Project on Alcohol and Other Drugs (ESPAD) and by national

surveys of youth in other countries.• S uch as the Monitoring the Future Survey in the Unit

edStates.However, the nationalyouthsur veys such as ESPADand Moni t or i ng t he Future are typically anonymous and respondents ar

e encouraged to provide truthful responses to surve y questions, such bias is likely to be minimal.

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• Based on pr evi ous r esear ch and on considerations derived from deterrence and availability theories.

They hypothesize their countries with more compreh ensive and stringent alcohol control policies. The ana

lyses examined simple bivariate correlations. Regres sion analyses controlling for per capita consumption were then conducted for those outcomes found to be

related significantly to the API scores. Per capita con sumption was included in these analyses because of

its potential role as a confounder or mediator of obse rved associations between alcohol control policies an

d youth alcohol consumption.

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METHOD

• Data sources Alcohol control policies

• API scores and scores for the 5 policy domains but Br and were not able to find any data for some countri

es. Because extensive efforts were made by Brand t o find data for each policy domain from a variety of

potential sources, zero values were used where poli cy data were missing.

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Per capita consumption

Per capita consumption was included in the regressi on analyses as a proxy for cultural or socioeconomic

factors thatmay influence both alcohol control polici es and alcohol use by youth.

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• Adolescent alcohol use• Prevalence data for any past 30 day alcohol use, me

asures of more frequent past 30 day use (3 to 5 tim es, 6 or more times), heavy or ‘binge’ drinking (5 or

more drinks) and age of having first standard drink of beer, wine and spiritswere obtained from the 2

003 ESPAD report. The 2003 ESPAD report includes separate prevalence rates for drinking beer, wine a

nd spirits by age 13. They used the highest of the th ree prevalence rates for each country.

• For simplicity, they refertothisvariableas“havi ng fi r st dr i nk by age 1 3

• 2003 30The ESPAD report also summarizes past da y alcohol use data from national secondary school s

urveys conducted in Spain in 2002 and the United St ates in 2003 (Monitoring the Future). F or national se

condary school surveys in Australia in 2002 and Ne w Zealand in 2 0 0 1 and a national household su

- rvey conducted in Canada in 2003 04. Prevalence d ata for adolescents in the same age range as the ES

w www wwwwwwww wwww wwwww wwwwwwww.

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• 1Table provides selected characteristics of ESPAD and o ther national youth surveys, the majority of which w

- ere self administered surveys in school settings in Mar ch –, 2003.

• Exceptions include:• w he Canadian household survey conducted from De

- cember 2003 to April 2004 using computer assisted telephone interviews.

• w he New Zealand secondary school survey conduct ed in 2001 with laptop computers and the nationals

chool surveys in Australia and Spain that were cond ucted in 2002. Response rates were greater than 80

- % for the majority of school based surveys, but lowe r response rates were reported for the Australian.

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• Canadian and New Zealand surveys. - Post hoc sampl e weights were developed for some of the surveys t

oadj ust f or under or over r epr esent at i on of dem ographicsubgr oups.

• Sample sizes varied across the 26 countries Further details about survey methods, data analysis proced

ures and validity and reliability of survey results can be found in the referenced reports.

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Table 1

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• Data analysis• Overall API scores and past 30 day alcohol use prev

26alence data were available for countries.The n umber of countries with data for at least one specifi

w wwwwww www www and alcoholuseprevalencedatarangedf r om21t o 26. Statisti cal power tables for Pearson product moment correl

ationsindicatethata mi ni mumsampl esi ze of 19i s needed t o det ect a large effect size ( r > 060. ) with power > 080. at th 005e . significance level

• Pearson product–moment correlations between alco hol policy ratings and alcohol prevalence measures

were examined first. Regression analyses controllin g for per capita consumption were then conducted f or those outcomes found to be related significantly t

o the API scores.

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Next Sopit Nasueb

PRESENT

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RESULTS

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Regression analyses

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Regression analyses

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DISCUSSION

• A lcohol availability and advertising contr ol reduce the prevalence and frequency

of alcohol consumption by youth.

• M ore comprehensive alcohol policies area ssociated with lower prevalence rates o f alcohol use among youth

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ndDISCUSSION

• The API is limited in a number of ways.

• Alcohol marketing to youth is of particula r concern to public health officials, healt h practitioners and parents, and has rec

eived a great deal of research attention.

• M otor vehicle policy ratings were not ass ociated with prevalence estimates for yo

uth alcohol consumption, they may be re lated to youth drinking and driving.

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Thank you