CORK Bibliography: Per Capita Alcohol Consumption

25 citations. 2009 to present

Prepared: June 2012

Adair T; Hoy D; Dettrick Z; Lopez AD. Reconstruction of long-term tobacco consumption trends in Australia and their relationship to lung cancer mortality. Cancer Causes & Control 22(7): 1047-1053, 2011. (32 refs.)

Analysis of long-term trends in smoking and causes of death in Australia are prevented by a lack of detailed tobacco consumption data prior to World War II. The objective of this study was to reconstruct data on tobacco consumption in Australia back to 1887 and examine its relationship with population-level lung cancer mortality, corrected for biases and miscoding. Back-extrapolation techniques and existing tobacco sales data were combined to estimate tobacco consumption prior to the 1940s. The relationship of tobacco and lung cancer mortality was examined with descriptive period and cohort analyses and log-linear Poisson regression models of cumulative cohort consumption. The results show that tobacco consumption rose steadily in Australia for the majority of years from 1887 to World War II, before increasing drastically in the following years and then falling sharply to the present day. Lung cancer mortality was strongly influenced by tobacco consumption, peaking 20-25 years after the peak in tobacco consumption for men and 25-30 years for women. Regression models found cumulative consumption a very strong predictor of mortality. Period and cohort trends in smoking and lung cancer were similar to many other Western countries. The effectiveness of smoking reduction campaigns in Australia clearly reduced male lung cancer mortality and provides guidance for other countries, such as China, where smoking prevalence remains high.

Astudillo M; Kuntsche S; Graham K; Gmel G. The influence of drinking pattern, at individual and aggregate levels, on alcohol-related negative consequences. European Addiction Research 16(3): 115-123, 2010. (38 refs.)

Aim: To determine the extent drinking patterns (at the individual and country level) are associated with alcohol-related consequences over and above the total alcohol the person consumes. Methods: Hierarchical linear models were estimated based on general population surveys conducted in 18 countries participating in the GENACIS project. Results: In general, the positive association between drinking pattern scores and alcohol-related consequences was found at both the individual and country levels, independent of volume of drinking. In addition, a significant interaction effect indicated that the more detrimental the country's drinking pattern, the less steep the association between the volume of drinking and its consequences. Conclusion: Drinking patterns have an independent impact on consequences over and above the relationship between volume and consequences.

Bagnardi V; Sorini E; Disalvatore D; Assi V; Corrao G; De Stefani R. 'Alcohol, less is better' project: outcomes of an Italian community-based prevention programme on reducing per-capita alcohol consumption. Addiction 106(1): 102-110, 2011. (26 refs.)

Aims: To evaluate differences in the individual alcohol consumption after a community-based prevention programme. Design settings and participants 'Alcohol, less is better' is a controlled intervention trial. The intervention adopted a community approach, based on the active involvement of community leaders and institutional or volunteer organizations. Between 1999 and 2006, 2.5 years of activities aiming at informing and sensitizing the community on the harmful effects of alcohol on social life and health were carried out in 10 selected small Italian communities, involving a total of 123 235 individuals. Eight communities were chosen as control group. Measurements: Changes in self-reported individual alcohol consumption before and after the intervention were assessed on a random sample of intervention (n = 3382) and control (n = 2644) populations, using telephone and mailed surveys. Linear and log-linear models for repeated measures were used to evaluate differences between intervention and control samples. Findings: Overall, a significant reduction (P < 0.001) of individual self-reported alcohol consumption was observed in the intervention sample (-1.1 drinks/week) relative to control sample (+0.3 drinks/week). The reduction was significantly greater in males than in females (P for heterogeneity = 0.016). In the young (15-24-year-olds) intervention and control samples showed opposite trends (-0.4 drinks/week and +1.7 drinks/week, respectively). Conclusions: A coordinated community-based intervention can reduce alcohol consumption in the general population.

Fielding JE; Rimer BK; Abraido-Lanza A; Calonge N; Clymer JM; Glanz K et al. Increasing alcoholic beverage taxes is recommended to reduce excessive alcohol consumption and related harms. (editorial). American Journal of Preventive Medicine 38(2): 230-232, 2010. (4 refs.)

Fuhr DC; Gmel G. What is alcohol per capita consumption of adults telling us about drinking and smoking among adolescents? A population-based study across 68 countries. Alcohol and Alcoholism 46(1): 88-92, 2011. (35 refs.)

Aims: To investigate whether recorded alcohol per capita consumption of adults could be linked with alcohol drinking and smoking among adolescents. Methods: Adult alcohol per capita has been plotted graphically together with the prevalence of current drinking and smoking among adolescents. Results: Across all 68 countries, a highly statistically significant correlation was detected, indicating a linear relationship. Conclusion: Countries which are high in alcohol per capita consumption among adults need to pay heightened attention to alcohol and tobacco use among the younger population.

Graham LJC; Mackinnon D. Grasping the thistle: The role of alcohol brief interventions in Scottish alcohol policy. (review). Drug and Alcohol Review 29(6): 603-607, 2010. (35 refs.)

Issue. Scotland has experienced a substantial rise in alcohol-related harm, which is now one of the biggest public health challenges it faces. Approach. Alcohol problems in Scotland are described along with national alcohol policy response in addressing them. The role of a program of Alcohol Brief Interventions is discussed therein. Key Findings. In Scotland, considerable proportions of the population are drinking hazardously or harmfully, common across different age and socioeconomic groups. Rising consumption has been set in wider environmental changes with alcohol becoming more available and affordable. Scotland has had one of the fastest growing chronic liver disease mortality rates in the world at a time when rates in most of Western Europe are falling. Scotland's alcohol policy has an explicit aim to reduce population consumption and includes legislative measures to tackle price and availability. A national program to deliver Alcohol Brief Interventions for hazardous drinkers is a key plank of this wider strategy. A portfolio of studies will monitor and evaluate national policy and, through contribution analysis, describe the role Alcohol Brief Interventions play in reducing alcohol misuse. Implications. Effective alcohol policy recognises that determinants of health not only lie at individual level, but include wider social, environmental and economic factors. Scotland's policy is addressing these determinants with both population-based and population-targeted interventions. Conclusion. Scotland has a serious problem with alcohol. A comprehensive, evidence-based, resourced alcohol policy is being implemented, which will need continual review to ensure it remains anchored in evidence while maintaining its ambition.

Grittner U; Gustafsson NK; Bloomfield K. Changes in alcohol consumption in Denmark after the tax reduction on spirits. European Addiction Research 15(4): 216-223, 2009. (31 refs.)

Aims: This paper examines changes in alcohol consumption in Denmark between 2003 and 2006 after the excise tax on spirits in Denmark was lowered by 45% on October 1, 2003 and travelers' allowances for the import of alcohol were increased on January 1, 2004. Methods: Cross-sectional and panel data from Denmark from 2003 to 2006 were analyzed. Samples were collected by telephone interviews using random digit dialing. Results: Panel data for Denmark revealed that alcohol consumption remained relatively stable. Similar results were found in the Danish cross-sectional data. It appears that 'substitution' rather than increased importation occurred. Conclusion: We found no evidence to support earlier research stating that decreased prices and increased availability is related to higher alcohol consumption. This could be partly because (1) Denmark has reached a 'saturation' level of consumption over the past 30 years and (2) the survey mode of data collection did not capture specific sub-populations who might have increased their consumption. It may be necessary to examine other indicators of alcohol use or alcohol-related harm in order to fully assess the consequences of such changes in alcohol availability.

Jamieson PE; Romer D. Trends in US movie tobacco portrayal since 1950: A historical analysis. Tobacco Control 19(3): 179-184, 2010. (46 refs.)

Objective: Portrayal of tobacco use in films has been causally linked to youth smoking initiation. However, findings regarding trends in portrayal in US films since 1950 are inconsistent, potentially due to differences in sampling densities, intercoder reliabilities and time periods covered. The present study was designed to overcome these inconsistencies with a common sampling frame and methodology. Methods: A half sample of the 30 top-grossing US films per year from 1950 to 2006 (N=855) was coded in 5-min segments for total tobacco-related content and main character tobacco use. Film tobacco trends were identified using linear regression and compared to national per capita cigarette consumption and historically significant tobacco control events. Results Tobacco content declined considerably since 1950. Total tobacco-related content peaked around 1961, while the decline in portrayal of main character use was already underway in 1950. Cigarette consumption peaked around 1966 with a trend that closely paralleled total tobacco content and that coincided with major tobacco control events. Conclusions: This study, which had high reliability, dense sampling and covered a long time period, indicates that tobacco content has declined in top-ranked US movies since 1950 with a trend in total tobacco content that closely paralleled the drop in per capita cigarette consumption and the increase in significant tobacco control efforts. Despite the inability to draw causal conclusions, tobacco portrayal in films may serve as barometer of societal support for the habit and thus efforts should continue to limit exposure to such content.

Kerr WC. Commentary on Nelson et al. (2010): The many sources of survey under-coverage. (editorial)18. Addiction 105(9): 1597-1598, 2010. (18 refs.)

Kerr WC; Subbaraman M; Ye Y. Per capita alcohol consumption and suicide mortality in a panel of US states from 1950 to 2002. Drug and Alcohol Review 30(5, special issue): 473-480, 2011. (41 refs.)

Introduction and Aims. The relationship between per capita alcohol consumption and suicide rates has been found to vary in significance and magnitude across countries. This study utilises a panel of time-series measures from the US states to estimate the effects of changes in current and lagged alcohol sales on suicide mortality risk. Design and Methods. Generalised least squares estimation utilised 53 years of data from 48 US states or state groups to estimate relationships between total and beverage-specific alcohol consumption measures and age-standardised suicide mortality rates in first-differenced semi-logged models. Results. An additional litre of ethanol from total alcohol sales was estimated to increase suicide rates by 2.3% in models utilising a distributed lag specification while no effect was found in models including only current alcohol consumption. A similar result is found for men, while for women both current and distributed lag measures were found to be significantly related to suicide rates with an effect of approximately 3.2% per litre from current and 5.8% per litre from the lagged measure. Beverage-specific models indicate that spirits is most closely linked with suicide risk for women while beer and wine are for men. Unemployment rates are consistently positively related to suicide rates. Discussion and Conclusions. Results suggest that chronic effects, potentially related to alcohol abuse and dependence, are the main source of alcohol's impact on suicide rates in the USA for men and are responsible for about half of the effect for women.

Landberg J. Per capita alcohol consumption and suicide rates in the US, 1950-2002. Suicide and Life-Threatening Behavior 39(4): 452-459, 2009. (32 refs.)

The aim of this paper was to estimate how suicide rates in the United States are affected by changes in per capita consumption during the postwar period. The analysis included annual suicide rates and per capita alcohol consumption data (total and beverage specific) for the period 1950-2002. Gender- and age-specific models were estimated using the Box-Jenkins technique for time series analysis. No significant estimate was found for males. For females the total alcohol estimate (0.059) was significant at the 10% level whereas the spirits estimate was significant with an effect of 0.152. The results imply that a change in U.S. per capita consumption would result in a change in female suicide rates, whereas the male rates would not be affected.

Landberg J. Population drinking and fatal injuries in Eastern Europe: A time-series analysis of six countries. European Addiction Research 16(1): 43-52, 2010. (38 refs.)

Aims: To estimate to what extent injury mortality rates in 6 Eastern European countries are affected by changes in population drinking during the post-war period. Data and Methods: The analysis included injury mortality rates and per capita alcohol consumption in Russia, Belarus, Poland, Hungary, Bulgaria and the former Czechoslovakia. Total population and gender-specific models were estimated using auto regressive integrated moving average time-series modelling. Results: The estimates for the total population were generally positive and significant. For Russia and Belarus, a 1-litre increase in per capita consumption was associated with an increase in injury mortality of 7.5 and 5.5 per 100,000 inhabitants, respectively. The estimates for the remaining countries ranged between 1.4 and 2.0. The gender-specific estimates displayed national variations similar to the total population estimates although the estimates for males were higher than for females in all countries. Conclusions: The results suggest that changes in per capita consumption have a significant impact on injury mortality in these countries, but the strength of the association tends to be stronger in countries where intoxication-oriented drinking is more common.

Manchikanti L; Fellows B; Ailinani H; Pampati V. Therapeutic use, abuse, and nonmedical use of opioids: A ten-year perspective. (review). Pain Physician 13(5): 401-435, 2010. (295 refs.)

The treatment of chronic pain, therapeutic opioid use and abuse, and the nonmedical use of prescription drugs have been topics of intense focus and debate. After the liberalization of laws governing opioid prescribing for the treatment of chronic non-cancer pain by state medical boards in the late 1990s, and with the introduction of new pain management standards implemented by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in 2000, opioids, in general, and the most potent forms of opioids including Schedule II drugs, in particular, have dramatically increased. Despite the escalating use and abuse of therapeutic opioids, nearly 15 to 20 years later the scientific evidence for the effectiveness of opioids for chronic non-cancer pain remains unclear. Concerns continue regarding efficacy; problematic physiologic effects such as hyperalgesia, hypogonadism and sexual dysfunction; and adverse side effects especially the potential for misuse and abuse and the increase in opioid-related deaths. Americans, constituting only 4.6% of the world's population, have been consuming 80% of the global opioid supply, and 99% of the global hydrocodone supply, as well as two-thirds of the world's illegal drugs. Retail sales of commonly used opioid medications (including methadone, oxycodone, fentanyl base, hydromorphone, hydrocodone, morphine, meperidine, and codeine) have increased from a total of 50.7 million grams in 1997 to 126.5 million grams in 2007. This is an overall increase of 149% with increases ranging from 222% for morphine, 280% for hydrocodone, 319% for hydromorphone, 525% for fentanyl base, 866% for oxycodone, to 1,293% for methadone. Average sales of opioids per person have increased from 74 milligrams in 1997 to 369 milligrams in 2007, a 402% increase. Surveys of nonprescription drug abuse, emergency department visits for prescription controlled drugs, unintentional deaths due to prescription controlled substances, therapeutic use of opioids, and opioid abuse have been steadily rising. This manuscript provides an updated 10-year perspective on therapeutic use, abuse, and nonmedical use of opioids and their consequences.

Nelson DE; Naimi TS; Brewer RD; Roeber J. US state alcohol sales compared to survey data, 1993-2006. Addiction 105(9): 1589-1596, 2010. (52 refs.)

Aims: Assess long-term trends of the correlation between alcohol sales data and survey data. Design: Analyses of state alcohol consumption data from the US Alcohol Epidemiologic Data System based on sales, tax receipts or alcohol shipments. Cross-sectional, state annual estimates of alcohol-related measures for adults from the US Behavioral Risk Factor Surveillance System using telephone surveys. Setting United States. Participants: State alcohol tax authorities, alcohol vendors, alcohol industry (sales data) and randomly selected adults aged >= 18 years 1993-2006 (survey data). Measurements: State-level per capita annual alcohol consumption estimates from sales data. Self-reported alcohol consumption, current drinking, heavy drinking, binge drinking and alcohol-impaired driving from surveys. Correlation coefficients were calculated using linear regression models. Findings: State survey estimates of consumption accounted for amedian of 22% to 32% of state sales data across years. Nevertheless, state consumption estimates from both sources were strongly correlated with annual r-values ranging from 0.55-0.71. State sales data had moderate-to-strong correlations with survey estimates of current drinking, heavy drinking and binge drinking (range of r-values across years: 0.57-0.65; 0.33-0.70 and 0.45-0.61, respectively), but a weaker correlation with alcoholimpaired driving (range of r-values: 0.24-0.56). There were no trends in the magnitude of correlation coefficients. Conclusions: Although state surveys substantially underestimated alcohol consumption, the consistency of the strength of the association between sales consumption and survey data for most alcohol measures suggest both data sources continue to provide valuable information. These findings support and extend the distribution of consumption model and single distribution theory, suggesting that both sales and survey data are useful for monitoring population changes in alcohol use.

Norstrom T; Moan IS. Per capita alcohol consumption and sickness absence in Norway. European Journal of Public Health 19(4): 383-388, 2009. (38 refs.)

Background: There is only one previous study addressing the relationship between population drinking and sickness absence. That study, based on Swedish time-series data, showed a statistically significant relationship between per capita alcohol consumption and the male sickness absence rate. Estimates suggested that a 1-l increase in consumption was associated with a 13% increase in sickness absence among men. In the present study, we aim at replicating and expanding the Swedish study on the basis of data for Norway. Methods: The outcome measure comprised annual data for Norway on registered sickness absence for manual employees covering the period 19572001. The unemployment rate was included as a control, as this factor may be correlated with alcohol as well as sickness absence. Alcohol consumption was gauged by sales of alcohol (total and beverage specific by beer, spirits and wine) per inhabitant 15 years and above. The data were analysed using the BoxJenkins method for time-series analysis. Results: The results suggested that a 1-l increase in total consumption was associated with a 13% increase in sickness absence among men (P < 0.05). This corresponds to an elasticity coefficient equal to 0.62. The alcohol effect was not significant for women. Unemployment was negatively associated with the outcome for men as well as for women (P < 0.05). In the beverage-specific analyses, spirits were statistically significant for men (P < 0.05), but not beer and wine. Conclusion: The present findings strengthen the conclusion from the Swedish study, that sickness absence may be added to the list of indicators of alcohol-related harm.

Norstrom T; Razvodovsky Y. Per capita alcohol consumption and alcohol-related harm in Belarus, 1970-200526. European Journal of Public Health 20(5): 564-568, 2010. (26 refs.)

Background: Although alcohol seems to be an important determinant of the mortality crisis in the former Soviet Republic of Belarus, little systematic research has been done on the relationship between alcohol consumption and harm at the aggregate level. The aims of the present study were to estimate the effect of per capita alcohol consumption on all-cause mortality, mortality from alcohol poisoning and hospital admissions for alcohol psychosis in Belarus. Methods: Annual data on the three outcomes and alcohol sale per capita for the period 1970-2005 were analysed using the Box-Jenkins technique. Female mortality was included as a control variable and regarded as a proxy for other causal factors. To incorporate the lag structure, a weighted input was used in which a geometrical lag-scheme was applied. Results: The outcomes suggest that a 1 l increase in consumption was associated with an increase in male all-cause mortality of similar to 2.3%. The corresponding figures for alcohol poisoning mortality and alcohol psychosis admissions are 12 and 25%. Conclusions: The present study strengthens the notion of alcohol consumption as an important determinant of population health in this part of the world, and thus the notion that alcohol control must be a key priority for Belorussian public health policy.

Paradis C; Demers A; Picard E; Graham K. The importance of drinking frequency in evaluating individuals' drinking patterns: implications for the development of national drinking guidelines. Addiction 104(7): 1179-1184, 2009. (25 refs.)

This paper examines the relationship between frequency of drinking, usual daily consumption and frequency of binge drinking, taking into consideration possible age and gender differences. Subjects were 10,466 current drinkers (5743 women and 4723 men) aged between 18 and 76 years, who participated in the GENACIS Canada (GENder Alcohol and Culture: an International Study) study. Canada. The independent variable was the annual drinking frequency. The dependent variables were the usual daily quantity consumed, annual, monthly and weekly frequency of binge drinking (five drinks or more on one occasion). Logistic regressions show (i) that those who drink less than once a week are less likely than weekly drinkers to take more than two drinks when they do drink; (ii) that the usual daily quantity consumed by weekly drinkers is not related to their frequency of drinking; but that (iii) the risk and frequency of binge drinking increase with the frequency of drinking. Given that risk and frequency of binge drinking among Canadians increases with their frequency of drinking, any public recommendation to drink moderately should be made with great caution.

Polednak AP. US mortality from liver cirrhosis and alcoholic liver disease in 1999-2004: Regional and state variation in relation to per capita alcohol consumption. Substance Use & Misuse 47(3): 202-213, 2012. (42 refs.)

Apparent per-capita alcohol consumption in 2001 in four US regions (West, Northeast, South, and Midwest), and in 50 states was examined in relation to mortality rates (1999-2004) from liver cirrhosis and for the subcategory alcoholic liver disease. Alcohol consumption and mortality rates were highest in the west. The alcoholic liver disease mortality rate by state was strongly correlated with alcohol consumption, but several outlier or mismatch states were identified. Per-capita alcohol consumption should be useful for US public health policy, as suggested for Europe and Canada, but outlier states require further study.

Popova S; Giesbrecht N; Bekmuradov D; Patra J. Hours and days of sale and density of alcohol outlets: Impacts on alcohol consumption and damage. A systematic review. (review). Alcohol and Alcoholism 44(5): 500-516, 2009. (99 refs.)

Aims: The aim of this study was to examine recent research studies published from 2000 to 2008 focusing on availability of alcohol: hours and days of sale and density of alcohol outlets. Methods: Systematic review. Results: Forty-four studies on density of alcohol outlets and 15 studies on hours and days of sale were identified through a systematic literature search. The majority of studies reviewed found that alcohol outlet density and hours and days of sale had an impact on one or more of the three main outcome variables, such as overall alcohol consumption, drinking patterns and damage from alcohol. Conclusions: Restricting availability of alcohol is an effective measure to prevent alcohol-attributable harm.

Razvodovsky YE. Alcohol consumption and ischemic heart disease mortality in Russia. Adicciones 24(1): 23-29, 2012. (48 refs.)

It has been repeatedly emphasized that alcohol provides the most plausible explanation for both the high rate of cardiovascular mortality rate and its dramatic fluctuations in Russia over recent decades, while other traditional risk factors identified in epidemiological studies have little predictive value. The aim of this study was to examine the relation between alcohol consumption and ischemic heart disease (IHD) mortality rates in Russia. Age-standardized sex-specific male and female IHD mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means of ARIMA time series analysis. The results of the analysis showed that alcohol consumption was significantly associated with both male and female IHD mortality rates: a 1-liter increase in overall alcohol consumption would result in a 3.9% increase in the male IHD mortality rate and a 2.7% increase in the female IHD mortality rate. As a conclusion, the results of this study provide indirect support for the hypothesis that the drastic fluctuations in IHD mortality in Russia over recent decades are related to alcohol, as indicated by the close temporal association between number of deaths from IHD and overall alcohol consumption per capita.

Sand J; Valikoski A; Nordback I. Alcohol consumption in the country and hospitalizations for acute alcohol pancreatitis and liver cirrhosis during a 20-year period. Alcohol and Alcoholism 44(3): 321-325, 2009. (18 refs.)

Aims: Between 1970 and 1989 the incidence of pancreatitis increased in Finland in association with increased alcohol consumption. During the1990s there was a temporary decrease in alcohol consumption. We examined the trends in the amount of alcohol consumed in Finland and the incidence of hospital admissions for acute alcoholic pancreatitis and liver cirrhosis. Patients and methods: The data on hospital admissions and annual alcohol consumption between 1987 and 2007 were obtained from the Finnish National Agency for Welfare and Health. Results: Alcohol consumption increased from 8.2 litres of ethanol per inhabitant per year in 1987 to 10.5 litres in 2007, but during the economic recession in the country there was a temporary decrease in alcohol consumption between 1992 and 1994, with the lowest consumption of 8.0 litres in 1994. The incidence of hospitalizations for acute alcoholic pancreatitis in the whole population increased significantly during the study period among both men (from 57 to 69/100,000/year) and women (from 7 to 12/100,000/year). However, there was a significant decrease in hospitalizations in 1996 and 1997 correlating with alcohol consumption three years earlier. The incidence of hospitalizations due to liver cirrhosis increased in the age groups over 45 years in both genders throughout the study period. A temporary decrease was observed in 1994, when alcohol consumption was at its lowest. Interestingly, there was a trend from pancreatitis to cirrhosis during the last six years, when the hospitalizations for acute pancreatitis decreased, although the hospitalizations for liver cirrhosis increased following increased alcohol consumption. During the study period the female-to-male ratio for liver cirrhosis was twice as high as for acute alcoholic pancreatitis, but the relative portion of females increased by 50% in both diagnoses. Conclusions: In contrast to liver cirrhosis, the hospital admissions for which followed the national alcohol consumption, admissions for acute alcoholic pancreatitis ceased to show a connection with the national alcohol consumption during the past several years.

Smyth BP; Kelly A; Cox G. Decline in age of drinking onset in Ireland, gender and per capita alcohol consumption. Alcohol and Alcoholism 46(4): 478-484, 2011. (53 refs.)

Aims: We sought to examine the fall in age of first drinking in Ireland and to determine whether there were gender differences. We also aimed to determine whether there was a relationship between the per capita alcohol consumption evident when people entered later adolescence and their age of drinking onset. Methods: Information on age of first drinking was based on retrospective recall of 9832 interviewees from the pooled samples obtained from two population surveys. We examined the change in age of first drinking, by birth cohort and by gender, utilizing survival analysis. We utilized Pearson's correlation to explore the relationship between median age of first drinking within each birth cohort and the mean per capita alcohol consumption when that birth cohort was aged 16 years. Results: The average age of first drinking fell steadily and significantly across birth cohorts from the late 1930s to the early 1990s. This change was significantly greater in females. Per capita alcohol consumption was very highly negatively correlated with the median age at which each birth cohort commenced drinking (r = -0.96, P < 0.001). Conclusion: The prevailing level of drinking in society at the point when young people enter later adolescence is very closely associated with the age at which they commence drinking. Per capita consumption may be contributing to the changes in age of onset of drinking and/or both may share a similar set of determinants. In light of this apparent relationship, it is possible that efforts to reduce per capita alcohol consumption may also reduce underage drinking.

Stehr MF. The effect of sunday sales of alcohol on highway crash fatalities. Contributions to Economic Analysis & Policy 10(1): article 73, 2010. (18 refs.)

A large body of evidence indicates that increased alcohol availability leads to increased consumption of alcohol. From 1995 to 2008, fourteen states relaxed or repealed their bans on the Sunday sale of packaged alcohol. This paper leverages these repeals to provide quasi-experimental evidence on the effect of Sunday sales bans on alcohol related crash fatalities. Previous published studies in this area have found conflicting results regarding the effect of Sunday sales on traffic accidents and fatalities, but these studies have focused on repeals in single states, cities, or provinces; are outdated; or have failed to control for underlying changes in traffic fatalities that may be correlated with repeals but are due to other factors affecting traffic safety. Drawing upon data from the lower 48 states from the Fatality Analysis Reporting System (FARS), this paper finds that only the repeal in New Mexico led to an increase in fatalities. The effect is evident only in New Mexico because this repeal led to larger increases in drinking in New Mexico than in other states, residents of New Mexico drive more than residents of the other repeal states, and there is a greater fraction of traffic fatalities involving alcohol in New Mexico than in the other repeal states.

Stockwell T; Zhao JH; Macdonald S; Pakula B; Gruenewald P; Holder H. 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. Addiction 104(11): 1827-1836, 2009. (25 refs.)

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.

Tian GQ; Liu F. Is the demand for alcoholic beverages in developing countries sensitive to price? Evidence from China. International Journal of Environmental Research and Public Health 8(6): 2124-2131, 2011. (13 refs.)

Economic literature in developed countries suggests that demand for alcoholic beverages is sensitive to price, with an estimated price elasticity ranging from -0.38 for beer and -0.7 for liquor. However, few studies have been conducted in developing countries. We employ a large individual-level dataset in China to estimate the effects of price on alcohol demand. Using the data from China Health and Nutrition Survey for the years 1993, 1997, 2000, 2004 and 2006, we estimate two-part models of alcohol demand. Results show the price elasticity is virtually zero for beer and only -0.12 for liquor, which is far smaller than those derived from developed countries. Separate regressions by gender reveals the results are mainly driven by men. The central implication of this study is, while alcohol tax increases can raise government revenue, it alone is not an effective policy to reduce alcohol related problems in China.