Suchergebnisse

In Spain the legal age to buy alcohol is 18 years. However, official surveys show that minors perceive alcohol availability to be easy. This paper describes the impacts of a community-based intervention to increase vendors' compliance with age limits regarding alcohol sales in supermarkets. The aim of this study was to explore the association between implementation of a multicomponent intervention to reduce adolescents' alcohol use and sale of alcohol to minors in the city of Palma (Spain). Twenty trained adolescents (14-17 years old) conducted 138 alcohol test purchases in nine supermarket chains in August 2018 (baseline; n = 73) prior to the intervention, and again in January 2020 (follow-up; n = 65). Analysis was conducted according to three levels of intervention implemented across the supermarkets: (i) personnel from the supermarkets' Human Resources or Corporate Social Responsibility teams received alcohol service training as trainers (i.e., community mobilization); (ii) managers and vendors training by the capacitated trainers; and (iii) no training of managers or vendors (i.e., control group). In the supermarkets that completed the Training of Trainers and the vendors' training program, average sales decreased significantly from 76.9% in 2018 to 45.5% in 2020, asking for the age of the shopper significantly increased from 3.8% to 45.4%, and asking for proof of age significantly increased from 15.4% to 72.7%. Additionally, a statistically significant increase was observed in the visibility of prohibition to sell alcohol to minors' signs, from 61.5% to 100%. No statistically significant differences were found for the Training of Trainers intervention alone nor in the control group. In conclusion, community mobilization combined with staff training is associated with significant increases in supermarket vendors' compliance with alcohol legislation in Spain.

Background: Government alcohol monopolies were created in North America and Scandinavia to limit health and social problems. The Swedish monopoly, Systembolaget, reports to a health ministry and controls the sale of all alcoholic beverages with > 3.5% alcohol/volume for off-premise consumption, within a public health mandate. Elsewhere, alcohol monopolies are being dismantled with evidence of increased consumption and harms. We describe innovative modelling techniques to estimate health outcomes in scenarios involving Systembolaget being replaced by 1) privately owned liquor stores, or 2) alcohol sales in grocery stores. The methods employed can be applied in other jurisdictions and for other policy changes. Methods: Impacts of the privatisation scenarios on pricing, outlet density, trading hours, advertising and marketing were estimated based on Swedish expert opinion and published evidence. Systematic reviews were conducted to estimate impacts on alcohol consumption in each scenario. Two methods were applied to estimate harm impacts: (i) alcohol attributable morbidity and mortality were estimated utilising the International Model of Alcohol Harms and Policies (InterMAHP); (ii) ARIMA methods to estimate the relationship between per capita alcohol consumption and specific types of alcohol-related mortality and crime. Results: Replacing government stores with private liquor stores (Scenario 1) led to a 20.0% (95% CI, 15.3-24.7) increase in per capita consumption. Replacement with grocery stores (Scenario 2) led to a 31.2% (25.1-37.3%) increase. With InterMAHP there were 763 or + 47% (35-59%) and 1234 or + 76% (60-92%) more deaths per year, for Scenarios 1 and 2 respectively. With ARIMA, there were 850 (334-1444) more deaths per year in Scenario 1 and 1418 more in Scenario 2 (543-2505). InterMAHP also estimated 10,859 or + 29% (22-34%) and 16,118 or + 42% (35-49%) additional hospital stays per year respectively. Conclusions: There would be substantial adverse consequences for public health and safety were Systembolaget to be privatised. We demonstrate a new combined approach for estimating the impact of alcohol policies on consumption and, using two alternative methods, alcohol-attributable harm. This approach could be readily adapted to other policies and settings. We note the limitation that some significant sources of uncertainty in the estimates of harm impacts were not modelled.