Suchergebnisse

Purpose. Public policies that reduce the availability of alcohol in communities can reduce consumption and related harms. In this article, we propose a practical model to guide alcohol policy implementation. Approach. The conceptual model is informed by a case study of three U.S. cities that adopted restrictions on high-alcohol malt liquor sales. Setting. The three cities included Seattle, Washington; Santa Ana, California; and Washington, D.C. Participants. Participants (n = 39) represented neighborhood groups, city officials, local police, Alcohol Beverage Control (board members and enforcement personnel), alcohol retailers, alcohol industry representatives, and advocacy and service organizations. Method. We conducted key informant interviews with participants in each city. We coded and analyzed the data by using a grounded theory approach. Findings were used to identify and illustrate model components. Results. Implementation components include building public awareness and educating stakeholders, monitoring and enforcing compliance, evaluating process and outcomes, and institutionalizing the policy. The experiences of study cities illustrate the importance of these activities in maintaining policy effectiveness; for example, a lack of enforcement resources appeared to contribute to the erosion of compliance over time. Conclusion. The model addresses an important gap in alcohol policy research. It is intended to spur further research on the subject, provide a guide for policy practitioners, and ultimately improve the long-term effectiveness of alcohol control policies.

Abstract

Aim
Kingdon [(2014) Agendas, Alternatives, and Public Policies. Essex. United Kingdom: Pearson Education Limited] argues that windows of opportunity to pass policies emerge when problems, solutions and policy support co-occur. This study aims to identify a set of alcohol policies with the potential to reduce alcohol-related disparities given high levels of support from marginalized groups, such as racial/ethnic minorities and lower-income groups.


Methods
This study used data from five US National Alcohol Surveys, which were based on household probability samples of adults in 1995 (n = 4243), 2000 (n = 5736), 2005 (n = 1445), 2010 (n = 4164) and 2015 (n = 4041). We used multiple logistic regression to determine the odds of policy support by racial/ethnic group and income level, considering price, place and marketing policies as well as individual-level interventions.


Results
Overall a majority of Americans supported banning alcohol sales in corner stores (59.4%), banning alcohol advertisements on television (55.5%), and establishing universal health coverage for alcohol treatment (80.0%). Support was particularly high among Blacks, Hispanics/Latinos and lower-income persons. Multivariate models showed that compared with White people, foreign-born Hispanics/Latinos had the most robust levels of support, including raising alcohol taxes (aOR = 2.40, 95% CI: 2.00, 2.88, P < 0.0001), banning alcohol sales in corner stores (aOR = 2.85, 95% CI: 2.22, 3.65, P < 0.0001) and reducing retail sales hours (aOR = 2.91, 95% CI: 2.38, 3.55, P < 0.0001).


Conclusion
Of the policies examined, banning alcohol sales at corner stores is most likely to be in a "window of opportunity" for reducing alcohol-related disparities. By simultaneously reducing population-level consumption and harms from others' drinking, place-based policies have the potential to reduce harms experienced by marginalized groups.

We describe a multi‐step method of coding the strength of 18 alcohol policies included in the Alcohol Policy Information System for each of the 50 states. After thoroughly reviewing each policy area, we chose components that were most important in categorizing the strength or restrictiveness of the policy using the following criteria: overall reach, enforceability, and implementation. We determined a unique coding scheme for each policy area. The total number of categories per policy area ranged from two to six, with categories numbered in an ordered sequence from least to most restrictive. We provide three examples of our coding schemes: Keg Registration, Underage Possession, and Sunday Sales. We also rank the states on their alcohol policy sum score. This study demonstrates how alcohol policies can be measured quantitatively, an important step for assessing the effects of alcohol policies on various outcomes.

Purpose. We examined the relationships among fruit and vegetable intake, alcohol consumption, and socioeconomic status (SES). We hypothesized that fruit and vegetable consumption would be inversely associated with alcohol consumption and the relationship would differ by SES. Design. A cross-sectional analysis. Setting. Large, urban Midwestern county. Subjects. A unique, racially/ethnically diverse sample of 9959 adults (response rate: 66.3%). Measures. Fruit and vegetable intake was measured using two items that assessed servings per day. Alcohol consumption was measured in terms of volume of alcohol consumed and binge drinking. Individual measures of SES included education and household income. Analysis. Weighted multivariate linear and Poisson regression were used to estimate effects. Results. The relationship between fruit and vegetable intake and alcohol consumption varied by SES. Those with lower household incomes who consumed five or more servings of fruits and vegetables per day were less likely to engage in binge drinking relative to those consuming zero to one servings of fruits and vegetables per day (risk ratio = .66; 95% confidence interval: .46, .95). No association was observed for higher–household-income individuals. Conclusion. We observed an inverse relationship between fruit and vegetable consumption and alcohol intake in those with lower household incomes but not in those with higher household incomes. Results suggest that the relationship between diet and alcohol consumption may be more relevant in populations with more restricted economic choices. Results are, however, based on cross-sectional data.

Purpose. To learn how the local context may affect a city's ability to regulate alcohol products such as high–alcohol-content malt liquor, a beverage associated with heavy drinking and a spectrum of nuisance crimes in urban areas. Approach. An exploratory, qualitative case study comparing cities that adopted policies to restrict malt liquor sales with cities that considered, but did not adopt policies. Setting. Nine large U.S. cities in seven states. Participants. City legislators and staff, alcohol enforcement personnel, police, neighborhood groups, business associations, alcohol retailers, and industry representatives. Method. Qualitative data were obtained from key informant interviews (n = 56) and media articles (n = 360). The data were coded and categorized. Similarities and differences in major themes among and across Adopted and Considered cities were identified. Results. Cities faced multiple barriers in addressing malt liquor–related problems, including a lack of enforcement tools, alcohol industry opposition, and a lack of public and political will for alcohol control. Compared to cities that did not adopt malt liquor sales restrictions, cities that adopted restrictions appeared to have a stronger public mandate for a policy and were less influenced by alcohol industry opposition and lack of legislative authority for alcohol control. Strategies common to successful policymaking efforts are discussed. Conclusion. Understanding the local context may be a critical step in winning support for local alcohol control policies.