Suchergebnisse

Abstract

Aims
To estimate risk of injury associated with frequency of drinking and heavy drinking (5+ drinks on occasion) by gender and race/ethnicity in the US population.


Methods
Data were from a merged sample of two National Alcohol Surveys (telephone and web-based) (2014–2015 and 2019–2020) on 16,639 respondents, and analyzed using Cox proportional hazards models with age as the timescale in a retrospective cohort design. Life-course drinking was determined by age of onset and questions on any drinking and heavy drinking by decade of life. The outcome measure was having had an injury from a serious accident at a certainage.


Results
Frequent heavy drinking (5+ daily, weekly and monthly) was significantly predictive of injury with hazard ratios (HRs) of 2.40, 1.81 and 1.50, respectively, while frequent light drinking (alcohol at least weekly and 5+ yearly or less) was also significant for women (HR = 1.73). For White respondents, 5+ at least weekly was significant for both men (HR = 1.74) and women (HR = 2.42). Among Hispanic respondents, 5+ at least weekly and 5+ monthly were both significant for men (HR = 2.81 and 2.49, respectively) and women (HR = 2.81 and 3.48, respectively). Among Black women, risk was significant for 5+ monthly (HR = 2.90) and for any alcohol ≥ weekly (HR = 2.72), but neither frequency of any drinking or 5+ was significant for Blackmen.


Conclusions
Data suggest a greater risk of injury from a serious accident for frequent heavy drinkers among all White and Hispanic respondents, and Black women, but not for Blackmen.

In 2011, Washington State voters approved Initiative 1183 (I-1183), the privatization of liquor sales. The aim here was to examine how voter support for privatization has changed since I-1183 passed. Data came from five state-representative surveys, with recruitment between 2014 and 2016 (N = 4,290). Primary outcomes were voting on I-1183 (vs. not), voting for (vs. against) I-1183, and changing vote for I-1183 to against among those who voted for it (vs. not changing). Bivariate and multivariable logistic regressions were used for analyses. Results show that voting for (vs. against) I-1183 was related to 2.59 (P < 0.001) times greater odds of wanting to change one's vote. This difference was large enough to have changed the result of the election if voters could know their later opinions. Among those who voted for I-1183, odds of retracting support were positively related to total past 12-month drink volume. Those who agreed that number of stores selling liquor should decrease were more likely to change votes from for to against, while those who considered that youth alcohol abuse has remained the same since privatization were less likely to change votes. Thus, in the years immediately following liquor privatization in Washington State, public opinion has changed enough to shift the result of the election from supporting privatization to rejecting it. Findings are especially relevant for other US states and countries considering privatization.

INTRODUCTION AND AIMS: The privatisation of the Washington Liquor Monopoly in 2012 offered a unique opportunity to study spirits purchasing behaviour changes from a government to licensed system. DESIGN AND METHODS: Four representative cross-sectional surveys of adults aged 18 and older in Washington state were recruited between January 2014 and October 2015 (Wave 1, N=1202; W2, N=804; W3, N=823; W4, N=662). Analyses compared spirits purchasing behaviours before privatisation from retrospective reports to current reports in the areas of travel distance, spirits quality, purchase frequency and size of bottle. Respondents also directly reported on changes in convenience, selection and prices. RESULTS: No significant changes were found in these aspects of purchasing. However, subgroup analyses found that younger drinkers 18-29 reduced travel distance and increased purchase frequency while drinkers aged 50 and older travelled further. Reduced travel distances were associated with grocery and drug stores while increased travel distances were associated with liquor superstores, wholesale stores and government stores in bordering states. Respondents reported that liquor purchasing was more convenient after privatisation but that the selection of spirits was better and prices were lower in the government-controlled stores. DISCUSSION AND CONCLUSIONS: The government monopoly stores were viewed as offering a wider selection of products and as having lower prices than those in the privatised system. The variety of store types in the licensed system allowed drinkers to select stores based on convenience, selection or prices, so that travel times increased for some buyers, presumably those seeking lower prices or a wider selection.

BACKGROUND: Washington State ended their wholesale and retail monopoly on liquor on June 1, 2012, resulting in a five-fold increase in liquor outlets in diverse store types. The legislation also included taxes at the wholesale and retail levels. This study seeks to investigate whether prices have changed from 2014 through 2016, as a follow up to a previous study finding increases in prices from 2012 to 2014, compared to prices in other states. METHODS: We developed an index of 68 brands that were popular in Washington in early 2012. Data on final liquor prices (including taxes) in Washington and California were obtained through store visits and online sources between November 2013 and March 2014, and again between April and May 2016 for Washington only. Pricing data for Idaho and Oregon were obtained from the Statistics for Alcohol Management Database over both sampling periods. Primary analyses were conducted on the utmost brands available in the majority of the stores sampled. RESULTS: Liquor prices in Washington rose an average of 3.9% for 750 mL and 6.5% for 1.75 L containers overall from 2014 to 2016; while bordering states Idaho (+2.9%) and Oregon (+1.5%) experienced smaller increases for 750 mL and declines for 1.75 L containers (Idaho: −2.9%, Oregon: −4.9%). In the analyses of spirits prices in Washington compared to California, prices in California were 24.1% lower for 750 mL containers and 29.6% lower for 1.75 L containers. CONCLUSION: Our findings indicate liquor prices in Washington have increased since our 2014 assessment at a larger percentage than prices in the neighboring control states Oregon and Idaho, with varying effects on brands, container sizes, and store types. We demonstrate privatization is associated with a different pattern of prices across store types than seen in California.

Abstract

Aims
To analyze racial/ethnic disparities in risk of two alcohol-related events, alcohol-related injury and self-reported perceived driving under the influence (DUI) from hours of exposure to an elevated blood alcohol concentration (BAC).


Methods
Risk curves for the predicted probability of these two outcomes from the number of hours of exposure to a BAC ≥ 0.08 mg% in the past year were analyzed separately for whites, blacks and Hispanics in a merged sample of respondents from four US National Alcohol Surveys (2000–2015).


Results
Hours of exposure to a BAC ≥ 0.08 showed a stronger association with perceived DUI than with alcohol-related injury for all racial/ethnic groups. Greater risk was found for whites than blacks or Hispanics for outcomes at nearly all BAC exposure levels, and most marked at the highest level of exposure. Risk of both outcomes was significant for whites at all exposure levels, but small for alcohol-related injury. Little association was found for alcohol-related injury for blacks or Hispanics. For perceived DUI, risk for blacks was significantly elevated at lower levels of exposure, while risk for Hispanics was significantly elevated beginning at 30 h of exposure.


Conclusions
Findings showed racial/ethnic differences in risk of alcohol-related injury and perceived DUI from hours of exposure to elevated BAC. Risk increased at relatively low levels of exposure to a BAC ≥ 0.08, especially for whites, highlighting the importance of preventive efforts to reduce harmful outcomes for moderate drinkers.

Abstract
Co-use of multiple drugs may prolong or increase heavy drinking, even for individuals with health conditions adversely affected by it. Patterns of alcohol and drug use may vary across racial/ethnic groups, with differential implications for health. This study examines racial/ethnic differences in the associations between risky drinking and other drug use in adults with diabetes, hypertension, heart disease, or cancer. Multiple logistic regression modeling, stratified by condition, was performed using a nationally representative sample of adults drawn from the 2015 to 2019 National Survey on Drug and Health. The outcome was risky drinking (consuming more than 7/14 drinks weekly). Other drugs considered were tobacco, marijuana, illicit drugs, and non-medical prescription drugs. Covariates included age, sex, education, income, marital/cohabitation status, health insurance coverage, and self-rated health status. Each drug category was positively associated with risky drinking across all four conditions. Racial/ethnic minority adults were less likely than White adults to engage in risky drinking, with this pattern most consistent for those with hypertension. Other drug use in minority adults (i.e. tobacco and illicit drug use in Black and Hispanic adults, and marijuana and prescription drug use in Asian adults) was associated with disproportionately greater odds of risky drinking compared with White adults. This pattern was more prominent for those with a heart condition, and not found for those with cancer. Future interventions might address co-use of alcohol and other drugs in adults with chronic conditions, with special attention to racial/ethnic minority adults.

In the United States, some racial/ethnic minorities suffer from higher rates of chronic alcohol problems, and alcohol-related morbidity and mortality than Whites. Furthermore, state-level alcohol policies may affect racial/ethnic subgroups differentially. We investigate effects of beverage-specific taxes and government control of spirits retail on alcohol-related mortality among non-Hispanic Whites, non-Hispanic Blacks, non-Hispanic American Indians/Alaska Natives (AI/AN) and Hispanics using death certificate and state-level alcohol policy data for 1999–2016. Outcomes were analyzed as mortality rates (per 10,000) from 100% alcohol-attributable chronic conditions ("100% chronic AAD"). Statistical models regressed racial/ethnic-specific logged mortality rates on state-level, one-year lagged and logged beer tax, one-year lagged and logged spirits tax, and one-year lagged government-controlled spirits sales, adjusted for mortality trends, fixed effects for state, and clustering of standard errors. Government control was significantly (P < 0.05) related to 3% reductions in Overall and non-Hispanic White mortality rates, and 4% reductions in Hispanic mortality rates from 100% chronic AAD. Tax associations were not robust. Results support that government control of spirits retail is associated with significantly lower 100% AAD from chronic causes Overall and among non-Hispanic Whites and Hispanics. Government control of spirits retail may reduce both population-level 100% chronic AAD as well as racial/ethnic disparities in 100% chronic AAD.