Aims This study investigated the hypotheses that (i) intentional and unintentional injuries occur more frequently in areas with greater density of off-premises alcohol outlets; and (ii) larger and chain outlets selling cheaper alcohol contribute more substantially to injury risk than smaller and independent outlets. DesignEcological cross-sectional. Setting From the 256 Statistical Area level 2 (SA2) census units in Melbourne, Australia, we selected a random sample of 62 units. There were 2119 Statistical Area level 1 (SA1) units nested within the selected SA2 units. Participants The selected units contained 295 off-premises outlets.
Measurements Two independent observers conducted premises assessments in all off-premises outlets, assessing the volume of alcohol available for sale (paces of shelf space), price (least wine price) and other operating characteristics (chain versus independent, drive-through). Outlet counts, assessed outlet characteristics and other area characteristics (population density, median age, median income, retail zoning) were aggregated within SA1 units. Dependent variables were counts of ambulance attended intentional injuries (assaults, stabbings, shootings) and unintentional injuries (falls, crush injuries and object strikes).
Findings In univariable analyses, chain outlets were larger (r = 0.383; P < 0.001) and sold cheaper alcohol (r = −0.484; P < 0.001) compared with independent outlets. In Bayesian spatial Poisson models, off-premises outlet density was positively related to both intentional [incidence rate ratio (IRR) = 1.38; 95% credible interval (CI) = 1.19, 1.60] and unintentional injuries (IRR = 1.18; 95% CI = 1.06, 1.30). After disaggregation by outlet characteristics, chain outlet density was also related to both intentional (IRR = 1.35; 95% CI = 1.11, 1.64) and unintentional injuries (IRR = 1.20; 95% CI = 1.08, 1.38).Conclusions Greater off-premises outlet density is related to greater incidence of traumatic injury, and chain outlets appear to contribute most substantially to traumatic injury risk.
ALCOHOL MISCELLANEOUS 7. Health information on alcoholic beverage containers: has the alcohol industry's pledge in England to improve labelling been met?
Mark Petticrew, Nick Douglas, Cécile Knai, Mary Alison Durand, Elizabeth Eastmure and Nicholas Mays
Addiction 2016:111(1);51-55 Abstract
Aims In the United Kingdom, alcohol warning labels are the subject of a voluntary agreement between industry and government. In 2011, as part of the Public Health Responsibility Deal in England, the industry pledged to ensure that 80% of products would have clear, legible health warning labelling, although an analysis commissioned by Portman found that only 57.1% met best practice. We assessed what proportion of alcohol products now contain the required health warning information, and its clarity and placement.
DesignSurvey of alcohol labelling data. Setting United Kingdom. Participants Analysis of the United Kingdom's 100 top-selling alcohol brands (n = 156 individual products).
Measurements We assessed the product labels in relation to the presence of five labelling elements: information on alcohol units, government consumption guidelines, pregnancy warnings, reference to the Drinkaware website and a responsibility statement. We also assessed the size, colour and placement of text, and the size and colouring of the pregnancy warning logo. Findings The first three (required) elements were present on 77.6% of products examined. The mean font size of the Chief Medical Officer's (CMO) unit guidelines (usually on the back of the product) was 8.17-point. The mean size of pregnancy logos was 5.95 mm. The pregnancy logo was on average smaller on wine containers. Conclusions The UK Public Health Responsibility Deal alcohol labelling pledge has not been fully met. Labelling information frequently falls short of best practice, with font and logos smaller than would be accepted on other products with health effects.
Keywords: Alcohol; evaluation; labelling; marketing; public health policy; public health responsibility deal
8. How to think about your drink: Action-identification and the relation between mindfulness and dyscontrolled drinking
Laura Schellhas, Brian D. Ostafin, Tibor P. Palfai, Peter J. de Jong
Addictive Behaviours 2016:56;51-56 Abstract
Cross-sectional and intervention research have shown that mindfulness is inversely associated with difficulties in controlling alcohol use. However, little is known regarding the mechanisms through which mindfulness is related to increased control over drinking. One potential mechanism consists of the way individuals represent their drinking behaviour. Action identification theory proposes that self-control of behaviour is improved by shifting from high-level representations regarding the meaning of a behaviour to lower-level representations regarding “how-to” aspects of a behaviour. Because mindfulness involves present-moment awareness, it may help to facilitate such shifts. We hypothesized that an inverse relation between mindfulness and dyscontrolled drinking would be partially accounted for by the way individuals mentally represent their drinking behaviour — i.e., reduced levels of high-level action identification and increased levels of low-level action identification. One hundred and twenty five undergraduate psychology students completed self-report measures of mindful awareness, action identification of alcohol use, and difficulty in controlling alcohol use. Results supported the hypothesis that high-level action identification partially mediates the relation between mindfulness and dyscontrolled drinking but did not support a mediating role for low-level action identification. These results suggest that mindfulness can improve self-control of alcohol by changing the way we think about our drinking behaviour.