| 1. |
- Jayasekara, Harindra, et al.
(författare)
-
Alcohol Consumption Over Time and Risk of Death : A Systematic Review and Meta-Analysis
- 2014
-
Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 179:9, s. 1049-1059
-
Forskningsöversikt (refereegranskat)abstract
- The results from the few cohort studies that have measured usual alcohol consumption over time have not been summarized. We therefore conducted a systematic review and meta-analysis to quantify mortality risk. Pertinent studies were identified by searching the Medline, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Scopus databases through August 2012 using broad search criteria. Studies reporting relative mortality risks for quantitatively defined categories of alcohol consumption over time were eligible. Nine cohort studies published during 1991-2010 (comprising 62,950 participants and 10,490 deaths) met the inclusion criteria. For men, there was weak evidence of lower mortality risk with low levels of alcohol intake over time but higher mortality risk for those with intakes over 40 g/day compared with abstainers using a random-effects model (P for nonlinearity = 0.02). The pooled relative risks were 0.90 (95% confidence interval: 0.81, 0.99) for 1-29 g/day, 1.19 (95% confidence interval: 0.89, 1.58) for 30-59 g/day, and 1.52 (95% confidence interval: 0.78, 2.98) for 60 or more g/day compared with abstention. There was moderate between-study heterogeneity but no evidence of publication bias. Studies including women were extremely scarce. Our findings include a curvilinear association between drinking over time and mortality risk for men overall and widespread disparity in methods used to capture exposure and report results.
|
|
| 2. |
- Rehm, Jürgen, et al.
(författare)
-
Regulatory Policies for Alcohol, other Psychoactive Substances and Addictive Behaviours : The Role of Level of Use and Potency. A Systematic Review
- 2019
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 16:19
-
Forskningsöversikt (refereegranskat)abstract
- The object of this contribution based on a systematic review of the literature is to examine to what degree the level of use and potency play a role in regulatory policies for alcohol, other psychoactive substances and gambling, and whether there is an evidence base for this role. Level of use is usually defined around a behavioural pattern of the user (for example, cigarettes smoked per day, or average ethanol use in grams per day), while potency is defined as a property or characteristic of the substance. For all substances examined (alcohol, tobacco, opioids, cannabis) and gambling, both dimensions were taken into consideration in the formulation of most regulatory policies. However, the associations between both dimensions and regulatory policies were not systematic, and not always based on evidence. Future improvements are suggested.
|
|
| 3. |
- Rehm, Juergen, et al.
(författare)
-
The impact of alcohol taxation changes on unrecorded alcohol consumption : A review and recommendations
- 2022
-
Ingår i: International journal of drug policy. - : Elsevier BV. - 0955-3959 .- 1873-4758. ; 99
-
Forskningsöversikt (refereegranskat)abstract
- Background: The diverse forms of unrecorded alcohol, defined as beverage alcohol not registered in official statistics in the country where it is consumed, comprise about one fourth of all alcohol consumed worldwide. Since unrecorded alcohol is usually cheaper than registered commercial alcohol, a standard argument against raising alcohol excise taxes has been that doing so could potentially result in an increase in unrecorded consumption. This contribution examines whether increases in taxation have in fact led to increases in consumption of unrecorded alcohol, and whether these increases in unrecorded alcohol should be considered to be a barrier to raising taxes. A second aim is to outline mitigation strategies to reduce unrecorded alcohol use.Methods: Narrative review of primary and secondary research, namely case studies and narrative and systematic reviews on unrecorded alcohol use worldwide.Results: Unrecorded alcohol consumption did not automatically increase with increases in taxation and subse-quent price increases of registered commercial alcohol. Instead, the level of unrecorded consumption depended on: a) the availability and type of unrecorded alcohol; b) whether such consumption was non-stigmatized; c) the primary population groups which consumed unrecorded alcohol before the policy change; and d) the policy measures taken. Mitigation strategies are outlined.Conclusions: Potential increases in the level of unrecorded alcohol consumption should be considered in the planning and implementation of substantial increases in alcohol taxation. However, unrecorded consumption should not be considered to be a principal barrier to implementing tax interventions, as evidence does not indicate an increase in consumption if mitigation measures are put in place by governments.
|
|
| 4. |
- Rehm, J., et al.
(författare)
-
The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease : an overview
- 2003
-
Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 98:9, s. 1209-1228
-
Forskningsöversikt (refereegranskat)abstract
- Aims As part of a larger study to estimate the global burden of disease attributable to alcohol:• to quantify the relationships between average volume of alcohol consumption, patterns of drinking and disease and injury outcomes, and• to combine exposure and risk estimates to determine regional and global alcohol-attributable fractions (AAFs) for major disease and injury categories.Design, methods, setting Systematic literature reviews were used to select diseases related to alcohol consumption. Meta-analyses of the relationship between alcohol consumption and disease and multi-level analyses of aggregate data to fill alcohol–disease relationships not currently covered by individual-level data were used to determine the risk relationships between alcohol and disease. AAFs were estimated as a function of prevalence of exposure and relative risk, or from combining the aggregate multi-level analyses with prevalence data.Findings Average volume of alcohol consumption was found to increase risk for the following major chronic diseases: mouth and oropharyngeal cancer; oesophageal cancer; liver cancer; breast cancer; unipolar major depression; epilepsy; alcohol use disorders; hypertensive disease; hemorrhagic stroke; and cirrhosis of the liver. Coronary heart disease (CHD), unintentional and intentional injuries were found to depend on patterns of drinking in addition to average volume of alcohol consumption. Most effects of alcohol on disease were detrimental, but for certain patterns of drinking, a beneficial influence on CHD, stroke and diabetes mellitus was observed.Conclusions Alcohol is related to many major disease outcomes, mainly in a detrimental fashion. While average volume of consumption was related to all disease and injury categories under consideration, pattern of drinking was found to be an additional influencing factor for CHD and injury. The influence of patterns of drinking may be underestimated because pattern measures have not been included in many epidemiologic studies. Generalizability of the results is limited by methodological problems of the underlying studies used in the present analyses. Future studies need to address these methodological issues in order to obtain more accurate risk estimates.
|
|
| 5. |
- Room, Robin, et al.
(författare)
-
Drinking and its burden in a global perspective : policy considerations and options
- 2003
-
Ingår i: European Addiction Research. - : S. Karger. - 1022-6877 .- 1421-9891. ; 9:4, s. 165-175
-
Forskningsöversikt (refereegranskat)abstract
- Aims: To identify the policy implications of the magnitude and characteristics of alcohol consumption and problems, viewed globally, and to summarize conclusions on the effectiveness of the strategies available to policymakers concerned with reducing rates of alcohol problems. Design/Methods/Setting: This summative article draws on the findings of the articles preceding it and of reviews of the literature. Findings and Conclusions: Overall volume of consumption is the major factor in the prevalence of harms from drinking. Since consumption and associated problems tend to increase with economic development, policymakers in developing economies should be especially aware of the need to develop policies to minimize overall increases in alcohol consumption. Unrecorded consumption is also an important consideration for policy in many parts of the world, and poses difficulties for alcohol control policies. Drinking pattern is also an important contributing factor toward alcohol-related harm. Although some drinking patterns have been shown to produce beneficial health effects, because the net effect of alcohol on coronary disease is negative in most parts of the world, policies that promote abstinence or lower drinking overall may be the safest options. Moreover, sporadic intoxication is common in many parts of the world, and policies are unlikely to change this drinking pattern at least in the short to medium term. At the same time, because injuries comprise a large proportion of the burden of alcohol, it is appropriate to enhance these policies with targeted harm reduction strategies such as drinking and driving countermeasures and interventions focused on reducing alcohol-related violence in specific high-risk settings. Alcohol consumption is a major factor for the global burden of disease and should be considered a public health priority globally, regionally, and nationally for the vast majority of countries in the world. The need for alcohol policy is even stronger when it is taken into consideration that the burden of alcohol estimated in the WHO Global Burden of Disease project includes primarily health problems related to drinking. From the limited evidence available, however, social problems related to drinking seem to impose at least as much burden. Moreover, the burden for both social and health harms fall not only on the drinker, but also on others. There is a broad literature on policy interventions to reduce alcohol problems. Effective strategies include controls over distribution and sale, taxation, drinking-driving countermeasures, brief interventions by health workers or counselors, and selected harm reduction measures. There is a need to develop the growing literature on comparative evaluations of cost-effectiveness of such strategies. In addition, international agreements are needed to support the effectiveness of national strategies.
|
|
