Light and heavy drinking in jurisdictions with different alcohol policy environments

Simon Foster; Gerhard Gmel; Meichun Mohler-Kuo

doi:10.1016/j.drugpo.2019.01.014

Light and heavy drinking in jurisdictions with different alcohol policy environments

Int J Drug Policy. 2019 Mar:65:86-96. doi: 10.1016/j.drugpo.2019.01.014. Epub 2019 Feb 1.

Authors

Simon Foster¹, Gerhard Gmel², Meichun Mohler-Kuo³

Affiliations

¹ Department of Child and Adolescent Psychiatry and Psychotherapy (KJPP), University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland; Swiss Research Institute for Public Health and Addiction at the University of Zurich, Zurich, Switzerland. Electronic address: simon.foster@uzh.ch.
² Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland; Addiction Switzerland, Lausanne, Switzerland; Centre for Addiction and Mental Health, Toronto, Ontario, Canada; University of the West of England, Bristol, United Kingdom.
³ Department of Child and Adolescent Psychiatry and Psychotherapy (KJPP), University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland; Swiss Research Institute for Public Health and Addiction at the University of Zurich, Zurich, Switzerland; La Source, School of Nursing, University of Applied Sciences and Arts, Western Switzerland, Lausanne, Switzerland.

PMID: 30711804
DOI: 10.1016/j.drugpo.2019.01.014

Abstract

Background: A basic, yet untested tenet underlying alcohol control policies is that they should affect both light and heavy drinking, thereby shifting the entire population in a favourable direction. The aim of this study was to test this assumption in young Swiss men.

Methods: Cross-sectional self-reported data - from 5755 young Swiss men participating in the Cohort Study on Substance Use Risk Factors (C-SURF), a large cohort study on young men living within 21 jurisdictions across Switzerland - were analysed via nested logistic regression. With this approach, a set of increasingly-heavy drinking patterns was broken down into a set of nested regression models, each one estimating the probability of heavier drinking, conditional on the lighter drinking pattern. Drinking patterns relating to heavy episodic drinking (HED), heavy volume drinking (HVD) on weekends, and workweek drinking, as well as alcohol use disorder (AUD) were examined. The explanatory variable was a previously-used alcohol policy environment index (APEI) reflecting the number of alcohol control policies implemented in each jurisdiction. Conventional and multilevel logistic regression models were tested, adjusted for age, education, linguistic region, urban/rural status, attention-deficit/hyperactivity disorder, depression, sensation seeking, antisocial personality disorder, and unobserved heterogeneity between jurisdictions.

Results: For HED, weekend HVD, and AUD, negative relationships with the APEI were found, such that with a higher APEI the probability of lighter drinking patterns was increased while the probability of heavier patterns was reduced, including a reduced probability of the heaviest patterns. These relationships were non-linear, however, and tapered off towards the heavy end of the drinking spectrum. No relationship was identified between the APEI and workweek drinking patterns.

Conclusion: Among young Swiss men, stricter alcohol policy environments were associated with a global shift towards lighter drinking, consistent with the basic tenet behind the universal prevention approach.

Keywords: Alcohol control policy; Alcohol drinking; Alcohol use disorder; Health policy; Young adult.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Alcohol Drinking / epidemiology*
Alcohol Drinking / legislation & jurisprudence*
Alcoholism / epidemiology*
Antisocial Personality Disorder
Attention Deficit Disorder with Hyperactivity
Binge Drinking
Cohort Studies
Cross-Sectional Studies
Ethnicity
Female
Humans
Logistic Models
Male
Public Policy / legislation & jurisprudence*
Risk Factors
Self Report
Switzerland / epidemiology
Young Adult