The burden of alcohol-related ill health in the United Kingdom

Background Although moderate alcohol consumption has been shown to confer a protective effect for specific diseases, current societal patterns of alcohol use impose a huge health and economic burden on modern society. This study presents a method for estimating the health and economic burden of alcohol consumption to the UK National Health Service (NHS).

Methods Previous estimates of NHS costs attributable to alcohol consumption were identified by systematic literature review. The mortality and morbidity due to alcohol consumption was calculated using information from the World Health Organization Global Burden of Disease Project and routinely collected mortality data. Direct health-care costs were derived using information on population attributable fractions for conditions related to alcohol consumption and NHS cost data.

Results We estimate that alcohol consumption was responsible for 31 000 deaths in the UK in 2005 and that alcohol consumption cost the UK NHS £3.0 billion in 2005–06. Alcohol consumption was responsible for 10% of all disability adjusted life years in 2002 (male: 15%; female: 4%) in the UK.

Conclusions Alcohol consumption is a considerable public health burden in the UK. The comparison of the health and economic burden of various lifestyle factors is essential in prioritizing and resourcing public health action.

Review of rural and regional alcohol research in Australia

INTRODUCTION: Alcohol is the most commonly used drug within Australia. Recently, there have been indications that there is a greater incidence of high-risk drinking within rural populations as compared with their urban counterparts. High-risk drinking is associated with numerous conditions, such as diabetes, heart attack and cancer, as well as acute harms such as assault, suicide and road accidents. The objective of this article is to review the current research and relevant data pertaining to alcohol use and alcohol-related harms within rural Australia. METHODS: This paper is a systematic review of 16 databases, including PubMed, PsycINFO and Google Scholar. RESULTS: Overall, 18 studies describing alcohol consumption or alcohol-related harms were found. Approximately half of these studies were large-scale national population surveys, which were therefore limited in their representativeness of specific regional and rural towns. Most studies examining alcohol consumption used self-report data collection, meaning that interpretation of results needs to be tentative. There is a consistent pattern of higher rates of alcohol consumption and consequent harm within regional and rural Australia than in urban areas. CONCLUSIONS: There is emerging research examining alcohol consumption and alcohol-related harms within regional and rural Australia. All studies show that these populations experience disproportionate harm because of alcohol consumption. The causes and mechanism for this have not been investigated, and a program of research is required to understand how and why rural populations experience disproportionate levels of alcohol-related harm and ultimately, what interventions will be most effective in reducing alcohol-related harms.

The association between an abusive father-son relationship, quantity of alcohol consumption, and male-to-male alcohol-related agression

Background:
While alcohol consumption and heavy episodic (binge) drinking are well-established predictors of male-to-male alcohol-related aggression (MMARA), the role of the father-son relationship in MMARA has yet to be explored.
Methods:
This study therefore examined whether fathering by the biological father rather than another father figure, negative fathering, and gender role modeled by the father figure were significant predictors of involvement in MMARA, once drinking frequency and quantity and heavy episodic drinking were controlled for. A total of 121 university students aged 18 to 25 years (M = 20.63, SD = 1.77 years) voluntarily completed the online questionnaire.
Results:
The only significant predictors of perpetration of MMARA were a more abusive paternal relationship and drinking quantity (number of standard drinks usually consumed when drinking).
Conclusions:
Negative father-son relationships may play a role in fostering young men's perpetration of MMARA in the barroom context. © 2013 by the Research Society on Alcoholism.

Cannabis use and related harms in the transition to young adulthood: a longitudinal study of Australian secondary school students

The current study documents the changing rates of cannabis use, misuse and cannabis-related social harms among Australian adolescents as they grow into young adulthood. It utilised data from a longitudinal study of young people at ages 15, 16, 17, and 19. The rates of cannabis use were found to increase as participants aged; past year use increased from 7.5% at age 15 to 29.8% at age 19. Further, at ages 17 and 19, cannabis use was more prevalent among males than females. Among those who reported cannabis use, the rates of cannabis-related harms were low to moderate, and did not increase with age in the same manner as rates of cannabis use. The most prevalent self-reported cannabis-related harm was anxiety/depression; affecting between 20–30% of the cannabis users at each age. These findings may assist in understanding the extent of cannabis-related problems among youth, and in planning relevant services.

Last drinks: a study of rural emergency department data collection to identify and target community alcohol-related violence

The present study summarises the methodology and findings of a pilot project designed to measure the sources and locations of alcohol-related harm by implementing anonymised 'last drinks' questions in the ED of a rural community.

Review article: Emergency department data sharing to reduce alcohol-related violence: a systematic review of the feasibility and effectiveness of community-level interventions.

The present paper aims to review current evidence for the effectiveness and/or feasibility of using inter-agency data sharing of ED recorded assault information to direct interventions reducing alcohol-related or nightlife assaults, injury or violence. Potential data-sharing partners involve police, local council, liquor licensing regulators and venue management. A systematic review of the peer-reviewed literature was conducted. The initial search discovered 19,506 articles. After removal of duplicates and articles not meeting review criteria, n = 8 articles were included in quantitative and narrative synthesis. Seven of eight studies were conducted in UK EDs, with the remaining study presenting Australian data. All studies included in the review deemed data sharing a worthwhile pursuit. All studies attempting to measure intervention effectiveness reported substantial reductions of assaults and ED attendances post-intervention, with one reporting no change. Negative logistic feasibility concerns were minimal, with general consensus among authors being that data-sharing protocols and partnerships could be easily implemented into modern ED triage systems, with minimal cost, staff workload burden, impact to patient safety, service and anonymity, or risk of harm displacement to other licensed venues, or increase to length of patient stay. However, one study reported a potential harm displacement effect to streets surrounding intervention venues. In future, data-sharing systems should triangulate ED, police and ambulance data sources, and assess intervention effectiveness using randomised controlled trials that account for variations in venue capacity, fluctuations in ED attendance and population levels, seasonal variations in assault and injury, and control for concurrent interventions.

The effect of community interventions on alcohol-related assault in Geelong, Australia

Alcohol has consistently been demonstrated to increase levels of aggression and violence, particularly in late night licensed venues. Since 2005, the City of Geelong in Australia has implemented a substantial number of interventions to reduce alcohol related violence, including a liquor accord, increased police surveillance, ID scanners, CCTV, a radio network and an alcohol industry sponsored social marketing campaign. The aim of the current study is to assess the individual and collective impact of community interventions on indicators of alcohol-related assaults in the Geelong region. This paper reports stage one findings from the Dealing with Alcohol-related problems in the Night-time Economy project (DANTE) and specifically examines assault rate data from both emergency department presentations, ICD-10 classification codes, and police records of assaults. None of the interventions were associated with reductions in alcohol-related as-sault or intoxication in Geelong, either individually or when combined. However, the alcohol industry sponsored social marketing campaign ‘Just Think’ was associated with an increase in assault rates. Community level interventions appeared to have had little effect on assault rates during high alcohol times. It is also possible that social marketing campaigns without practical strategies are associated with increased assault rates. The findings also raise questions about whether interventions should be targeted at reducing whole-of-community alcohol consumption.