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Alcohol Issues Insights

The Ledermann theory that average consumption rates help determine problem-drinking rates, and that alcohol policy should aim to reduce average consumption, still has its adherents among public health officials here and abroad. But the data continue to belie this theory, suggesting that drinking cultures and drinking patterns should be the focus of prevention. Three recent developments support a focus on culture vs. average consumption: recent drinking data from the UK, findings from a recent Finnish survey and a study of drinking habits in four Euro cities. As we noted in the last update, a recent survey of drinking habits in Great Britain shows significant decreases in average consumption, even while reports of increasing alcohol problems, especially among youth, continue to raise alarm, draw attention and will result in some new alcohol policy measures (see below). The table below shows that average consumption in Great Britain dropped from 14.3 units per week in 2005 to 11.5 units, a nearly 20% decline. Average Weekly Alcohol Consumption (Units) Age 2005 2010 % Change 16-24 16.9 11.1 -34.3 25-44 15.1 12.2 -19.2 45-64 16.0 13.1 -18.1 65+ 8.7 8.1 -6.9 Total 14.3 11.5 -19.6 Significantly, given the concern about youth drinking there, average consumption…

Publishing Info

  • Year 2012
  • Volume 29
  • Issue # 3
The virtual elimination of alcohol energy drinks from store shelves did not end state attorney generals’ interest in alcohol policy. State AGs will continue their efforts to “curb youth access” to alcohol. That was one of several takeaways from Washington State AG and current president of the National Association of AGs Rob McKenna’s talk to the Center for Alcohol Policy symposium recently. While not detailing future actions or recommending specific policies, he made several “concerns” very clear. They include: • High-alcohol, single-serve flavored malt beverages in large containers, dubbed “super-sized alcopops” by other folks on CAP agenda (see September 9 Update). McKenna asked “what is the message sent?” by having “cheap packages” of these products in “every gas station and c-store.” Will Washington take specific action on high-alcohol single-serves? “It’s not clear,” McKenna said, though there’s some interest along those lines. Legislation like that is difficult to obtain, he suggested, and perhaps “more time needs to pass” before legislators see the need for action. He has “encouraged” the liquor control board to “step up.” • “Unprecedented levels of youth exposure to alcohol marketing.” Evidence suggests marketing exposure “speeds up onset” of youth drinking and increases consumption of those who have…

Publishing Info

  • Year 2011
  • Volume 28
  • Issue # 9
For years, public health advocates have insisted higher excise taxes will reduce both overall consumption and alcohol problems. Meanwhile, industry members and some researchers have argued that alcohol beverages are relatively “inelastic” (higher prices don’t significantly reduce consumption) and that heavy drinkers/problem drinkers especially are unlikely to be deterred by higher taxes. A new study of US Government surveys strongly supports the industry’s position. Looking at drinking rate data from the federal Behavioral Risk Factor Surveillance System (BRFSS) surveys from 1984-2009 and federal/ state beer excise taxes (a proxy for overall alcohol taxes), the authors tried to tease out the effects of tax rates among different races and among light, moderate and heavy drinkers. They made three broad conclusions: • Most important: “For all races/ethnicities, the estimated tax effects on consumption are large and significant among light drinkers (1-40 drinks per month), but shrink considerably for moderate drinkers (41-99) and heavy drinkers (100+).” In fact, the authors wrote: “We cannot reject [that] alcohol consumption of the latter types is unresponsive to tax changes.” Translated, it is very possible, perhaps likely, that tax changes have no effect on moderate to heavy drinkers, those most likely to experience alcohol-related problems. • “The…

Publishing Info

  • Year 2011
  • Volume 28
  • Issue # 8
The findings of a recently-published Finnish study support previous research that light/moderate drinking may reduce risks for cognitive impairment. Recall, INSIGHTS reported a Norwegian study in August 2010 that linked light-moderate wine and beer consumption to better cognitive performance after 7 years of follow up. The Finnish study followed patients for over 20 years. It found that both lifelong abstention and heavy consumption significantly increased the risks of cognitive impairment, as did binge drinking and "passing out" experiences. The Norwegian study had found that abstainers "had significantly worse cognitive performance" compared to light drinkers. In the Finnish study, light drinkers (0-3 drinks/week) were the baseline group. Lifelong abstainers had approximately 2X the risk for cognitive impairment after an average of 23 years follow-up compared to light drinkers. Heavy drinkers (>7 drinks/week for women, >14 drinks/week for men) also had double the risk. Moderate drinkers had the lowest risk of later cognitive impairment, about 13% lower than light drinkers, in fact. Those who binged (5+ drinks at least monthly) also had elevated risks, regardless of their overall consumption. Similarly, those who said they'd passed out due to excessive drinking more than twice in a given year, had quadruple the risk for…

Publishing Info

  • Year 2011
  • Volume 28
  • Issue # 1
As we've documented in INSIGHTS over the last few years, the Centers for Disease Control, via its interpretation of research findings and their policy implications, its Community Prevention Guides and other programs, has become the lead federal agency voicing support for public health approaches to alcohol problems. CDC did not play an official role in the CAB ban last month, but a CDC official joined FDA, FTC and TTB at the press conference. And while neither FDA nor TTB took part in AP 15, CDC officials spoke at 3 separate sessions. CDC's approach became clear from presentations by Dr. Robert Brewer, who leads CDC's Alcohol Program, Randy Elder from the Community Guide group and Janet Collins, an associate director. Some of their key points: 1) there is "unequivocal evidence" linking alcohol prices with consumption and harm levels, and higher excise taxes are among the most effective policies to reduce both; 2) CDC's Community Guides also recommend stricter limits on alcohol availability via location, days and/or hours of sale, or at least no increases in availability; 3) CDC officials focused sharply on binge drinking, noting several times that most binge drinkers are "not alcohol dependent" and that most binge drinkers, especially…

Publishing Info

  • Year 2010
  • Volume 27
  • Issue # 12
For those familiar with only the press accounts and/or FDA's November 17 new release effectively banning a number of caffeinated alcohol beverages, the detailed analysis can be found in its letter to Phusion Projects, the makers of Four Loko. Here are FDA's main points and conclusions to support its conclusion that "caffeine is an unsafe food additive" in alcohol beverages. Therefore, the beverages to which caffeine has been "directly added" are "adulterated" and "unsafe." Under federal law, the makers were required to prove the added caffeine met its standard of "generally recognized as safe" (GRAS) "under its specific conditions of use" via "consensus among qualified experts" and publicly available "data and information." Net-net: FDA found "a number of experts" had concerns about added caffeine's safety, but no data to prove its safety. Specific concerns included: 1) negative "behavioral effects" in young people; 2) potential "life-threatening situations" resulting from consumption since caffeine "counteracts some, but not all of alcohols adverse effects"; 3) because of caffeine's masking effect, "naïve" drinkers may consume higher amounts of alcohol in CABs. FDA cited five studies in all to support those concerns. Beyond the product itself, "context" of use is also important. Indeed, FDA seemed equally…

Publishing Info

  • Year 2010
  • Volume 27
  • Issue # 11