Tanya Chikritzhs

Moderate alcohol use and reduced mortality risk: Systematic error in prospective studies

The majority of prospective studies on alcohol use and mortality risk indicates that abstainers are at increased risk of mortality from both all causes and coronary heart disease (CHD). This meta-analysis of 54 published studies tested the extent to which a systematic misclassification error was committed by including as ‘abstainers’ many people who had reduced or stopped drinking, a phenomenon associated with ageing and ill health. The studies judged to be error free found no significant all-cause or cardiac protection, suggesting that the cardiac protection afforded by alcohol may have been over-estimated. Estimates of mortality from heavier drinking may also be higher than previously estimated.

Changing the density of alcohol outlets to reduce alcohol-related problems

Increasingly, it seems, legal and political debates regarding the granting of new liquor licences are turning to the issue of whether the number and density of alcohol outlets makes a difference in rates of alcohol consumption and alcohol-related harm. But what is the state of the evidence on this question? In this Harm Reduction Digest Livingston, Chikritzhs and Room review the research literature on the effects of density of alcohol sales outlets on alcohol consumption and alcohol-related problems; suggest a new way of conceptualising the relationships; and discuss the implications for reducing alcohol-related harm.

Revealing the link between licensed outlets and violence: Counting venues versus measuring alcohol availability

INTRODUCTION AND AIMS Associations between alcohol-related harms and numbers of outlets at the neighbourhood level have been demonstrated; however, the degree to which alcohol consumption or sales plays a part in levels of violence is not clear. This has contributed to uncertainty regarding the actual mechanisms by which outlet density may influence levels of violence. This ecological cross-sectional study investigated the effect of outlet numbers and alcohol sales on the risk of assault in Western Australia. DESIGN AND METHODS For 2000/2001, information on type, number and wholesale alcohol purchases of all licensed outlets in operation, police-reported assault offences, socioeconomic/demographic data were obtained from official sources. Multivariate negative binomial regression was applied to at local government area level in order to assess associations between outlet density, alcohol sales and violence occurring in both licensed and domestic settings. RESULTS Average alcohol sales volume per off-site outlet was significantly associated with all measures of assault. Numbers of on-site outlets significantly predicted violence with the exception of assaults occurring at residential premises. Alcohol sales from off-site outlets predicted violence occurring at on-site outlets. DISCUSSION AND CONCLUSIONS The link between on-site outlets and violence may be primarily underpinned by negative amenity effects while off-site outlet effects occur via increased availability. Alcohol sales volumes from off-site outlets influence levels of violence, which occur at both licensed and residential settings. The substantial and wide-ranging effects of liquor stores on alcohol-related harms may have been underestimated in the literature and by policy makers.

Has the leaning tower of presumed health benefits from 'moderate' alcohol use finally collapsed?

The evolving epidemiological literature, including improved methodology for assessing causality in observational studies, is raising doubts about whether moderate alcohol consumption has a protective effect on health.

Selling addictions: Similarities in approaches between Big Tobacco and Big Booze

Background The purpose of this research was to identify, through alcohol industry documents, similarities between tobacco and alcohol companies in approaches to evidence and counter-arguments to public health measures. Method

Alcohol use and prostate cancer: A meta-analysis

Past reviews have concluded that there is no association between alcohol use and prostate cancer incidence. We performed a meta-analysis of existing epidemiological studies finding, in contrast, evidence to suggest that prostate incidence is positively linearly associated with heavier alcohol use. This finding was largely due to the contribution of population case-control studies and those measuring men recruited before age 60. No relationship between alcohol consumption and prostate cancer was found for cohort and hospital case-control studies. Analyses of design effects modestly suggests that population case-control studies were probably better suited to identify potential alcohol-prostate cancer relationships due to the close temporal proximity of the measurement of level of alcohol consumption to diagnosis. Future efforts should be made to exclude all ill subjects from control groups/baseline samples in addition to accounting for changes in consumption with advancing age and the onset of illness. The alcohol-prostate cancer association remained significant despite controlling for the degree to which studies endeavored to eliminate false negatives from their control groups.

Access to Confidential Alcohol Industry Documents: From 'Big Tobacco' to 'Big Booze'

BACKGROUND:

How good is the science

Ronksley and colleagues asserted that the association between moderate alcohol consumption and reduced mortality risk was “beyond question.”1 We reviewed all 67 studies that generated the 84 articles in their meta-analysis. All but two had at least one of six serious methodological problems, and these two had mixed findings (figure⇓); see http://carbc.ca/Portals/0/News/FeatureSupplement201203.pdf for bibliography).

Mortality rate of alcoholic liver disease and risk of hospitalization for alcoholic liver cirrhosis, alcoholic hepatitis and alcoholic liver failure in Australia between 1993 and 2005

Background:  Alcoholic liver disease (ALD) is an important contributor to the total burden of alcohol‐related harm; however, the morbidity of different types of ALD in Australia has not been described. The aim of this study was to investigate recent trends in hospital admission rates among alcoholic liver cirrhosis, alcoholic hepatic failure and alcoholic hepatitis in Australia, as well as the mortality of ALD.

Regional variation in alcohol consumption in the Northern Territory

Objective : To identify any regional variation in per capita consumption of alcohol and the types of beverages consumed in the NT; and to estimate the relative contributions to consumption by Aboriginal and non‐Aboriginal people.