William Gilmore

'Something's brewing': The changing trends in alcohol coverage in Australian newspapers 2000-2011

AIMS The portrayal of alcohol in the news media, including newspapers, plays an important role in influencing societal norms and setting public agendas. We present the first large-scale examination of news coverage of alcohol-related issues in Australian newspapers. METHOD Content analysis was performed on a sample of alcohol-related newspaper articles (n = 4217) published across Australia from 2000 to 2011. Articles were coded for type, theme, prominence, topic slant, opinion slant and sources/spokesperson. RESULTS Across the period, the most common themes were promotion (21%), drink-driving (16%) and restrictions/policy (16%). Themes of restrictions/policy and responsible beverage services became more common over time. Promotion and business-related articles significantly declined over time. Overall, the topic slant of the majority of news related articles disapproved of alcohol use. Disapproval increased over time while approval of alcohol use decreased. While the slant of opinion pieces was predominantly approving of alcohol, this decreased over time. Presence of an alcohol industry representative in articles declined over time. CONCLUSION The presentation of alcohol use in Australian newspapers became more disapproving over time, which may suggest that harmful alcohol use has become less acceptable among the broader Australian community.

Demographic and substance use factors associated with non-violent alcohol-related injuries among patrons of Australian night-time entertainment districts

This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries.

A comparative study of blood alcohol concentrations in Australian night-time entertainment districts

INTRODUCTION AND AIMS There is little research describing how intoxication levels change throughout the night in entertainment districts. This research aims to describe levels of alcohol intoxication across multiple Australian metropolitan and regional nightlife districts. DESIGN AND METHODS This study was conducted in the night-time entertainment districts of three metropolitan cities (Sydney, Melbourne and Perth) and two regional cities (Wollongong and Geelong) in Australia. Data collection occurred approximately fortnightly in each city on a Friday or Saturday night between 8 pm and 5 am. Brief structured interviews (3-10 min) and breathalyser tests were undertaken in busy thoroughfares over six months. RESULTS Of the 7037 individuals approached to participate in the study, 6998 [61.8% male, mean age 24.89 years (standard deviation 6.37; range 18-73)] agreed to be interviewed. There was a linear increase in blood alcohol concentration (BAC) levels throughout the night. Post hoc testing revealed significantly more highly intoxicated participants (i.e. BAC above 0.10 mg of alcohol per 100 mL of blood) after midnight (P < 0.05). The overall mean BAC was 0.06 mg/100 mL. Men were more intoxicated than women earlier in the night, but gender differences disappeared by 3 am. There was no age differences in intoxication earlier in the night, but after midnight, patrons over the age of 21 showed increasing BAC levels. DISCUSSION AND CONCLUSIONS There is a consistent trend across the cities of high to very high levels of intoxication later in the night, with trends after midnight being significantly different to those before.

Alcohol: taking a population perspective

Alcohol consumption is a global phenomenon, as is the resultant health, social and economic harm. The nature of these harms varies with different drinking patterns and with the societal and political responses to the burden of harm; nevertheless, alcohol-related chronic diseases have a major effect on health. Strong evidence exists for the effectiveness of different strategies to minimize this damage and those policies that target price, availability and marketing of alcohol come out best, whereas those using education and information are much less effective. However, these policies can be portrayed as anti-libertarian and so viewing them in the context of alcohol-related harm to those other than the drinker, such as the most vulnerable in society, is important. When this strategy is successful, as in Scotland, it has been possible to pass strong and effective legislation, such as for a minimum unit price for alcohol.

Pre-Drinking Behavior of Young Heavy Drinkers

ABSTRACT Background: Pre-drinking has been linked to subsequent heavy drinking and the engagement in multiple risky behaviors. Objectives: The present study examined a group of adolescents who recently had a “big night out” to determine whether there were differences in their pre-drinking behavior based on age, gender, geographic location, and social setting. Methods: Participants (n = 351, aged 16–19) representing the heaviest 20–25% of drinkers in their age group were recruited using nonrandom sampling from metropolitan (Melbourne, Sydney, Perth) or regional (Bunbury) locations across Australia and administered a survey by a trained interviewer. Results: Almost half the sample pre-drank (n = 149), most commonly at a friends house. Those aged 18–19 were more likely to pre-drink, and did so at higher quantities compared to their younger counterparts. Males and females reported similar pre-drinking duration, quantity and amount spent on alcohol. Compared to those in cities, regional participants consumed greater quantities over longer periods of time. Two-thirds of participants consumed alcohol in excess of national guidelines during their pre-drinking session. These participants were more likely to nominate price as a motivation to pre-drink and were less likely to report that someone else provided them alcohol. Conclusions: This study sheds light on the pre-drinking habits of a population of young risky drinkers, and highlights the need for policy makers to address this form of drinking to reduce alcohol-related harm among young people.

Alcohol: is the evidence base guiding public policy?

There is strong international evidence from many different countries, cultures and patterns of drinking on what works in reducing alcohol-related harm, but sadly there is also evidence that far too often is not translated into effective public health policies. Babor et al.1 and Stockwell2 are among those that have reviewed and presented the evidence base for policy relevant strategies. Studies in a number of countries have consistently shown that even small increases in alcoholic beverage price reduce both consumption and its related harms (long term and short term). Restriction on the physical availability of alcohol is also well known to work. This can be achieved by a number of measures, with the most successful known to be restricting hours and days of sale, restricting the legal drinking age for purchase or consumption of alcohol, restricting density of licensed outlets and restricting service to intoxicated patrons. Random breath testing, reducing blood alcohol concentration (BAC) limits and setting BAC limits of zero for drivers under the legal alcohol purchase age are all drink-driving countermeasures that have been shown to be effective. There is also a growing evidence base showing that young people who are exposed to alcohol advertising are more likely to start drinking and those that already drink are likely to drink at higher levels,3 yet the control of alcohol advertising in many countries remains an industry self-regulated system. Two clear examples of where there is strong evidence for the effectiveness of public health intervention in reducing alcohol-related harm, and how politics can get in the way of the evidence, are price regulation and trading hour restrictions.

Risks of alcohol-attributable hospitalisation and death in Australia over time: Evidence of divergence by region, age and sex.

BACKGROUND Past reports on trends of alcohol consumption and related harm have generally been descriptive in nature and have not provided evidence of whether changes over time are significant. AIMS We investigated whether: (i) the risk of alcohol-attributable hospitalisation and death between 1994 and 2005 for three different age groups changed significantly across all Australian jurisdictions; and (ii) the relative rates of hospitalisation for males and females changed over time. METHOD Estimates of alcohol-attributable hospitalisations and deaths were calculated using the aetiologic fraction method. Hospitalisations and deaths were grouped by age: 15-29 years, 30-44 years and 45+ years. Risk estimates and risk differences were analysed using Poisson regression. RESULTS Risk of alcohol-attributable hospital separations increased nationally and across most jurisdictions throughout the study period. Male and female rates converged over time. Alcohol-attributable deaths decreased nationally across the three age groups and across several jurisdictions beginning in the mid-1990s. CONCLUSION Nationally, alcohol-attributable deaths declined while hospitalisations rose. However, states with higher population density tended to drive national rates, with considerable variation by jurisdiction. The conditions which dominated hospitalisations (e.g. alcohol dependence, falls) differed substantially from those underlying alcoholattributable deaths (e.g. alcoholic liver cirrhosis, road crashes). Jurisdictional variation in death and hospitalisations rates as well as changes over time may be partly due to differences in: regulation of alcohol supply; patterns and levels of alcohol consumption; the nature and effectiveness of law enforcement; demographic characteristics of general and sub-populations; and medical health services and screening for chronic conditions.

Most recent risky drinking session with Australian teenagers

Objective: Despite declines in Australian alcohol consumption, youth alcohol related harms remain prevalent. These alcohol‐related consequences appear to be driven by a subset of risky drinkers who engage in ‘high intensity’ drinking episodes and are underrepresented in national health surveys. This project aims to investigate high risk drinking practices and alcohol‐related harms amongst young people not otherwise recorded in existing data.

The effect of short-term alcohol restriction on risk of alcohol-related injury: A state wide population-based study

BACKGROUND Alcohol consumption and related harms are largely determined by both demand and supply of alcohol. Across Western Australia, under state licensing laws, there are state-wide alcohol sales restrictions imposed on Good Friday and Christmas Day each year. This study aimed to evaluate the effect of the Good Friday and Christmas Day state-wide alcohol restrictions on the risk of alcohol-related injuries presenting at emergency departments. METHODS This is a population-based cohort study using ED injury presentation data for the period 1st January 2002 to 1st January 2015. Risk of injury during the alcohol-related time of day affected by the alcohol restrictions (intervention periods, including Good Friday and Christmas Day) were compared to the same time of day over a number of control days. Multivariable Poisson regression model was used to perform the analysis. RESULTS The crude injury risk was considerably lower during the alcohol restriction periods compared to control periods in both metropolitan and non-metropolitan areas. The protective effect observed on the days of the alcohol restrictions remained significant, and largely unchanged, when potential confounding effects were controlled for. CONCLUSION The significant reduction in alcohol-related injury presentations observed for public holiday periods with alcohol restrictions were likely caused by the alcohol restriction policy and its direct effect on alcohol supply.

The Wild West: Associations between mining and violence in Western Australia

OBJECTIVE To investigate the association between mining activity and police-reported assault offences across Western Australia. DESIGN A cross-sectional multivariable negative binomial regression analysis at the local government area level. SETTING Local government areas in Western Australia. PARTICIPANTS Victims of reported assault offences occurring in 2008-2009. MAIN OUTCOME MEASURES Eight reported assault measures by gender of victim and type of assault. The analysis controlled for a range of potentially confounding variables, including numbers of licensed outlets and alcohol sales. RESULTS Compared with females in other areas, females in mining regions had a 64% increased risk of assault, a 59% increased risk of non-domestic assault and a 136% increased risk of sexual assault. Risk of domestic assault was 64% higher for males in mining regions. CONCLUSIONS Regions where mining is a major employer of people usually or temporarily residing in the area (i.e. usual residents or temporary fly-in fly-out residents) are associated with higher risk of assaults among females and domestic assaults among males, and these associations appear to be independent of licensed outlet numbers and alcohol sales. Mining communities appear to present a special case for the management and reduction of violence; public health and safety intervention needs to identify and address risk factors independent of alcohol use.