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Goel R, Tiwari G, Varghese M, Bhalla K, Agrawal G, Saini G, Jha A, John D, Saran A, White H, Mohan D. Effectiveness of road safety interventions: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1367. [PMID: 38188231 PMCID: PMC10765170 DOI: 10.1002/cl2.1367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background Road Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low- and middle-income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high-income countries have successfully reduced RTI by using a public health approach and implementing evidence-based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high-income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge. Objectives The objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels. Search Methods The EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019. Selection Criteria The interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post-crash pre-hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non-fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes. Data Collection and Analysis The EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case-control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2. Main Results The EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post-crash pre-hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non-fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety-six percent of the studies were reported from high-income countries (HIC), 4.5% from upper-middle-income countries, and only 1.4% from lower-middle and low-income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality. Authors' Conclusions The EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence-synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.
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Affiliation(s)
- Rahul Goel
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Geetam Tiwari
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Kavi Bhalla
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinoisUSA
| | - Girish Agrawal
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Abhaya Jha
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Denny John
- Faculty of Life and Allied Health SciencesM S Ramaiah University of Applied Sciences, BangaloreKarnatakaIndia
| | | | | | - Dinesh Mohan
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
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Kudła J, Podsiadło A, Woźniak R. The effectiveness of regulations preventing alcohol-related road traffic crashes and fatalities in the European Union countries. JOURNAL OF SAFETY RESEARCH 2024; 88:161-173. [PMID: 38485359 DOI: 10.1016/j.jsr.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/05/2023] [Accepted: 11/07/2023] [Indexed: 03/19/2024]
Abstract
INTRODUCTION This article addresses the impact of policy measures on the number of alcohol-related crashes and fatalities in European Union countries. In particular, it assesses (1) whether mild or severe penalty measures should be used to reduce the number of crashes and fatalities caused by alcohol; and (2) whether alcoholic beverages should be treated differently or proportionally to their alcohol content. METHODS This study analyzed the number of alcohol-related crashes and fatalities in 24 European Union countries between 2002 and 2014. The methodology involved fixed-effects panel models, models with instrumental variables, the Hausman-Taylor model, and seemingly unrelated regressions (SUR). SUR improve the results of coefficient estimates when the data are not complete. RESULTS The results of the SUR indicated that vehicle impoundment, community service, and alcolocks correlate with lower crashes, while detention correlates with lower fatalities. Furthermore, a higher alcohol content in beverages is positively associated with fatalities and negatively associated with the number of crashes. CONCLUSIONS Mild and harsh measures for preventing alcohol-related crashes and fatalities differ in effectiveness; therefore, they should be used simultaneously. Blood alcohol concentration limits were found to be an ineffective tool for preventing crashes and fatalities under the influence of alcohol. PRACTICAL IMPLICATIONS The regulatory restrictions on different types of alcohol should be stricter for hard alcohol (especially spirits) and lower for low-alcohol beverages, such as beer, if fewer fatalities are preferred to fewer crashes.
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Liu L, Chui WH, Deng Y. Driving after alcohol consumption: A qualitative analysis among Chinese male drunk drivers. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 90:103058. [PMID: 33310635 DOI: 10.1016/j.drugpo.2020.103058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 10/22/2022]
Abstract
In China, alcohol-related impaired driving has been perceived as a crucial contributor to traffic accidents. However, the topic of driving after alcohol consumption is still understudied in the country. To fill this void, the aim of this study was to find out male drivers' unique experiences of drunk driving in China. A qualitative analysis was adopted based on semi-structured interviews with 38 Chinese male drunk drivers who were serving community corrections. The findings of this study revealed that, being regular alcohol consumers, Chinese male drunk drivers had very little knowledge of the impairment caused by alcohol intake on driving. They mostly underestimated alcohol's negative influence on their driving ability and were overconfident that they would have a safe drive and would not be involved in any traffic accidents after consuming alcohol. In addition, most participants of this study reported that there was very little possibility that they would be arrested after fully assessing the situation and implementing strategies to avoid detection by traffic police. All these reasons affected these men's decision to drive drunk. Several criminological theories are applied to explain the findings and implications are finally recommended to reduce the possibility of drunk driving among Chinese men.
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Affiliation(s)
- Liu Liu
- School of Social and Behavioral Sciences, Nanjing University, Heren Building, Room 409, 163 Xianlin Avenue, Nanjing, Jiangsu 210023, China.
| | - Wing Hong Chui
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Yali Deng
- School of Social Work, University of Maryland, Baltimore, MD, USA
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Scherer M, Romano E, Caldwell S, Taylor E. The impact of retail beverage service training and social host laws on adolescents' DUI rates in San Diego County, California. TRAFFIC INJURY PREVENTION 2018; 19:111-117. [PMID: 28696779 DOI: 10.1080/15389588.2017.1350268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 06/29/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Driving under the influence (DUI) citations are still a serious concern among drivers aged 16-20 years and have been shown to be related to increased risk of fatal and nonfatal crashes. A battery of laws and policies has been enacted to address this concern. Though numerous studies have evaluated these policies, there is still a need for comprehensive policy evaluations that take into account a variety of contextual factors. Previous effort by this research team examined the impact of 20 minimum legal drinking age-21 laws in the state of California, as they impacted alcohol-related crash rates among drivers under 21 years of age while at the same time accounting for alcohol and gas taxes, unemployment rates, sex distribution among drivers, and sobriety checkpoints. The current research seeks to expand this evaluation to the county level (San Diego County). More specifically, we evaluate the impact of measures subject to county control such as retail beverage service (RBS) laws and social host (SH) laws, as well as media coverage, city employment, alcohol outlet density, number of sworn officers, alcohol consumption, and taxation policies, to determine the most effective point of intervention for communities seeking to reduce underage DUI citations. METHODS Annual DUI citation data (2000 to 2013), RBS and SH policies, and city-wide demographic, economic, and environmental information were collected and applied to each of the 20 cities in San Diego County, California. A structural equation model was fit to estimate the relative contribution of the variables of interest to DUI citation rates. RESULTS Alcohol consumption and alcohol outlet density both demonstrated a significant increase in DUI rates, whereas RBS laws, SH laws, alcohol tax rates, media clusters, gas tax rates, and unemployment rates demonstrated significant decreases in DUI rates. CONCLUSIONS At the county level, although RBS laws, SH laws, and media efforts were found to contribute to a significant reduction in DUI rates, the largest significant contributors to reducing DUI rates were alcohol and gas taxation rates. Policy makers interested in reducing DUI rates among teenagers should examine these variables within their specific communities and consider conducting community-specific research to determine the best way to do so. Future efforts should be made to develop models that represent specific communities who are interested in reducing DUI rates among drivers aged 16-20 years.
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Affiliation(s)
- Michael Scherer
- a Pacific Institute for Research and Evaluation (PIRE) , Calverton , Maryland
| | - Eduardo Romano
- a Pacific Institute for Research and Evaluation (PIRE) , Calverton , Maryland
| | - Susan Caldwell
- b Institute for Public Strategies (IPS) , San Diego , California
| | - Eileen Taylor
- a Pacific Institute for Research and Evaluation (PIRE) , Calverton , Maryland
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Nazif-Muñoz J, Falconer J, Gong A. Are child passenger fatalities and child passenger severe injuries equally affected by child restraint legislation? The case of Chile. Int J Inj Contr Saf Promot 2017; 24:501-509. [DOI: 10.1080/17457300.2016.1278236] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J.I. Nazif-Muñoz
- Institute for Health and Social Policy, McGill University, Montreal, Canada
| | | | - A. Gong
- Department of Sociology, McGill University, Montreal, Canada
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Nazif-Muñoz JI, Gariépy G, Falconer J, Gong A, Macpherson A. The impact of child restraint legislation on the incidence of severe paediatric injury in Chile. Inj Prev 2016; 23:291-296. [DOI: 10.1136/injuryprev-2016-042218] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 10/19/2016] [Accepted: 11/04/2016] [Indexed: 11/04/2022]
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Giesbrecht N, Greenfield TK, Anglin L, Johnson S. Changing the Price of Alcohol in the United States: Perspectives from the Alcohol industry, Public Health, and Research. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/009145090403100406] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Based on a study examining the development, modification, and blockage of U.S. federal alcohol policy during the 1980s and 1990s, this paper focuses on alcohol prices and taxes. Data consist of 64 in-depth interviews of experts on U.S. federal alcohol policy, supplemented by findings from archival government reports, trade journals, and the research literature. Prior research has shown an association between increases in price and decreases in per capita consumption and certain aggregated problem rates. Using analysis of the interview material, we illustrate and interpret the perspectives of those who agree and of those who disagree with tax increases on alcoholic beverages. We offer interpretations of the relatively low attention given to this effective intervention by policy makers and offer some grounds for optimism that federal tax increases on alcoholic beverages, in conjunction with other, less proven control measures, might yet be acceptable to the general public and beneficial to public health.
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Nazif-Munoz JI, Quesnel-Vallée A, van den Berg A. Did Chile’s traffic law reform push police enforcement? Understanding Chile’s traffic fatalities and injuries reduction. Inj Prev 2014; 21:159-65. [DOI: 10.1136/injuryprev-2014-041358] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 11/10/2014] [Indexed: 11/03/2022]
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Nazif-Muñoz JI, Quesnel-Vallée A, Van den Berg A. Explaining Chile's traffic fatality and injury reduction for 2000-2012. TRAFFIC INJURY PREVENTION 2014; 15 Suppl 1:S56-S63. [PMID: 25307399 DOI: 10.1080/15389588.2014.939270] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES The objective of the current study is to determine the contribution of Chile's 2005 traffic law reform, police enforcement, and road investment infrastructure to the reduction of traffic fatalities and severe injuries from 2000 to 2012. METHODS Analyses based on structural equation models were carried out using a unique database merging aggregate administrative data from several Chilean public institutions. The sample was balanced (13 regions, over 13 years; N=169). Dependent variables were rates of traffic fatality (total, drivers, passengers, and pedestrians), severe injuries, and total number of crashes per vehicle fleet. Independent variables were (1) traffic law reform, (2) police enforcement, and (3) road infrastructure investment. Oil prices, alcohol consumption, proportion of male population 15-24 years old, unemployment, years' effects and regions' effects, and lagged dependent variables were entered as control variables. RESULTS Empirical estimates from the structural equation models suggest that the enactment of the traffic law reform is significantly associated with a 7% reduction of pedestrian fatalities. This association is entirely mediated by the positive association the law had with increasing police enforcement and reducing alcohol consumption. In turn, police enforcement is significantly associated with a direct decrease in total fatalities, driver fatalities, passenger fatalities, and pedestrian fatalities by 17%, 18%, 8%, and 60%, respectively. Finally, road infrastructure investment is significantly associated with a direct reduction of 11% in pedestrian fatalities, and the number of total crashes significantly mediates the effect of road infrastructure investment on the reduction of severe injuries. Tests of sensitivity indicate these effects and their statistical significance did not vary substantively with alternative model specifications. CONCLUSIONS Results suggest that traffic law reform, police enforcement, and road infrastructure investment have complex interwoven effects that can reduce both traffic fatalities and severe injuries. Though traffic reforms are ultimately designed to change road user behaviors at large, it is also important to acknowledge that legislative changes may require institutional changes--that is, intensification of police enforcement--and be supported by road infrastructure investment, in order to effectively decrease traffic fatalities and injuries. Furthermore, depending on how road safety measures are designed, coordinated, and implemented, their effects on different types of road users vary. The case of Chile illustrates how the diffusion of road safety practices globally promoted by the World Health Organization and World Bank, particularly in 2004, can be an important influence to enhance national road safety practices.
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Norström T, Rossow I. Population drinking and drink driving in Norway and Sweden: an analysis of historical data 1957-89. Addiction 2013; 108:1051-8. [PMID: 23461568 DOI: 10.1111/add.12126] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 08/08/2012] [Accepted: 01/17/2013] [Indexed: 02/02/2023]
Abstract
AIM Research suggests an association between population drinking and a large number of outcomes. However, driving while under the influence of alcohol (DWI) is conspicuously absent from this list of outcomes. The aim of this study was to estimate the relation between DWI and total consumption of alcohol on annual time-series data for Norway and Sweden. DESIGN, SETTING, AND MEASUREMENTS: For Norway, we used data on convictions for DWI per 100 000 inhabitants (aged 15-69 years). The DWI proxy for Sweden comprised the proportion (%) of all police-reported traffic accidents with personal injuries where the driver was under the influence of alcohol. Data on total alcohol sales in litres of pure alcohol per inhabitant (aged 15 years and older) were used as proxy for total alcohol consumption. We focused on the period 1957-89, during which the legislation concerning DWI remained unchanged in Norway as well as in Sweden. The statistical analyses were based on co-integrated models. FINDINGS The estimates of the association between DWI and per capita alcohol consumption were strongly significant in Norway as well as in Sweden. For Norway, the estimated elasticity equalled 2 (P < 0.001) and for Sweden 1.5 (P < 0.001). CONCLUSIONS In Norway and Sweden, as total population level of alcohol consumption increases or decreases so does the incidence of driving while intoxicated.
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Affiliation(s)
- Thor Norström
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden.
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Drinking, substance use and the operation of motor vehicles by young adolescents in Canada. PLoS One 2012; 7:e42807. [PMID: 22936992 PMCID: PMC3425571 DOI: 10.1371/journal.pone.0042807] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Accepted: 07/11/2012] [Indexed: 11/27/2022] Open
Abstract
Background Impaired driving is a recognized cause of major injury. Contemporary data are lacking on exposures to impaired driving behaviours and related injury among young adolescents, as well as inequities in these youth risk behaviours. Methods and Findings Cycle 6 (2009/10) of the Health Behaviour in School-Aged Children survey involved 26,078 students enrolled in 436 Canadian schools. We profiled cross-sectionally the reported use of alcohol, marijuana, or other illicit drugs by on-road and off-road vehicle operators when young adolescents (mean age 13.3 (±1.6) years) were either driving or riding as a passenger. Comparisons were made across vulnerable subgroups. Multi-level logistic regression analyses were used to quantify the effects of the driving behaviours on risks for motor vehicle-related injury. Attributable risk fractions were also estimated. A total of 10% (±3%) of participants reported recent operation of an on-road or off-road motor vehicle after consuming alcohol, marijuana, or other illicit drugs, while 21% (±3%) reported riding as a passenger with a driver under the same conditions. Larger proportions of youth reporting these risk behaviours were males, and from older age groups, rural communities, and socio-economically disadvantaged populations. The behaviours were consistently associated with increased risks for motor vehicle-related injury at the individual level (RR 2.35; 95% CI: 1.54 to 3.58 for frequent vs. no exposure as a driver; RR 1.68; 95% CI: 1.20 to 2.36 for frequent vs. no exposure as a passenger) and at the population level (Attributable Risk Fraction: 7.1% for drivers; 14.0% for passengers). The study was limited mainly by its reliance on self-reported data. Conclusion Impaired driving is an important health priority among young adolescents in Canada. Inequities in the involvement of younger adolescents in these risk behaviours suggest the need for targeted interventions for specific subgroups such as youth from rural communities, and among socially disadvantaged populations.
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Patra J, Giesbrecht N, Rehm J, Bekmuradov D, Popova S. Are Alcohol Prices and Taxes an Evidence-Based Approach to Reducing Alcohol-Related Harm and Promoting Public Health and Safety? A Literature Review. ACTA ACUST UNITED AC 2012. [DOI: 10.1177/009145091203900103] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This literature review examines alcohol prices and taxes as potential prevention strategies—examining the links with high-risk drinking and drinking patterns and alcohol-related harm. A literature search of the studies on alcohol price and taxation was conducted using multiple electronic bibliographic databases. Examined outcomes were a) drinking patterns and high risk drinking; and b) harm from alcohol. Fifty-four relevant studies were evaluated, and the majority found that a change in price or taxes on alcohol had an impact on one or more of the two main outcome variables. Significant variations exist across studies in terms of designs, settings, effects across groups, and types of harm. In order to reduce alcohol-related trauma, chronic disease, and other consequences of high-risk drinking, an increase in pricing/taxation is a central component of an overall alcohol strategy.
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Wagenaar AC, Tobler AL, Komro KA. Effects of alcohol tax and price policies on morbidity and mortality: a systematic review. Am J Public Health 2010; 100:2270-8. [PMID: 20864710 PMCID: PMC2951962 DOI: 10.2105/ajph.2009.186007] [Citation(s) in RCA: 297] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2010] [Indexed: 12/14/2022]
Abstract
OBJECTIVES We systematically reviewed the effects of alcohol taxes and prices on alcohol-related morbidity and mortality to assess their public health impact. METHODS We searched 12 databases, along with articles' reference lists, for studies providing estimates of the relationship between alcohol taxes and prices and measures of risky behavior or morbidity and mortality, then coded for effect sizes and numerous population and study characteristics. We combined independent estimates in random-effects models to obtain aggregate effect estimates. RESULTS We identified 50 articles, containing 340 estimates. Meta-estimates were r = -0.347 for alcohol-related disease and injury outcomes, -0.022 for violence, -0.048 for suicide, -0.112 for traffic crash outcomes, -0.055 for sexually transmitted diseases, -0.022 for other drug use, and -0.014 for crime and other misbehavior measures. All except suicide were statistically significant. CONCLUSIONS Public policies affecting the price of alcoholic beverages have significant effects on alcohol-related disease and injury rates. Our results suggest that doubling the alcohol tax would reduce alcohol-related mortality by an average of 35%, traffic crash deaths by 11%, sexually transmitted disease by 6%, violence by 2%, and crime by 1.4%.
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Affiliation(s)
- Alexander C Wagenaar
- University of Florida, College of Medicine, Department of Epidemiology and Health Policy Research, Gainesville, FL 32610-0177, USA.
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Elder RW, Lawrence B, Ferguson A, Naimi TS, Brewer RD, Chattopadhyay SK, Toomey TL, Fielding JE. The effectiveness of tax policy interventions for reducing excessive alcohol consumption and related harms. Am J Prev Med 2010; 38:217-29. [PMID: 20117579 PMCID: PMC3735171 DOI: 10.1016/j.amepre.2009.11.005] [Citation(s) in RCA: 268] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Revised: 11/02/2009] [Accepted: 11/03/2009] [Indexed: 11/22/2022]
Abstract
A systematic review of the literature to assess the effectiveness of alcohol tax policy interventions for reducing excessive alcohol consumption and related harms was conducted for the Guide to Community Preventive Services (Community Guide). Seventy-two papers or technical reports, which were published prior to July 2005, met specified quality criteria, and included evaluation outcomes relevant to public health (e.g., binge drinking, alcohol-related crash fatalities), were included in the final review. Nearly all studies, including those with different study designs, found that there was an inverse relationship between the tax or price of alcohol and indices of excessive drinking or alcohol-related health outcomes. Among studies restricted to underage populations, most found that increased taxes were also significantly associated with reduced consumption and alcohol-related harms. According to Community Guide rules of evidence, these results constitute strong evidence that raising alcohol excise taxes is an effective strategy for reducing excessive alcohol consumption and related harms. The impact of a potential tax increase is expected to be proportional to its magnitude and to be modified by such factors as disposable income and the demand elasticity for alcohol among various population groups.
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Affiliation(s)
- Randy W Elder
- National Center for Health Marketing, CDC, Atlanta, Georgia, USA.
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Mann RE, Zalcman RF, Asbridge M, Suurvali H, Giesbrecht N. Drinking-driving fatalities and consumption of beer, wine and spirits. Drug Alcohol Rev 2009; 25:321-5. [PMID: 16854657 DOI: 10.1080/09595230600741099] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Drinking-driving is a leading cause of preventable morbidity and mortality in Canada. The purpose of this paper was to examine factors that influenced drinking driver deaths in Ontario. We examined the impact of per capita consumption of total alcohol, and of beer, wine and spirits separately, on drinking-driving deaths in Ontario from 1962 to 1996, as well as the impact of the introduction of Canada's per se law and the founding of People to Reduce Impaired Driving Everywhere - Mothers Against Drunk Driving (PRIDE - MADD) Canada. We utilised time-series analyses with autoregressive integrated moving average (ARIMA) modelling. As total alcohol consumption increased, drinking driving fatalities increased. The introduction of Canada's per se law, and of PRIDE-MADD Canada, acted to reduce drinking driving death rates. Among the specific beverage types, only consumption of beer had a significant impact on drinking driver deaths. Several factors were identified that acted to increase and decrease drinking driver death rates. Of particular interest was the observation of the impact of beer consumption on these death rates. In North America, beer is taxed at a lower rate than other alcoholic beverages. The role of taxation policies as determinants of drinking-driving deaths is discussed.
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Affiliation(s)
- Robert E Mann
- Social, Prevention and Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.
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Vingilis E, Mcleod AI, Mann RE, Seeley J. A tale of two cities: the effect of extended drinking hours in licensed establishments on impaired driving and assault charges. TRAFFIC INJURY PREVENTION 2008; 9:527-533. [PMID: 19058098 PMCID: PMC2693378 DOI: 10.1080/15389580802344788] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES On May 1, 1996, Ontario, Canada, amended the Liquor Licence Act to extend the hours of alcohol sales and service in licensed establishments from 1 to 2 a.m. The purpose of this study was to examine the effect of extended drinking hours on two cities in southwestern Ontario, Canada, one of which (London) would be affected by the alcohol control policy of extended drinking hours and the second city (Windsor) would be affected by two alcohol policies, extended drinking hours, and cross-border legal drinking age differences between Ontario and Michigan. Specifically, this study tested whether there were differences in impaired driving and assault charges in London and Windsor, Ontario, concomitant with the extended drinking hour amendment. METHODS A quasi-experimental design using interrupted time series was used to assess changes. The analyzed data sets were monthly police impaired driving and assault charges data for Ontario, for the 11-12 p.m., 12-1 a.m., 1-2 a.m., 2-3 a.m. and 3-4 a.m. time windows, for 4 years pre- and 3 years post-policy change. RESULTS Overall, London and Windsor exhibited significant overall reductions in impaired driving charges and no changes for assault charges aggregated over the 11 p.m.-4 a.m. time period after the drinking hours were extended. Within the different time windows, London showed significant decreases for the 1-2 a.m. Sunday-Wednesday and Thursday-Sunday time periods and a significant increase for the Sunday-Wednesday 3-4 a.m. time period, while Windsor demonstrated significant decreases in impaired driving charges for 1-2 a.m. Sunday-Wednesday and Thursday-Saturday time periods and significant increases for Sunday-Wednesday 2-3 and 3-4 a.m. and for Thursday-Saturday 2-3 a.m. For assault charges, no overall pre-post differences were found for the aggregated 11 p.m.-4 a.m. time period for either city. When the data were disaggregated by hour, a significant decrease was found in London for Thursday-Saturday 1-2 a.m. and significant increases for Sunday-Wednesday 2-3 a.m. and Thursday-Saturday 3-4 a.m. time periods, while no significant decreases were found in Windsor during the 1-2 a.m. time periods and one significant increase occurred during the Thursday-Saturday 2-3 a.m. time period. CONCLUSIONS These findings, based on police data, suggest no overall effect on charges aggregated over the 11 p.m. to 4 a.m. time window, although some differences were observed for the different hours after 2 a.m., with a possible effect of the one hour extension of drinking in licensed establishments.
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Affiliation(s)
- Evelyn Vingilis
- Population & Community Health Unit, University of Western Ontario, Ontario, Canada.
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Wagenaar AC, Maldonado-Molina MM, Wagenaar BH. Effects of alcohol tax increases on alcohol-related disease mortality in Alaska: time-series analyses from 1976 to 2004. Am J Public Health 2008; 99:1464-70. [PMID: 19008507 DOI: 10.2105/ajph.2007.131326] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We evaluated the effects of tax increases on alcoholic beverages in 1983 and 2002 on alcohol-related disease mortality in Alaska. METHODS We used a quasi-experimental design with quarterly measures of mortality from 1976 though 2004, and we included other states for comparison. Our statistical approach combined an autoregressive integrated moving average model with structural parameters in interrupted time-series models. RESULTS We observed statistically significant reductions in the numbers and rates of deaths caused by alcohol-related disease beginning immediately after the 1983 and 2002 alcohol tax increases in Alaska. In terms of effect size, the reductions were -29% (Cohen's d = -0.57) and -11% (Cohen's d = -0.52) for the 2 tax increases. Statistical tests of temporary-effect models versus long-term-effect models showed little dissipation of the effect over time. CONCLUSIONS Increases in alcohol excise tax rates were associated with immediate and sustained reductions in alcohol-related disease mortality in Alaska. Reductions in mortality occurred after 2 tax increases almost 20 years apart. Taxing alcoholic beverages is an effective public health strategy for reducing the burden of alcohol-related disease.
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Affiliation(s)
- Alexander C Wagenaar
- Department of Epidemiology and Health Policy Research, College of Medicine, University of Florida, Gainesville, FL 32610-0177, USA.
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Trolldal B. An investigation of the effect of privatization of retail sales of alcohol on consumption and traffic accidents in Alberta, Canada. Addiction 2005; 100:662-71. [PMID: 15847624 DOI: 10.1111/j.1360-0443.2005.01049.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Privatization of the retail sale of alcohol in Alberta took place primarily between the end of the 1980s and the beginning of the 1990s. The aim of this study was to evaluate the effects of this privatization on alcohol sales and on the incidence of fatal motor vehicle traffic accidents in the province. DATA AND METHOD Interrupted time-series analysis (ARIMA) with a quasi-experimental control area design was used, and all series were differenced to remove long-term trends. Canada, with the exception of Alberta, was the control area. The effects of privatization were measured by means of created privatization variables. In the analyses of the effects of privatization on alcohol sales, the inhabitants' disposable income and alcohol prices were used as control variables. The study period was 1950-2000. When effects on the number of fatal motor vehicle traffic accidents were analysed the number of road motor vehicle registrations was used as a control variable, and the study period was 1950-98. FINDINGS Privatization had a significant permanent effect on the sale of spirits, but the effect was not large enough to affect total sales. The effect on wine and beer sales was not significant. There was no significant effect on the number of fatal motor vehicle traffic accidents. CONCLUSION The fact that sales on the wholesale level continued to be monopolized, along with the fact that alcohol sales were never allowed in ordinary grocery stores, may explain the lack of any larger effects of privatization on alcohol sales in Alberta.
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Affiliation(s)
- Björn Trolldal
- Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Stockholm, Sweden.
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Abstract
AIMS To evaluate the effects of changes in aggregate alcohol consumption on overall fatal accidents, motor vehicle accidents, fatal falling accidents and drowning accidents in Canadian provinces after 1950. DESIGN Time-series analysis of annual mortality rates (15-69 years) in relation to per capita alcohol consumption, utilising the Box-Jenkins technique. All series were differenced to remove long-term trends. MEASUREMENTS Gender-specific and age-adjusted mortality rates for the age group 15-69 years were calculated on the basis of mortality data for 5-year age groups, using a standard population. Data on per capita alcohol consumption was converted to consumption per inhabitant 15 years and older. In the analysis of motor vehicle accidents, the number of motor vehicles was used as a control variable. FINDINGS Statistically significant associations between alcohol consumption and overall fatal accident rates were uncovered in all provinces for males, and in all provinces except Ontario for females. For Canada at large, an increase in per capita alcohol consumption of 1 litre was accompanied by an increase in accident mortality of 5.9 among males and 1.9 among females per 100,000 inhabitants. Among males there was a significant association with alcohol for both falling accidents, motor vehicle accident and other accidents, but the association was insignificant for drowning accidents. Among females, the association with falling accidents and other accidents was significant. CONCLUSION Changes in alcohol consumption have had substantial effects on most of the main types of fatal accidents in Canada during the second half of the 20th century. The size of the association is comparable to the one previously reported from Northern Europe.
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Affiliation(s)
- Ole-Jørgen Skog
- Centre for Advanced Study, The Norwegian Academy of Science and Letters, Oslo, Norway.
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Pouletty P. Drug addictions: towards socially accepted and medically treatable diseases. Nat Rev Drug Discov 2002; 1:731-6. [PMID: 12209153 DOI: 10.1038/nrd896] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
What is the disease that affects more than 30 million individuals in the United States and Europe, is a leading cause of death and costs 2-3.5% of gross domestic product? The answer -- alcohol abuse and drug addictions -- still surprises many, and in general, addictions are undertreated. But advances in the understanding of the underlying biology and clinical manifestations of addictions are creating new opportunities for the development of novel pharmacotherapies to complement psychosocial interventions.
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Affiliation(s)
- Philippe Pouletty
- DrugAbuse Sciences, 25954 Eden Landing Road, Hayward, California 94545-3816, USA.
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