Alcohol policy compliance among retailers in Bhutan: a multisite community intervention study

Trends in behavioral and biological risk factors for non-communicable diseases among adults in Bhutan: results from cross-sectional surveys in 2007, 2014, and 2019

Background

The study aimed to evaluate trends in the prevalence and correlates of risk factors for non-communicable diseases (NCDs; low physical activity, insufficient fruit/vegetable intake, current tobacco use, problem alcohol use, diabetes, hypertension, increased total cholesterol, and obesity) in Bhutan.

Methods

Three repeat cross-sectional Bhutan STEPS surveys (N = 9,281) in 2007, 2014, and 2019 were analyzed.

Results

The proportion of people with 3-8 NCD risk factors significantly decreased from 62.8% in 2007 to 32.6% in 2019 (p < 0.001), and the mean number of NCD risk factors significantly decreased from 3.0 in 2007 to 2.1 in 2019 (p < 0.001). In linear regression analyses by study year, older age (p < 0.001) was positively associated with eight NCD risk factors across all study years. Furthermore, male subjects were negatively (p < 0.01) and positively (p < 0.001) associated with eight NCD risk factors, respectively. Higher education levels (p < 0.05) were positively associated with eight NCD risk factors in 2007 and negatively associated with eight NCD risk factors in 2019 (p < 0.05). Employment (p < 0.001) and urban residence (p < 0.001) were positively associated with eight risk factors for NCD in 2019, while urban residence (p < 0.001) was negatively associated with eight NCD risk factors in 2014.

Conclusion

The prevalence of eight NCD risk factors decreased in Bhutan over the past 13 years. Inadequate fruit and vegetable intake, problem alcohol use, and hypertension increased, current tobacco use, low physical activity, obesity, diabetes, and elevated total cholesterol decreased from 2007 to 2019. Several factors associated for eight and each individual NCD risk factor were identified, which can help guide interventions.

Effects of multi-component programmes in preventing sales of alcohol to intoxicated patrons in nightlife settings in the United Kingdom

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Alcohol service to intoxicated patrons in nightlife settings is common.

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Multi-component interventions can prevent alcohol over-service.

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Effects are stronger for interventions including enhanced law enforcement.

Introduction

Alcohol service to intoxicated patrons is common across nightlife settings and preventing such sales is a key priority globally. In England and Wales, three multi-component programmes have been implemented including: (1) community mobilisation, responsible beverage server (RBS) training and routine law enforcement; (2) community mobilisation and enhanced law enforcement; and, (3) community mobilisation, RBS training and enhanced law enforcement. This study estimates the association between sales of alcohol to pseudo-intoxicated patrons and implementation of three multi-component interventions in four nightlife settings.

Methods

Alcohol test purchases by pseudo-intoxicated actors were implemented at pre (n = 206) and post-intervention (n = 224). Actors/observers recorded venue and test purchase characteristics. Logistic regression assessed service refusal by intervention type, adjusting for venue/test purchase characteristics.

Results

Pre-intervention, 20.9% of sales were refused. Post-intervention, 42.1%, 68.8% and 74.0% of sales were refused in areas with intervention 1, 2, and 3 respectively. In adjusted analyses, compared to pre-intervention, the odds of service refusal were higher for all interventions, with the highest odds when the intervention included enhanced law enforcement (adjusted odds ratios, interventions 1, 2, 3: 2.6, 7.1, 14.4; p < 0.01). Service refusal was higher if the test purchase was implemented on a Saturday/Sunday night; and lower if implemented in a nightclub or if age verification was requested at the bar.

Conclusion

Community-based multi-component interventions were associated with significant increases in service refusal to pseudo-intoxicated actors in nightlife settings in England and Wales. Effects were stronger for interventions including enhanced law enforcement, and particularly if all intervention components were implemented.