Showing papers by "Norman Giesbrecht published in 2007"
TL;DR: There is a relative absence of evidence of the effectiveness of education and persuasion in reducing consumption, curtailing high-risk drinking or reducing damage from alcohol, and interventions that have not been shown to be effective need to be phased out and those most effective and of widest scope should receive more attention and enhanced resources.
Abstract: Aim In order to potentially enhance the impact of most effective policies and interventions in reducing the population level damage from alcohol, a new perspective with regard to education and persuasion interventions is offered.
Methods Recent studies were examined on the global burden of alcohol and also those focusing on the links between overall consumption and high-risk drinking, on one hand, and drinking-related damage on the other hand. A synopsis of main findings from reviews and other analysis provides the basis for conclusions about the impacts of education and persuasion interventions.
Results There is a relative absence of evidence of the effectiveness of education and persuasion in reducing consumption, curtailing high-risk drinking or reducing damage from alcohol. This is in contrast to the rising levels of damage from alcohol, and also to the demonstrated effectiveness of certain alcohol policies and interventions, as summarized in Babor et al.
Conclusions Given that only a small fraction of education and persuasion interventions have any positive impact, generating ‘more of the same’ is not an impact-effective and cost-efficient approach. Therefore, interventions that have not been shown to be effective need to be phased out and those most effective and of widest scope should receive more attention and enhanced resources. A reframing of the roles and foci of persuasion interventions is advised, including, for example, focusing on informing policy-makers, and stimulating public discussions about the rationale of alcohol policies and the roles that citizens can play in promoting and supporting these policies.
49 citations
TL;DR: This study provides further evidence of the validity of self-reported drinking measures in crossnational ED studies based on the objective criterion of BAC estimates.
Abstract: Objective: Self-reports of alcohol consumption among patients visiting an emergency department (ED) have been used extensively in the investigation of the relationship between drinking and injury. Little is known, however, about the associations between validity of self-reports with patient and injury characteristics and whether these relationships vary across regions or countries. Both of these issues are explored in this article. Method: In the construct of a multilevel logistical model, validity of self-reports was estimated as the probability of a positive self-report given a positive blood alcohol concentration (BAC). The setting included 44 EDs across 28 studies in 16 countries. Participants included 10,741 injury patients from the combined Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study of Alcohol and Injuries. Data were analyzed on self-reported drinking within 6 hours before injury compared with BAC results obtained from breath-analyzer readings in all but two studies, which used urine screens. Covariates included demographic, drinking, and injury characteristics and aggregate-level contextual variables. Results: At the individual level, a higher BAC measurement was associated with a higher probability of reporting drinking, as was heavy drinking and sustaining injuries in traffic accidents or violence-related events. At the study level, neither aggregate BAC nor other sociocultural variables affected the validity of self-reported drinking. Conclusions: This study provides further evidence of the validity of self-reported drinking measures in crossnational ED studies based on the objective criterion of BAC estimates.
46 citations
TL;DR: Multivariate results show heavier drinkers are least supportive of alcohol policy, while ethnic minorities, especially Hispanics are more favorable to alcohol controls and raising alcohol taxes.
Abstract: This article examines public opinion in US alcohol policies during the 1990s and their correlates in 2000, using five national telephone surveys. Trend analyses of public opinion on 11 common alcohol policies is presented and factor‐based policy scales, based on 14 items in 2000, are used to examine demographic correlates of support for various policy areas, using bivariate, linear (OLS) and logistic regression analyses. With the exception of the alcohol warning label policy, national support for alcohol policies declined (eight policies) or was unchanged in the 1990s for 11 measured policies. In 2000, four meaningful policy opinion factors were found with adequate reliabilities (αs 0.65–0.75) for three of four derived scales. In 2000, support for specific policies varies. Warnings on labels and advertisements have highest support (>90%), then interventions like prevention, treatment, and responsible beverage service at 70% (with similar levels seen for improving access to treatment). Alcohol controls sho...
41 citations
TL;DR: Examining trends in United States public opinion during a dynamic drop in per capita intake until the mid-1990s, followed by the first sustained upturn seen since 1980, finds several empirically effective policy levers have weak support, which continues to erode.
Abstract: In the United States, public opinion on alcohol policies has received only intermittent attention since the 1990s (Greenfield, Johnson & Giesbrecht 2004b; Wagenaar & Streff 1990). The need for more research on the role of public opinion in alcohol policy development has been identified (Greenfield 1994) because public support for a policy may make its enactment more politically viable and help sustain a policy once enacted (Room, Graves, Giesbrecht & Greenfield 1995). Although they are not likely to determine which policies will be established, public opinions may help legitimate political courses of action (Leedham 1987). Additionally, gaps are quite commonly seen between evidence-based alcohol policies (Babor, Caetano, Casswell, Edwards, Giesbrecht, Graham, et al. 2003) and public opinions regarding the same policies (Giesbrecht & Greenfield 2003). When this gap is large it may indicate the need for further educational efforts designed to improve people's understanding of policy rationales (Greenfield, Johnson & Giesbrecht 2004b).The present analyses involve 14 survey items, of which 11 measures of alcohol-related policy opinions came from the 1989 Canadian National Alcohol and Other Drugs Survey (NADS) (Eliany, Giesbrecht, Nelson, Wellman & Wortley 1992) and were subsequently used in US national and Canadian provincial and national surveys. For example, these items were included in a series of US surveys from 1989 through 1994, the Impact of Alcoholic Beverage Warning Labels (WL) surveys. These cross-sectional national surveys were conducted by the Alcohol Research Group (ARG) in California. In this article we use the 1989 to 1994 WL surveys and two later surveys conducted by the ARG Center, the National Alcohol Surveys (NASs) conducted in 2000 and 2005. Earlier reports have concerned aspects of the WL policy-opinion data series (Greenfield 1997a; Greenfield, Johnson and Giesbrecht 2004b; Hilton and Kaskutas 1991; Kaskutas 1993; Room, Graves et al. 1995) and the 2000 NAS (Greenfield, Ye & Giesbrecht, 2007). Here we extend the series by adding data from the 2005 NAS, extending the series to 15 years. All included surveys (WL and NAS) were conducted by telephone. The latest two NAS surveys included three additional items, one mandating warnings on alcohol advertisements and two about policies designed to enhance alcohol treatment access: (1) Requiring that health insurance policies cover alcohol treatment and (2) Providing free alcohol treatment.Given our focus on US policy opinions, for brevity we will not review policy-opinion research in other countries, but these have included Canada (Giesbrecht, Ialomiteanu, Room & Anglin 2001, Giesbrecht & Greenfield 1999), New Zealand (Casswell, Gilmore, Maguire & Ransom 1989), European and Scandinavian countries (Ahlstrom & Osterberg 1992; Moskalewicz & Tigerstedt 1998) and Puerto Rico (Harwood, Bernât, Lenk, Vazquez & Wagenaar 2004). Such international results have been summarized elsewhere (Greenfield, Johnson & Giesbrecht 2004b). A previous article (Greenfield, Ye & Giesbrecht 2007; and also see Greenfield, Johnson & Giesbrecht 2004b) reviews a number of prior attempts to classify or factor analyze alcohol policy items or scales (Giesbrecht & Greenfield 1999; Latimer, Harwood, Newcomb & Wagenaar 2003; Wagenaar, Harwood, Toomey, Denk & Zander 2000), noting that results have varied greatly based on the number and type of items and their wording. One rational classification by Giesbrecht & Greenfield (1999), also used by Room, Graves and colleagues (1995), divided the 11 policy items included here into three groups of policy types: (1) Interventions (including increasing treatment, prevention and server intervention programs), (2) Promotion controls/counterpromotions (including beverage warning labels, TV alcohol advertising bans, government counter-advertising and banning alcohol sponsorship of sports and cultural events) and (3) Access controls (decreasing hours of sale; raising the minimum drinking age, or MDA-already at 21 in the United States; not allowing alcohol to be sold in corner stores; increasing alcohol taxes). …
33 citations
TL;DR: Women, older respondents, and lighter drinkers and abstainers were more likely to be supportive of alcohol control policies, and intensive marketing and retailing of alcohol may be important factors in declining public support.
Abstract: Recent developments in alcohol policy in Canada, particularly those pertaining to alcohol marketing and retailing, provide the context for this study of public opinion on alcohol policy topics. Three national surveys were conducted in 1989, 1994 and 2004. Respondents to the telephone interviews were sampled by province to be representative of the population aged 15 and older; numbers ranged from 4658 (2004) to 12,155 (1994). The key variables were gender, age group, province, education, drinking pattern and frequency of heavy drinking. Ten questions about alcohol policy were included in the analysis, but not all questions were asked in all 3 years. The logistic regression models contained a year effect, independent variable effect, and a year‐by‐independent variable effect. There was considerable variation in support across policy topics, the rank order being similar from year to year. There was somewhat less support for those items, e.g. higher taxes or fewer outlets, considered to be effective by evalua...
31 citations
TL;DR: This article focuses on the erosion of alcohol management policies and the implications for local prevention efforts, and draws lessons from three large-scale multi-year multi-site programs in Canada, e.g., local addiction prevention projects, heart health programs, and tobacco control experiences.
Abstract: This article focuses on the erosion of alcohol management policies and the implications for local prevention efforts. It draws lessons from three large-scale multi-year multi-site programs in Canada, e.g., local addiction prevention projects, heart health programs, and tobacco control experiences. It explores five themes: getting alcohol on the agenda and implementing effective local responses to alcohol problems; assessing conceptual frameworks in order to identify the essential components of an effective prevention strategy; developing a system of local prevention initiatives that give priority to long-lasting structural changes; generating accurate information on alcohol-related damage in order to set priorities; and developing a prevention action plan in order to support local initiatives.
18 citations
TL;DR: Five papers in this issue explore trends in alcohol-related consumption, damage, controls on alcohol and changes in public opinion on alcohol policy.
Abstract: Recent developments in many parts of the world suggest that the journey ahead for those wishing to foster effective harm reduction alcohol policies will be neither smooth nor uneventful. There is a...
8 citations
TL;DR: This issue and its companion issue are based on some of the research papers presented at a thematic symposium of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol, which offered an update on recent and ongoing international studies of alcohol consumption and damage.
Abstract: In recent decades there have been dramatic international changes in alcohol policy initiatives, access to alcohol, level of consumption, drinking patterns and damage associated with alcohol consumption. A number of studies have shown strong associations among drinking levels, drinking patterns and the physical harms and social problems derived from the effects of alcohol (e.g., Babor, Caetano, Casswell, Edwards, et al. 2003; Edwards 1994; Rehm, Chisholm, Room & Lopez 2006). Concurrently, evaluations and reviews of alcohol policies and other interventions demonstrate that some prevention strategies are more effective than others in reducing alcohol-related harms (Babor et al. 2003). However, recent changes in many jurisdictions have effectively increased access to alcohol, suggesting that drinking rates and levels of damage may increase in the future (e.g., World Health Organization (WHO) 2007).While research has documented the substantial damage from alcohol (Rehm et al. 2006; WHO 2002) and pointed to effective interventions, some of the most effective policy levers have been eroded in recent years (Room, Babor & Rehm 2005). Thus it is expected that alcohol-related social and health harms will increase, particularly in jurisdictions where controls on alcohol are eroded or underdeveloped, where a large portion of drinking occasions involve high-volume consumption and/or where overall alcohol consumption rates are on the rise.The articles in this issue and its companion issue (Volume 34, No. 4) are based on some of the research papers presented at a thematic symposium of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol (KBS), which was held in Toronto, Canada, in October 2006. The title of the symposium was "Population Level Studies of Alcohol Consumption and Harm." It offered an opportunity to provide an update on recent and ongoing international studies of alcohol consumption and damage and to examine their implications and impact, if any, on the policy process or outcomes. Of particular interest were international and national studies that examined population-level studies of changes in alcohol management and access to alcohol, alcohol control systems, drinking patterns and levels, and damage associated with alcohol use.As illustrated in this issue and its companion issue, articles were presented from several Latin American countries, two European jurisdictions, Canada and the United States. The seven articles in this edition focus on population surveys and epidemiological studies. In the companion edition the focus is on policy-effect studies and policy formation and implementation themes.In the first article, Guilherme Borges and colleagues (2007) report on the Mexican National Comorbidity Survey, which involved 5,826 interviews. They note that just under 8% of respondents were classified as being dependent on alcohol during their lifetimes, but only 31% of all respondents with an alcohol-use disorder had ever used any treatment services, and in many cases only after a delay of several years.A second article from Mexico focuses on interviews with a sample of 211 female inmates. Martha Romero Mendoza (2007) notes that 20% of the women qualified for alcohol dependence on three or more criteria, and many experienced a combination of health problems associated with alcohol consumption, as well as mental health problems such as a major episode of depression. The author points to the need to have enhanced public policies for marginalized women that provide greater access to mental health services and addictions treatment.Maria Lima and colleagues (2007) report on the results of a household interview survey of 1,473 Sao Paulo City residents. They use a logistic regression model to analyze heavy drinking, and note that for both genders heavy drinking was associated with having a heavy-drinking partner, as well as with feeling less inhibited about sex when drinking. …
1 citations
TL;DR: This issue and its companion issue are based on some of the research papers presented at a thematic symposium of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol (KBS), which was held in Toronto, Canada, in October 2006.
Abstract: In recent decades there have been dramatic international changes in alcohol policy initiatives, access to alcohol, level of consumption, drinking patterns, and damage associated with alcohol consumption. A number of studies have shown strong associations among drinking levels, drinking patterns and the physical harms and social problems derived from the effects of alcohol (e.g., Babor, Caetano, Casswell, Edwards, Giesbrecht, Graham, et al. 2003; Edwards, Anderson, Babor, Casswell, Ferrence, Giesbrecht et al. 1994; Rehm, Chisholm, Room & Lopez 2006). Concurrently, evaluations and reviews of alcohol policies and other interventions demonstrate that some prevention strategies are more effective than others in reducing alcohol-related harms (Babor et al. 2003). However, recent changes in many jurisdictions have effectively increased access to alcohol, suggesting that drinking rates and levels of damage may increase in the future (e.g., WHO 2007).While research has documented the substantial damage from alcohol (Rehm et al. 2006; WHO 2002) and pointed to effective interventions, some of the most effective policy levers have been eroded in recent years (Room, Babor & Rehm 2005). Thus it is expected that alcohol-related social and health harms will increase, particularly in jurisdictions where controls on alcohol are eroded or underdeveloped, where a large portion of drinking occasions involve high-volume consumption and/or where overall alcohol consumption rates are on the rise.The articles in this issue and its companion issue (Volume 34, No. 3) are based on some of the research papers presented at a thematic symposium of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol (KBS), which was held in Toronto, Canada, in October 2006. The title of the symposium was "Population Level Studies of Alcohol Consumption and Harm." It offered an opportunity to provide an update on recent and ongoing international studies of alcohol consumption and damage and to examine their implications and impact, if any, on the policy process or outcomes. Of particular interest were international and national studies that examined population-level studies of changes in alcohol management and access to alcohol, alcohol control systems, drinking patterns and levels, and damage associated with alcohol use.As illustrated in this issue and its companion issue, articles were presented from several Latin American countries, two European jurisdictions, Canada, and the United States. The ten articles in this edition are organized into two groups: the first four are policy-effect studies and the next six focus on themes of policy opinion and policy formation and implementation. In the companion issue the focus is on population surveys and epidemiological studies.Salme Ahlstrom and Petri Huhtanen (2007) use a combination of archival data (minimum legal purchasing age or MLDA) and cross-sectional self-reported data from 30 countries that participated in the 2003 European School Survey Project on Alcohol and Other Drugs (ESPAD). The authors examine the perceived availability of alcoholic beverages, reported purchasing habits, and prevalence of drinking and intoxication. Perceived good availability of wine and spirits was associated with the probability of purchasing and drinking wine and spirits; however, perceived availability was not associated with prevalence of self-reported intoxication.Martin Stafstrom (2007) uses two cross-sectional student surveys conducted in southern Sweden in 2003 and 2005 to examine the drinking patterns of adolescents. Between the two surveys he found an increase of 31% in the proportion reporting that they often or always consumed imported alcohol, but a significant decrease in binge drinking. In recent years an increase in access to alcohol, particularly in southern Sweden-brought about by a dramatic elevation in import upper limits from the late 1990s and increased transportation access to cheaper alcohol in Denmark and Germany-appears to have contributed to changes in beverage choices among adolescents in southern Sweden, but not necessarily to an increase in binge drinking. …
1 citations