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      Evaluating the impact of the alcohol act on off-trade alcohol sales: a natural experiment in Scotland

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          Abstract

          Background and Aims

          A ban on multi-buy discounts of off-trade alcohol was introduced as part of the Alcohol Act in Scotland in October 2011. The aim of this study was to assess the impact of this legislation on alcohol sales, which provide the best indicator of population consumption.

          Design, Setting and Participants

          Interrupted time–series regression was used to assess the impact of the Alcohol Act on alcohol sales among off-trade retailers in Scotland. Models accounted for underlying seasonal and secular trends and were adjusted for disposable income, alcohol prices and substitution effects. Data for off-trade retailers in England and Wales combined (EW) provided a control group.

          Measurements

          Weekly data on the volume of pure alcohol sold by off-trade retailers in Scotland and EW between January 2009 and September 2012.

          Findings

          The introduction of the legislation was associated with a 2.6% (95% CI = −5.3 to 0.2%, P = 0.07) decrease in off-trade alcohol sales in Scotland, but not in EW (−0.5%, 95% CI = −4.6 to 3.9%, P = 0.83). A statistically significant reduction was observed in Scotland when EW sales were adjusted for in the analysis (−1.7%, 95% CI = −3.1 to −0.3%, P = 0.02). The decline in Scotland was driven by reduced off-trade sales of wine (−4.0%, 95% CI = −5.4 to −2.6%, P < 0.001) and pre-mixed beverages (−8.5%, 95% CI = −12.7 to −4.1%, P < 0.001). There were no associated changes in other drink types in Scotland, or in sales of any drink type in EW.

          Conclusions

          The introduction of the Alcohol Act in Scotland in 2011 was associated with a decrease in total off-trade alcohol sales in Scotland, largely driven by reduced off-trade wine sales.

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          Most cited references30

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          International guide for monitoring alcohol consumption and related harm

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            Effects of alcohol tax increases on alcohol-related disease mortality in Alaska: time-series analyses from 1976 to 2004.

            We evaluated the effects of tax increases on alcoholic beverages in 1983 and 2002 on alcohol-related disease mortality in Alaska. 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. 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. 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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              The impact of the Northern Territory's Living With Alcohol program, 1992-2002: revisiting the evaluation.

              To evaluate the effects of the Living With Alcohol (LWA) program and the LWA Alcoholic Beverage Levy on alcohol-attributable deaths in the Northern Territory (NT) controlling for simultaneous trends in death rates from a control region and non-alcohol related death trends in the NT, between 1985 and 2002. The LWA program was introduced in 1992 with funding from a special NT tax (Levy) on beverages with greater than 3% alcohol content by volume. The Levy was removed in 1997 but the LWA program continued to be funded by the federal government until 2002. Trends in age standardised rates of acute and chronic alcohol-attributable deaths in the NT were examined before, during and after the combined implementation of the LWA program and Levy and before and during the full length of the LWA program. Auto-regressive integrated moving average (ARIMA) time series analyses included internal and external control series and adjustments for possible confounders. Separate estimates were made for Indigenous and non-Indigenous NT residents. When combined, the Levy and the LWA program were associated with significant declines in acute alcohol-attributable deaths in the NT as well as Indigenous deaths between 1992 and 1997. A significant but delayed decline in chronic deaths was evident towards the end of the study period between 1998 and 2002. The combined impact of the LWA program Levy and the programs and services funded by the Levy reduced the burden of alcohol-attributable injury to the NT in the short term and may have contributed to a reduction in chronic illness in the longer term. The results of this study present a strong argument for the effectiveness of combining alcohol taxes with comprehensive programs and services designed to reduce the harm from alcohol, and underline the need to distinguish between the acute and chronic effects of alcohol in population level studies.
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                Author and article information

                Journal
                Addiction
                Addiction
                add
                Addiction (Abingdon, England)
                BlackWell Publishing Ltd (Oxford, UK )
                0965-2140
                1360-0443
                December 2014
                12 September 2014
                : 109
                : 12
                : 2035-2043
                Affiliations
                [1 ]Public Health Science Directorate, NHS Health Scotland Glasgow, UK
                [2 ]Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow Glasgow, UK
                [3 ]MRC/CSO Social and Public Health Sciences Unit, University of Glasgow Glasgow, UK
                Author notes
                Correspondence to: Mark Robinson, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow G2 6QE, UK. E-mail: markrobinson1@ 123456nhs.net
                Article
                10.1111/add.12701
                4241028
                25099127
                c5ff0034-0e0b-4a16-ba7c-e69ea3434e8a
                © 2014 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction

                This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 08 October 2013
                : 27 November 2013
                : 28 July 2014
                Categories
                Research Reports

                Clinical Psychology & Psychiatry
                alcohol consumption,alcohol policy,alcohol sales data,multi-buy discount ban,price legislation,scotland,time–series

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