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      Demographic and Substance Use Factors Associated with Non-Violent Alcohol-Related Injuries among Patrons of Australian Night-Time Entertainment Districts

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          Abstract

          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.

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          Most cited references 38

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          Neighbourhood deprivation and alcohol consumption: does the availability of alcohol play a role?

          Previous studies suggest that the physical availability of alcohol may mediate the association between neighbourhood-level material deprivation and alcohol consumption. This study tests the relationships between neighbourhood-level deprivation, alcohol availability, and individual-level alcohol consumption using a multilevel analysis. Data are from cross-sectional surveys conducted between 1979 and 1990 as part of the Stanford Heart Disease Prevention Program (SHDPP). Women and men (n = 8197) living in four northern/central California cities and 82 neighbourhoods were linked to neighbourhood deprivation variables derived from the US census (e.g. unemployment, crowded housing) and to measures of alcohol availability (density of outlets in the respondent's neighbourhood, nearest distance to an outlet from the respondent's home, and number of outlets within a half mile radius of the respondent's home). Separate analyses were conducted for on- and off-sale outlets. The most deprived neighbourhoods had substantially higher levels of alcohol outlet density than the least deprived neighbourhoods (45.5% vs 14.8%, respectively). However, multilevel analyses showed that the least deprived neighbourhoods were associated with the heaviest alcohol consumption, even after adjusting for individual-level sociodemographic characteristics (OR 1.30, CI 1.08-1.56). Alcohol availability was not associated with heavy drinking and thus did not mediate the relationship between neighbourhood deprivation and heavy alcohol consumption. Although alcohol availability is concentrated in the most deprived neighbourhoods, women and men in least deprived neighbourhoods are most likely to be heavy drinkers. This mismatch between supply and demand may cause people in the most deprived neighbourhoods to disproportionately suffer the negative health consequences of living near alcohol outlets.
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            Policy implications of the widespread practice of 'pre-drinking' or 'pre-gaming' before going to public drinking establishments: are current prevention strategies backfiring?

            To describe the research, policy and prevention implications of pre-drinking or pre-gaming; that is, planned heavy drinking prior to going to a public drinking establishment. The authors describe the phenomenon of pre-drinking, motivations for pre-drinking and its associated risks using available research literature, media and popular internet vehicles. Heavy drinking prior to going out has emerged as a common and celebrated practice among young adults around the world. Apparent motivations are: (i) to avoid paying for high priced drinks at commercial drinking establishments; (ii) to achieve drunkenness and enhance and extend the night out; and (iii) to socialize with friends, reduce social anxiety or enhance male group bonding before going out. Limited existing research on pre-drinking suggests that it is associated with heavy drinking and harmful consequences. We argue that policies focused upon reducing drinking in licensed premises may have the unintended consequence of displacing drinking to pre-drinking environments, possibly resulting in greater harms. Effective policy and prevention for drinking in licensed premises requires a comprehensive approach that takes into account the entire drinking occasion (not just drinking that occurs in the licensed environment), as well as the 'determined drunkenness' goal of some young people.
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              Alcohol and injuries: a review of international emergency room studies since 1995.

              This paper provides a review of emergency room (ER) studies on alcohol and injury, using representative probability samples of adult injury patients, and focuses on the scope and burden of the problem as measured by estimated blood alcohol concentration (BAC) at the time of the ER visit, self-report drinking prior to injury, violence-related injury and alcohol use disorders. A computerized search of the English-language literature on MEDLINE, PsychINFO and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Alcohol and Alcohol Problems Science Database (ETOH) was conducted for articles published between 1995 and 2005, using the following key descriptors: (1) emergency room/emergency department/accident and emergency, (2) alcohol/drinking and (3) injuries (intentional and unintentional). Findings support prior reviews, with injured patients more likely to be positive for BAC and report drinking prior to injury than non-injured, and with the magnitude of the association substantially increased for violence-related injuries compared to non-violence-related injuries. Indicators of alcohol use disorders did not show a strong association with injury. Findings were not homogeneous across studies, however, and contextual variables, including study-level detrimental drinking pattern, explained some of the variation. This review represents a broader range of ER studies than that reported previously, across both developed and developing countries, and has added to our knowledge base in relation to the influence of contextual variables on the alcohol-injury relationship. Future research on alcohol and injury should focus on obtaining representative samples of ER patients, with special attention to both acute and chronic alcohol use, and to organisational and socio-cultural variables that may influence findings across studies. In-depth patient interviews may also be useful for a better understanding of drinking in the injury event and associated circumstances.
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                Author and article information

                Contributors
                Role: Academic Editor
                Role: Academic Editor
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                12 January 2017
                January 2017
                : 14
                : 1
                Affiliations
                [1 ]School of Psychology, Faculty of Health, Deakin University, Geelong VIC 3220, Australia; richelle.mayshak@ 123456deakin.edu.au (R.M.); shannon.hyder@ 123456deakin.edu.au (S.H.); nic.droste@ 123456deakin.edu.au (N.D.); ashlee.curtis@ 123456deakin.edu.au (A.C.); A.Pennay@ 123456latrobe.edu.au (A.P.); petermiller.mail@ 123456gmail.com (P.G.M.)
                [2 ]Centre for Alcohol Policy Research, Department of Psychology and Public Health, La Trobe University, Melbourne VIC 3000, Australia
                [3 ]National Drug Research Institute, Curtin University, Perth WA 6845, Australia; william.gilmore@ 123456curtin.edu.au (W.G.); tina.lam@ 123456curtin.edu.au (T.L.); t.n.chikritzhs@ 123456curtin.edu.au (T.C.)
                Author notes
                [* ]Correspondence: k.coomber@ 123456deakin.edu.au ; Tel.: +61-3-5227-8249
                Article
                ijerph-14-00075
                10.3390/ijerph14010075
                5295326
                © 2017 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license ( http://creativecommons.org/licenses/by/4.0/).

                Categories
                Article

                Public health

                alcohol, intoxication, injury, licensed venues, patron interviews

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