Europe. An Analysis of Changes in the Consumption of Alcoholic Beverages: The Interaction Among Consumption, Related Harms, Contextual Factors and Alcoholic Beverage Control Policies

Abstract

This AMPHORA study's aim was to investigate selected factors potentially affecting changes in consumption of alcoholic beverages in 12 European countries during the 1960s–2008 (an average increase in beer, decreases in wine and spirits, total alcohol drinking decrease). Both time series and artificial neural networks-based analyses were used. Results indicated that selected socio-demographic and economic factors showed an overall major impact on consumption changes; particularly urbanization, increased income, and older mothers’ age at their childbirths were significantly associated with consumption increase or decrease, depending on the country. Alcoholic beverage control policies showed an overall minor impact on consumption changes: among them, permissive availability measures were significantly associated with consumption increases, while drinking and driving limits and availability restrictions were correlated with consumption decreases, and alcohol taxation and prices of the alcoholic beverages were not significantly correlated with consumption. Population ageing, older mother's age at childbirths, increased income and increases in female employment, as well as drink driving limitations were associated with the decrease of transport mortality. Study's limitations are noted.

Keywords :

• Alcohol policies
• socio-demographic and economic factors
• time series analysis
• artificial neural network analysis

THE AUTHORS

Allaman Allamani, M.D., Psychiatrist; Family Therapist; Researcher. He has been coordinator of the Alcohol Centre, Florence Health Agency (1993–2009); since 2009 he has been consultant to the Region of Tuscany Health Agency for research on social epidemiology and prevention policy First non-alcoholic trustee of Italian Alcoholics Anonymous (1997–2003). He is a member of the editorial board of “Substance Use and Misuse.” Coordinator of a few Italian projects on alcohol prevention and policies, he has co-lead work package 3 of the European Commission-funded AMPHORA project. Author and co-author of more than 170 articles, editor and co-editor of 16 books.

Pasquale Pepe, M.Sc., is a Senior Statistician at the Epidemiology Observatory of the Health Agency of Tuscany Region. He has worked for several years on medical statistics, clinical trials and epidemiological studies, and as a statistician has been part of the AMPHORA team in Florence. He has co-authored more than 30 papers.

Michela Baccini, Ph.D., is researcher in medical statistics at the University of Florence. Author of several papers in the field of environmental epidemiology and biostatistics, she worked on time series analysis, meta-analysis, health impact assessment, multiple imputation.

Giulia Massini, Ph.D., Senior Researcher of Semeion-Research Center of Sciences of Communication, Rome (Italy). She is inventor of new algorithms of Neural Networks and Adaptive Artificial Systems. She's responsible of the application of Neural Computation mainly in medical and social field. She is author of many research software packages. She published several scientific papers in peer reviewed journal and book chapters.

Fabio Voller, Ph.D. Sociologist, at the Epidemiology Observatory of the Region of Tuscany Health Agency. He has worked on epidemiological studies of lifestyle, alcohol consumption, and psychoactive drug use in the Tuscan population. Among his publications, he is the co-author of a number of monographs about the health consequences of alcohol consumption in Italy. He is a work package 3 leader of the AMPHORA project.

Notes

1 Big events is a relatively new term, introduced into the intervention literature by Friedman et al. (Samuel R. Friedman, Diana Rossi, Peter L. Flom. (2006). “Big events” and networks: Thoughts on what could be going on. Connections 27(1): 9–14) refers to major events such as mega-disasters, natural, as well as man-made, famine, conflict, genocide, disparities in health, epidemics, mass migrations, economic recessions, etc. which effect adaptation, functioning and quality-of-life of individuals as well as systems. Existential threat, instability and chaos are major dimensions and loss of control over one's life is experienced (Editor's note)

2 The reader is referred to Hiil's criteria for causation that were developed in order to help assist researchers and clinicians determine if risk factors were causes of a particular disease or outcomes or merely associated. (Hill, A. B. (1965). The environment and disease: associations or causation? Proceedings of the Royal Society of Medicine 58: 295—300. (Editor's note.).

3 The reader is asked to consider that a range of necessary processes associated with a person's active involvement, or non-involvement in any of his/her many intoxicating-satiating appetites and behaviors are rarely, if ever, considered by the relevant stakeholders as they plan, implement and assess a range of “appetite”/behavioral control policies (regulations, laws, edicts, traditions, etc.). These processes include a person's awareness, perceptions, expectations, judgments, decision-making which is or is not implemented, learning or not learning from his/her experience, etc., and are bounded (temporal period, place, culture, traditions, age, gender, ethnicity, religiosity, SES, etc. The influencing processes’ actions can be known, unknown and unknowable, visible and hidden, measureable and unmeasurable. With the advent of complexity, chaos and uncertainty theories it is reasonable to consider that man's “doing,” as well as “not doing” something, is usefully considered to be the outcome of complex, non-linear, dynamic, multi-dimensional processes and factors which are evidence-informed. Alcoholic beverage control policies have not and are not based upon these considerations. The following references may be of interest to the reader: The reader is referred to Tilly, Charles (2006). Why. Princeton Univ. Press. Princeton, NJ for a stimulating analysis about generic “causative” reasons given in the West; to Tilly, Charles (2008). Credit and Blame Princeton Univ. Press. Princeton, NJ for an important analysis about “blame” and “credit”; Ormerod, Paul, (2005), Why most things fail: Evolution, extinction and economics. Faber & Faber, UK; and to Miller, Matt, (2010). The tyranny of dead ideas; New York: Henry Holt & Co. (Editor's note).