Alcohol Consumption, Alcohol Consumption –Related Harm and Alcohol Control Policy in Austria: Do They Link Up?

Abstract

The study identifies changes in selected (“unplanned”) socio-demographic and economic factors as well as in (planned) political measures that are most strongly correlated with changes in alcohol consumption and alcohol consumption-related harm between 1961 and 2006 in Austria. During the period of investigation consumption increased until the early 1970s, dropped during the next decade and have leveled off since. Increasing urbanization, female employment and average age of mothers at their child births are associated with the best time series model for the interpretation of consumption changes. The results regarding alcohol control policies and their impact on consumption were paradoxical. Study limitations were noted pointing up the necessity to improve indicators and concepts.

Keywords :

• alcohol consumption, alcohol consumption-related harms
• alcohol control policies

THE AUTHORS

Irmgard Eisenbach-Stangl, Sociologist and group analyst, teaches at the University of Vienna and is lead researcher in the research area “alcohol, drugs, addiction” at the European Centre for Social Welfare Policy and Research, Vienna.

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 many articles, editor and co-editor of 17 books and special issues.

Notes

2 For influental lawyers Hans Hoegel (1887), for influental medical doctors Hans Hoff (1954), for influental party politicians Otto Bauer (Bundesvorstand 1970). The most important representative studies dealing, among other things, with attitudes are Mader et al. 1981, and Uhl et al. 1996.

3 Treatment can be briefly and usefully defined as a unique, planned, goal directed, temporally structured, multidimensional change process, of necessary quality, appropriateness, and conditions (endogenous and exogenous), which is bounded (culture, place, time, etc.) and can be categorized into professional-based, tradition-based, mutual-help based (AA,NA, etc.) and self-help (“natural recovery”) models. There are no unique models or techniques used with substance users- of whatever types and heterogeneities, which aren't also used with nonsubstance users. Whether or not a treatment technique is indicated or contra-indicated, and its selection underpinnings (theory-based, empirically-based, “principle of faith-based, tradition-based, etc. continues to be a generic and key treatment issue. In the West, with the relatively new ideology of “harm reduction” and the even newer Quality of Life (QOL) and wellbeing treatment-driven models there are now new sets of goals in addition to those derived from/associated with the older tradition of abstinence driven models. Conflict-resolution models may stimulate an additional option for intervention. Each ideological model has its own criteria for success as well as failure as well as iatrogenic-related harms. Treatment is implemented in a range of environments; ambulatory as well as within institutions which can include controlled environments Treatment includes a spectrum of clinician-caregiver-patient relationships representing various forms of decision-making traditions/models; (1). the hierarchical model in which the clinician-treatment agent makes the decision(s) and the recipient is compliant and relatively passive, (2) shared decision-making which facilitates the collaboration between clinician and patient(s) in which both are active, and (3) the ‘informed model’ in which the patient makes the decision(s). Editor's note

4 The reader is reminded that the concepts of “risk factors”, as well as “protective factors”, are often noted in the literature, without adequately noting their dimensions (linear, nonlinear; rates of development and decay; anchoring or integration, cessation, etc.)), their “demands”, the critical necessary conditions (endogenously as well as exogenously; from a micro to a meso to a macro level) which are necessary for either of them to operate (begin, continue, become anchored and integrate, change as de facto realities change, cease, etc.) or not to and whether their underpinnings are theory-driven, empirically-based, individual and/or systemic stake holder- bound, based upon “principles of faith doctrinaire positions,” personal truths,” historical observation, precedents, and traditions that accumulate over time, conventional wisdom, perceptual and judgmental constraints, “transient public opinion.” or what. This is necessary to consider and to clarify if these term are not to remain as yet additional shibboleth in a field of many stereotypes, tradition-driven activities, “principles of faith” and stakeholder objectives. Editor's note.

5 Akaike Information Criterion (AIC) is a measure of the relative quality of a statistical model for a given set of data. The model that generates the minimum AIC is the best model for the interpretation of results.

6 The reader is referred to Hills's criteria for causation which 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.