1 EVIDENCE-BASED POLICIES TO REDUCE ALCOHOL-RELATED HARM Best practices in the prevention of alcohol problems Prof. Isidore S. Obot Director, Centre for Research and Information on Substance Abuse (CRISA) Abuja & Uyo, Nigeria Johannesburg, South Africa 6-8 November 2012
2 What does effective mean Refers to the likely effectiveness of the intervention in real world settings Reflects the strength of scientific evidence
3 Effect on what? Consumption Harm Intermediate outcomes Knowledge Attitude Reduced sales to minors
4 Choosing Effective Strategies Ratings of 42 policy-relevant prevention strategies and interventions on basis of: Evidence of effectiveness the quality of scientific information Breadth of research support quantity and consistency of the evidence Cross national testing Other considerations: population reach; feasibility; adverse side effects; cost to implement and sustain
5 Rating scales used Effectivenes: 0 Lack of effectiveness + Limited effectiveness ++ Moderate effectiveness +++ High degree of effectiveness (?) No studies have been undertaken Cost: Low, Moderate, High
6 Prevention Strategies Reviewed and Evaluated Restrictions on Affordability Availability Accessibility Drinking-Driving Measures Altering the Drinking Context Education and Persuasion Alcohol Marketing Restrictions Treatment and Early Intervention
7 Regulating Physical Availability Strategy or Effectiveness Research X- National Cost Intervention Support Testing Total ban on sales High Minimum legal Low purchase age Rationing High Government Low monopoly of retail sales Hours and days of Low sale restrictions Restrictions on density of outlets Low Different availability by alcohol strength Low
8 MODIFYING THE DRINKING ENVIRONMENT Many prevention measures seek to re-define the contexts or change the environments where alcohol is typically sold and consumed (e.g., bars and restaurants), under the assumption that such changes can reduce alcohol-related aggression and intoxication Options include training bar staff, imposing voluntary house policies to refuse service, enforcement of regulations, community mobilization to influence problem establishments
9 Modifying the Drinking Environment Strategy or Intervention Outlet policy to not serve intoxicated patrons Training bar staff and managers to prevent and better manage aggression Voluntary codes of bar practice Enforcement of onpremise regulations and legal requirements Effectiveness Research Support X- Cultural Testing Cost Moderate Moderate O + + Low High
10 PRICING AND TAXATION POLICY OPTIONS Policy Assumption High taxes, prices Reduce demand by increasing economic cost of alcohol relative to alternative commodities
11 Taxation/Pricing Controls Strategy or Intervention Effectiveness Research Support Cross national testing Cost Alcohol Taxes Low
12 Pricing and Taxation Evidence suggests that: People increase their drinking when prices are lowered, and decrease their consumption when prices rise. Adolescents and problem drinkers are no exception to this rule. Increased alcoholic beverage taxes and prices are related to reductions in alcohol-related problems. Alcohol taxes are thus an attractive instrument of alcohol policy because they can be used both to generate direct revenue and to reduce alcoholrelated harm. The most important downside to raising alcohol taxes is smuggling and illegal in-country alcohol production.
13 REGULATING ALCOHOL PROMOTION The marketing of alcohol is a global industry. Alcohol brands are advertised through television, radio, print, point-of-sale promotions, and the Internet. Exposure to repeated high-level alcohol promotion inculcates pro-drinking attitudes and increases the likelihood of heavier drinking. Alcohol advertising predisposes minors to drinking well before legal age of purchase. Advertising has been found to promote and reinforce perceptions of drinking as positive, glamorous, and relatively risk-free.
14 Policy Options No regulation Industry self-regulation Partial bans Total bans
15 Regulating Alcohol Promotion Strategy or Intervention Legal restrictions on exposure Voluntary controls by alcohol industry Effectiveness Research Support X- Cultural Testing Cost +/ Low Low
16 Regulating alcohol promotion Industry Self-regulation Codes Self-regulation tends to be fragile and largely ineffective. These codes may work best where the media, advertising, and alcohol industries are all involved, and an independent body has powers to approve or veto advertisements, rule on complaints, and impose sanctions. Few countries currently have all these components.
17 DRINK-DRIVING POLICY OPTIONS Policy Assumption Drink-driving countermeasures Reduce drink driving through deterrence, punishment and social pressure
18 Drinking-Driving Countermeasures Strategy or Intervention Sobriety check points Random breath testing (RBT) Lowered BAC Limits Administrative license suspension Low BAC for young drivers ( zero tolerance ) Graduated licensing for novice drivers Designated drivers and ride services Severity of punishment Effectiveness Research Support X- Cultural Testing Cost Moderate Moderate Low Moderate Low Low O + + Moderate 0/
19 Random Breath Testing (RBT) Motorists are stopped at random by police and required to take a preliminary breath test, even if they are in no way suspected of having committed an offence or been involved in an accident. Highly visible, non-selective testing can have a sustained effect in reducing drinkingdriving and the associated crashes, injuries, and deaths.
20 EDUCATION AND PERSUASION POLICY OPTIONS Policy Assumption Provide information to adults and young people especially through mass media and school-based alcohol education programs Health information increases knowledge, changes attitudes and prevents drinking problems
21 Education Strategies School-based alcohol education programs are among the most popular types of prevention programs for policymakers. Approaches include giving information, values clarification, building selfesteem, teaching general social skills, and alternatives approaches that provide activities inconsistent with alcohol use (e.g., sports).
22 Education and Persuasion Strategy or Intervention Alcohol education in schools College student education Mass media campaigns Warning labels Social marketing Effectiveness Research Support X- Cultural Testing Cost O High O + + High O Moderate O + + Low
23 Education and Persuasion Strategies Public service announcements (PSAs) Messages prepared by nongovernmental organizations, health agencies, and media organizations that deal with responsible drinking, the hazards of drinking-driving, and related topics. Despite their good intentions, PSAs are an ineffective antidote to the high-quality prodrinking messages that appear much more frequently as paid advertisements in the mass media.
24 Summary: Education Strategies The impact of education and persuasion programs tends to be small at best. When positive effects are found, they do not persist. Among the hundreds of studies, only a few show lasting effects (after 3 years) (Foxcroft et al. 2003). The time is past for arguments on behalf of substituting education for other, more effective approaches. If educational approaches are to be used, they should be implemented within the framework of broader environmental interventions that address availability of alcohol.
25 TREATMENT AND EARLY INTERVRENTION Policy Assumption Increase availability of treatment programs Conduct screening and brief intervention in health care settings Problem drinking is responsive to various therapeutic interventions Heavy drinkers can be motivated to drink moderately before they acquire alcohol dependence
26 Treatment and Early Intervention Services In general, exposure to any treatment is associated with significant reductions in alcohol use and related problems, regardless of the type of intervention used. Regarding specific treatment modalities, the weight of evidence suggests that behavioral treatments are likely to be more effective than insight-oriented therapies
27 Residential Treatment There is no consistent evidence that intensive in-patient treatment provides more benefit than less intensive outpatient treatment Residential treatment may be indicated for patients who: 1) are highly resistant to treatment; 2) have few financial resources; 3) come from environments that are not conducive to recovery; 4) have more serious, coexisting medical or psychiatric conditions (Finney et al., 1996).
28 Brief interventions Consist of one to three sessions of counseling or advice delivered in general medical settings. Randomized controlled trials (conducted in a variety of settings) indicate that clinically significant changes in drinking behavior and related problems can follow from brief interventions with non-alcoholic heavy drinkers.
29 Treatment and Early Intervention Strategy or Intervention Brief intervention with at-risk drinkers Alcohol problems treatment Mutual help/selfhelp attendance Mandatory treatment of repeat drinkingdrivers Effectiveness Research Support X- Cultural Testing Cost Moderate High Low Moderate
30 Treatment and Early Intervention, contd. Strategy Effectiveness Research support Medical and social detoxification Cross national testing Talk therapies Pharmaceutical therapies
31 Strong strategies Alcohol marketing restrictions Restrictions on affordability, availability, and accessibility, as well as drink-driving deterrence measures Treatment and early intervention services Altering the drinking context
32 Least Effective Practices Voluntary codes of bar practice Promoting alcoholfree activities Alcohol education in schools College student education Public service messages Warning labels Designated drivers and ride services
33 Conclusions Opportunities for effective, evidence-based alcohol policies are more available than ever to better serve the public good. Alcohol policies that limit access to alcoholic beverages, discourage driving under the influence of alcohol, reduce the legal purchasing age for alcoholic beverages, and increase the price of alcohol, are likely to reduce the harm linked to underage drinking Alcohol problems can be minimized or prevented using a coordinated, systematic and comprehensive policy response.
Alcohol Marketing, the Alcohol Industry and Their Impact on Binge Drinking by Adolescents Thomas F. Babor, PhD, MPH The University of Connecticut School of Medicine Department of Community Medicine and
Alcohol Consumption and Alcohol-Related Harms 2012 Australians drink a large volume of alcohol overall, and many drink at harmful levels, including teenagers and young adults. Young Australians are starting
244 East 58 th Street, 4th Floor New York, NY 10022 212-269-7797 212-269-7510 Fax www.ncadd.org NCADD POLICY STATEMENT Drinking and Driving Preamble A significant percentage of drinking drivers are suffering
A GLOBAL PERSPECTIVE ON DRINKING AGES AND ALCOHOL USE David Jernigan, PhD Johns Hopkins Bloomberg School of Public Health Dartmouth in the 1970s Death and Disability Attributable to Alcohol Use Among Youth
European status report on alcohol and health 2014 Reducing the negative consequences of drinking and alcohol intoxication Reducing the negative consequences of drinking and alcohol intoxication Background
http:// www..paho.org Driving under the influence of alcohol and other drugs Prevention best buys 21ST INTERNATIONAL COUNCIL ON ALCOHOL, DRUGS AND TRAFFIC SAFETY CONFERENCE GRAMADO, BRAZIL 18 OCTOBER 2016
Alcohol and Other Drugs Policy and Procedure No. 126 Definitions Drugs - refer to alcohol and illegal drugs and tobacco. Reasonable is defined as moderate, not excessive or not exceeding the limit. Social
UNITED NATIONS E Economic and Social Council Distr. GENERAL ECE/TRANS/WP.1/2006/3 5 January 2006 Original: ENGLISH ECONOMIC COMMISSION FOR EUROPE INLAND TRANSPORT COMMITTEE Working Party on Road Traffic
Evidence-based Prevention of Alcohol-related Problems for College Students Toben F. Nelson, ScD www.epi.umn.edu/alcohol Recommendations for Reducing College Student Drinking Individual interventions for
Reducing Drinking and Driving in Europe RECOMMENDATIONS & CONCLUSIONS European Commission European Commission The report has been funded and prepared under a contract with the European Commission (Grant
Binge Drinking on College Campuses: A Road Map to Successful Prevention Preventing binge drinking on college campuses: A guide to best practices Binge Drinking on College Campuses: A Road Map to Successful
The Prevention Status Reports (PSRs) highlight for all 50 states and the District of Columbia the status of public health policies and practices designed to prevent or reduce important health problems.
Part 1 - Preliminary 1 Citation This code of practice may be cited as the under the Liquor Licensing Act 1997. 2 Commencement This code of practice came into operation on 18 January 2013 and was amended
22 SAFER JOURNEYS DISCUSSION DOCUMENT Have your say on our next road safety strategy AUGUST 29 11 Reducing the impact of alcohol/drug impaired driving What is the problem? Alcohol/drug impaired driving
Impaired Driving Countermeasures: an Australian perspective Dr. Barry Watson NTSB Substance Impaired Driving Forum, Washington, D.C., May 15-16, 2012 CRICOS No. 00213J 2 Overview The prevalence of impaired
REDUCING THE DRINK DRIVE LIMIT IN SCOTLAND CONSULTATION QUESTIONNAIRE 1. Do you agree that the drink drive limits should be reduced in Scotland? Yes. Lowering the prescribed alcohol limit for driving should
Alcohol and Drug-Free Work Place Policy Cleary University, in compliance with Public Law 101-226 (Drug-Free Schools and Communities Act), presents the standards listed below to the entire University community:
A review of policy-relevant strategies and interventions to address the burden of alcohol on individuals and society in South Africa Charles DH Parry Alcohol & Drug Abuse Research Group, Medical Research
Treatment of Alcoholism Why is it important Prevents further to body by getting people off alcohol. Can prevent death. Helps keep health insurance down. Provides assistance so alcoholics don t t have to
A Community-based Primary Prevention Plan to Reduce High-Risk and Underage Alcohol Use Minnesota Department of Health Attached is a comprehensive community-based primary prevention plan for reducing high-risk
Grenada National Alcohol Policy CONTENTS 1. Purpose 1.1 Policy objectives 1.2 Scope 1.3 Target population 1.4 Expected outcomes 2. Background 2.1 What is the public health problem? 2.2 Stakeholders 2.3
Key message: Public Health Association of Australia: Policy-at-a-glance Alcohol Policy 1. Alcohol is responsible for a substantial burden of death, disease and injury in Australia. Alcohol-related harm
Commentaries on WHO:s alcohol strategy Pekka Puska Alcohol control A global public health issue Noncommunicable diseases and conditions have become the leading cause of mortality worldwide. According to
What You Should Know About: Impaired Driving National Statistics Drunk driving is known in some states as DUI (driving under the influence), DWI (driving while intoxicated) and OWI (operating while intoxicated).
REDUCING THE DRINK DRIVE LIMIT IN SCOTLAND CONSULTATION QUESTIONNAIRE 1. Do you agree that the drink drive limits should be reduced in Scotland? Yes No If yes, please go to Q1A. If no, please go to Q2.
CURRENT BEST PRACTICE FOR REDUCING CAMPUS ALCOHOL AND OTHER DRUG PROBLEMS Focusing On The Roles Of Law Enforcement And Medical Amnesty In Impacting These Problems INTRODUCTION By: Aviva B. Grasso, MPH,
Utica College Annual Notice Regarding Drug and Alcohol Abuse Prevention Policies Utica College is required by federal law to provide the following notice to all students and employees. This notice is being
Teen Drinking: the Facts, the Risks, and Potential Solutions A Presentation for Parents Based on information provided by the Maine Office of Substance Abuse, May 2003 (A new slide appears every 10 seconds)
Frequently Asked Questions 1. What do the changes include? These changes will introduce progressive administrative penalties for drivers with blood alcohol levels of.05 or greater, tougher penalties for
Policy Number: S-II.XXVI.-1 University of Louisiana System Title: ALCOHOL AND ILLEGAL CONTROLLED SUBSTANCES Effective Date: Fall Session, 2000 Cancellation: None Chapter: Students Policies and Procedures
REDUCING ALCOHOL USE AND RELATED PROBLEMS AMONG COLLEGE STUDENTS: A GUIDE TO BEST PRACTICES About the Maryland Collaborative to Reduce College Drinking and Related Problems The Maryland Collaborative to
Page 1 of 7 You and the Drinking Driving Laws WHY ARE PENALTIES FOR DRINKING AND DRIVING SO STRICT? Drinking and driving is a hazardous combination. CONSIDER THESE FACTS: One third of the fatalities in
Trends in Impaired Driving in the United States: Complacency and Backsliding? K. Stewart 1 and J. Fell 2 1 Safety and Policy Analysis, International, 3798 Mosswood Drive, Lafayette, CA 94549, USA; 2 Pacific
1 GUIDE TO ALCOHOLISM Understanding Alcoholism While a glass of wine with dinner or a couple of beers while watching the big game may seem like a harmless way to unwind, for 14 million Americans, it is
How are you getting home? Drinking, Driving and the Law... 1-888-THE-TABC www.tabc.texas.gov www.2young2drink.com 2 3 Drinking and Driving Laws If you are over 21, -.08 is the limit in Texas on all roadways.
DISTRICT OF COLUMBIA OFFICIAL CODE TITLE 44. CHARITABLE AND CURATIVE INSTITUTIONS SUBTITLE I. HEALTH RELATED INSTITUTIONS CHAPTER 12. SUBSTANCE ABUSE TREATMENT AND PREVENTION Current as of November 19,
Key Strategies for Violence and Substance Abuse Prevention III: Working in the Community July 2004 The nature of the community in which youth live and their relationship to this community can have a profound
Underage Drinking Underage drinking is a serious public health problem in the United States. Alcohol is the most widely used substance of abuse among America s youth, and drinking by young people poses
Chapter 6 Drinking, Drugs & Health Drinking, Drugs & Health 103 104 104 106 106 107 107 108 Effects of Alcohol How Much is Too Much? Drinking and Driving Good Hosts and the Drinking Driver Designated Drivers
Department for Transport Road Safety Compliance Consultation Don t Die from a Broken Heart Response from the Institute of Alcohol Studies Elmgren House, 1 The Quay, St Ives, Cambridgeshire, PE27 5AR Drink
Consumer and Business Services Licensee Risk Assessment and Management Plan General Code of Practice Liquor Licensing Act 1997 Chesser House, 91-97 Grenfell Street Adelaide SA 5000 GPO Box 2169 Adelaide
SAMHSA Model Programs Communities Mobilizing for Change on Alcohol Brief Description Recognition Program IOM Intervention Type Content Focus Interventions by Domain Key Program Approaches Outcomes Evaluation
Alcohol marketing and youth Sven Andréasson, MD Karolinska institutet Forte seminar Aug 22, 2014 Take home message The same alcohol availability reduction strategies that are effective for the adult population
The Review of Drink and Drug Driving Law Chaired by Sir Peter North, CBE, QC Response by the Criminal Bar Association of England and Wales The Criminal Bar Association, which represents over 3,800 barristers
The Impact of Alcohol on Road Crashes Global Overview and Perspectives Brett Bivans November, 13, 2014 1 Road Traffic Crashes: A Global Epidemic (1) Worldwide 1.2 million people die each year in road traffic
Kennesaw State University Drug and Alcohol Policy I. Introduction National statistics reveal that the leading causes of death among the 18-23 year-old population are alcohol-related accidents, alcohol-related
Alcohol Reform Bill Submission to the Justice & Electoral Select Committee The New Zealand Automobile Association Incorporated 342-352 Lambton Quay PO Box 1 Wellington New Zealand 9 February 2011 1 9 February
European status report on alcohol and health 2014 Drink driving policies and countermeasures Drink driving policies and countermeasures Background Alcohol is a central nervous system depressant that impairs
Addiction Counseling Competencies Forms Addiction Counseling Competencies Supervisors and counselor educators have expressed a desire for a tool to assess counselor competence in the Addiction Counseling
The Community Alcohol Personality Survey Learn how to establish the size and shape of alcohol problems in your community and where to focus your efforts for the most impact. www.faceproject.org Toll Free
It s More Than DWI: Reducing Death and Harm From Alcohol in New Mexico Problem Statement Alcohol is an intoxicating flammable liquid according to the dictionary. It is also considered a drug. That is a
The National Hardcore Drunk Driver Project NEW JERSEY STATE PROFILE KEY HARDCORE DRUNK DRIVING LEGISLATION: Administrative License Revocation Yes High BAC Law (0.15 BAC or greater) Yes Enhanced Penalties
POLICY ON THE MISUSE OF ALCOHOL AND DRUGS AND ON SMOKING STUDENTS Introduction The Governors of The Royal Ballet School are committed to ensuring that the School is a healthy school, free from the misuse
08/09 Locally Enhanced Service for a practice-based Alcohol Monitoring, Withdrawal and Detoxification Service Reference: LES24 Contents: 1. Finance Details 2. Service Aims 3. Service Criteria 4. Ongoing
Drunk Driving in the United States: A Roadmap for Progress J. H. Hedlund and A. T. McCartt Preusser Research Group, Trumbull, Connecticut, USA Abstract The study investigated why drunk driving in the United
DWI Penalties Driving While Intoxicated (DWI) in Texas is a serious offense. Blood Alcohol Content (BAC) over.08% or being under the influence of a controlled substance are grounds for arrest under Texas
THE NORTH REVIEW INTO DRINK AND DRUG DRIVING This is the Royal Society for the Prevention of Accidents submission to the North Review of Drink and Drug Driving Law. It has been produced following consultation
MOVING TOWARD EVIDENCE-BASED PRACTICE FOR ADDICTION TREATMENT June, 2014 Dean L. Babcock, LCAC, LCSW Associate Vice President Eskenazi Health Midtown Community Mental Health Centers Why is Evidence-Based
Alcohol in QLD: The current situation Caterina Giorgi, Director of Policy and Research Foundation for Alcohol Research and Education 2 If you are going to deal with alcohol and drug fuelled violence. It
NHS Swindon and Swindon Borough Council Executive Summary: Adult Alcohol Needs Assessment Aim and scope The aim of this needs assessment is to identify, through analysis and the involvement of key stakeholders,
University of Michigan-Flint Alcohol and Other Drugs (AOD) Policy 2013-2014 Introduction The University of Michigan-Flint, is committed to providing a safe, healthy learning community for all its members.
AZERBAIJAN SOCIOECONOMIC CONTEXT Total population 8,406,000 Annual population growth rate 0.6% Population 15+ years 76% Adult literacy rate 98.8% Population in urban areas 52% Income group (World bank)
Alcohol and Other Drug Prevention Program Cowley College Drug and Alcohol Task Force December 4, 2014 The Cowley College Drug and Alcohol Task Force ( Task Force ) met on October 29, 2014 in order to begin
DECISIONS DECISIONS DECISIONS CONSEQUENCES CONSEQUENCES CONSEQUENCES 80 Vandenburgh Avenue Troy, New York 1210-6096 OUR COMMITMENT Hudson Valley Community College is committed to an environment that fosters
NUMBER: SECTION: SUBJECT: HR 1.95 (NEW) Human Resources Drug and Alcohol Testing Policy DATE: June 15, 2012 Policy for: Procedure for: Authorized by: Issued by: All Campuses All Campuses Chris Byrd Division
Drug-Driving: Proposed New Law New law on drug driving to be introduced in the near future The new law on drug driving is designed, in part, to reduce the number of failed prosecutions under the existing
4.40 STRUCTURED DAY TREATMENT SERVICES 4.401 Substance Use Partial Hospitalization Program (Adults and Adolescents) Description of Services: Substance use partial hospitalization is a nonresidential treatment
T2007 Seattle, Washington Factors Influencing Night-time Drivers Perceived Likelihood of Getting Caught for Drink- Driving Jean Wilson *1, Ming Fang 1, Gabi Hoffmann 2. 1 Insurance Corporation of British
Coca-Cola HBC Responsible Marketing Policy Premium Spirits Introduction The Coca-Cola HBC Premium Spirits Responsible Marketing Policy is intended to provide clear and consistent guidance to all employees
Alcohol Quick Facts ALCOHOL FACTS New Zealand s drinking patterns The proportion of New Zealanders aged 15 years or more who drank alcohol in the past year dropped from 84% in 2006/07 to 80% in 2011/12
Alcohol and drug prevention - national policies and possibilities in communities Zaza Tsereteli, MD, MPH International Technical Advisor Alcohol and Substance Abuse Expert Group (ASA EG) NDPHS Recorded
DEFINITIONS sus.pen.sion n 1: Your license, permit, or privilege to drive is taken away for a period of time before it is returned. You may be required to pay a suspension termination fee. re.vo.ca.tion
Gabriel Romanus EU strategy on alcohol lobbied by the alcohol industry but the Council conclusions are better than the Commission s In June 2001 the European Council during the Swedish presidency adopted
Reduction in Drink Driving in Victoria Anne Randall General Manager, Accident Prevention, Transport Accident Commission, 222 Exhibition Street, Melbourne VIC 3000, Australia ASTRACT The Transport Accident
Informe especial / Special report Evidence-based alcohol policy in the Americas: strengths, weaknesses, and future challenges Thomas F. Babor 1 and Raul Caetano 2 Suggested citation Babor TF, Caetano R.
Administrative Licence Suspensions What is an Administrative Licence Suspension (ALS)? An Administrative Licence Suspension (ALS) is a drivers licence suspension for impaired drivers, administered by enforcement
A Guide to Host Responsibility Policy and Plans On Licences Host responsibility policies and plans are designed to reduce the abuse of alcohol by creating and promoting a safe drinking environment. The
Screening, Brief Intervention, and Referral to Treatment Core Curriculum Acknowledgments The material included in this course is based largely on the works of previously funded SAMHSA grantees. Other information
Offences and penalties Enforcement Licence sanctions Disqualified and unlicensed driving 153 Enforcement Speed cameras Fixed speed cameras are installed at locations that have a history of road crashes,
A conversation with CDC s Alcohol Program, September 5, 2014 Participants Robert Brewer, MD, MSPH Epidemiologist; Lead, Excessive Alcohol Use Prevention Team (Alcohol Program), Division of Population Health