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The impact of alcohol sale restrictions on unnatural deaths during the COVID-19 pandemic in Johannesburg, South Africa.

The COVID-19-related restrictions on the sale of alcohol in South Africa presented a unique opportunity to examine the association between alcohol availability and the prevalence of unnatural deaths. The study sample included all unnatural deaths investigated by the Johannesburg Forensic Pathology Services Medico-Legal Laboratory during the four COVID-19 alcohol restriction periods compared to the same time periods in the previous year when there were no restrictions. When alcohol sales were initially prohibited, there was a 54.2% decrease in cases of unnatural deaths (p&#x2009;<&#x2009;0.05), suggesting a link between alcohol use and the occurrence of such deaths. Over all four periods of alcohol sale bans, there was a total reduction of unnatural deaths by 26.4% with declining frequencies in all demographics. There were significant decreases (p&#x2009;<&#x2009;0.05) in the frequency of deaths in males, Black and Coloured individuals, and the 21-40 years age group. Deaths whose circumstances were a result of motor vehicle accidents, pedestrian vehicle accidents, and firearm discharges decreased significantly (p&#x2009;<&#x2009;0.05). The cause of death due to blunt forces trauma and gunshot wounds also significantly decreased (p&#x2009;<&#x2009;0.05). This study highlights the significant impact alcohol consumption has on mortality in South Africa.

Humans

[Clandestine places: illegal sale of alcohol for urban worker populations].

The authors have studied the illegal commerce of alcohol in popular urban communities. This sale is done in so called clandestine places. The study was approached from a cultural-anthropological point of view and its objective is a descriptive-exploratory study based on observation and interview techniques. A definition and a tipology of these places was attempted, emphasizing group dynamics and interpersonal relations between the owner of the place and the customer; among the customers; among the place itself and the rest of the community organizations, formal and informal ones. A primary analysis was done, according to which these clandestine places appear legitimized by nets of interpersonal relations, critical economic situations and places that satisfy recreational needs of the inhabitants. In order to eliminate the former, adecuate substitutes for recreation and social interaction ought to be considered.

Aged

Changes in alcoholic beverage sales after reductions in the legal drinking age.

This study reports changes in the sales of beer, wine, and spirits in 25 states which lowered legal drinking ages and adjacent states which did not. Most of the states which changed drinking ages had an increase in beer sales whereas the unchanged ones did not. The increase for beer in the changed over the not changed states was 5.7%. The differences for wine and spirits are not statistically significant. The variations in changes from one state to another are considerable. Analyses of the effects of new age laws on traffic accidents should take account of changes in sales and other preventive efforts occurring simultaneously. Whether the increases will be permanent is uncertain.

Adolescent

Heavy alcohol consumption and physical health problems: a review of the epidemiological evidence.

A review of morbidity and mortality studies bearing on the hazards to physical health of chronic heavy alchol use indicates that such use carries a risk of premature death greatly exceeding normal expectancy. While the life style typical of many heavy drinker contributes to this risk, the effects of alcohol per se account for a substantial part of the excess mortality. The lowest level of consumption at which there is a significant increase in the death rate has yet to be determined. It is certainly below 120 g/day- the lower limit of consumption of most clinical alcoholics-and quite possibly below 35-60g: levels which appear to carry an increased likelihood of cirrhosis and certain cancers. On the other hand, the mortality experience of drinkers commonly identified as 'moderate' in the literature does not seem to differ notably from that of life-long abstainers. The relationship between heavy drinking and elevated mortality is exhibited in populations at large by the generally close covariation of cirrhosis death rates and per capita alcohol sales. There are also indications of co-variation between the latter and the excess of male over female general mortality in the middle age range.

Accidents

Simulating the effects of an alcohol minimum unit price policy on distilled spirits sales in 28 states of the USA.

BACKGROUND AND AIMS: Excessive alcohol use is a leading preventable chronic disease risk factor. Alcohol minimum unit pricing (MUP) policies are not used in the United States despite evidence of associations with reduced drinking and alcohol-related harms. To inform potential population-level chronic disease prevention strategies, we estimated effects of various hypothetical MUPs on alcohol sales. METHOD: Simulation based on observational time-series data. We used weekly off-premises product-specific alcohol retail sales and prices in 28 states of the United States for November 2022-November 2023 from NielsenIQ to estimate the own-price elasticity of spirits and cross-price elasticities of wine, beer and ready-to-drinks with respect to spirits. Using estimated elasticities, we simulated changes in total alcohol sales associated with hypothetical spirits MUPs ranging from $0.10 to $1.10 per standard drink (0.6 fluid ounces of alcohol). RESULTS: A hypothetical MUP of $0.80 per standard drink on spirits yielded the largest estimated decrease in alcohol sales (-1.7%) and would affect 5374 of 26&#x2009;249 spirits products. To reach the $0.80 MUP, the sales-weighted average price increase among affected products was $0.24 per drink. CONCLUSIONS: Minimum unit pricing policies on distilled spirits in the United States could shift purchasing behavior and help reduce alcohol-related harms.

alcohol policy

Alcohol consumption and the incidence of violent crime.

The incidence of violent crime in an industrialized area of Ontario was positively correlated with sales of alcoholic beverages to establishments licensed to serve them on premises and negatively correlated with mean income and percentage of owner-occupied dwellings.

Alcohol Drinking

Drinking problems among employed, unemployed and shift workers.

This study investigated the relationships between drinking problems and the following: current employment status, current occupation, unemployment, shift work and alcohol-related problems. The study involved a household survey of 993 persons in Durham, an area near Toronto. A scale of 17 alcohol problems and symptoms was used. It was found that the highest rates of problems were among shift workers and the unemployed. The workers most likely to have serious problems were in processing/manufacturing, transport, artistic/literary/recreational and sales areas. Males with serious problems and shift workers reported drinking more when unemployed. Sanctions for work-related drinking problems, even for those with serious dependency, were rarely applied. This study suggests that priority targets for programs to assist employees with drinking problems should be males in processing/manufacturing, transport, artistic/literary/recreational areas and sales.

Adult

Correlates of alcohol arrests in a rural state.

Arrest and conviction rates for public intoxication, driving while intoxicated, and liquor law violations were correlated with population, population change, liquor sales, number of law officers, Indian population, and overall crime rate for 23 counties in Wyoming. It was concluded that increased liquor sales, but not arrest rates, are associated with population increase. Alcohol arrests are related positively to population magnitude and overall crime rate, but not to number of law officers. Counties with larger Indian populations report higher arrest rates for public intoxication and liquor law violations, but conviction rates for alcohol arrests in these counties are not different.

Alcoholic Intoxication

The prevention of alcoholism: an empirical report on the effects of outlet availability.

Recent studies suggest that alcohol availability as measured by outlet rates is unrelated to per capita consumption or rates of alcoholism in the United States. Drawing from the same data bases, this article assesses the effects of outlet rates while controlling for the effects of per capita income, urbanism, and limitations by population on the number of sales outlets. The analysis discloses strong effects of outlet availability on per capita consumption and alcoholism rates in states that do not have restrictions on the number of outlets per unit of population.

Alcohol Drinking

Associations of cancer site and type with occupation and industry from the Third National Cancer Survey Interview.

From the Third National Cancer Survey (TNCS) Interview Study of 7,518 incident cases, lifetime histories of occupations and industries were studied for associations with specific cancer sites and types while controlling for age, sex, race, education, use of cigarettes or alcohol, and geographic location. Lung cancer patients were found more often than expected among several categories including trucking, air transportation, wholesaling, painting, building construction, building maintenance, and manufacturing (furniture, transportation equipment, and food products). Controlling for cigarette smoking did not change these associations. Leukemia and multiple myeloma were associated with sales personnel of both sexes, whereas lymphomas and Hodgkin's disease were excessive among women working in the medical industry. Other associations included rectal cancer with several retail industries; prostate cancer with ministers, farmers, plumbers, and coal miners; malignant melanoma with school teachers; and invasive cervical cancer with women working in hotels and restaurants. Breast cancer patients were more common among women who were teachers or other professionals and who worked in business and finance (even after controlling for education). Many other findings are presented in detailed tables. Results are reported mainly as a research resource for use by other investigators doing work in this field. Suggestions are given for future studies.

Adult

Increased prescribing of Valium, Librium, and other drugs--an example of the influence of economic and social factors on the practice of medicine.

Drug prescriptions per capita in the United States have more than doubled since 1950 without a commensurate improvement in health. Drugs are often prescribed for clinical conditions in which therapeutic benefits do not outweigh the risk of adverse drug reactions. Deaths due to adverse drug reactions are roughly as frequent as deaths due to automobile accidents. Valium and Librium are the first and fourth most commonly prescribed drugs in the U.S., used by one ten adults each year. The rapid rise in use of these drugs has occurred during a period of rising social stress, as indicated by increases in alcohol consumption, suicide, and homicide, Valium and Librium are frequently prescribe for patients who go to doctors with social or other nonmedical problems, often in lieu of attempts to resolve these underlying problems. Overprescribing occurs because the decision to prescribe is influenced not only by consideration of therapeutic benefit, but also by nonmedical factors, for example the widespread expectation by both patient and doctor that the doctor will provide a drug or some other technological treatment. Prescribing decisions are also influenced by the profit-motivated activities of drug companies, including the expenditure of almost one-quarter of every sales dollar on drug promotion. The most widely used source of drug information for doctors is the industry-sponsored Physicians' Desk Reference, which overrates the therapeutic value of Valium and Librium as compared to disinterested medical sources. Drug companies also contribute to overprescribing by introducing numerous minor variants of existing drugs. The therapeutic benefits of such new drugs are often overestimated in the early years of use when adverse side effects are not well known and apparent efficacy is enhanced by placebo effects in uncontrolled observations.

Adult