Alcohol policy and regulating availability: impacts on population-level alcohol use and related disorders and diseases in Australia – PhD Project

This thesis by compilation presents a narrative literature review and three original studies focused on using novel approaches to address gaps in alcohol availability scientific research at both individual and population levels. Mental health effects of bar trading hours and sexual health effects of alcohol taxation were the subjects of this research program.

The bar trading hour studies capitalised on special trading hour permits available to bars in Perth allowing a proportion to trade past standard closing time (typically midnight). Street intercept surveys of nightlife-goers, a novel method in trading hours research, were used to investigate: (i) association between participant risk of alcohol use disorder (assessed using AUDIT-C) and closing time of the bar where they spent most time that night (standard vs. late), (ii) association between participant alcohol use disorder risk and their blood alcohol concentration (assessed using breathalyser), and (iii) whether preferred bar closing time moderated any association between alcohol use disorder risk and blood alcohol concentration. Logistic and multinomial logistic regression models found evidence that females who typically drank at hazardous levels (score 5-7) preferred late closing bars, and both males with alcohol use disorder (8-12) and females who typically drank at hazardous levels and above (5-12) were more likely to have high-range blood alcohol concentration (males ≥0.1; females ≥0.08 g/100 mL) than their counterparts drinking at lower risk (0-4). Evidence of a moderating effect of trading hours on the association between alcohol use disorder risk and blood alcohol concentration was found among males, such that males with alcohol use disorder and high-range blood alcohol concentration were less likely to prefer late closing bars than males who typically drank at lower risk levels with high-range blood alcohol concentration.

The alcohol taxation study capitalised on a change in federal taxation on ready-to-drink alcoholic beverages (27th April 2008), which increased the tax by 70%. Using an interrupted time series design, the study investigated the association between the tax increase and chlamydia rates among young people. Both population rates, as typically used in alcohol pricing research, and test positivity rates, a novel and more sensitive outcome measure, were compared. There was no evidence of association with population-based chlamydia rates, however, there was evidence of immediate and lagged reductions in chlamydia test positivity rates among young males.

With the ultimate aim of improving the health and well-being of individuals and communities in mind, this body of published work strengthens the existing evidence base regarding how government regulatory strategies may impact on individual-level and population-level alcohol use and alcohol-related harm. It will contribute to informing future evidence-based alcohol policy debate.