The association between alcohol outlet density and alcohol use among urban and regional Australian adolescents

Abstract

Aims: While recent evidence suggests that higher alcohol outlet density is associated with greater alcohol use among adolescents, influence of the four main outlet types on youth drinking within urban and regional communities is unknown. This study provides the first investigation of this relationship. Design:Repeated cross-sectional surveys with random samples of secondary students clustered by school. Mixed effects logistic regression analyses examined the association between each outlet type and the drinking outcomes, with interaction terms used to test urban/regional differences. Measurements:The key outcome measures were past month alcohol use, risky drinking amongst all students and risky drinking amongst past week drinkers. For each survey year, students were assigned a postcode-level outlet density (number of licenses per 1,000 population) for each outlet type (general, on-premise, off-premise, clubs). Findings:Interaction terms revealed a significant association between off-premises outlet density and risky drinking among all adolescents in urban [OR=1.36, 95% confidence interval (CI) = 1.05-1.75, p<.05) but not regional areas. Similarly, club density was associated with the drinking outcomes in urban communities only. General and on-premises density was associated with alcohol use and risky drinking among all adolescents.

Does Industry-Driven Alcohol Marketing Influence Adolescent Drinking Behaviour? A Systematic Review

“…Participants ranged between 9 and 17 years old at baseline; sample sizes ranged from 172 to 371,194 participants. In total, 57% ( n  = 20) of the studies originated in the USA (Workman, 2003; Stacy et al ., 2004; Zogg, 2004; Ellickson et al ., 2005; McClure et al ., 2006; Saffer and Dave, 2006; Collins et al ., 2007; Fisher et al ., 2007; Paschall et al ., 2007; Dumsha, 2008; Grenard, 2008; Henriksen et al ., 2008; Truong, 2008; McClure et al ., 2009; Pasch et al ., 2009; Tobler, 2009; Tobler et al ., 2009; Truong and Sturm, 2009; Chen et al ., 2010; Dumsha, 2011; Reboussin et al ., 2011; Shamblen et al ., 2011; Stanley et al ., 2011; Tobler et al ., 2011; Stoolmiller et al ., 2012; Grenard et al ., 2013; Lo et al ., 2013a, b; McClure et al ., 2013; Rowland et al ., 2014), 6% ( n  = 2) from the UK (Gordon et al ., 2010a, b; Gordon, 2011; Young et al ., 2013), 9% ( n  = 3) from Australia (Jones and Magee, 2011; Rowland et al ., 2014; Azar et al ., 2016), 6% ( n  = 2) from New Zealand (Huckle et al ., 2008; Lin et al ., 2012) and one study from Denmark (Bendtsen et al ., 2013), Brazil (Faria et al ., 2011), Switzerland (Kuntsche et al ., 2008), Zambia (Swahn et al ., 2011), the Philippines (Swahn et al ., 2013) and the Netherlands (van Hoof et al ., 2008). Two further studies (6%) spanned several European countries, with data collected in Germany, Italy, Scotland, the Netherlands and Poland (de Bruijn et al ., 2012; Anderson et al ., 2012; Morgenstern et al ., 2014; de Bruijn et al ., 2016a, b).…”

“…(2007) measured school district-level alcohol sales across 3 months whilst nine studies focused upon community-level outlet density (Huckle et al ., 2008; Kuntsche et al ., 2008; Truong, 2008; Pasch et al ., 2009; Chen et al ., 2010; Stanley et al ., 2011; Lo et al ., 2013a; Young et al ., 2013; Azar et al ., 2016). Young et al .…”

“…of drinks consumed in a typical occasion multiplied by frequency of alcohol use) among 12–17-year olds in Switzerland ( P < 0.05). Nevertheless, one study reported a mixture of positive associations and null results (Azar et al ., 2016); two studies identified negative as well as positive associations (Chen et al ., 2010; Stanley et al ., 2011); while four studies found no relationship whatsoever between alcohol outlet density and drinking frequency (Huckle et al ., 2008; Truong, 2008; Pasch et al ., 2009; Lo et al ., 2013a, b) (see Supplementary Table S2). Furthermore, despite a domination of studies measuring alcohol placement and drinking frequency, none were categorized methodologically ‘strong’ (moderate: n  = 5; weak: n  = 5).…”

“…Furthermore, no studies reported wholly positive associations. Thus, 4 studies (of 8, 50%) identified both positive associations and null results (Huckle et al ., 2008; Kuntsche et al ., 2008; Truong, 2008; Azar et al ., 2016), whilst 2 studies (of 8, 25%) reported both positive and negative associations (Chen et al ., 2010; Lo et al ., 2013a). Specifically, Lo et al .…”

Adolescents’ alcohol use and strength of policy relating to youth access, trading hours and driving under the influence: findings from Australia

“…bottle shops); general (consumption at a venue and take‐away); and clubs (e.g. sporting, ethnic/social clubs)—were obtained from relevant state licensing authorities . Following previous work , total alcohol outlet density was used to indicate pervasiveness of alcohol outlets in an adolescent's local environment.…”