Alcohol control policy measures and all-cause mortality in Lithuania: an interrupted time-series analysis.


Journal

Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118

Informations de publication

Date de publication:
10 2021
Historique:
revised: 24 11 2020
received: 26 06 2020
accepted: 24 02 2021
pubmed: 23 3 2021
medline: 30 9 2021
entrez: 22 3 2021
Statut: ppublish

Résumé

Alcohol use has been identified as a major risk factor for burden of mortality and disease, particularly for countries in eastern Europe. During the past two decades, several countries in this region have implemented effective alcohol policy measures to combat this burden. The aim of the current study was to measure the association between Lithuania's alcohol control policies and adult all-cause mortality. Interrupted time-series methodology by means of general additive models. Lithuania. Adult population of Lithuania, aged 20 years and older. Alcohol control policies were ascertained via a document review of relevant legislation materials. Policy effects were evaluated as follows: (1) slope changes in periods of legislative (non-)activity with regard to alcohol control policy (analysis 1); (2) level changes of three interventions following recommendations of the World Health Organization (analysis 2); and (3) level changes of seven interventions judged a priori by an international panel of experts (analysis 3). Mortality was measured by sex-stratified and total monthly age-standardized rates of all-cause mortality for the adult population. During the period 2001-18, effective alcohol control policy measures were implemented on several occasions, and in those years the all-cause mortality rate declined by approximately 3.2% more than in years without such policies. In particular, the implementation of increased taxation in 2017 was associated with reduced mortality over and above the general trend for men and in total for all analyses, which amounted to 1452 deaths avoided (95% confidence interval = -166 to -2739) in the year following the implementation of the policy. Alcohol control policies in Lithuania appear to have reduced the overall adult all-cause mortality over and above secular trends.

Sections du résumé

BACKGROUND AND AIMS
Alcohol use has been identified as a major risk factor for burden of mortality and disease, particularly for countries in eastern Europe. During the past two decades, several countries in this region have implemented effective alcohol policy measures to combat this burden. The aim of the current study was to measure the association between Lithuania's alcohol control policies and adult all-cause mortality.
DESIGN
Interrupted time-series methodology by means of general additive models.
SETTING
Lithuania.
PARTICIPANTS
Adult population of Lithuania, aged 20 years and older.
MEASUREMENTS
Alcohol control policies were ascertained via a document review of relevant legislation materials. Policy effects were evaluated as follows: (1) slope changes in periods of legislative (non-)activity with regard to alcohol control policy (analysis 1); (2) level changes of three interventions following recommendations of the World Health Organization (analysis 2); and (3) level changes of seven interventions judged a priori by an international panel of experts (analysis 3). Mortality was measured by sex-stratified and total monthly age-standardized rates of all-cause mortality for the adult population.
FINDINGS
During the period 2001-18, effective alcohol control policy measures were implemented on several occasions, and in those years the all-cause mortality rate declined by approximately 3.2% more than in years without such policies. In particular, the implementation of increased taxation in 2017 was associated with reduced mortality over and above the general trend for men and in total for all analyses, which amounted to 1452 deaths avoided (95% confidence interval = -166 to -2739) in the year following the implementation of the policy.
CONCLUSIONS
Alcohol control policies in Lithuania appear to have reduced the overall adult all-cause mortality over and above secular trends.

Identifiants

pubmed: 33751693
doi: 10.1111/add.15470
pmc: PMC8873029
mid: NIHMS1779810
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2673-2684

Subventions

Organisme : World Health Organization
ID : 001
Pays : International
Organisme : NIAAA NIH HHS
ID : R01 AA028224
Pays : United States
Organisme : National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIAAA)
ID : 1R01AA028224-01

Informations de copyright

© 2021 Society for the Study of Addiction.

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Auteurs

Mindaugas Štelemėkas (M)

Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Jakob Manthey (J)

Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany.

Robertas Badaras (R)

Clinic of Anaesthesiology and Intensive Care, Faculty of Medicine, Centre of Toxicology, Vilnius University, Vilnius, Lithuania.
Vilnius University Emergency Hospital, Vilnius, Lithuania.

Sally Casswell (S)

SHORE and Whariki Research Centre, College of Health, Massey University, New Zealand.

Carina Ferreira-Borges (C)

WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia.

Ramunė Kalėdienė (R)

Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Shannon Lange (S)

Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.

Maria Neufeld (M)

Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia.
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.

Janina Petkevičienė (J)

Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Ričardas Radišauskas (R)

Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Robin Room (R)

Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia.
Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.

Tadas Telksnys (T)

Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Ingrida Zurlytė (I)

WHO Country Office Lithuania, Vilnius, Lithuania.

Jürgen Rehm (J)

Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of International Health Projects, Institute for Leadership and Health Management, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.

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