Measures: Taxation, Trade Agreements, Outlets, Policy Changes, Interventions

To restrict physical, economic and social availability of alcohol is an important tool for alcohol policy.

Evidence-based recommendations are paramount to drive alcohol policy change and analyses conducted by CAPR staff, for example, provide scenarios of pricing policy and alcohol outlet changes on consumption, health, social inequality and as well as responses to alcohol-related harm.

Moreover, when a policy or intervention or prevention program aimed at reducing alcohol consumption or alcohol-related harms is about to be implemented it is important to demonstrate the impact and efficiency of said action.

This includes large-scale policy interventions (e.g. state-level policy changes) as well as more targeted interventions or programs to specific groups (e.g. middle-aged women in the Australian Capital Territory (ACT)). Therefore, CAPR conducts evaluation projects in this space.

Research Team:

Research leaders, Senior researchers: Jason Jiang, Robin Room, Sandra Kuntsche, Michael Livingston, Emmanuel Kuntsche, Robyn Dwyer, Cassandra Wright

Research officers, PhD/honours/ma students: Megan Cook, Yvette Mojica Perez, Mia Miller, Miranda Goizzo, Melvin Marzan

Projects within this area:

(Either recent, or currently underway)

Effects of alcohol pricing policies on consumption, health, social inequality (NHMRC project grant)

The mortality and morbidity rates due to risky or heavy drinking are substantial in Australia and could be halved by reforming the alcohol tax system or introducing a floor price per standard drink. A significant CAPR project led by Heng (Jason) examines the effects, effectiveness and cost-benefits of alcohol pricing policy initiatives in reducing risky drinking, social harms and health inequalities among priority populations in Australia. This project is providing key research evidence to cut through current policy debates and will point towards the most effective potential options for alcohol tax reform.
Some of the key data that will be generated include estimates of the effects of different alcohol pricing policies on consumption amongst different subpopulation groups in Australia, as well as on health and social outcomes and on health inequities. These studies will also provide robust cost-effectiveness and cost-benefit analyses of potential alcohol pricing policies.
In 2018, this research resulted in journal publications, as well as multiple articles in The Conversation.

la Trobe Researchers: Heng (Jason) Jiang, Robin Room, Michael Livingston, Sarah Callinan, Melvin Barrientos Marzan

Funder: National Health and Medical Research Council Project grant

Research outputs in 2018-2019

Relevant Journal articles

Conference presentations and news articles

Updating the evidence of the effect of alcohol availability on family violence (VicHealth)

There is little Australian evidence to inform liquor licensing policy approaches to reducing or preventing family violence. Currently, the literature relies heavily on one longitudinal analyses by Livingston (1), which examined post-code level correlations between the per-capita density of alcohol outlets and police rates of ‘family incidents’, a proxy for family violence. This work has a number of limitations that have meant it has had limited impact on policy or practice (e.g. (2)). These include:

  1. It’s age – the data used in this paper span 1996 to 2005, a period of substantial change in the Victorian liquor market. The subsequent 12 years have seen ongoing shifts in terms of both licence numbers and types that mean updated analyses are needed.
  2. The outlet types analysed were relatively broad and based on licence categories that could be consistently defined. Thus, for example, each packaged liquor outlet was treated the same, meaning a large scale ‘big box’ outlet was considered equivalent to a small grocery store. Similarly, restaurants and bars were combined into the ‘on-premise’ licence category. This limits the specificity of the findings, making it harder to apply them to licensing policy.
  3. The study did not examine whether outlets effects varied across neighbourhood types (although subsequent work published only in a PhD thesis suggest that they do (3)). Key questions for policy include whether or not adding an outlet to an area of socio-economic disadvantage has more or less impact on harms than a more advantaged area and whether or not adding outlets to areas with different pre-existing levels of alcohol availability will have different effects.

We propose an updated analysis that will address these three limitations, providing critical new findings to inform liquor licensing policy in this space. We will use historical liquor licensing data from 2011 to 2017 (more detailed licence codes were introduced in 2011) and police data on ‘family incidents’. Analyses will be conducted using postcode-level data and spatial-panel models will be developed adjusting for other neighbourhood characteristics (e.g. socio-economic status, population density). We will also explore whether any identified effect of alcohol outlets on harm is larger in areas with lower socio-economic status.

More detailed licence types will be included in the model using both the more detailed categories provided in the standard licensing database (e.g. restaurant vs on-premise, late night general vs general licence etc) as well as some specific coding of licensing data (e.g. we will code ‘big box’ packaged outlets as a specific category of packaged liquor outlet).

The project team will be led by Dr Michael Livingston, a world leading researcher on the relationship between alcohol outlets and alcohol-related harm (see, e.g., (4-7)) see below for other investigators.

Researchers: Michael Livingston, Dr Rowan Ogeil (turning point), Dr Ingrid Wilson (Judith Lumley Centre ).

Funder: The Victorian Health Promotion Foundation (VicHealth)

References

  1. Livingston M. A longitudinal analysis of alcohol outlet density and domestic violence. Addiction. 2011;106(5):919-25.
  2. Willingham R. Liquor licensing must consider family violence say councils after booze barn approved in hot spot. The Age. 2016.
  3. Livingston M. The effects of changes in the availability of alcohol on consumption, health and social problems: University of Melbourne, School of Population Health; 2012.
  4. Livingston M. Alcohol outlet density and assault: a spatial analysis. Addiction. 2008;103(4):619-28.
  5. Livingston M. A longitudinal analysis of alcohol outlet density and assault. Alcoholism: Clinical and Experimental Research. 2008;32(6):1074-9.
  6. Livingston M. Alcohol outlet density and harm: comparing the impacts on violence and chronic harms. Drug and Alcohol Review. 2011;30(5):515-23.
  7. Livingston M. The social gradient of alcohol availability in Victoria, Australia. Australian and New Zealand Journal of Public Health. 2012;36(1):41-7.

Critical review of evidence used by the alcohol industry in liquor licence applications (FARE)

There is good evidence that the number of alcohol outlets in a neighbourhood is associated with a range of alcohol-related harms. With this in mind, communities and public health actors often object to the granting of new licences in an attempt to reduce alcohol-related harm. These objections are generally unsuccessful, with industry arguments in various hearings largely successful.

This study examines the specific evidence given by industry actors in a sample of planning and licensing hearings related to new liquor licences around Australia.

We will thematically analyse the arguments made and summarise the key points raised by industry, the status of the evidence in these areas and the ways in which arguments are interpreted by the various bodies conducting the hearings (courts, tribunals etc).

The findings of this study will identify key areas for public health to 1) improve the evidence base and 2) strengthen the specific legal arguments put to judicial bodies in future hearings.

Researchers: Michael Livingston, Megan Cook, Claire Wilkinson (UNSW), Chris Morrison (Columbia)

Funder: Foundation for Alcohol Research and Education (FARE)

Impact of the NT’s minimum pricing regime on alcohol prices and promotions (FARE)

Sub-study 1 - Estimate the effects of minimum unit price policy on prices of off-premise beverages in NT using online sales data

Minimum unit price (MUP) has been implemented in a number of countries to tackle alcohol related harms, for example in Scotland, Canadian provinces, Russia, Ukraine, Uzbekistan and the Republic of Moldova. The forthcoming alcohol minimum unit pricing policy of $1.30 per standard drink in Northern Territory (NT), Australia on 1 October 2018 has recently attracted a great deal of attention to this public health strategy.

This study aims to measure the impact of introducing a minimum unit price in Northern Territory on prices of different off-premise beverages.

Off-premises alcohol price and product information will be collected through websites of 5 top off-premise alcohol retailers in NT. The online alcohol price and product information data will be collected on a random day once per month for 6 months -- three months before and three months after the Policy intervention.

The sales prices also will be converted to the price per standard drink, which allow us to compare price changes across different beverages before and after the policy intervention.

La Trobe Researchers: Jason Jiang, Michael Livingston and Robin Room

Funder: Foundation for Alcohol Research and Education (FARE)


Sub-study 2 - Estimate the effects of minimum unit price policy on alcohol promotion in NT using catalogue data

Minimum unit price (MUP) has been implemented in a number of countries to tackle alcohol related harms. In Australia, Northern Territory (NT) Government will introduce an alcohol MUP on 1 October 2018 in order to reduce harmful use of alcohol.

This study aims to measure the impact of introducing a minimum unit price in Northern Territory on alcohol promotion in three large alcohol retailers, namely BWS (belongs to Woolworth), Liquorland (belongs to Coles) and Cellarbrations.

Weekly catalogues from Woolworths and Coles and fortnightly issued catalogues from Cellarbrations in NT will be collected from 6th August to 9th January. The information of variety of promotion and price of different types of beverages will be collected and recorded (e.g., product type, promotion type, original price, promotion price, promotion rate, price per standard drink).

The impact of MUP policy on promotion type and prices of different beverages will be measured using pre- and post-intervention data. The catalogues data from  Woolworths and Coles in NSW will be used as a control group in our analysis.

A report will be submitted to FARE and a journal article will be written up for peer reviewed journal publication.

La Trobe Researchers: Jason Jiang, Michael Livingston and Robin Room

Funder: Foundation for Alcohol Research and Education (FARE)

Online alcohol delivery services: an exploratory study (FARE)

Shopping online is increasing in popularity for a range of products and alcohol is no exception.  Online shopping for alcohol comes in a variety of broad categories: wine clubs and similar regular deliveries, grocery-style purchasing from big chains like Dan Murphy’s and fast-turnaround delivery from new players like Tipple and Jimmy Brings, where delivery occurs rapidly after the order is placed. Little is known about who takes advantage of these services.  This project will recruit people who have purchased alcohol online in the past month using Facebook advertising and ask them to fill out a web survey about their online alcohol purchasing habits.  We’ve asked respondents will also be asked about their alcohol consumption, their motives for purchasing online and to detail the context of the last couple of times they purchased alcohol online with a focus on fast deliveries.

Researchers: Michael Livingston, Sarah Callinan, Yvette Mojica Perez

Funder: Foundation for Alcohol Research and Education (FARE)

Boozy boomer women intervention evaluation (ACT Health)

With alcohol consumption continuing to decrease amongst young people, there is increasing concern that baby boomers (those born between 1946 and 1964) are not decreasing their consumption in the same way, and thus are still experiencing the same harm from alcohol as when overall consumption was at its peak.

Using data from the Household Income and Labour Dynamics in Australia (HILDA) survey, this study carried out by Sarah and Michael tested the hypothesis that boomers were failing to decrease their consumption at the same rate as generations before them at the same age. However, no evidence for this particular hypothesis was found.

CAPR is continuing to focus on the drinking practices of older drinkers, in particular, habitual drinking in the home, with future work planned to look at whether alcohol researchers are under-identifying older drinkers through commonly used alcohol measurement surveys.

La Trobe Researchers: Sarah Callinan, Michael Livingston

Funder: ACT Health

Find the full report here: http://bit.ly/CAPR-Boomers

Australian media analysis of representations of alcohol consumptions guidelines for pregnant women (FARE)

Alcohol consumption during pregnancy is linked to Fetal Alcohol Spectrum Disorder (FASD), as well as a range of other conditions such as low birth weight, neurophysiological disorders and pre-term births. The 2009 National Health and Medical Research Council’s (NHMRC) Australian Guidelines to Reduce Health Risks from Drinking Alcohol recommend that for women who are pregnant, planning a pregnancy or breastfeeding, not drinking alcohol is the safest option.
In order to better understand the trends in alcohol consumption during pregnancy and before knowledge of pregnancy, Oliver, Megan and Sarah undertook an analysis of data from six waves of the NDSHS. The study looked at overall alcohol consumption during pregnancy between 2001 and 2016, as well as the level of consumption in women before they knew they were pregnant, and the level of consumption after knowledge of their pregnancy.
Overall, the study found that the estimated proportion of pregnant women who consumed alcohol whilst pregnant decreased between 2001 and 2016, and this decline was largest between 2001 and 2010. Many women, however, continue to drink during pregnancy, particularly those who are older and more highly educated. Another significant finding was that overall, the proportion of women drinking before the knowledge of their pregnancy has declined, suggesting that health promotion efforts around reducing drinking when trying to conceive may have been effective.
The study made clear that more must be done to address misconceptions among many Australians around the dangers of drinking whilst pregnant. The findings gained significant media coverage in a range of outlets, and the research was used to highlight the need for mandatory alcohol pregnancy warning labels.

La Trobe Researchers: Oliver Stanesby, Megan Cook, Sarah Callinan

Funder: Foundation for Alcohol Research and Education (FARE)

Find the full report here: http://bit.ly/CAPR-Trends-01-16

Impact of changes to packaged liquor trading laws in NSW on family violence (FARE)

In 2014 the New South Wales government made some sweeping changes to liquor regulation, particularly around late night trading. While the implementation of lock-outs and last-drinks in key inner city entertainment precincts has been well studied (and has drawn most public and political attention), the government also implemented mandatory 10pm closing for all packaged liquor outlets around the state. This was extended to 11pm in 2017. This study will conduct exploratory analyses to assess whether these regulatory changes had any influence on the distribution of calls to police for domestic assault offences across the night. We will focus our analyses on rural areas of the state, unlikely to be affected by the various other interventions being implemented in entertainment precincts and will examine trends in non-domestic assaults across the course of the night with two key intervention points: the initial restriction to 10pm closing and the subsequent extension to 11pm. These results will add to a very limited literature on the impacts of restrictions on late trading for packaged liquor (currently limited to two studies in European settings focussing on youth drinking).

La Trobe Researchers: Michael Livingston

Funder: Foundation for Alcohol Research and Education (FARE)

Impact of alcohol policy changes on drinking patterns (QLD Dept of Premier & Cabinet)

The QUeensland Alcohol-related violence and Night-Time Economy Monitoring (QUANTEM) project is an evaluation of major alcohol policy changes in Queensland. In July 2016 the Queensland government introduced mandatory 2am last drinks in licensed premises state-wide (or 3am for venues located in key entertainment areas known as ‘Safe Night Precincts’).

In July 2017 a further requirement was introduced mandating ID scanning for all customers at late-trading venues around the state. These interventions represented major changes to the way to the regulation of nightlife in Queensland and CAPR joined a large consortium of researchers led by Deakin University to evaluate their impacts.

CAPR’s work on QUANTEM has been concentrated in two areas: 1) assessing the economic costs and benefits of the regulatory changes, and 2) modelling the impact of the policy changes on rates of harm measured in administrative systems (e.g. emergency departments, police). The initial report on the QUANTEM project has been published on the project website, but work on the evaluation will continue.

La Trobe Researchers: Professor Robin Room, Dr Sarah Callinan, Dr Jason Jiang, Dr Michael Livingston

Funder: ARC Linkage grant

Relevant publications:

Evaluation of VicHealth alcohol cultural change initiative (VicHealth)

In 2017, VicHealth commissioned a series of projects from NGOs and other service providers around the state aiming to trial and evaluate programs to change drinking cultures within particular population sub-groups.

VicHealth committed over a million dollars to these projects and have funded La Trobe University to evaluate them via a collaboration between The Australian Institute for Primary Care and Ageing and CAPR.

This cross-project evaluation aims to assess the effectiveness of each of the individual interventions and to draw out the strengths and weaknesses of the projects to provide critical guidance for future work in the alcohol culture change space. The project involves a mix of quantitative data collection, stakeholder interviews and workshops.