Hollingworth William, Ebel Beth E, McCarty Carolyn A, Garrison Michelle M, Christakis Dimitri A, Rivara Frederick P
Harborview Injury Prevention and Research Center, Box 359960, 325 Ninth Avenue, Seattle, Washington 98104-2499, USA.
J Stud Alcohol. 2006 Mar;67(2):300-8. doi: 10.15288/jsa.2006.67.300.
Harmful alcohol consumption is a leading cause of death in the United States. The majority of people who die from alcohol use begin drinking in their youth. In this study, we estimate the impact of interventions to reduce the prevalence of drinking among youth on subsequent drinking patterns and alcohol-attributable mortality.
We first estimated the effect of public health interventions to decrease harmful drinking among youth from literature reviews and used life table methods to estimate alcohol-attributable years of life lost by age 80 years among the cohort of approximately 4 million U.S. residents aged 20 in the year 2000. Then, from national survey data on transitions in drinking habits by age, we modeled the impact of interventions on alcohol-attributable mortality.
A tax increase and an advertising ban were the most effective interventions identified. In the absence of intervention, there would be 55,259 alcohol-attributable deaths over the lifetime of the cohort. A tax-based 17% increase in the price of alcohol of dollar 1 per six pack of beer could reduce deaths from harmful drinking by 1,490, equivalent to 31,130 discounted years of potential life saved or 3.3% of current alcohol-attributable mortality. A complete ban on alcohol advertising would reduce deaths from harmful drinking by 7,609 and result in a 16.4% decrease in alcohol-related life-years lost. A partial advertising ban would result in a 4% reduction in alcohol-related life-years lost.
Interventions to prevent harmful drinking by youth can result in reductions in adult mortality. Among interventions shown to be successful in reducing youthful drinking prevalence, advertising bans appear to have the greatest potential for premature mortality reduction.
有害饮酒是美国主要的死亡原因之一。大多数死于酒精使用的人在年轻时就开始饮酒。在本研究中,我们估计了减少青少年饮酒流行率的干预措施对随后饮酒模式和酒精所致死亡率的影响。
我们首先从文献综述中估计公共卫生干预措施对减少青少年有害饮酒的效果,并使用生命表方法估计在2000年约400万20岁美国居民队列中到80岁时酒精所致生命年损失。然后,根据按年龄划分的饮酒习惯转变的全国调查数据,我们模拟了干预措施对酒精所致死亡率的影响。
增税和广告禁令是最有效的干预措施。在没有干预的情况下,该队列一生中将有55259例酒精所致死亡。每六罐装啤酒价格基于税收提高17%(每罐啤酒价格提高1美元),可使有害饮酒导致的死亡减少1490例,相当于31130个贴现潜在生命年得以挽救,或占当前酒精所致死亡率的3.3%。全面禁止酒精广告将使有害饮酒导致的死亡减少7609例,并使与酒精相关的生命年损失减少16.4%。部分广告禁令将使与酒精相关的生命年损失减少4%。
预防青少年有害饮酒的干预措施可降低成人死亡率。在已证明成功降低青少年饮酒流行率的干预措施中,广告禁令似乎在降低过早死亡率方面具有最大潜力。