Public Health Science Directorate, NHS Health Scotland, Glasgow, UK.
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Addiction. 2018 Mar;113(3):429-439. doi: 10.1111/add.14019. Epub 2017 Oct 2.
The introduction of the Alcohol Act in Scotland on 1 October 2011, which included a ban on multi-buy promotions, was probably associated with a fall in off-trade alcohol sales in the year after its implementation. The aim of this study was to test if the same legislation was associated with reduced levels of alcohol-related deaths and hospital admissions in the 3-year period after its introduction.
A natural experiment design using time-series data to assess the impact of the Alcohol Act legislation in Scotland. Comparisons were made with unexposed populations in the rest of Great Britain.
Scotland with comparable data obtained for geographical control groups in other parts of Great Britain.
For alcohol-related deaths, a total of 17 732 in Scotland and 88 001 in England and Wales throughout 169 4-week periods between January 2001 and December 2013 and for alcohol-related hospital admissions, a total of 121 314 in Scotland and 696 892 in England throughout 182 4-week periods between January 2001 and December 2014.
Deaths and hospital admissions in Scotland and control groups that were wholly attributable to alcohol for consecutive 4-week periods between January 2001 and December 2014. Data were obtained by age, sex and area-based socio-economic position.
There was no evidence to suggest that the Alcohol Act was associated with changes in the overall rate of alcohol-related deaths [incidence rate ratio (IRR) = 0.99, 95% confidence interval (CI) = 0.91-1.07)] or hospital admissions (IRR = 0.98, 95% CI = 0.95-1.02) in Scotland. In control group analyses, the pseudo intervention variable was not associated with a change in alcohol-related death rates in England/Wales (IRR = 0.99, 95% CI = 0.95-1.02), but was associated with an increase in alcohol-related hospital admission rates in England (IRR = 1.05, 95% CI = 1.03-1.07). In combined models, the interaction analysis did not provide support for a 'net effect' of the legislation on alcohol-related deaths in Scotland compared with England/Wales (IRR 0.99, 95% CI = 0.95-1.04), but suggested a net reduction in hospital admissions for Scotland compared with England (IRR = 0.93, 95% CI = 0.87-0.98).
The implementation of the Alcohol Act in Scotland has not been associated clearly with a reduction in alcohol-related deaths or hospital admissions in the 3-year period after it was implemented in October 2011.
2011 年 10 月 1 日，苏格兰出台《酒精法案》，其中包括禁止多买促销活动，这可能与该法案实施后的一年中，非即饮酒精销售量下降有关。本研究的目的是检验同样的立法是否与引入该法案后的 3 年内，与酒精相关的死亡人数和住院人数的减少有关。
使用时间序列数据的自然实验设计，评估苏格兰《酒精法案》的影响。与大不列颠其他地区未受影响的人群进行比较。
苏格兰，使用来自大不列颠其他地区地理对照组的可比数据。
在 2001 年 1 月至 2013 年 12 月的 169 个 4 周期间，苏格兰共有 17732 例与酒精相关的死亡和英格兰威尔士的 88001 例，以及在 2001 年 1 月至 2014 年 12 月的 182 个 4 周期间，苏格兰共有 121314 例与酒精相关的住院和英格兰的 696892 例。
苏格兰和对照组中完全归因于酒精的连续 4 周内的死亡和住院人数，年龄、性别和基于地区的社会经济地位。
没有证据表明《酒精法案》与苏格兰与酒精相关的死亡总发生率（发病率比[IRR]0.99，95%置信区间[CI]0.91-1.07）或住院率（IRR 0.98，95%CI 0.95-1.02）的变化有关。在对照组分析中，伪干预变量与英格兰威尔士与酒精相关的死亡率变化无关（IRR 0.99，95%CI 0.95-1.02），但与英格兰与酒精相关的住院率上升有关（IRR 1.05，95%CI 1.03-1.07）。在综合模型中，交互分析并未为苏格兰与英格兰威尔士相比，该立法对与酒精相关的死亡的“净效应”提供支持（IRR 0.99，95%CI 0.95-1.04），但表明苏格兰的住院人数净减少（IRR 0.93，95%CI 0.87-0.98）。
2011 年 10 月实施《酒精法案》后，苏格兰的与酒精相关的死亡或住院人数在 3 年内并未明显减少。
