评估苏格兰酒类最低单位定价对道路交通碰撞事故的影响：一项基于控制的中断时间序列研究。

Evaluating the effect of minimum unit pricing for unit of alcohol on road traffic accidents in Scotland: a controlled interrupted time-series study.

机构信息

School of Health and Wellbeing, University of Glasgow, Glasgow, UK.

Faculty of Medicine, Health and Life Sciences, Swansea University, Swansea, UK.

出版信息

Lancet. 2022 Nov;400 Suppl 1:S10. doi: 10.1016/S0140-6736(22)02220-6. Epub 2022 Nov 24.

DOI:10.1016/S0140-6736(22)02220-6

PMID:36929952

Abstract

BACKGROUND

Scotland was the first country to implement on May 1, 2018, a minimum unit pricing (MUP) for alcohol volume in beverages to tackle alcohol-related harms. In this study, we assessed the effect of MUP on road traffic accidents (RTAs) after 20 months of its implementation. We hypothesise that MUP would be associated with decreases in RTAs-ie, rises in alcohol prices and consequent decreases in consumption could lead to reductions in drink driving episodes, leading to reductions in RTAs.

METHODS

Interrupted time-series regression was used to evaluate the effect of MUP on RTAs (ie, total, fatal, nighttime) and any effect modification across socioeconomic deprivation groups. Data were obtained from the UK Department for Transport. As well as Scotland, RTAs in England and Wales were used as the control group. Covariates for severe weather events, bank holidays, and seasonal and underlying trends were included.

FINDINGS

The number of weekly RTAs per 100 000 population decreased over time in Scotland (2·52 in the 20 months before the intervention and 2·15 after the intervention-ie, a reduction of 15%) and in England and Wales (4·00 in the 20 months before the intervention and 3·76 after the intervention-ie, a reduction of 6%). Inferentially, in Scotland, the introduction of MUP was associated with a 7·2% (95% CI 0·9-13·7; p=0·03) increase in the total number of RTAs. For the corresponding period in England and Wales, a 0·9% (95% CI -2·3 to 3·2; p=0·75) increase was reported. Similar results not supporting the a priori hypothesis were seen for other RTA categories, and no evidence for effect modification was found.

INTERPRETATION

The decrease in alcohol consumption due to MUP found in other studies was not translated into a reduction in the number of RTAs. Because MUP is unlikely to be causally linked to increased RTAs, the most likely explanation of these results is that unmeasured time-varying confounding was present and affected Scotland as well as England and Wales differently.

FUNDING

None.

摘要

背景

苏格兰于 2018 年 5 月 1 日成为首个实施饮料酒品最小单位定价（MUP）的国家，以此应对与酒精相关的危害。本研究旨在评估 MUP 实施 20 个月后对道路交通碰撞事故（RTA）的影响。我们假设 MUP 与 RTA 减少相关，即随着酒精价格上涨和消费减少，酒后驾车事件减少，从而 RTA 减少。

方法

采用中断时间序列回归评估 MUP 对 RTA（即总 RTA、致命性 RTA、夜间 RTA）的影响，并检验社会经济剥夺程度组间的任何效应修饰作用。数据来自英国交通部。除苏格兰外，还将英格兰和威尔士的 RTA 作为对照组。纳入严重天气事件、银行假日、季节性和潜在趋势等协变量。

发现

苏格兰每 10 万人每周 RTA 数量随时间推移而减少（干预前 20 个月为 2.52，干预后 20 个月为 2.15，即减少 15%），英格兰和威尔士也呈减少趋势（干预前 20 个月为 4.00，干预后 20 个月为 3.76，即减少 6%）。推断而言，苏格兰 MUP 的引入与总 RTA 数量增加 7.2%（95%CI 0.9-13.7；p=0.03）相关。同期，英格兰和威尔士报告增加 0.9%（95%CI -2.3 至 3.2；p=0.75）。其他 RTA 类别也未见支持假设的相似结果，也未发现效应修饰作用的证据。