Correia Daniela, Manthey Jakob, Allebeck Peter, Kraus Ludwig, Månsson Anastasia, Rehm Jürgen
Department of Mathematics, Faculty of Sciences, University of Porto, Porto, Portugal
EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.
BMJ Open. 2025 Mar 15;15(3):e094586. doi: 10.1136/bmjopen-2024-094586.
Alcohol consumption poses a significant health risk, contributing to 10% of deaths in the WHO European Region. To combat this, the WHO recommends the implementation of its 'best buy' policies-three cost-effective alcohol policies that include higher taxes, restricted availability and marketing bans. While evidence links alcohol marketing to increased consumption, the effectiveness of marketing bans in decreasing alcohol use remains inconclusive. Lithuania's 2018 comprehensive alcohol marketing ban offers a unique opportunity to measure the impact of this particular 'best buy' control policy.
We will analyse repeated cross-sectional measures of alcohol use among 15-year-old and 16-year-old adolescents from Lithuania and other five European Union countries (Estonia, France, Italy, Latvia and Poland). Data from the European School Survey Project on Alcohol and Other Drugs collected between 2003 and 2019 will be used, as well as longitudinal alcohol policy data meticulously gathered through official records, supplemented by relevant literature and consultations with national authorities. Although all six countries introduced best buy alcohol policies-primarily via excise tax increases implemented at different times-only Lithuania implemented a full marketing ban. Generalised linear mixed models will be employed to assess the impact of national alcohol marketing restrictions on alcohol consumption, controlling for participant characteristics, social behaviours and country-level variables such as other alcohol control policies evaluated through a partial Bridging the Gap (BtG) scale. Sensitivity analyses will explore different outcome time periods and model specifications.
The Research Ethics Board of the primary recipient of the grant has approved the secondary data analyses as outlined in the grant proposal (CAMH REB 050/2020 delegated review, renewed annually). The study results will be published in a peer-reviewed journal, presented at conferences, and shared with policymakers.
饮酒对健康构成重大风险，在世卫组织欧洲区域，饮酒导致的死亡占总死亡人数的10%。为应对这一问题，世卫组织建议实施其“最佳选择”政策——三项具有成本效益的酒精政策，包括提高税收、限制供应和营销禁令。虽然有证据表明酒精营销与消费增加有关，但营销禁令在减少酒精使用方面的有效性仍无定论。立陶宛2018年全面的酒精营销禁令为衡量这一特定“最佳选择”控制政策的影响提供了独特机会。
我们将分析立陶宛以及其他五个欧盟国家（爱沙尼亚、法国、意大利、拉脱维亚和波兰）15岁和16岁青少年饮酒情况的重复横断面测量数据。将使用2003年至2019年期间收集的欧洲学校酒精和其他药物调查项目的数据，以及通过官方记录精心收集的纵向酒精政策数据，并辅以相关文献以及与国家当局的磋商。尽管所有六个国家都出台了最佳选择酒精政策——主要是通过在不同时间提高消费税——但只有立陶宛实施了全面的营销禁令。将采用广义线性混合模型来评估国家酒精营销限制对酒精消费的影响，同时控制参与者特征、社会行为以及国家层面的变量，如通过部分弥合差距（BtG）量表评估的其他酒精控制政策。敏感性分析将探讨不同的结果时间段和模型规格。
该研究资助主要接受方的研究伦理委员会已批准了资助提案中概述的二次数据分析（成瘾与心理健康中心研究伦理委员会0·50/2020委托审查，每年更新）。研究结果将发表在同行评审期刊上，在会议上展示，并与政策制定者分享。
