Shakory Shima, Smith Brendan T, Jansen Rachel, Reel Breanne, Hobin Erin
Public Health Ontario, Toronto, Canada.
University of Toronto Dalla Lana School of Public Health, Toronto, Canada.
Addiction. 2025 Oct;120(10):1951-1969. doi: 10.1111/add.70070. Epub 2025 Apr 9.
To systematically review the evidence on the impacts of policies regulating the spatial availability of off-premises alcohol on consumption and harms.
Narrative review that examined peer-reviewed studies published from 2016 to 2024 on policy changes affecting the spatial availability of off-premises alcohol. Outcomes of interest were alcohol consumption, alcohol-related harms and mortality.
The review identified 20 observational studies, primarily natural experiments, examining four policy types: malt liquor restrictions, sales expansion to retail outlets, privatization and changes to allowable alcohol content. Across studies, there was a suggestion that allowing alcohol sales in gas station convenience stores was associated with increased consumption and harms, whereas expanding to grocery stores was not. There was no clear evidence that restricting malt liquor reduces crime. Similarly, privatization was not associated with crime or health outcomes, though it was accompanied by price increases. Increases in allowable alcohol content were not associated with higher consumption, but decreases were associated with fewer alcohol-related emergency visits and hospitalizations.
The impact of policy changes in spatial alcohol availability depends on the policy details and retail outlet types. To mitigate public health impacts, policymakers should consider comprehensive alcohol control measures, such as regulating convenience store sales and accompanying grocery store expansions with minimum unit pricing, taxation and marketing restrictions. High-quality natural experiments with pre-post designs, control groups and confounder adjustments are needed to better understand how these policies impact both the general population and high-risk subgroups.
系统回顾关于规范店外酒精饮料空间可得性的政策对消费及危害影响的证据。
叙述性综述，审视2016年至2024年发表的关于影响店外酒精饮料空间可得性政策变化的同行评审研究。关注的结果是酒精消费、与酒精相关的危害及死亡率。
该综述确定了20项观察性研究，主要是自然实验，考察了四种政策类型：麦芽酒限制、向零售店扩大销售、私有化以及对允许酒精含量的改变。在各项研究中，有迹象表明，允许在加油站便利店销售酒精饮料与消费及危害增加有关，而向杂货店扩大销售则不然。没有明确证据表明限制麦芽酒能减少犯罪。同样，私有化与犯罪或健康结果无关，不过其伴随着价格上涨。允许酒精含量增加与更高的消费无关，但降低则与较少的酒精相关急诊就诊和住院有关。
酒精饮料空间可得性政策变化的影响取决于政策细节和零售店铺类型。为减轻对公众健康的影响，政策制定者应考虑全面的酒精控制措施，如规范便利店销售，并在杂货店扩张的同时实施最低单位定价、税收和营销限制。需要高质量的前后设计、对照组和混杂因素调整的自然实验，以更好地了解这些政策如何影响普通人群和高危亚组。
