A composite index of provincial alcohol control policy implementation capacity in Thailand.

BACKGROUND: There is a well-published literature on the effectiveness and stringency of alcohol control policies, but not many studies focus on policy implementation, where policies transform into impact. The objective of this study is to create a composite index that measures the capacity for implementing effective alcohol control policies across all provinces in Thailand. METHODS: Based on the international literature, we developed a list of key indicators for tracking the implementation of alcohol policies at the subnational level. To ensure these indicators were relevant to the Thai context, we obtained feedback from Thai experts. We collected primary data according to the developed indicators using questionnaires filled in by key informants at the implementing agencies and gathered secondary data at the provincial level. On this basis, we developed indices that reflect the status of alcohol control policy implementation. We then investigated the association between the indices and the prevalence and pattern of alcohol consumption and alcohol-related harms while adjusting for potential confounders using multiple linear regression and negative binomial regression, respectively. RESULTS: Scores on the Provincial Alcohol Policy Implementation Capacity (PAPIC) Index ranged between 39 and 79. We found that each 1-point increase in PAPIC score was associated with a 1.98 % reduction in the quantity of alcohol consumed in grams per day (coefficient: -0.02; 95 %CI: -0.03, -0.00; p-value<0.05; e-0.02= 0.9802). We also found that for each 1-point increase in PAPIC score, the proportion of regular drinkers reduced by 0.30 per cent (coefficient: -0.30; 95 %CI: -0.55, -0.05; p-value<0.05). However, we did not find any association between the indices and alcohol-related harms. CONCLUSION: The level of implementation of alcohol control policy at the sub-national level is associated with alcohol consumption levels. The findings suggest the value of allocating resources to the implementation of alcohol control policy.

Quantitative tools and measurements for assessing the implementation of regulatory policies in reducing alcohol consumption and alcohol-related harms: A scoping review.

ISSUES: Implementation of alcohol control policy is a global priority as alcohol contributes to negative individual health and societal impacts. However, there are no available reviews that comprehensively provide tools and measurements for assessing the implementation of alcohol control policy. This study reviews tools and measurements for assessing alcohol policy implementation. Policies considered include alcohol pricing and taxation, alcohol marketing control, physical availability control and drink-driving policy. APPROACH: We conducted a scoping review from Scopus, Web of Science and the World Health Organization's website. We included studies on policy implementation for the four most effective prevention policies published worldwide between 2000 and 2021. KEY FINDINGS: The search yielded 11,654 articles and these were narrowed down to 39 included studies. Of these 39 studies, almost half assessed the implementation of a drink-driving policy (n = 19), followed multipolicy (n = 12) and physical availability control (n = 8). There was no single study assessing policy implementation of pricing and taxation or alcohol marketing control. The majority of the studies were conducted in high-income countries (n = 31). Globally, there is no standardised tool or guidelines for measuring the policy implementation of these four policies. The tools for measuring policy implementation mostly focused on a single policy, and few covered multiple policies. IMPLICATIONS: We recommend developing standardised tools and measurements to monitor policy implementation across multiple policies at country levels. CONCLUSION: This review highlighted a lack of comprehensive and standardised tools to assess policy implementation and the limited number of studies on alcohol policy implementation in low- and middle-income countries.

The Association among Alcohol Consumption Patterns, Drink-Driving Behaviors, and the Harm from Alcohol-Related Road Traffic Injuries Due to the Drinking of Others in Thailand.

Thailand has one of the highest rates of traffic-related fatalities and alcohol-related road traffic injuries globally. Previous studies focused on alcohol consumption and road traffic injuries. However, no existing studies investigate the association between drink-driving behaviors and road traffic injuries due to the drinking of others. This study aims to explore any potential associations among alcohol drinking patterns, drink-driving behaviors, and the harm from alcohol-related road traffic injuries due to the drinking of others. The Thai Tobacco and Alcohol Use Household National Survey data in 2017 (n = 80,797) were analyzed using multiple logistic regression. This study found that current drinkers and binge drinkers were more likely to suffer from road traffic injuries due to others' drink-driving behavior, i.e., 1.50 times (95% CI: 1.49-1.51) and 2.31 times (95% CI: 2.30-2.33), respectively, compared with non-drinkers. In addition, we found that drink-driving behavior was associated with harm from road traffic injuries due to others' drink-driving behavior by 2.12 times (95% CI: 2.10-2.14) compared with the non-drinker group. This study calls for effective measures to reduce drink-driving behaviors to prevent road traffic injuries due to the drinking of others.

Barriers and Facilitators to the Implementation of Effective Alcohol Control Policies: A Scoping Review.

Implementation of effective alcohol control policies is a global priority. However, at the global and national levels, implementing effective policies is still challenging, as it requires commitment from multiple stakeholders. This review provides a synthesis of barriers and facilitators to implementing effective alcohol control policies. We conducted a scoping review from two main databases: Scopus and Web of Science, and the grey literature from the World Health Organization's website. We included any studies investigating barriers and facilitators to implementing four effective policies: Alcohol pricing and taxation, control of physical availability, alcohol marketing control, and drink-driving policy. Articles published between 2000 and 2021 were included. The search yielded 11,651 articles, which were reduced to 21 after the assessment of eligibility criteria. We found five main barriers: resource constraint; legal loopholes; lack of evidence to support policy implementation, particularly local evidence; low priority of policy implementation among responsible agencies; and insufficient skills of implementers. Facilitators, which were scarce, included establishing monitoring systems and local evidence to support policy implementation and early engagement of implementing agencies and communities. We recommend that national governments pay more attention to potential barriers and facilitators while designing alcohol control regulations and implementing effective policies.

Thailand Prevalence and Profile of Food Insecurity in Households with under Five Years Children: Analysis of 2019 Multi-Cluster Indicator Survey.

This study aimed to estimate the prevalence and profile of food insecurity in households with children under 5 years old using the Food Insecurity Experience Scale (FIES) in Thailand. We integrated FIES into the 2019 Multiple Indicator Cluster Surveys (MICS). A total of 861 households were successfully interviewed with FIES. The Rasch model was applied to examine the validity and reliability. Multiple logistic regression was used to assess the association between socio-economic status and prevalence of food insecurity, adjusting for geographical regions and characteristics of households. We found that FIES measurement is valid as Infit falls within the normal range of 0.7−1.3 and is reliable (Rasch reliability value of 0.81). The overall prevalence of moderate or severe food insecurity was 2.79%. The wealthiest households were less likely to suffer from food insecurity than the poorest households (adjusted OR: 0.07; 95% CI: 0.02−0.34; p-value < 0.05). Households with children under 5 years old living in rural areas had lower food insecurity severity scores. We recommend social protection policies such as food and nutrition subsidies or conditional cash transfer to poor households with children under the age of 5.

Price elasticity of demand for manufactured cigarettes and roll-your-own cigarettes across socioeconomic status groups in Thailand.

BACKGROUND: Pricing policies have been proven to be effective in reducing tobacco consumption. However, studies investigating the effectiveness of pricing policies across different types of tobacco products and socioeconomic status (SES) groups are limited, particularly in low-income and middle-income countries. OBJECTIVE: This study aimed to quantify the price elasticity of demand for different types of cigarettes across different SES groups. METHODS: This study used data from a nationally representative survey in Thailand conducted in 2017 and included current smokers aged at least 15 years. To quantify the price elasticity of demand for cigarette consumption, a two-part model was employed for five different types of cigarettes: domestic and imported manufactured cigarettes with a low and high price, and roll-your-own cigarettes. Personal income was used to determine SES. RESULTS: Price elasticity of demand for cigarettes exists for all types of cigarettes. The price elasticity of demand for manufactured and roll-your-own cigarettes was -0.49 (p<0.05) and -0.32 (p<0.05), respectively. People who smoked domestic manufactured cigarettes were more responsive to price change than those who smoked imported manufactured cigarettes. Low-income smokers of manufactured and roll-your-own cigarettes were more responsive to price change than those with high income. CONCLUSION: Smokers with a low income were more responsive to price change than those with higher income. The effectiveness of pricing policy in reducing demand for manufactured cigarettes was greater in domestic cigarettes than imported ones.

Associations between alcohol consumption trajectory and deaths due to cancer, cardiovascular diseases and all-cause mortality: a 30-year follow-up cohort study in Thailand.

OBJECTIVES: This study examined the association between alcohol consumption trajectory and deaths due to cancer, cardiovascular diseases (CVDs) and all-cause mortality in Thailand. DESIGN: Data were obtained from a Thai prospective cohort study with more than 30 years of follow-up (n=1961). SETTING: All participants resided in Bangkok and its vicinity. PARTICIPANTS: Employees from the Electricity Generating Authority of Thailand aged between 35 and 54 years old were randomly selected. MAIN OUTCOME MEASURES: Exposure was alcohol consumption trajectory over the study period from 1985 to 2012. The main outcomes were all-cause mortality, and deaths due to cancer and CVDs recorded in national vital registries between 2002 and 2015. Cox's proportional hazard regression was used to determine the associations between alcohol consumption trajectory and each outcome adjusting for sample characteristics, health behaviours and health conditions. RESULTS: From a total of 59 312 person years, 276 deaths were observed. Compared with drinkers who drank occasionally or most occasional over their lifetime, consistent regular or mostly consistent-regular drinkers had higher rates of all-cause mortality (HR: 1.53; 95% CI 1.09 to 2.16) and cancer mortality (HR: 2.05; 95% CI 1.13 to 3.74). The study did not find a significant association between trajectory of alcohol consumption and deaths due to CVDs. CONCLUSIONS: Regular drinking of alcohol increased risk for all-cause and cancer mortality. Effective interventions should be implemented to reduce number of regular drinkers in order to saves life of individuals.

Alcohol's harm to others and subjective well-being: Cross-sectional studies in Lao People's Democratic Republic and Thailand.

INTRODUCTION AND AIMS: Previous studies have confirmed that the number of heavy drinkers in a household negatively correlates with the subjective well-being of individuals in the household. However, limited studies have investigated the experiences of alcohol's harm to others (HTO) and subjective well-being, particularly in low- and middle-income countries. The purpose of this study was to investigate the associations between experiences of HTO and subjective well-being in two selected low- and middle-income countries. DESIGN AND METHODS: We analysed population survey data on 1205 and 1491 individuals aged 18-64 years from Lao People's Democratic Republic (Lao PDR) and Thailand, respectively. The respondents' experiences of HTO and their subjective well-being were measured using face-to-face interviews. The association between experiencing HTO and subjective well-being was investigated using Tobit regression models. RESULTS: A significant association between experiencing HTO and subjective well-being was found in Thailand, but not in Lao PDR. Those who had ever experienced HTO had a 2.77-point lower score of subjective well-being than those who had never experienced HTO (95% confidence interval -4.67, -0.88; P-value <0.05) in Thailand. In Lao PDR, the physical harm dimension showed the strongest association with subjective well-being compared to other types of harm, while in Thailand, financial harm was the dimension most strongly associated with the outcome. DISCUSSION AND CONCLUSIONS: There was a significant association between HTO and subjective well-being, particularly physical harm in Lao PDR and financial harm in Thailand. The study suggests that services to mitigate the impacts of HTO on well-being should focus on physical harm in Lao PDR and financial harm in Thailand.