A systematic review of the influence of community level social factors on alcohol use.

PURPOSE: To explore evidence on the influence of community level social factors on alcohol use among adults and adolescents. METHODS AND RESULTS: Major bibliographic databases were searched for quantitative studies meeting inclusion criteria. After screening, narrative synthesis and a quality review were applied. Forty-eight studies met the eligibility criteria. While the findings were inconclusive for associations between alcohol use and deprivation, poverty, income, unemployment, social disorder and crime, there was some indication that social capital characteristics were protective. CONCLUSIONS: Social capital has a potentially important association with reducing alcohol use. Further studies are required to better understand social influences on alcohol use.

Voluntary agreements between government and business - a scoping review of the literature with specific reference to the Public Health Responsibility Deal.

OBJECTIVES: A scoping review was conducted to synthesise the findings of evaluations of voluntary agreements between business and government. It aimed to summarise the types of agreements that exist, how they work in practice, the conditions for their success and how they had been evaluated. METHODS: Voluntary agreements were included if they involved a transparent signing-up process and where businesses agreed to carry out specific actions or to achieve specific outcomes. Studies of any design published in English were included. RESULTS: 47 studies were identified. Voluntary agreements may help to improve relationships between government and business, and can help both parties agree on target-setting and data-sharing. Governments may also use the experience to help develop subsequent legislation. For voluntary agreements to be successful, targets should be ambitious and clearly defined, with robust independent monitoring. Public knowledge of agreements can help encourage participation and ensure compliance. CONCLUSIONS: If properly implemented and monitored, voluntary agreements can be an effective policy approach, though there is little evidence on whether they are more effective than compulsory approaches. Some of the most effective voluntary agreements include substantial disincentives for non-participation and sanctions for non-compliance. Many countries are moving towards these more formal approaches to voluntary agreements.

Knowledge of the health impacts of smoking and public attitudes towards tobacco control in the former Soviet Union.

AIMS: To describe levels of knowledge on the harmful effects of tobacco and public support for tobacco control measures in nine countries of the former Soviet Union and to examine the characteristics associated with this knowledge and support. METHODS: Standardised, cross-sectional nationally representative surveys conducted in 2010/2011 with 18 000 men and women aged 18 years and older in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Respondents were asked a range of questions on their knowledge of the health effects of tobacco and their support for a variety of tobacco control measures. Descriptive analysis was conducted on levels of knowledge and support, along with multivariate logistic regression analysis of characteristics associated with overall knowledge and support scores. RESULTS: Large gaps exist in public understanding of the negative health effects of tobacco use, particularly in Azerbaijan, Kazakhstan, Kyrgyzstan and Moldova. There are also extremely high levels of misunderstanding about the potential effects of 'light' cigarettes. However, there is popular support for tobacco control measures. Over three quarters of the respondents felt that their governments could be more effective in pursuing tobacco control. Higher levels of education, social capital (membership of an organisation) and being a former or never-smoker were associated with higher knowledge on the health effects of tobacco and/or being more supportive of tobacco control measures. CONCLUSIONS: Increasing public awareness of tobacco's health effects is essential for informed decision-making by individuals and for further increasing public support for tobacco control measures.

Patterns of public support for price increases on alcohol in the former Soviet Union.

AIMS: To measure levels of public support for price increases on beer and spirits in nine former Soviet Union countries and to examine the characteristics influencing such support. METHODS: Cross-sectional surveys were conducted in 2010 with 18,000 respondents aged 18+ in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Descriptive and multivariate logistic regression analyses were used. RESULTS: The lowest level of support for price increases on beer were in Georgia (men 5%, women 9%) and Armenia (men 5%, women 11%); and the highest were in Kyrgyzstan (men 30%, women 38%), Azerbaijan (men 27%, women 37%) and Russia (men 23%, women 34%). The lowest levels of support for price increases on spirits were Armenia (men 8%, women 14%) and Georgia (men 14%, women 21%); and the highest were in Kyrgyzstan (men 38%, 47% women) and Moldova (men 36%, women 43%). Characteristics associated with supporting price increases included gender (women), higher education, good economic situation, lower alcohol consumption and greater knowledge of harmful alcohol behaviour. CONCLUSION: Alcohol price increases are an effective means to reduce hazardous alcohol use. Despite opposition in some groups, there is evidence of public support for alcohol price increases in the study countries.

A systematic review of the influence on alcohol use of community level availability and marketing of alcohol.

PURPOSE: Exposure to a high number of alcohol outlets and adverts within a community may lead to higher alcohol use by local residents. The aim of this systematic review was to explore evidence on the influence on alcohol use of community level availability and marketing of alcohol. RESULTS: 26 studies met the eligibility criteria. While the findings were not conclusive, there was some indication that higher outlet density and greater exposure to advertising in a local community may be associated with an increase in alcohol use, particularly among adolescents. CONCLUSIONS: This review disentangled the existing evidence on the overall relationships between availability, marketing and alcohol use at a community level. Further studies are required to better understand the influence of these factors on alcohol use.