Occupational level of the father and alcohol consumption during adolescence; patterns and predictors.

STUDY OBJECTIVE: This paper describes and attempts to explain the association between occupational level of the father and high alcohol consumption among a cohort of New Zealand adolescents from age 11 to 21. DESIGN: Data were obtained from the longitudinal Dunedin multidisciplinary health and development study. At each measurement wave, those who then belonged to the quartile that reported the highest usual amount of alcohol consumed on a typical drinking occasion were categorised as high alcohol consumers. Potential predictors of high alcohol consumption included environmental factors, individual factors, and educational achievement measured at age 9, 11, or 13. Longitudinal logistic GEE analyses described and explained the relation between father's occupation and adolescent alcohol consumption. SETTING: Dunedin, New Zealand. PARTICIPANTS: About 1000 children were followed up from birth in 1972 until adulthood. MAIN RESULTS: A significant association between fathers' occupation and adolescent alcohol consumption emerged at age 15. Overall adolescents from the lowest occupational group had almost twice the odds of being a large consumer than the highest occupational group. The association between father's occupation and high alcohol consumption during adolescence was explained by the higher prevalence of familial alcohol problems and friends approving of alcohol consumption, lower intelligence scores, and lower parental attachment among adolescents from lower occupational groups. CONCLUSIONS: Socioeconomic background affects adolescent alcohol consumption substantially. This probably contributes to cumulation of disadvantage. Prevention programmes should focus on adolescents from lower socioeconomic groups and make healthier choices the easier choices by means of environmental change.

Marijuana use in New Zealand, 1990 and 1998.

AIMS: To examine changes in marijuana use in a metropolitan region and a provincial/rural region in New Zealand between 1990 and 1998. METHODS: Two random sample surveys of people aged 15 -45 years were carried out in Auckland and Bay of Plenty regions in 1990 and 1998, using a computer-assisted telephone interviewing system. RESULTS: Use of marijuana in the last twelve months increased in the metropolitan sample from 18% to 22%, but not in the provincial area. Those who had ever tried marijuana increased from 43% of the total sample in 1990 to 52% in 1998. Use was higher among men than women, but had increased among women. There was a trend towards more frequent users of marijuana (ten or more occasions in the previous 30 days), from 2.4% to 3.2%. CONCLUSIONS: Experience of marijuana was slightly more common in 1998 than in 1990, but increases in recent use were small and were found only in the metropolitan area. The increase in use was relatively limited: only one in five of each sample had used marijuana in the past year, and opportunity to use marijuana by non-users had not increased. Use was predominantly casual and social, and most who had tried marijuana no longer used the drug. However, the age at which first use occurred appeared to have declined.

Te Whanau Cadillac--a waka for change.

Community action research is an effective mechanism to improve the relationship between research and public health practice. The Alcohol and Public Health Research Unit (APHRU) and its Maöri research partner Whariki have developed practice in building partnerships with communities characterized by mutual respect of the different resources the partners bring to public health. A current APHRU/Whariki project focused on youth and drugs is a partnership with six communities in rural and urban areas throughout New Zealand, many predominantly Maöri. This project illustrates a model that aims to bridge the gap between research and practice, and to improve health and well-being through working with communities to increase their capacity to deal with alcohol and drug issues, and to introduce sustainable initiatives.

Introduction: community action research and the prevention of alcohol problems at the local level.

Many community action projects from around the world exist to reduce alcohol problems at the local level. The role of research within this international movement is discussed within this introduction for the entire special issue on community action research in alcohol problem prevention. Previous community prevention programs have utilized a variety of prevention strategies: (a) an educational approach which focuses on changing behavior through changes in knowledge, attitudes, and information; and (b) an environmental approach which focuses on changing behavior through changes in the social and economic systems within a community. Many projects have used both approaches. This special issue provides a current overview of many types of community action projects from different countries and summarizes what has been learned to date from these experiences.

A decade of community action research.

The aim of this paper is to reflect on the past decade of research and community action on alcohol and especially on some of the presentations given in the three previous international meetings on community action: in Ontario 1989, San Diego 1992, and Greve Florence 1995. The projects reported on are diverse, reflecting the different cultures represented, but there are also common strands. Among these common strands is the growing consensus that at the heart of successful evaluated community action projects is a process of reciprocal and respectful communication: between different community sectors and also between the community and researchers. While there is increased acknowledgment of the knowledge community sectors bring to planning and implementing community action, there is also an increasing focus on the role of the researcher in providing research-based knowledge to facilitate the development of effective community strategies to reduce alcohol-use-related harm. This is in contrast to a research role which emphasizes only outcome evaluation. Another development apparent through the years covered in the international meeting is the use of more naturalistic approaches to evaluation in acknowledgment that experimental design may not be feasible or scientifically appropriate for the evaluation of community action projects.

Risk functions for frequency of alcohol-related negative consequences: New Zealand survey data.

AIMS: To examine the dose-response relationship between self-reported alcohol consumption and levels of self-reported negative consequences of drinking. DESIGN: Data from 10 general population random sample surveys over the years 1990-1997 were combined and responses were plotted and subjected to regression analysis. SETTING: Auckland, a city of approximately 1 million people in the North Island of New Zealand. Participants were interviewed in their homes using a computer-assisted telephone interviewing system. PARTICIPANTS: General population sample of 11,817 aged 14-65 years, representative of the Auckland population. MEASUREMENTS: Frequency of experience of 14 negative consequences; annual volume of alcohol consumed; frequency of drinking larger quantities of alcohol. RESULTS: Three different patterns of relationship between consequences and consumption were found for different consequences. These differed between the prevalence and the frequency of consequences but were similar for two different measures of consumption, annual volume and larger quantity drinking. Analysis of the frequency of experienced consequences found that the risk curves for the most common consequences approximated a straight line and the effects at low volume intake were due to those drinking larger quantities. Three less common consequences clearly showed a concave curve suggesting a threshold effect, with effects beginning at about 20 litres per annum of absolute alcohol. CONCLUSION: The different relationships between consumption and consequences imply that some consequences occur only once a very heavy volume of drinking is reached, while others show a direct relationship with consumption, reflecting that volume of alcohol consumed is closely related to the quantities consumed.

The extent and nature of televised food advertising to New Zealand children and adolescents.

OBJECTIVE: There has been international concern over the balance of television advertising for healthy and less-healthy foods to which children and adolescents are exposed. This study examined the extent to which 9-17 year old New Zealanders were exposed to advertising for different food groups over a year and compared New Zealand rates of advertising with a 13-country study. METHOD: 'People meter' data collected over three months--May and September 1995 and February 1996--and food advertising from a sample week of television during hours when children were likely to be watching were also examined. Comparison was made with a similar 1989 South Australian study and an international study covering 13 countries. RESULTS: Both the exposure estimated for a year and the opportunities for exposure during the sample week were highest for sweet snacks, drinks, fast food/takeaways and breakfast cereals. There were very low levels for fruit, vegetables, and meat/fish/eggs. Water was not advertised in any sample month. Comparisons with the 13-country study showed New Zealand had the third-highest rate of food advertising, the highest rate of confectionery and drinks advertising, and the second-highest rate of restaurant advertising which included fast food restaurants. CONCLUSION: Current patterns of food advertising pose a conflict of interest between public health and commercial interests. Regulation of food advertising may be needed to address this in order to improve future health.

Impact of liking for advertising and brand allegiance on drinking and alcohol-related aggression: a longitudinal study.

AIMS: To test a hypothesized model of the effect of televised alcohol advertising and allegiance to specific brands of beer on subsequent beer consumption and self-reports of aggressive behaviour linked with drinking. DESIGN: Structural equation modelling was used to assess the fit between data collected as part of a longitudinal study of young people's health and development and a hypothesized model based on theoretical perspectives and previous research. SETTING: A birth cohort has been assessed every few years, most of them in their home city of Dunedin, New Zealand. The questions about alcohol are asked as part of the day-long assessment. PARTICIPANTS: Members of a longitudinal survey cohort at ages 18 and 21 years. Data from 630 beer drinking participants were analysed in this study. MEASUREMENTS: Responses to questions about beer consumption, liking for advertising, favourite brand of beer and self-reports of alcohol-related aggressive behaviour. FINDINGS: Our hypothesized model assumed a positive impact of liking of alcohol advertising and brand allegiance at age 18 on the volume of beer consumed at age 21 and self-reports of alcohol-related aggressive behaviour. This was found to be a good fit to the data from the longitudinal study. CONCLUSION: This measurable impact of alcohol advertising occurred during a time of decline in aggregate alcohol in New Zealand. While this effect was not large enough to halt the decline in aggregate alcohol consumption it does indicate a measurable, specific impact of broadcast alcohol advertising on alcohol consumption and related behaviour which is of relevance for public health policy.

Positive responses to televised beer advertisements associated with drinking and problems reported by 18 to 29-year-olds.

AIMS: To examine the nature of the relationships between responses to alcohol advertisements and drinking behaviour and related problems. To examine the role of positive and negative beliefs about drinking as intervening variables. DESIGN: Survey utilizing a CATI (computer-assisted telephone interviewing) system, involving interviews with 1012 randomly selected respondents. SETTING: Respondents were randomly selected from throughout New Zealand. PARTICIPANTS: Eighteen to twenty-nine-year-old New Zealanders. MEASUREMENTS: Response to specific alcohol advertisements was measured by recalled exposure (how often they recalled having seen the advertisements) and liking (a measure of positive response). FINDINGS: An exploratory non-recursive structural equation model, based on 791 drinkers provided tentative support for the hypothesis that positive responses to televised beer advertisements (as measured by liking) contributed to the quantity of alcohol consumed on drinking occasions, which in turn contributed to the level of alcohol-related problems. The model, which provided a good fit to the data, was consistent with the hypothesis that liking of beer advertisements had both a direct influence on quantities of alcohol consumed and an indirect influence, via its influence on positive beliefs. These effects were present after controlling for reciprocal effects, none of which were significant. The data did not support the hypothesis that the quantities of alcohol consumed would influence the respondent's liking of beer advertisements. Recalled exposure was not a significant influence on the quantities consumed. CONCLUSIONS: The results are consistent with a number of theoretical perspectives and with a growing body of research that are suggestive of alcohol advertising having some influence on the consumption of younger people.

Cannabis policy: issues and options.

This paper examines some of the key points relevant to the debate about cannabis policy in New Zealand. It provides a brief overview of cannabis use patterns, the cannabis market and the public health implications of use. It describes the various strategies which comprise our current cannabis policy and the context of and primary concerns relating to it. Several alternative policy options are explained and in each case some evaluative comments are made. These alternatives are: total prohibition with an expediency principle; prohibition with civil penalties, partial prohibition, and regulation of private enterprise producers/distributors. From a public health perspective none of these options is unproblematic but each has the potential to overcome some of the disadvantages of the current policy and each needs to be further evaluated.

Responses to televised alcohol advertisements associated with drinking behaviour of 10-17-year-olds.

AIMS: To examine the nature of the relationships between 10-17-year-old New Zealanders' responses to alcohol advertisements and their drinking behaviour and future drinking expectations, with consideration also being given to the role of positive and negative beliefs about drinking. DESIGN: Survey involving 500 face-to-face interviews, with selection based on random cluster sampling. SETTING: In respondents' homes in New Zealand's three largest urban areas. PARTICIPANTS: Ten-17-year-old New Zealanders. MEASUREMENTS: Response to specific alcohol advertisements was measured by recalled exposure (how often they recalled having seen the advertisements) and liking (a measure of positive response). FINDINGS: An exploratory structural equation model provided tentative support for the theory-based hypothesis that positive responses to beer advertisements increased the frequency of current drinking and expected future drinking, among this age group. There was no evidence for the hypothesized reciprocal effects; the frequency of drinking (including non-drinking) did not significantly affect the respondent's liking of beer advertisements. There was also no support for a hypothesis that linking of the beer advertisements was a product of a general liking for alcohol. Many of the young people themselves felt that alcohol advertising encouraged teenagers to drink. This was especially the case among 10-13-year-old males, who were the most likely to accept the portrayals in alcohol advertising as realistic. CONCLUSIONS: Although there are limitations on the confidence with which conclusions can be drawn, the findings are consistent with qualitative and quantitative research and different theoretical perspectives on advertising processes which suggest alcohol advertising is likely to have some influence on young people.

Access to alcohol from licensed premises during adolescence: a longitudinal study.

Control of young people's access to alcohol via licensed premises has been shown to be an effective alcohol harm reduction strategy in the United States. In a longitudinal study of young New Zealanders their access to alcohol at the ages of 15 and 18 years was shown to be significantly predictive of the quantities of alcohol they consumed during a drinking occasion both then and in subsequent years. In turn the quantities of alcohol consumed were predictive of the respondents' experience of intoxication related adverse consequences. The impact of access via licensed premises on drinking and related problems was greater in this cohort of young people than the impact of peer or parental influences.

Population level policies on alcohol: are they still appropriate given that "alcohol is good for the heart'?

The research finding that a reduced risk of coronary heart disease is associated with alcohol use has been widely disseminated. This paper addresses the significance of this research finding for decisions about what kind of alcohol harm reduction policies it is appropriate to implement. The public policies of greatest concern to the vested interest groups are population-based policies such as taxation and restrictions on availability. Other public policies which impact on the drinkers' environment are minimum drinking age laws, drink drive deterrence, prevention of intoxication in public drinking places and restrictions on advertising. A review of the effectiveness of the available strategies provided strong support for environmentally focused approaches rather than education targeting high-risk drinkers. Many of these environmental strategies seem unlikely to have a significant direct effect of reducing "heart healthy' drinking by older people. Furthermore, the impact of alcohol on premature mortality among the older sectors of the population has to be weighed against any possible impact on younger drinkers resulting in loss of or disability in many years of life. Given the relative effectiveness of environmental strategies for reducing harm and the likely low level of impact of these strategies on the heart healthy drinking of older people it is concluded that the evidence of reduced risk of coronary heart disease does not preclude their implementation.

The economic costs of alcohol-related absenteeism and reduced productivity among the working population of New Zealand.

Lost productivity accounts for a significant proportion of the total cost of alcohol. This study quantifies the costs associated with alcohol consumption using survey data collected from four alcohol surveys conducted in Auckland between November 1990 to May 1992. The total sample size was 4662, of which 2638 were drinkers in paid employment. A computer-assisted telephone interviewing system was used to interview a random sample that closely matched the Auckland population. Respondents gave information about their typical alcohol consumption and frequency of absences from paid employment which were a result of their drinking. They also gave a report of the number of times in the past 12 months when they felt their work had been impaired as a result of their drinking. The cost of absenteeism was recorded as the number of times a respondent reported time away from work multiplied by gross income. Estimates of reduced work efficiency were derived from US figures, which estimated a 25% reduction in work performance among heavy alcohol users; 3.7% of the sample reported alcohol-related absences and 12% reported reduced efficiency days. There was a significant difference in both the number and cost of absentee and reduced efficiency days reported between the top 10% and the bottom 10% drinkers. A conservative estimate of alcohol-related lost productivity among the working population of New Zealand (with a population of 3.4 million and a per capita absolute alcohol consumption of 9.7 litres) was found to be $57 million per year.