Professor Steve Allsop, National Drug Research Institute (PPTX KB)

Report
What’s happening with alcohol?
Steve Allsop, Elise Gordon, Michelle
Hobday, Will Gilmore, Eveline
Lensvelt, Tina Lam, Tanya
Chikritzhs
Trends in per capita alcohol consumption
Litres of pure alcohol consumed per adult, 1991 – 2013
Sources: Australia trend, ABS (2014)
WA trend, Loxley et al. (2012)
Trends in per capita alcohol consumption
Litres of pure alcohol consumed per adult, 2005/06 – 2010/11
Sources: WA, NT & QLD trend: Loxley, Gilmore et al. (2014)
Australian trend: ABS (2014)
Consumption trends & harms
According to the 2013 National Drug Strategy Household Survey:
•
18.2% of Australians aged 14 and older drank alcohol in quantities that
exceeded the lifetime risk guidelines in 2013, down from 20% in 2010.
•
26% of Australians aged 14 and older drank alcohol in quantities that
exceeded the and single occasion risk, down from 29% in 2010.
•
Men in their 40s and late 20s were most likely to drink at risky levels (32%),
while for women it was young adults aged 18–24 (14.6%).
•
1 in 6 (15.6%) Australians had consumed 11 or more standard drinks on a
single drinking occasion in the past 12 months, however this has decreased
since 2010 (16.8%).
•
Over a quarter of Australians aged 14 or older (26%) reported being a victim
of an alcohol-related incident in 2013, down from 29% in 2010.
•
8% of people experienced physical abuse by someone under the influence of
alcohol.
Trends in liver disease, liver cancer and
colorectal cancer deaths 1996-2010
•
Over 16,000 Australians died from alcoholic liver disease, alcohol-attributable
liver cancer or colorectal cancer. This equals 1000 people each year, on average
.
• 1,397 Australians died from liver cancer.
• Male alcohol-attributable death
rates were about twice that for
females.
2.0
Deaths per 100,000 adults
• Alcohol-attributable liver cancer
death rates appeared to increase
overall.
Liver cancer deaths
2.4
1.6
1.2
0.8
0.4
0.0
1996
Source: Pascal, Gilmore, et al. (2013)
1998
2000
2002
2004
2006
2008
2010
Trends in liver disease, liver cancer and
colorectal cancer deaths 1996-2010
• On average, 2 Australians died from alcoholic liver disease every day
(10,728 in total).
• National alcoholic liver disease death rates remained relatively
consistent over time.
Alcoholic liver cirrhosis deaths
• The Northern Territory had
the highest rates of alcoholic
liver disease in Australia
18
16
Deaths per 100,000 adults
• Male death rates were about
twice that for females.
20
14
12
10
8
6
4
2
0
1996
Source: Pascal, Gilmore, et al. (2013)
1998
2000
2002
2004
2006
2008
2010
Trends in liver disease, liver cancer and
colorectal cancer deaths 1996-2010
• 5 Australians died every week from colorectal cancers attributable to risky
and high risk drinking (4,179 in total)
• Alcohol-attributable colorectal cancer death rates declined.
Colorectal cancer deaths
• Male alcohol-attributable death rates
were about 1.3 times greater than for
females.
4.0
3.6
Deaths per 100,000 adults
• Annual rates of alcohol-attributable
colorectal cancers appeared to be
declining faster for Australian males
than for females.
4.4
3.2
2.8
2.4
2.0
1.6
1.2
0.8
0.4
0.0
1996
Source: Pascal, Gilmore, et al. (2013)
1998
2000
2002
2004
2006
2008
2010
Alcohol-attributable hospitalisations &
deaths
4
Alcohol-attributable deaths in Australia 1994 2005
3.5
rate per 10,000 adults
Hospitalisations are
increasing whilst
deaths are decreasing:
3
2.5
2
1.5
1
0.5
0
1994
1995
1996
1997
1998
Males
Source: Based on ABS data
1999
2000
2001
Females
2002
2003
2004
2005
Alcohol-attributable hospitalisations & deaths
• Improved treatment?
• RBT?
rate per 10,000 adults
Hospitalisations are
increasing whilst
deaths are decreasing:
Alcohol-attributable deaths in Australia 1994 2005
4
3.5
3
2.5
2
1.5
1
0.5
0
1994
1995
1996
1997
1998
Males
rate per 10,000 adults
100
1999
2000
2001
2002
2003
2004
2005
Females
Alcohol-attributable hospitalisations in Australia
1994 - 2005
80
60
40
20
0
93/94 94/95 95/96 96/97 97/98 98/99 99/00 00/01 01/02 02/03 03/04 04/05
Source: Based on ABS data
Males
Females
Change in availability
• Hours of sale
• Number and nature of outlets
• Emergence of off-sale ‘superstores’
Effect of outlet density & trading hours on
late night injuries presenting at Perth EDs
Night2 injuries
Outlet/ trading hours
Count of on-premise outlets (extended trading hours)
IRR
95% CI
95% CI
1.046*
1.014
1.078
Count of on-premise outlets (no extended trading hours) 1.006*
1.001
1.011
On-premise sales#/outlet (extended trading hours)
0.985
0.958
1.013
On-premise sales#/outlet (no extended trading hours)
1.022
0.985
1.06
Table excludes off-premise counts and sales, socio-demographic and distance which were included in the negative binomial regression with random
effects. Data from July 2002 to June 2010
Source: Hobday (2014)
The rise of the liquor superstore
Active superstore licenses in Western Australia
18
16
14
12
10
8
6
4
2
0
2005
2006
2007
2008
2009
2010
2011
Number of active superstore licenses
• There are currently another 8 superstore licenses
pending
Source: Drug and Alcohol Office, WA (2014)
2012
2013
Young people’s alcohol consumption
• In the past decade, there has been a significant increase in the
rates of young Australians, aged 14-17, who choose to abstain
from drinking alcohol.
• Similar patterns are being seen internationally:
- US:  prevalence of drinking among 8th graders (13-14
year olds)
- UK:  proportion of 10-15 year olds who had consumed
alcohol
- Sweden, Finland, Iceland, Norway & Russia have also seen
a reduction in adolescent drinking over the past decade
However…
Young people’s alcohol consumption
• Australian students aged 12-17 who do drink appear to be
drinking more frequently and drinking at riskier levels:
- In the 2011 ASSAD survey, among the ‘current drinkers’
the average number of alcoholic drinks consumed in the
seven days before the survey increased with age from
3.7 drinks among 12 year olds to 8.1 drinks among 17
year olds.
- Of those current drinkers, 11% of 12 year olds, 32% of
15 year olds and 51% among 17 year olds drank more
than four drinks on at least one occasion in the seven
days before the survey.
Bottle store purchases
How easy is it, in general, for
people under the age of 18 to
buy alcohol from the bottle
store?
The last time you tried, how easy was it
for YOU as someone under the age of
18, to buy alcohol from the bottle store?
Consequences attributed to alcohol in past 12 months
Personal harms
11% presented to hospital
ED with an injury (N=875)
47% rode in a car where
the driver was affected by
alcohol (N=877)
14% drove a car when they
knew they had too much to
drink to drive safely (N=351)
48% got into sexual
situations they later
regretted (N=351)
26% physical appearance
has been harmed (N=351)
Harms to others
23% been in trouble with the law
(N=351)
38% verbally abused
someone (N=351)
24% physically abused
someone/got into a fight
(N=351)
41% caused damage to
property (N=351)

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