The estimated health impact of alcohol interventions in New Zealand: A modelling study

IF 5.2 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2023-08-30 DOI:10.1111/add.16331

Tim Chambers, Anja Mizdrak, Sarah Herbert, Anna Davies, Amanda Jones

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引用次数: 0

Abstract

Aims

To estimate the health impacts of key modelled alcohol interventions among Māori (indigenous peoples) and non-Māori in New Zealand (NZ).

Design

Multi-stage life-table intervention modelling study. We modelled two scenarios: (1) business-as-usual (BAU); and (2) an intervention package scenario that included a 50% alcohol tax increase, outlet density reduction from 63 to five outlets per 100 000 people, outlet hours reduction from 112 to 50 per week and a complete ban on all forms of alcohol marketing.

Setting and participants

The model’s population replicates the 2018 NZ population by ethnicity (Māori/non-Māori), age and sex.

Measurements

Alcohol consumption was estimated using nationally representative survey data combined with sales data and corrected for tourist and unrecorded consumption. Disease incidence, prevalence and mortality were calculated using Ministry of Health data. We used dose–response relationships between alcohol and illness from the 2016 Global Burden of Disease study and calculated disability rates for each illness. Changes in consumption were based on the following effect sizes: total intervention package [−30.3%, standard deviation (SD) = 0.02); tax (−7.60%, SD = 0.01); outlet density (−8.64%, SD = 0.01); outlet hours (−9.24%, SD = 0.01); and marketing (−8.98%, SD = 0.02). We measured health gain using health-adjusted life years (HALYs) and life expectancy.

Findings

Compared with the BAU scenario, the total alcohol intervention package resulted in 726 000 [95% uncertainty interval (UI) = 492 000–913 000] HALYs gained during the life-time of the modelled population. Māori experienced greater HALY gains compared with non-Māori (0.21, 95% UI = 0.14–0.26 and 0.16, 95% UI = 0.11–0.20, respectively). When modelled individually, each alcohol intervention within the intervention package produced similar health gains (~200 000 HALYs per intervention) owing to the similar effect sizes.

Conclusions

Modelled interventions for increased alcohol tax, reduced availability of alcohol and a ban on alcohol marketing among Māori and non-Māori in New Zealand (NZ) suggest substantial population-wide health gains and reduced health inequities between Māori and non-Māori.

Abstract Image

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新西兰酒精干预措施对健康的估计影响：模型研究

目的对新西兰毛利人（原住民）和非毛利人的主要酒精干预模型的健康影响进行估计。设计多阶段生命表干预建模研究。我们模拟了两种情况：(1）"一切照旧"（BAU）；（2）一揽子干预方案，包括增加 50%的酒精税、将销售点密度从每 10 万人 63 个减少到 5 个、将销售点每周营业时间从 112 小时减少到 50 小时，以及全面禁止一切形式的酒精营销。环境和参与者该模型的人口按种族（毛利人/非毛利人）、年龄和性别复制了2018年的新西兰人口。测量方法利用全国代表性调查数据和销售数据估算酒精消费量，并对游客和未记录的消费量进行校正。疾病发病率、流行率和死亡率是通过卫生部的数据计算得出的。我们使用了2016年全球疾病负担研究中酒精与疾病之间的剂量反应关系，并计算了每种疾病的致残率。消费变化基于以下效应大小：总干预方案[-30.3%，标准差（SD）= 0.02]；税收（-7.60%，SD = 0.01）；销售点密度（-8.64%，SD = 0.01）；销售点时间（-9.24%，SD = 0.01）；营销（-8.98%，SD = 0.02）。我们使用健康调整生命年（HALYs）和预期寿命来衡量健康收益。研究结果与 "一切照旧 "方案相比，酒精干预一揽子方案在模拟人口的一生中可获得 726 000 [95% 不确定区间 (UI) = 492 000-913 000] 个健康调整生命年。与非毛利人相比，毛利人的 "健康年 "收益更高（分别为 0.21，95% UI = 0.14-0.26 和 0.16，95% UI = 0.11-0.20）。在单独建模时，由于效果大小相似，一揽子干预措施中的每项酒精干预措施都产生了相似的健康收益（每项干预措施约 200 000 HALYs）。结论对新西兰（NZ）毛利人和非毛利人增加酒精税、减少酒精供应和禁止酒精营销的干预措施建模表明，整个人口的健康水平大幅提高，毛利人和非毛利人之间的健康不平等现象有所减少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.