The effectiveness and cost-effectiveness of population-level policies to reduce alcohol use: A systematic umbrella review.

IF 2.9 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-04-03 DOI:10.17269/s41997-025-01013-9

G Emmanuel Guindon, Clement Li, Riya Trivedi, Umaima Abbas, Grace Xiong, Alisha Atri

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引用次数: 0

Abstract

Objective: To systematically review and synthesize evidence from reviews about the effectiveness and cost-effectiveness of population-level policies to reduce alcohol use.

Methods: We searched peer-reviewed literature using eight electronic bibliographic databases, grey literature using two databases, two search engines, and two working paper repositories, and examined references of included studies. At least two reviewers independently screened articles for inclusion, extracted detailed characteristics, and assessed the risk of bias of each included study. We considered all reviews that included studies which quantitatively examined the relationship between alcohol consumption and population-level policies that seek to regulate the public availability and marketing of alcoholic beverages. After screening according to a set of predetermined criteria, we included 32 reviews.

Synthesis: We found consistent evidence that addressing alcohol availability (introducing or increasing minimum purchasing age, restrictions on temporal availability, decreasing outlet density, government monopolization) was associated with lower alcohol use; and a general lack of evidence on the associations between alcohol marketing (marketing self-regulation, advertising from government authorities, regulating the volume of advertising from alcohol manufacturers, and introducing warning labels) and alcohol consumption, which precludes any conclusions about these regulations. Additionally, we found scarce evidence about the cost-effectiveness of population-level policies to reduce alcohol use, which is likely due to the relatively low cost of implementation and enforcement of these policies.

Conclusion: The Government of Ontario began expanding privatized alcohol sales in 2015 with further expansions starting in August 2024. Evidence from reviews suggests that this increase in availability will result in increased alcohol consumption.

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减少酒精使用的人口层面政策的效力和成本效益：一项系统的总括审查。

目的：系统回顾和综合有关人口层面减少酒精使用政策的有效性和成本效益的证据。方法：我们使用8个电子书目数据库检索同行评议文献，使用2个数据库、2个搜索引擎和2个工作论文库检索灰色文献，并检查纳入研究的参考文献。至少有两名审稿人独立筛选文章纳入，提取详细特征，并评估每个纳入研究的偏倚风险。我们考虑了所有的综述，这些综述包括对酒精消费与试图规范酒精饮料的公共供应和营销的人口水平政策之间关系的定量研究。根据一套预先确定的标准进行筛选后，我们纳入了32篇评论。综合：我们发现一致的证据表明，解决酒精供应问题（引入或提高最低购买年龄、限制时间供应、降低出口密度、政府垄断）与降低酒精使用量有关；而且普遍缺乏关于酒精营销（营销自我监管、政府当局的广告、管制酒精制造商的广告数量以及引入警告标签）与酒精消费之间关系的证据，因此无法就这些法规得出任何结论。此外，我们发现关于减少酒精使用的人口水平政策的成本效益的证据很少，这可能是由于这些政策的实施和执行成本相对较低。结论：安大略省政府于2015年开始扩大私人酒精销售，并从2024年8月开始进一步扩大。来自评论的证据表明，这种可得性的增加将导致酒精消费量的增加。

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

Canadian Journal of Public Health-Revue Canadienne De Sante Publique PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.10

自引率

4.70%

发文量

128

期刊介绍： The Canadian Journal of Public Health is dedicated to fostering excellence in public health research, scholarship, policy and practice. The aim of the Journal is to advance public health research and practice in Canada and around the world, thus contributing to the improvement of the health of populations and the reduction of health inequalities. CJPH publishes original research and scholarly articles submitted in either English or French that are relevant to population and public health. CJPH is an independent, peer-reviewed journal owned by the Canadian Public Health Association and published by Springer. Énoncé de mission La Revue canadienne de santé publique se consacre à promouvoir l’excellence dans la recherche, les travaux d’érudition, les politiques et les pratiques de santé publique. Son but est de faire progresser la recherche et les pratiques de santé publique au Canada et dans le monde, contribuant ainsi à l’amélioration de la santé des populations et à la réduction des inégalités de santé. La RCSP publie des articles savants et des travaux inédits, soumis en anglais ou en français, qui sont d’intérêt pour la santé publique et des populations. La RCSP est une revue indépendante avec comité de lecture, propriété de l’Association canadienne de santé publique et publiée par Springer.