Projects - Alcohol, tobacco and other drugs: Impact and policies
Alcohol Control, Consumption and Consequences: Time series alalyses of the Australian experience
William Kerr (ARG, California)
Thor Norström (University of Stockholm)
Mats Ramstedt (SoRAD, Sweden)
Tanya Chikritzhs (Curtin University)
Paul Dietze (The Burnet Institute)
Summary: This project has three broad aims: 1) to develop a database of alcohol consumption and mortality data for Australia (and Australian states) from 1907 to 2006; 2) to assess the relationship over this time period between per-capital alcohol consumption and mortality from a range of conditions, using ARIMA time-series methods comparable with a range of studies undertaken in Europe and the USA; and 3) to estimate the impact of historical changes in alcohol policies on rates of consumption and mortality. The study will bring a well-established tradition of studies to bear on Australian populations and circumstances, and also extend beyond existing studies into new areas of analysis. The studies elsewhere will provide a comparative context for the Australian results. The results of the study will constitute a major building block in both epidemiological and policy studies in the alcohol field in Australia.
Understanding and reducing alcohol-related harm among young adults in urban settings: Opportunities for Intervention
David Moore, Curtin University of Technology;
Brian Vandenberg, VicHealth
Karen Goltz, Victorian Department of Human Services
Alcohol use is a major contributing factor to injury and death, with 2634 young Australians dying from alcohol related causes in the decade to 2004. Local governments (LGs) urgently require research evidence on which to base policy to reduce alcohol-related harms. This ARC-funded Linkage Project will provide an analysis of patterns of alcohol consumption by young adults in inner and peri-urban (growth corridor) LG areas, along with information about how young adults view alcohol use. In collaboration with industry partners VicHealth, the Victorian Department of Health, the Municipal Association of Victoria and LGs in Hume and Yarra, specific policy recommendations for implementation at LG, state and national levels will be developed and disseminated.
Contact: Sarah MacLean: (03) 8413 8412
'Liberalising Liquor Licensing - implications for alcohol-related harm'
In the last two decades, the regulation of liquor licensing regimes in Victoria has undergone a substantial liberalisation, with access to alcohol becoming increasingly convenient. In broad terms, this research will attempt to examine the effects that these changes in access to alcohol have had on a range of alcohol-related health and social problems. This will be done, for example, by examining rates of outcomes (e.g. assault rates) and numbers of alcohol outlets at the community level over periods of ten years or more to assess whether communities in which alcohol outlet numbers increase also experience increased rates of harm. The study will provide results that will inform alcohol policy at the local, state and national levels.
Support System for Alcohol Related Problems in Japan: Self help groups and the medicalisation of alcoholism
Tomofumi Oka, Sophia University
The World Health Organisation estimates that alcohol use is a leading cause of mortality and disability, contributing 58 million or 4% of all disability adjusted life years (DALYs) lost globally and ranking in the top five risk factors for disease burden (WHO, 2002).
Support systems for individuals suffering from alcohol related problems are in the form of formal medical interventions and/or informal support groups, such as self help groups. From a policy perspective, both are an important part of an alcohol strategy. This project seeks to develop collaborations with colleagues in Japan to examine the different knowledge systems (and their inter-relationship) of formal and informal support systems for people suffering from alcohol misuse. The project will examine the effect that the medicalisation of alcohol problems has had on socio-cultural understandings of alcohol misuse and in the orientation of informal support groups in Japan.
Indigenous Youth with Co-occurring Mental Health and Substance Use Problems
An international collaborative project that aims to create an evidence-base for cultural awareness models for service providers that de-stigmatizes Indigenous youth with co-occurring mental health and substance use problems, with a specific focus on volatile solvent abuse.
Assessing the effectiveness of alcohol and drug therapeutic community treatment
The capacity to accurately measure client progress in treatment is critical to investigating and understanding the elements of effective alcohol and drug misuse treatment. However, research into client progress in substance misuse treatment programs is still in a developmental stage (Kressel et al, 2000). There are only a few studies of client progress in traditional long-term residential therapeutic community (TC) settings. Some TCs utilise progress scales derived from TC writings (Sugarman, 1974). These scales are mainly used for record-keeping and reporting requirements. In 2009, the CAI, CAS and SAS developed by David Kressel and colleagues (2000) were adapted and trialed within Banyan House, with a further Peer Assessment Scale (PAS) developed by Chenhall and Banyan House.
The current project seeks to:
• Implementation and integration of the CAI, CAS, PAS, SAS into the treatment system;
• Development of monitoring, feedback and continuous improvement systems so that services can provide a responsive and ‘best practice’ service;
• Comparison of data with longitudinal post-treatment outcome data to assess the predictive ability of the tools; and
• Collection of qualitative interview data with staff related to the 14 domains of behaviour, attitude and cognitive change to assess the ongoing reliability of the tool and to understand the treatment experience of clients.
Project (PhD) Title: Alcohol and child maltreatment through the windows of child protection and a national survey
Alcohol impacts on the relationships and experiences of families, and in particular children within families, as do the social contexts within which families function. The relationship between parental or carer alcohol problems and alcohol-related child maltreatment will be examined and alcohol’s role in child maltreatment will be discussed. Five years of de-identified Victorian child protection data are available for analysis as is data from a national telephone survey of the general population.
In an estimated 12,780 Victorian child protection cases of substantiated child abuse alcohol was identified as a risk factor. Alcohol was more commonly identified in emotional abuse and neglect cases than in physical abuse and sexual abuse cases. As child protection involvement increased, alcohol was identified in progressively higher percentages of substantiated cases, protective interventions and court orders respectively. After adjusting for family economic, living situation, other drug use, mental health, parental history of abuse and domestic violence factors alcohol was significantly associated with more serious child protection outcomes.
To date the extent of alcohol and other risk factors in child protection cases in Victoria, including demographic and social location factors has been documented. Cross-sectional and longitudinal patterns in the child protection data have been identified and interviews with child protection policy workers will be undertaken across a range of different regions. Analysis of the effects on children from others’ drinking reported in general population in the alcohol’s harm to others survey is underway. Analysis of the national Alcohol’s harm to others survey on how children have been affected by others’ drinking responses (n= 1,142) revealed that 11,8% adult respondents living with children or with parental responsibility for children reported that one or more children had been verbally abused, left unsupervised or in an unsafe situation, physically hurt or exposed to serious family violence in the home in the last year because of others’ drinking. Socio-deomographic variables were less explanatory in the regression models examining child maltreatment as measured in the survey data.
Peering through both data windows estimates of substantiated cases of child abuse involving alcohol from the child protection system and general population estimates can be compared. A number of social and demographic explanatory variables were examined. Alcohol and multi-factorial theories of the nature of child abuse were supported in child protection data analyses.
In contrast the survey data suggested that social and economic differences played less of a role and that child maltreatment, as defined in the survey, was spread across social groupings. Theoretical explanations of alcohol’s role and other potential causal factors are continuing to be examined as are the limitations and significance of these findings.