Natural Observation of Alcohol Price and Promotions at Bars: Implications for Alcohol Misuse Prevention

Alcohol misuse among young adults remains a primary public health concern given the wide range of short- and long-term physical, social, and societal consequences of the behavior. On-premise drinking establishments, which allow alcohol consumption on site (i.e., bars), are frequent locations for young adult alcohol use. Risks for alcohol misuse within the bar setting are key factors to identify for prevention. Notably, alcohol price and promotions are associated with alcohol consumption among young adults. This study sought to develop and pilot test an observational protocol to assess the alcohol environment at on-premise drinking establishments. Following qualitative exploration of salient risk factors in these settings through focus groups with young adults, an observational tool was adapted and tested in a feasibility study. The refined tool was then pilot tested with two independent data collectors conducting natural observation at 13 establishments in the downtown nightlife district of a small, southeastern city. High interrater reliability was noted. Descriptive summary statistics of bar characteristics demonstrate low alcohol prices with variability across types of alcohol (e.g., beer, wine, and liquor), greater numbers of alcohol promotions inside rather than outside the building, and higher rates of manual versus electronic age verification procedures. Observational assessment of alcohol price and marketing at on-premise drinking establishments as described in this study is needed to inform prevention policy and programs to reduce harms associated with young adult alcohol misuse.

P119 The impact of minimal alcohol price policy on premature CVD mortality in Kazakhstan

Background In Kazakhstan, premature cardiovascular (CVD) mortality is one of the highest in the world despite the dramatic decline of CVD mortality since 2006. Our previous research found that alcohol consumption was the main determinant of premature CVD mortality in Kazakhstan and the decrease of alcohol use was the main factor influencing the CVD mortality decline. Purpose With the aim of examining the impact of minimal price changes for strong spirits (vodka) and alcohol sales on premature CVD mortality in 2006-2014, we compared age-specific CVD mortality for the age group 19-49 with changes in the minimal price of strong spirit (vodka) and alcohol sales. Methods Age-specific CVD mortality rates in age group 19-49 in Kazakhstan were obtained from the Global Burden of Disease database and explored with regard to changes in minimal prices of vodka and alcohol sales in Kazakhstan over this period. Results Age-standardized CVD mortality rates in age group 19-49 declined by 47% from 2006 to 2014, for both men and women. However, we observed the plateauing effect in CVD mortality trend in 2015-2017. These mortality trends coincided with the sharp increase in minimal vodka prices and decrease or flatten in alcohol sales in 2006-2014 period and consequent minimal price decrease and plateauing in 2015-2017 that was accompanied by increase of alcohol sales in this period. Conclusions Our findings indicate that public health measures such as tax increases for strong spirits can be a very effective CVD prevention strategy in Kazakhstan and other former USSR countries, where similar mortality trends can be observed. Unfortunately, this mortality decline was not sustained over time. We believe it happened due to a weakened policy in regard to the minimal alcohol prices. Therefore, there is much scope for further policy action in this area. Abstract P119 Figure. CVD and Alcohol price

Our Priceless Youth

Young people’s excessive alcohol consumption is considered a societal problem in many countries, and higher alcohol taxes are often suggested as a possible remedy. Price increases cannot be effective if unnoticed, but little is known about young people’s alcohol price knowledge and sensitivity, as aggregate price sensitivity studies have produced ambiguous results. Applying individual data, this study examines young people’s knowledge of retail alcohol prices using two price memory tests. Results show that the majority holds fairly accurate reference prices, while a large segment intentionally checks in-store alcohol prices, though large variations exist across categories. Furthermore, logistic regressions revealed ‘purchased a special’ and ‘simple prices’ as determinants of alcohol price knowledge. The results suggest that alcohol tax increases must be significant to be effective when targeting young people. Otherwise, such increases go unnoticed and other policy instruments may perform better, not least when targeting the youngest, and thus most vulnerable group.