Does Tobacco Legislation Reduce Alcohol Consumption?

描述(由申请人提供)： 众所周知，酒精和尼古丁的使用在临床和非临床样本中都是高度共病的行为，越来越多的证据表明，这两种行为往往是互补的，而不是替代的。无烟政策和烟草税是减少烟草消费的两个最有效的手段。鉴于酒精和烟草使用之间的关联程度，烟草立法对公众健康的益处可能超越与吸烟有关的结果而扩展到酒精使用。然而，很少有研究研究烟草立法是否减少了饮酒行为，以及部分人口中危险饮酒和酒精使用的诊断率。如果这种关系得到证明，这将是降低与饮酒有关的发病率和死亡率的一种新的政策方法。鉴于该项目的创新性和探索性，我们对PA-08-168《现有酒精流行病学数据的二次分析(R21)》做出了回应。使用前瞻性设计，我们的目标是调查无烟政策和烟草税(和价格)是否影响饮酒行为，以及美国危险饮酒和酒精使用障碍的发生率。在之前的一项研究中，我们发现，在苏格兰，酒吧的无烟立法将酗酒吸烟者的酒精使用量减少了48%。此外，我们已经证明，酒吧的无烟禁令降低了酗酒的频率，以及危险饮酒和酒精使用的诊断率。对于目前的应用，我们有兴趣将这一调查范围扩大到检查已知的影响酒精-烟草共病的人口因素(即年龄、性别、教育程度和种族/民族)，以突出哪些人群可能从烟草立法对酒精使用结果的影响中获得更大的好处。为了检验这些问题，我们建议对美国的两项大型前瞻性调查(全国酒精及相关疾病流行病学调查和国际烟草控制项目)进行二次数据分析。该应用程序是耶鲁大学的酒精研究人员和罗斯威尔公园的烟草政策研究人员之间的联合合作，并将被用作扩展烟草政策(税收、无烟立法)对其他重要酒精结果(例如，酒后驾车以及与酒精相关的发病率和死亡率)的影响的这一系列研究的平台。 公共卫生相关性： 项目简介：烟草政策(即无烟政策、税收)在减少香烟使用方面非常有效；然而，与不吸烟者相比，几乎没有研究烟草政策如何影响吸烟者的饮酒行为。鉴于酒精和烟草使用之间的关联程度，有理由假设烟草立法可能会减少特定人群的酒精消费。这种关系将是减少与饮酒有关的发病率和死亡率的一种新的创新政策方法。

DESCRIPTION (provided by applicant): It is well established that alcohol and nicotine use are highly co-morbid behaviors in both clinical and non- clinical samples and accruing evidence suggests that the two behaviors tend to operate as complements, rather than substitutes. Smokefree policies and tobacco taxation are two of the most effective means of reducing tobacco consumption. Given the degree of association between alcohol and tobacco use it is possible that the public health benefits of tobacco legislation may extend beyond smoking-related outcomes to alcohol use. However, little research has examined whether tobacco legislation reduces drinking behavior, and rates of hazardous drinking and alcohol use diagnosis among segments of the population. If such relationships were demonstrated, this would represent a new policy approach to decrease morbidity and mortality associated with alcohol consumption. In light of the innovative and exploratory nature of the project, we have responded to PA- 08-168 "Secondary Analysis of Existing Alcohol Epidemiological Data (R21)". Using a prospective design, we aim to investigate whether smokefree policies and tobacco taxation (and price) influence alcohol drinking behavior, and rates of hazardous drinking and alcohol use disorders in the United States. In a prior study, we found that smokefree legislation in bars reduced alcohol use by 48% in heavy drinking smokers in Scotland. Additionally, we have demonstrated that smokefree bans in bars reduced the frequency of binge drinking, and rates of hazardous drinking and alcohol use diagnoses. For the current application, we are interested in extending this line of inquiry to examine demographic factors known to influence alcohol-tobacco comorbidity (i.e., age, gender, education, and race/ethnicity) to highlight which populations may derive greater benefit from the impact of tobacco legislation on alcohol use outcomes. To examine these questions, we propose to conduct secondary data analyses of two large prospective surveys in the US (National Epidemiological Survey on Alcohol and Related Conditions and International Tobacco Control Project). This application represents a joint collaboration between alcohol researchers at Yale University and tobacco policy researchers at Roswell Park, and will be used as a platform to extend this line of research examining the impact of tobacco policy (tax, smokefree legislation) on other important alcohol outcomes (e.g., drunk driving, and alcohol-related morbidity and mortality). PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE: Tobacco policies (i.e., smokefree policies, taxation) have been highly effective at reducing cigarette use; however, there are virtually no studies that look at how tobacco policies may influence alcohol drinking behavior in smokers, as compared to non-smokers. Given the degree of association between alcohol and tobacco use, it is plausible to hypothesize that tobacco legislation may reduce alcohol consumption among particular segments of the population. Such a relationship would represent a new and innovative policy approach towards decreasing morbidity and mortality associated with alcohol consumption.