Changes in alcohol policy and trends in individual alcohol consumption over 22 years in a Swiss adult population: a population-based cross-sectional study from 1993 to 2014
Shireen Dumont, Pedro Marques-Vidal, Thierry Favrod-Coune, Jean-Marc Theler, Jean-Michel Gaspoz, Barbara Broers, Idris Guessous.
Alcohol policy changes and 22-year trends in individual alcohol consumption in a Swiss adult population: a 1993-2014 cross-sectional population-based study., BMJ Open, March 2017, doi: 10.1136/bmjopen-2016-014828.
Abstract
Aim: Evidence on the impact of legislative changes on individual alcohol consumption is limited. Supported by an observational study, we assessed trends in individual alcohol consumption in a Swiss adult population following public policy changes between 1993 and 2014, while taking into account individual characteristics and secular trends on the subject.
Design: Cross-sectional study.
Setting: General Swiss adult population.
Participants: Data from 18,963 participants aged between 18 and 75 were collected between 1993 and 2014.
Method: We used data from the 'Bus Santé' study, an annual health survey conducted on random samples of the adult population of the canton of Geneva, Switzerland. Individual alcohol consumption was assessed using a validated food frequency questionnaire. Individual characteristics, including level of education, were self-reported. Seven policy changes (six concerning alcohol and one concerning tobacco) between 1993 and 2014 defined six different time periods. We predicted alcohol consumption using quantile regression with multivariate analysis for each period, adjusting for participant characteristics and testing for period significance. A sensitivity analysis was performed including only drinkers, the 10th percentile of heaviest drinkers and smoking status.
Results: Between 1993 and 2014, participants' individual alcohol consumption fell from 7.1 to 5.4 g/day (reduction of 24%, p<0.001). Men reduced their alcohol consumption by 34% compared with 22% for women (p<0.001). The reduction in alcohol consumption remained significant when considering only drinkers (28% reduction, p<0.001) and the 10th percentile of heaviest drinkers (24% reduction, p<0.001). Consumption of all alcoholic beverages decreased between 1993 and 2014, except for moderate beer consumption, which increased. After adjusting for participant characteristics and secular trends, no independent association between changes in alcohol legislation and individual alcohol consumption was found.
Conclusions: Between 1993 and 2014, alcohol consumption declined in the Swiss adult population independently of policy changes.