Bullets & Booze: Alcohol Outlet Access and Violent Crime in Baltimore City, MD

Background: The association between alcohol outlets and violent crime is well-established. However, the literature contains conflicting findings, which this dissertation assumes could be the result of poor measurement. It compares three measurement methods – counts, proximity, and spatial access – to determine how to best quantify alcohol outlet access and then uses the method that performs the best to determine the association between alcohol outlets and violent crime in Baltimore, MD. Lastly, this dissertation translates these findings for policy discussions using cost-effectiveness analysis to determine the number of violent crimes one could prevent, money one could save, and quality-adjusted life years (QALYs) one could preserve with alcohol outlet density zoning policies. Methods: Chapter 3 tests a total of 32 models, using negative binomial regression for count outcomes and linear regression for continuous outcomes. Choropleth maps and Akaike’s Information Criterion (AIC) guided determination of which model yielded the best fit for the data. Chapter 4 uses the spatial access methods from chapter 3 and linear regression to measure the association between alcohol outlet access and violent crime exposure in Baltimore, MD. Chapter 5 uses cost-effectiveness analysis based on the measure of association from Chapter 3. Results: Greater alcohol outlet access was consistently associated with more violent crime. Spatial access measures contained the most statistical and conceptual advantages. Each 10% increase in access to alcohol outlets was associated with a 4.2% increase in exposure to violent crime. A 10% increase in access to off-premise and LBD-7 outlets, which are combined off- and on-premise licensed outlets, had a greater association with violent crime than access to on-premise outlets. Removing both the liquor stores in residential zones and the bars/taverns operating as liquor stores would prevent 781 violent crimes, save $57.6 million, and preserve 608 QALYs. Conclusion: Greater alcohol outlet access is associated with higher exposure to violent crime. Accurate measurement of the alcohol environment is important for scientific and policy discussions and should become part of routine public health surveillance

Associations between Delta-8 THC and Four Loko retail availability in Fort Worth, Texas

Alcohol and cannabis are two of the most widely used substances among young people, and availability and price are two of the most significant determinants of use. Four Loko products contain up to 5.5 standard alcoholic drinks in a single can, are one of the least expensive ready-to-drink alcohol products on the market and are commonly consumed by underage drinkers. Delta-8 THC is a psychoactive substance with no federal regulations regarding minimum purchase age, ingredients and synthesis, marketing, and testing for potency or contaminants. Delta-8 THC products can be inexpensively synthesized and are sold for low prices. Given that young people often use both products, and use of these products can result in negative consequences, it is important to understand whether these products are being sold in the same stores, which would indicate the presence of niche stores marketing high-risk, youth-oriented substances. This study included 360 locations with off-premise beer or beer/wine licenses in Fort Worth, Texas. Locations were called and asked whether they sold Delta-8 THC. Four Loko’s availability was determined using the manufacturer’s website. A logistic regression model examined associations between the availability of Delta-8 THC and Four Loko. Of the 360 locations, 38% sold Four Loko and 9% sold Delta-8 THC. Delta-8 THC availability was significantly associated with higher odds of Four Loko availability (OR=2.15,95%CI=1.05,4.43). Given the associations between the retail availability of Delta-8 THC and Four Loko, policies that limit access to such products, including near schools and in stores that youth patronize, may be warranted

Heavy drinking and contextual risk factors among adults in South Africa: findings from the International Alcohol Control study

Abstract Background There is limited information about the potential individual-level and contextual drivers of heavy drinking in South Africa. This study aimed to identify risk factors for heavy drinking in Tshwane, South Africa. Methods A household survey using a multi-stage stratified cluster random sampling design. Complete consumption and income data were available on 713 adults. Heavy drinking was defined as consuming ≥120 ml (96 g) of absolute alcohol (AA) for men and ≥ 90 ml (72 g) AA for women at any location at least monthly. Results 53% of the sample were heavy drinkers. Bivariate analyses revealed that heavy drinking differed by marital status, primary drinking location, and container size. Using simple logistic regression, only cider consumption was found to lower the odds of heavy drinking. Persons who primarily drank in someone else’s home, nightclubs, and sports clubs had increased odds of heavy drinking. Using multiple logistic regression and adjusting for marital status and primary container size, single persons were found to have substantially higher odds of heavy drinking. Persons who drank their primary beverage from above average-sized containers at their primary location had 7.9 times the odds of heavy drinking as compared to persons who drank from average-sized containers. Some significant associations between heavy drinking and age, race, and income were found for certain beverages. Conclusion Rates of heavy drinking were higher than expected giving impetus to various alcohol policy reforms under consideration in South Africa. Better labeling of the alcohol content of different containers is needed together with limiting production, marketing and serving of alcohol in large containers

Alcopops Disproportionately Consumed by Minors in Sexual Assault Cases

Alcohol is present in a large proportion of sexual assault cases. However, research largely overlooks the role that providing alcoholic beverages – particularly those with high-alcohol- content and/or whose flavors mask the taste of alcohol – may have in making young people more vulnerable to being assaulted. This research is especially important given the rise in the availability of sugar-sweetened alcopops and their high-alcohol-content counterparts “supersized alcopops,” which contain up to 5.5 standard alcoholic drinks. In the current study, we examined whether alcopops and supersized alcopops, relative to beer, were involved in disproportionately more sexual assault cases involving victims who were minors (\u3c 18 years old) rather than adults. In this secondary data analysis, we used Nexis Uni to search legal documents for the brands of supersized alcopop (Four Loko), alcopop (Smirnoff Ice), and beer (Bud Light) most commonly consumed by underage drinkers. Inclusion criteria were U.S. sexual assault cases occurring from 2010 to 2019 and involving victims who consumed one of these three alcohol brands. Two researchers coded information from the case facts, compared coding, and reaching consensus. Thirty-six cases were included for analyses. Compared to victims of sexual assault who consumed beer, victims who consumed supersized alcopops or alcopops were significantly more likely to be minors. Similar results were observed after adjusting for the victim being given the alcohol by the perpetrator, which was strongly associated with the victim being a minor. This study provides initial evidence that sexual assault perpetrators may disproportionately use alcopops and supersized alcopops for the sexual victimization of minors

Associations between cannabis dispensary density and cannabis use behaviors and related harms: a systematic review protocol

This systematic review protocol details planned actions of our review team. Document includes purpose, research question(s), inclusion and exclusion criteria, and planned methods for searching the literature, data extraction, and quality assessment