Preventing Alcohol-related Harm in Australia - Department of Health

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Table 5: Key to the rating scales shown in Table 6RatingEvidence ofeffectivenessBreadth ofresearch supportTest across culturesAustralianevaluation0 Lack of effectiveness No studies undertaken Not tested Limited investigation★ Limited effectiveness 1 well-designed studycompletedTested in 1 countryEvidence forimplementation★ ★ Moderate effectiveness 2–4 studies completed Tested in 2–4 countries Evidence for outcomeeffectiveness★ ★ ★High degree ofeffectiveness5+ studies completed Tested in 5+ countries Evidence for effectivedissemination? No evidence available N/A●✖Warrants furtherresearchEvidence iscontra-indicativeThis rating scale applies to the WHO’sinternational review [13] and Australianreviews.[14].Of the 39 interventions listed in Table 6, at leasthalf of these are universal (targeted at the wholepopulation) and approximately half are targetedat high-risk groups. The international reviewby Babor et al. concludes that interventionstargeting the whole population generally havehigher effectiveness ratings and are less costlyto implement and maintain, on average, thanthose targeting high-risk groups.[13] In general,the types of interventions that are consideredmost effective according to the ratings are,in order:1. Regulating physical availability.2. Taxation and pricing.3. Drink-driving countermeasures.4. Treatment and early intervention.The types of interventions for which there issomewhat less evidence of effectivenessare, in order:5. Altering the drinking context6. Regulating promotion7. Education and persuasionThere are differences in the ratings of someinterventions between the internationalreview[13] and the Australian review.[7](for example, the treatment of alcoholproblems and mass media campaigns).Also, importantly, it should be recognisedthat although the effectiveness of someinterventions do not rate highly, in somecases this may be due to the limitedresearch evidence that is available toinform the rating (for example, advertisingcontent controls).18
Table 6: Ratings of policy-relevant strategies and interventionsStrategy or intervention EffectivenessBreadth ofresearchCrossculturaltestingCost toimplementRegulating physical availability Total ban on sales ★ ★ ★ ★ ★ ★ ★ ★ High ★ ★AustralianevaluationMinimum legal purchase age ★ ★ ★ ★ ★ ★ ★ ★ LowHours and days of sale restrictions ★ ★ ★ ★ ★ ★ Low ★ ★Restrictions on density of outlets ★ ★ ★ ★ ★ ★ ★ Low ●Staggered closing times for bars and clubs ✖Server liability ★ ★ ★ ★ ★ Low ★Different availability by alcohol strength ★ ★ ★ ★ ★ LowTaxation and pricing Alcohol taxes ★ ★ ★ ★ ★ ★ ★ ★ ★ Low ★ ★Hypothecated tax to pay for treatment / prevention ★ ★ ★Setting floor prices / banning discounting ★ ★Drink-driving countermeasures Sobriety checkpoints ★ ★ ★ ★ ★ ★ ★ ★ ModerateRandom breath testing ★ ★ ★ ★ ★ ★ Moderate ★ ★ ★Lowered BAC limits ★ ★ ★ ★ ★ ★ ★ ★ LowAdministrative licence suspension ★ ★ ★ ★ ★ ★ ModerateLow BAC for young drivers ★ ★ ★ ★ ★ ★ Low ★Graduated licensing for novice drivers ★ ★ ★ ★ ★ ★ LowDesignated drivers and ride services 0 ★ ★ Moderate ★Ignition interlocks ★Treatment and early intervention Brief intervention in primary health settings ★ ★ ★ ★ ★ ★ ★ ★ Moderate ★ ★ ★Alcohol problems treatment ★ ★ ★ ★ ★ ★ ★ High ★ ★ ★Thiamine supplementation ★ ★Workplace interventions ●Mutual help/self-help attendance ★ ★ ★ ★ LowMandatory treatment of repeat drink drivers ★ ★ ★ ★ ModerateAltering the drinking context Bans on serving intoxicated persons ★ ★ ★ ★ ★ ★ ModerateTraining staff to prevent intoxication / aggression ★ ★ ★ Moderate ★ ★ (✖ if not enforced)Voluntary codes of bar practice 0 ★ ★ Low ★ ★ (✖ if not enforced)Enforcement of on-premises regulations and laws ★ ★ ★ ★ ★ HighPromoting alcohol-free events 0 ★ ★ ★ HighCommunity mobilisation ★ ★ ★ ★ ★ High ★ ★Plastic or tempered-glass serving containers ★Food service ★Regulating promotion Advertising bans ? ● ● LowAdvertising content controls ? ● ● Low ●Education and persuasion Alcohol education in schools 0 ★ ★ ★ ★ ★ High ★College student education 0 ★ ★ HighParent education ? ● ● Moderate ●Public service messages / Mass media campaigns ● ● ● Moderate ★Warning labels / National drinking guidelines 0 ★ ★ Low ★Source: Adapted from Babor et al. (2003),[13] Loxley et al. (2004),[7] Toumbourou et al. (2007)[41]19
Page 1: Preventative Health TaskforceNation
Page 4 and 5: Contents1 Introduction: changing th
Page 6 and 7: 1. Introduction:changing thedrinkin
Page 8 and 9: ModifiableDeterminants:Cultural Pla
Page 10 and 11: 2. Key trends in alcoholconsumption
Page 12 and 13: Figure 3: Drinking at risky/high ri
Page 14 and 15: 2.4 Alcohol prices andconsumer spen
Page 16 and 17: More males than females died from b
Page 18 and 19: Families and childrenIt is a realit
Page 20 and 21: Young AustraliansRates of risky dri
Page 24 and 25: 4.2 Regulating the physicalavailabi
Page 26 and 27: The distinction is important becaus
Page 28 and 29: While increasing the price through
Page 30 and 31: These changes have resulted in majo
Page 32 and 33: 4.5 Treatment and early interventio
Page 35 and 36: number of RSA training programs hav
Page 37 and 38: Table 8: Alcohol advertising in Aus
Page 39 and 40: nThe effectiveness of the current s
Page 41 and 42: 5. Policy imperatives5.1 The state
Page 43 and 44: Table 10: Cost-effectiveness (avera
Page 45 and 46: There are some specific challenges
Page 47 and 48: thousands of Australians at the ear
Page 49 and 50: 21. Chikritzhs T, Catalano P, Stock
Page 51 and 52: 63. Gruenewald P, Freisthler B and

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