Ireland has regulated for all packaged alcohol products to include a health warning that states that ‘there is a link between alcohol and fatal cancers’. This warning is being opposed in the World Trade Organization by 12 member states who are raising that the warning is an unnecessary barrier to trade. The World Health Organization is supporting Ireland. Countries should not oppose Ireland's warning which is defensible from legal and public health perspectives.

Background: Published studies rarely assess associations between trajectories of drinking and mortality.

Methods: We aimed to assess associations between long-term sex-specific drinking trajectories and all-cause and disease-specific mortality for 39 588 participants (23 527 women; 16 061 men) enrolled in the Melbourne Collaborative Cohort Study in 1990–94 aged 40–69 years. Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for all-cause, cardiovascular disease- and cancer-specific mortality in relation to group-based alcohol intake trajectories.

Results: There were 7664 deaths (1117 cardiovascular; 2251 cancer) in women over 595 456 person-years, and 7132 deaths (1283 cardiovascular; 2340 cancer) in men over 377 314 person-years. We identified three distinct group-based alcohol intake trajectories for women: ‘lifetime abstention’, ‘stable light’, and ‘increasing moderate’; and six for men: ‘lifetime abstention’, ‘stable light’, ‘stable moderate’, ‘increasing heavy’, ‘early decreasing heavy’, and ‘late decreasing heavy’. We observed 9%–12% lower all-cause mortality, driven by associations with cardiovascular disease-specific deaths, for ‘stable light’ (women: HR 0.91; 95% CI 0.87–0.96; men: HR 0.88; 95% CI 0.82–0.94) and ‘stable moderate’ (HR 0.88; 95% CI 0.81–0.96) drinking, compared with ‘lifetime abstention’. In contrast, all-cause mortality was 18%–21% higher for ‘early decreasing heavy’ (HR 1.18; 95% CI 1.05–1.32) and ‘late decreasing heavy’ (HR 1.21; 95% CI 1.04–1.40) drinking, and cancer-specific mortality 19%–37% higher for ‘increasing moderate’ (HR 1.19; 95% CI 1.00–1.43), ‘early decreasing heavy’ (HR 1.34; 95% CI 1.10–1.64), and ‘late decreasing heavy’ (HR 1.37; 95% CI 1.06–1.77) drinking.

Conclusions: Our findings highlight the importance of avoiding higher levels of alcohol intake during the life course to reduce all-cause and cancer-specific mortality.

Research documenting the reach and varieties of alcohol’s harm to others than the person who drinks has emerged in the last 20 years, with studies in over 40 countries. Population surveys have asked respondents about harm to themselves or their children from others’ drinking. Staff of societal response agencies – police, hospitals, child protection agencies – have also been interviewed, along with studies of agency records and social cost analyses of alcohol’s harm to others.

While a few studies have compared cross-sectionally the relation between alcohol policies in countries or states and rates of specific harms from others’ drinking, analysis has been limited of how alcohol policies or other legal changes may reduce such rates. The new focus on alcohol’s harm to others has rarely been noticed in broader public health policy research. Neither has it received public notice; a study of the broad British newspaper discourse around minimum unit pricing policy for alcohol in Scotland found considerable mention of alcohol’s harm to others, but without any reference to the findings of the relevant research literature.

This paper reviews the situation and considers paths forward. One advance would be leveraging more data collection from the caseloads of health and other response agencies. For particular areas of harm, those controlling the relevant space need to be involved in the policy changes – e.g., employers and unions in workplaces. Alongside research on the prevalence, studies of policy change and related impacts on harm from others’ drinking, studies of policy processes and attitudes towards the harm to others paradigm amongst opinion leaders and the general public should be undertaken. To move public health interests in alcohol policy forward, alliances should be built, for example with women’s movements concerning harm to women from men’s drinking.

Public health discussions now apply the label of ‘unhealthy commodities’ to items attractive to consumers but which bring harm to health and welfare. The list includes tobacco, alcohol, cannabis and other drugs, sugar-sweetened beverages, overprocessed foods and commercial gambling. The histories of markets and controls in such commodities vary, with commerce in alcohol, drugs and gambling prohibited in many places at times during the last two centuries, but few limits on sugar, or on tobacco until recent years. In the current world, regimes vary for retail sale between commodities and in different jurisdictions. Some examples are given of successful control measures which might be more widely applied: measures such as licensing of retail sales; closing off web-based sales; and imposing minimum unit pricing. The new thinking in public health offers the opportunity to look across what have been separate fields of action and experience and to learn from case study examples of effective mechanisms to reduce rates of harmful consequences from unhealthy commodities.

OBJECTIVE: This article considers how harm from others' drinking is distributed across several economic and environmental factors. METHOD: Economic, environmental, demographic, and drinking measures include household income, financial disadvantage indicators, and home spaciousness; neighborhood socioeconomic status, connections, and safety; and respondent's gender, age group, and risky drinking status. This article explores the interactions of these factors with harms from the drinking of others in a 2021 survey of 2,574 Australian adults. RESULTS: The home's degree of crowding (persons per bedroom) is related to harms from others in the household, whereas financial disadvantage is related to harms from drinkers outside the household, whether known or strangers. Perceived neighborhood safety and knowing neighbors are negatively related to harms from the drinking of others outside the household. In multivariate analyses for harms from household members and strangers, these findings are little affected by three individual factors related to harms from others' drinking: the respondent's gender, age group, and risky drinking status. CONCLUSIONS: Some economic and ecological factors play an important role in the occurrence of harm from others' drinking, but the relationship varies between factors and by the category of the other person involved.

The paper analyses how the Covid-19 pandemic affected young people’s alcohol-related assemblages, trajectories of becoming and identity claims in Sweden. The data is based on longitudinal qualitative interviews among heavy and moderate drinking young people (n = 23; age range 15–24 years). The participants were interviewed two to three times before the Covid-19 pandemic and once at the end of it, between 2017 and 2021. The analysis draws on actor-network theory and narrative positioning approach. The analysis demonstrates how the lockdown produced trajectories of becoming boring, normal, stress-free, self-caring, self-confident and shielded. In these trajectories, drinking was positioned into relations that either increased young people’s capacities for well-being or decreased them. Due to the lockdown, some participants learnt to be moved by relations that contributed to replace drinking with competing activities, while others experienced that the lockdown made drinking a more attractive activity, turning it into a collective force that helped them to overcome isolation. The results show how drinking is a heterogeneous activity which may increase or decrease young people’s capacities for well-being, depending on what kinds of assemblages and trajectories of becoming it is embedded in.

Though the United Nations deals with its Sustainable Development Goals (SDGs) in blocs of 15 years at a time, “sustainable” indicates a longer-term focus, aiming at steady human progress, including in public health and welfare. But the alcohol history in many countries shows “long waves” of consumption, repetitively rising, then falling, then rising again. Underlying this dynamic are competing interests pushing in opposite directions. One set of interests, both private and governmental, seeks profits from an attractive and habit-forming product, with relative costs that have fallen with industrialisation and commercialisation. Opposed are the interests of those harmed by the effects of alcohol, and the interests of public health and welfare. With alcohol, there is also a less obvious set of interests favouring drinking: alcohol is an instrument of conviviality and collectivity, as expressed in rituals like reciprocal drink-buying and toast-offering. The long waves result from the competition of these interests. Alcohol becomes more available by industrialisation or other factors, and alcohol consumption and harms from drinking rise. Reaction to this from public health and welfare interests results in measures driving consumption levels back down. Then to a new generation the restrictions seem unnecessary; they are removed; and consumption rises again. Long waves with different periodicity are exemplified in 3 different patterns of national history: in countries with strong temperance movement histories, in Russia, and in France. The long waves raise an issue which challenges the steady-progress assumption of the SDGs: are moves to lower alcohol consumption sustainable? More complex thinking and policymaking may be required to deal with alcohol policies in the frame of the Sustainable Development Goals.

Introduction: Cross sectional research has demonstrated that screening tool questions on frequency of alcohol consumption are a better predictor of dependence and harmful drinking in younger adults; questions about quantity per occasion are a better predictor in older adults. The aim of this study is to see if this relationship also holds longitudinally.

Methods: A total of 9076 respondents aged 15 and over completed at least two waves of the longitudinal annual Household Income and Labour Dynamics in Australia survey 10 years apart between 2001–2010 and 2012–2020. Standardised scores from responses to questions on drinking quantity and frequency in the first survey were used to predict consumption 10 years later in groups stratified by age.

Results: Frequency of consumption was a significantly better predictor of future consumption than quantity in younger drinkers (aged < 36; β = 9.3, 95% confidence interval [CI] 8.6–10.0), than older drinkers (aged > 49; β = 5.1, 95% CI 4.8–5.5) while quantity was a better predictor in older drinkers (β = 8.2, 95% CI 7.2–9.3) than younger drinkers (β = 3.4, 95% CI 3.1–3.7).

Discussion and Conclusions: Some commonly used screening items, such as drinking quantity and frequency, are differentially effective at identifying future heavy drinkers between age groups. Development of age-specific screening tools could potentially lead to more accurate identification of people who could benefit from intervention to reduce their alcohol consumption.

Introduction: This paper aims to produce a comprehensive estimate of alcohol's harm to others (AHTO) from strangers among Australia adults in 2021. This survey was undertaken during COVID-19 and aims to compare AHTO results with those from 12 years before and identify differences across socio-demographics. Methods: Cross-sectional data of 2574 Australian adults were collected in November 2021 via two survey modes: random digit dialling and the Life in Australia™ panel. Questions pertained to harms from the drinking of known and unknown others (‘strangers’) in the previous 12 months. Multivariable logistic regression is used to analyse differences in the experience of AHTO from strangers across age, gender and other socio-demographics. Results: Under half of Australian adults reported experiencing AHTO from a stranger (42.2%) during the period of COVID-19. Women were at significantly higher odds of reporting harm than men. Significantly higher percentages of participants aged 18–49 reported harm than those 65 and over. Rates of experience of harm from strangers' drinking varied between different Australian regions. Adults engaging in less frequent risky drinking (less than 4 days a month) reported significantly greater experiences of harm than those not engaging in risky drinking in the past year. Discussion and Conclusions: The current study provides a national estimate of AHTO from strangers in Australia during the COVID-19 pandemic. Finding greater risk of experiencing AHTO from strangers among women than men differs from previous AHTO literature, and further research is required to determine if this is an emerging trend.

Introduction: Alcohol's harm to others (AHTO) refers to harms caused to those other than the drinker. The current paper estimates the prevalence of formal and informal supports sought due to AHTO and examines whether the type of support accessed varies by sociodemographic, economic and harm-related characteristics.

Methods: An Australian sample of 2574 people completed the 2021 AHTO survey, out of which 888 perceived they experienced harm from another's drinking. Prevalence of accessing services and supports was measured. Additionally, several sociodemographic factors, economic factors and harm-related factors were included in multivariable logistic regression models predicting service/support use. Specifically, four models were constructed probing use of any service/support, use of police, use of counselling services and use of family/friend support.

Results: Of the survey sample, 12.4% accessed any support/service. Seeking support from family and/or friends was most common, followed by police, counselling, healthcare services and being admitted to hospital. Women had higher odds of accessing counselling and family/friend support. Respondents with a higher education level and two or more financial stressors had higher odds of accessing police and counselling. Respondents harmed by a stranger had higher odds of accessing police, whereas respondents harmed by someone they know had higher odds of seeking support from family/friends. Experiencing more severe harm was associated with greater odds of accessing any support.

Discussion and Conclusions: Several sociodemographic and economic factors were associated with accessing different supports. These findings may inform service development, interventions and policy changes for people affected by others' drinking.