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The impact of an alcohol policy change on developmental trajectories of youth alcohol use: examination of a natural experiment in Canada

Abstract

Objectives

In 2015, the Liquor Control Board of Ontario (LCBO) authorized sale of alcohol in some Ontario grocery stores. This research evaluates the impact of the new policy on alcohol use patterns of youth in a quasi-experimental setting with two control groups.

Methods

The sample consists of 2267 grade 9 students attending 60 secondary schools across Ontario (n = 56) and Alberta (n = 4), who provided 4-year linked longitudinal data (2013–2014 to 2016–2017) in the COMPASS study. The study used the frequency of drinking and the frequency of binge drinking to characterize alcohol use behaviours.

Results

Latent transition analysis found four statuses of alcohol use: abstainer, periodic drinker, low-risk drinker, and high-risk regular drinker. The new policy had no negative impact among periodic and low-risk drinkers, but the risk of transitioning from the abstainer (lowest risk status) to high-risk regular drinker (highest risk status) among the exposed cohort was 1.71 times greater post-policy than pre-policy change, compared with those of Ontario-unexposed (0.50) and Alberta-unexposed cohorts (1.00). The probability of sustaining high-risk drinking among the exposed cohort increased by a factor of 1.76, compared with 1.13-fold and 0.89-fold among the Ontario-unexposed and Alberta-unexposed cohorts, respectively.

Conclusion

Youth are more likely to transition from abstinence to high-risk regular drinking, and high-risk regular drinkers are more likely to maintain their behaviours in the jurisdictions exposed to the latest change in LCBO policy authorizing grocery stores to sell alcohol. When formulating policy interventions, youth access to alcohol should be considered in order to reduce their harmful alcohol consumption.

Résumé

Objectifs

Depuis 2015, la Régie des alcools de l’Ontario (LCBO) autorise la vente d’alcool dans certaines épiceries de la province. Nous évaluons ici l’incidence de la nouvelle politique sur les habitudes de consommation d’alcool des jeunes dans un milieu quasi-expérimental avec deux groupes témoins.

Méthode

Notre échantillon est constitué de 2 267 élèves de 9e année, fréquentant 60 écoles secondaires en Ontario (n = 56) et en Alberta (n = 4), qui ont fourni des données longitudinales couplées sur une période de quatre ans (2013-2014 à 2016-2017) dans le cadre de l’étude COMPASS. L’étude utilise la fréquence de consommation et la fréquence d’hyperalcoolisation rapide pour caractériser les comportements de consommation d’alcool.

Résultats

Une analyse de transition latente a permis de répartir la consommation d’alcool en quatre catégories : non-consommation, consommation ponctuelle, consommation à faible risque et consommation régulière à haut risque. La nouvelle politique n’a pas eu d’effet nuisible chez les consommateurs ponctuels et à faible risque, mais le risque de passer de la catégorie de la non-consommation (risque minimal) à celle de la consommation régulière à haut risque (risque maximal) dans la cohorte exposée était 1,71 fois supérieur après l’instauration de la politique qu’avant le changement d’orientation, comparativement aux cohortes non exposées de l’Ontario (0,50) et de l’Alberta (1,00). La probabilité de maintenir une consommation d’alcool à haut risque dans la cohorte exposée a été de 1,76 fois supérieure, contre 1,13 fois et 0,89 fois dans les cohortes non exposées de l’Ontario et de l’Alberta, respectivement.

Conclusions

Dans les administrations exposées au changement récent de la politique de la LCBO, qui autorise les épiceries à vendre de l’alcool, les jeunes sont plus susceptibles de passer de l’abstinence à une consommation régulière à haut risque, et les consommateurs réguliers à haut risque sont plus susceptibles de maintenir leur comportement. Lors de l’élaboration de politiques, il faudrait tenir compte de l’accès des jeunes à l’alcool pour réduire la consommation nocive dans cette population.

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Funding

The COMPASS study was supported by a bridge grant from the Canadian Institutes of Health Research (CIHR) Institute of Nutrition, Metabolism and Diabetes (INMD) through the “Obesity – Interventions to Prevent or Treat” priority funding awards (OOP-110788; grant awarded to S. Leatherdale) and an operating grant from the Canadian Institutes of Health Research (CIHR) Institute of Population and Public Health (IPPH) (MOP-114875; grant awarded to S. Leatherdale), a CIHR Project Grant (PJT-148562; grant awarded to S. Leatherdale), a CIHR Project Grant (PJT-149092; grant awarded to K. Patte), and a research funding arrangement with Health Canada (#1617-HQ-000012; contract awarded to S. Leatherdale).

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Correspondence to Mahmood R. Gohari.

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Gohari, M.R., Cook, R.J., Dubin, J.A. et al. The impact of an alcohol policy change on developmental trajectories of youth alcohol use: examination of a natural experiment in Canada. Can J Public Health 112, 210–218 (2021). https://doi.org/10.17269/s41997-020-00366-7

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Keywords

  • Adolescents
  • Developmental trajectory
  • Substance use
  • Latent transition analysis
  • Policy evaluation

Mots-clés

  • Adolescents
  • trajectoire développementale
  • consommation de substances
  • analyse de transition latente
  • évaluation des politiques