International Journal of Alcohol and Drug Research

Editorial: Papers from the 50th Annual Symposium of the Kettil Bruun Society, 2025

2026-08-29T04:37:21+02:00

Can indirect methods be used as an approximation to estimate alcohol excise taxation revenue?

2026-08-28T16:40:25+02:00

Introduction: Alcohol excise taxation is one of the World Health Organization’s (WHO) “best buys” for reducing alcohol consumption and attributable harms. Despite its proven effectiveness, alcohol taxation remains globally underused, partly due to Member States’ concerns about potential revenue losses. Robust estimation methods are essential to predict future revenues after policy changes. This study compares two approaches for estimating alcohol excise tax revenue per capita and assesses their validity against reported figures.

Methods: Reported alcohol excise tax revenue per capita for 2022 was retrieved from official government sources for 17 countries in the European Union and the United Kingdom. These figures were compared to estimated values generated using two different methods: 1) a tax-and-consumption-based approach using beverage-specific tax and consumption data, and 2) an excise share-based approach using the linear relationship between excise tax share and revenue. Comparisons were made using visual inspection of scatterplots, relative error plots, and Bland-Altman plots, correlation analysis and linear regression models.

Results: Both methods showed strong correlation with reported revenue (tax-and-consumption-based: r = 0.959; excise share-based: r = 0.857) and high explained variance of the reported revenue. The tax-and-consumption-based method demonstrated higher precision, narrower limits of agreement, and significantly better model fit.

Conclusions: Both methods provide useful alternatives in the absence of reported data, but the tax-and-consumption-based approach offers a more accurate and consistent estimate of alcohol excise tax revenue per capita. These findings support its use in global monitoring and fiscal modelling, particularly in the context of WHO technical support to Member States.

Alcohol consumption and the risk of pancreatic cancer: A systematic review and meta-analysis of cohort studies

2026-08-28T16:40:26+02:00

Objective: Previous reviews have reported inconsistent relationships between alcohol use and risk of pancreatic cancer (PC). We investigated associations between alcohol consumption and PC in a meta-analysis.

Methods: PubMed and Web of Science were searched for cohort studies of alcohol and PC incidence/mortality up to January 1, 2024. Studies were coded for former drinker misclassification, extent of control for confounding, and other study characteristics. Mixed models were used to model the meta-data and calculate the summarized hazard ratio as relative risk (RR) of PC incidence/mortality. Former drinker misclassification and other study-level covariates were examined and controlled using adjustments, quality weighting and stratification.

Results: Thirty-seven cohort studies provided 279 PC incidence/mortality risk estimates for drinkers versus “non-drinkers”. In pooled analyses with and without adjustment for study-level covariates, there was no significant protection at any level, and significantly increased risk at >24 grams/day. Significant dose-response relationships were observed; e.g., there was a 2.4% increase in PC risk for each 10g ethanol/day increment in the adjusted model (P=0.0001). In stratified analyses, studies with former drinking bias showed significantly reduced PC risk for those drinking >14-24g/day and no significant increase in risk for people drinking >24-44g/day; neither finding was observed among studies with reduced former drinker bias.

Conclusion: Alcohol consumption and pancreatic cancer exhibits a dose-response risk relationship; consumption of >24 grams/day is significantly associated with increased risk. Failing to separate former drinkers from lifetime abstainers may yield spurious protective associations at low levels of consumption and may suppress risk estimates at higher levels.

Feasibility of a community-centred approach to mapping alcohol outlet density and outlet trading times in two South African communities

2026-08-28T16:40:27+02:00

Background: South Africa has high levels of alcohol consumption, and the availability of alcohol outlets plays a significant role in shaping drinking patterns. Alcohol outlets are typically concentrated in specific small areas, and their density and trading hours can influence alcohol-related harm. Several studies have shown that greater outlet density and extended trading hours are linked to higher levels of alcohol consumption and associated harm. However, community-centred approaches to mapping these factors are less common, especially in low- to middle- income countries (LMICs) such as South Africa.

Aim: To test the feasibility of participatory mapping of alcohol availability, to map this availability and gain stakeholder and community views in selected South African communities.

Methods: This mixed-method study included desktop research to identify known data sources for licensed alcohol outlets; geo-location and mapping of alcohol outlets by local community mappers; and focus group discussions (FGDs) and key informant interviews (KIIs) with community representatives.

Study findings: Alcohol outlets were densely distributed within residential areas, a large proportion of surveyed alcohol outlets were unlicensed, several had long trading times, many opening seven days a week in contravention of municipal by-laws. Spatial analysis showed marked variation in alcohol outlet density across zones, with several high-density hotspots. Outlet density per 1,000 population was substantially higher in Thembalethu than in Ga-Rankuwa. Community voices revealed that alcohol accessibility, long outlet trading times, outlet density, and poor licensing and enforcement contributed to alcohol’s ubiquitous availability.

Conclusion: Participatory, community-centred mapping is a feasible and valuable approach for mapping alcohol availability. Findings highlight high outlet density, widespread unlicensed and informal sales, and the need for stronger regulation and enforcement alongside community involvement in mapping, monitoring, and supporting alcohol regulations.

Barriers and facilitators to making an alcohol reduction attempt and strategies used among people who drink at risky levels in the United Kingdom: A qualitative study

2026-08-28T16:40:28+02:00

Aims: To understand the motives, goals, and strategies of attempts to reduce alcohol among people who drink at risky levels in the United Kingdom (UK).

Methods: We ran six online focus groups with people in the UK who drink at risky levels (Alcohol Use Disorders Identification Test [AUDIT] score ≥ 8; n = 26). We asked about participants’ reasons for making a reduction attempt or not, any goals they had, and any strategies used or considered. Transcripts were analysed using a codebook thematic analysis approach.

Findings: Barriers to making an alcohol reduction attempt included participants’ knowledge (e.g., not perceiving their drinking as harmful), motives to drink alcohol (e.g., coping, enhancement), and the physical (e.g., accessibility of alcohol) and social (e.g., cultural expectations) environment. Facilitators included their knowledge (e.g., realising consumption levels), motives to drink less alcohol (e.g., health-related), and social support. Goals included complete abstinence, reduction in units, improved mental health, and improved relationships. Strategies included changing drinking contexts or the behaviour within them (e.g., not drinking at home), abstinence-based strategies, and tracking units.

Conclusions: People drinking at risky levels in the UK reported a range of motives for drinking alcohol and drinking less alcohol, goals and strategies. These goals were largely inconsistent with the UK low risk drinking guidelines. Future research should assess whether alcohol reduction interventions that incorporate goals relevant to the individual, with tailored strategies based on the individual’s motives and goals for making a reduction attempt, are more effective than non-tailored strategies.

‘I didn’t realise there was a connection’: A qualitative study exploring public awareness of and support for alcohol policy in Ireland

2026-08-28T16:40:28+02:00

Introduction

In Ireland, there has been a shift to a public health approach to alcohol policy through the enactment of the multi-component Public Health (Alcohol) Act. Public opinion is an important factor influencing the legitimacy and sustainment of policies during implementation. This study aims to explore public awareness of and support for this comprehensive alcohol policy in Ireland.

Methods

A qualitative study using online focus groups was conducted with members of the public. We used purposive sampling to ensure a mix of gender, age, geographical location and drinking levels. Data from the focus groups were analysed using thematic analysis.

Results

A total of 29 participants across five focus groups took part in the study. The study found that there was limited awareness and understanding of the Act and its policy measures among participants. While participants were aware of some of the policy measures, many did not associate them with an overarching Act. Support for the policy measures was mixed. Participants showed strongest support for measures that they perceived as targeting children/young people and people with alcohol dependence. Price-based measures generated the lowest support and were perceived by many as unfair and ineffective.

Conclusions

The study suggests that participants’ perspectives on alcohol policy solutions are strongly influenced by industry narratives. Greater awareness-raising of industry tactics among the public and the use of more evidence-informed framing approaches for public communications on alcohol are among the measures suggested to help build public understanding of and support for public health alcohol policies.

Alcohol-related domestic violence in households with children: Analysis of protection order records in Lithuania

2026-08-28T16:52:35+02:00

Aim: A police-initiated domestic violence protection order is a preventive measure aimed at protecting individuals of the same household against the risk of domestic violence. The aim of this study is to examine the role of alcohol intoxication in domestic violence incidents in households with children, and identify factors associated with the application of police-initiated protection orders.

Data and Methods: The authors have analysed police records of domestic violence interventions in Lithuania from July 2023 until February 2024 (n = 20,010). The analysis was carried out using descriptive statistics and multivariable logistic regression.

Results: It was established that police-initiated domestic violence protection orders were issued in 70.1% of the analysed police records, whereas 46.7% of the cases involved an alcohol-intoxicated person who posed a risk of domestic violence to others. Furthermore, 26.5% of interventions involving domestic violence were carried out in households with children. Among households with children, the majority of individuals posing a risk of domestic violence to others while being intoxicated were men (85.2%, p < 0.01). The average blood alcohol concentration of intoxicated individuals was 0.23% (SD = 0.08). By applying the multivariable logistic regression model, the criteria of alcohol intoxication (OR = 4.08 CI[3.44, 4.84]), male gender (OR = 3.56; CI[3.00, 4.24]), history of domestic violence over the past 24 months (OR = 6.09; CI[4.97, 7.46]), and the presence of a child during the incident (OR = 8.38; CI[6.83, 10.29]) were independently associated with a higher likelihood of the issuance of a police-initiated domestic violence protection order.

Conclusion: In practice, the findings have revealed that alcohol consumption and male violence are important factors to consider when devising long-term strategies to prevent domestic violence.