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OBJECTIVE U.S. policymakers and public health practitioners lack composite indicators (indices) to assess and compare the restrictiveness of state-level alcohol policy environments, conceptualized as the presence of multiple policies in effect in a particular place and time. The purposes of this study were to characterize the alcohol policy environment in each U.S. state and Washington, DC, in 2018, and to examine changes during the past 20 years. METHOD State-specific Alcohol Policy Scale (APS) scores from 1999 to 2018 were based on 29 policies, after weighting each present policy by its efficacy and degree of implementation. Modified APS scores were also calculated on the basis of two sets of mutually exclusive policy subgroups. RESULTS APS scores in 2018 varied considerably between states, ranging from 25.6 to 67.9 on a theoretical scale of 0 to 100; the median score was 43.5 (based on a 0-100 range), and 43 states had scores less than 50. The median change in state APS scores from 1999 to 2018 was positive (+4.9, range -7.4 to +10.3), indicating increases in the restrictiveness of policy environments, with decreases in only five states. The increases in APS scores were primarily attributable to the implementation of stronger impaired-driving laws, whereas policies to reduce excessive drinking were unchanged. There was no correlation between states' excessive drinking policy scores and their impaired-driving scores (r = .05, p = .74). CONCLUSIONS Based on this policy scale, few states have restrictive policy environments. Although states adopted policies targeting impaired driving during the study period, there was no change in policies to reduce excessive drinking.OBJECTIVE Although alcohol consumption is considered a major modifiable risk factor for chronic disease, policies to reduce alcohol-related harm remain low on the Canadian policy agenda. The objective of this study was to understand support for population-level healthy public policies to reduce alcohol-related harm by assessing the attitudes of policy influencers and the public in two Canadian provinces, and by sociodemographic characteristics. METHOD A stratified sample of the general public (n = 2,400) and a census sample of policy influencers (n = 302) in Alberta and Quebec participated in the 2016 Chronic Disease Prevention Survey, which included questions to assess support for alcohol-specific policies. Differences in levels of support were determined by calculating differences in the proportion of support for alcohol control policies, comparing groups by regional and sociodemographic characteristics. The modified Nuffield Council on Bioethics Intervention Ladder was used to assess support according to the level of individual intrusiveness. SCR7 cost RESULTS We found that policy influencers and general public respondents were supportive of both information-based policies, with the exception of warning labels, and more restrictive policies targeting youth (e.g., enforcement). Both groups were less favorable to alcohol-specific policies that guided choice through disincentives (e.g., taxation). There were more differences in policy support by sociodemographic characteristics among the public. CONCLUSIONS For health advocates to advance policies to reduce alcohol-related harms at the population level, they will need to mobilize additional support for more intrusive, yet more effective, policy interventions. Advocacy efforts should focus on communicating the effectiveness and positive outcomes of these interventions to help garner support.OBJECTIVE The aim of this study was to assess the effectiveness of the 2015 law restricting alcohol marketing on social media in Finland. METHOD The study compared posts that market alcohol on Finnish and Swedish social media in terms of number, content, and user engagement during the month of January in three separate years 1 year before, 1 year after, and 2 years after the 2015 Alcohol Act came into effect in Finland. The data consisted of all posts (Finland, N = 1,536; Sweden, N = 1,204) published during the selected months by alcohol brands that had active national social media accounts at the time of data collection. The coding protocol included numbers of posts and measures of consumer engagement, as well as content restricted by the law. RESULTS Social media posting increased between the 2014 and 2016 samples in both countries. In Finland, the number of posts decreased in 2017. The proportion of posts with content restricted by the 2015 law increased in both countries between the 2014 and 2016 samples. However, in Finland, the amount of restricted content decreased in the 2017 sample, whereas in Sweden it increased, Pearson χ2(1) = 29.273, p less then .001. The level of user engagement increased in both countries between the 2014 and 2017 samples. CONCLUSIONS The social media regulation in the Finnish 2015 amendment has had an impact on alcohol brands' social media content, but it has not affected marketers' ability to increase consumer engagement.OBJECTIVE Do youth switch channels during alcohol advertisements at different rates than adults? This question has implications for the alcohol industry's self-regulation of its advertising placements. People may avoid television advertisements by switching channels, which can be measured by comparing two television audience metrics commercial ratings (which measure the audience during the advertisement) and program ratings (which measure the audience during the television program). We assessed changes in youth and adult audiences during alcohol advertisements with implications for alcohol industry self-regulatory compliance. METHOD A census of alcohol advertisements for 2010-2014 was licensed from Nielsen (New York, NY). We compared noncompliant advertisements (with youth making up >28.4% of the audience) and the percentage decline in per capita advertising exposure for youth and adult age groups using both commercial and program ratings. RESULTS The audience during the alcohol advertisement declined by 8.48% among underage viewers ages 12-17 years and by 7.04% for viewers ages 18-20 years, compared with 8.20% for adults ages 21-24, 10.43% for ages 25-34, and 9.74% for ages 35 and older. These declines exceeded the margin of error (±2.6%), indicating a decline in viewership across all age groups, but we could not draw conclusions about differences between age groups. Compared with audience estimates using commercial ratings, program ratings underestimated the number of noncompliant advertisements by 8,800, leading to an underestimate of noncompliant exposure by 140 million impressions. CONCLUSIONS Both underage viewers and young adults switched channels during alcohol advertisements. Using commercial ratings rather than program ratings may more accurately measure compliance with alcohol industry advertising guidelines.
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