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Alcohol‐selling outlets and mortality in S witzerland—the S wiss N ational C ohort
Author(s) -
Spoerri Adrian,
Zwahlen Marcel,
Panczak Radoslaw,
Egger Matthias,
Huss Anke
Publication year - 2013
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12218
Subject(s) - demography , hazard ratio , confidence interval , residence , medicine , confounding , proportional hazards model , marital status , alcohol consumption , population , alcohol , environmental health , chemistry , sociology , biochemistry
Aim To examine the association of alcohol‐related mortality and other causes of death with neighbourhood density of alcohol‐selling outlets for on‐site consumption. Design, setting and participants Longitudinal study of the adult Swiss population ( n = 4 376 873) based on census records linked to mortality data from 2001 to 2008. Measurements Sex‐specific hazard ratios ( HR ) for death and 95% confidence intervals (95% CI ) were calculated using C ox models adjusting for age, educational level, occupational attainment, marital status and other potential confounders. The density of alcohol‐selling outlets within 1000 m of the residence was calculated using geocodes of outlets and residences. Findings Compared with >17 outlets within 1000 m the HR for alcohol‐related mortality in men was 0.95 (95% CI : 0.89–1.02) for 8–17 outlets, 0.84 (95% CI : 0.77–0.90) for 3–7 outlets, 0.76 (95% CI : 0.68–0.83) for 1–2 outlets and 0.60 (95% CI : 0.51–0.72) for 0 outlets. The gradient in women was somewhat steeper, with a HR comparing 0 with >17 outlets of 0.39 (95% CI : 0.26–0.60). Mortality from mental and behavioural causes and lung cancer were also associated with density of alcohol‐selling outlets: HR s comparing 0 outlets with >17 outlets were 0.64 (95% CI : 0.52–0.79) and 0.79 (95% CI : 0.72–0.88), respectively, in men and 0.46 (95%CI: 0.27–0.78) and 0.63 (95% CI : 0.52–0.77), respectively, in women. There were weak associations in the same direction with all‐cause mortality in men but not in women. Conclusions In S witzerland, alcohol‐related mortality is associated with the density of outlets around the place of residence. Community‐level interventions to reduce alcohol outlet density may usefully complement existing interventions.