Applying an intersectional lens to alcohol inequities: A conceptual framework.

Background: Prior research has demonstrated substantial inequities in alcohol consumption, alcohol-related harms, and mortality. These inequities arise from a complex interplay of factors, unlikely addressed by single factor analyses or solutions. Conceptual frameworks, such as the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework, aim to reflect this complexity and support multifaceted research and action.

Estimating the differential exposure of household groups to alcohol duty reforms in Great Britain.

Background: We explored the potential impact of changes to the UK alcohol tax system implemented in August 2023 on increases on consumer spending, the separate impacts of the changes to the duty structures, and how these impacts vary between households depending on their level of alcohol purchasing and their socioeconomic position.

Methods: We used household-level purchasing data from Kantar's Worldpanel to analyse four alternative scenarios, reflecting the three separate components of the duty reforms (the changes to the duty structures, the temporary wine easement, and the additional 10.1% increase in duty rates).

Estimating recent trends in alcohol sales in the United Kingdom from alcohol duty revenue.

Background And Aims: The onset of the COVID-19 pandemic led to significant changes in individual-level alcohol consumption and a sharp increase in heavy drinking in the United Kingdom (UK). More recently, high rates of inflation, the resulting 'cost of living crisis' and reforms to alcohol taxation have affected the affordability of alcohol, but little is understood about how these changes have impacted on alcohol sales and consumption. We aimed to measure recent trends in alcohol sales by assessing changes in alcohol duty revenue collected by the UK government since 2020.

Model-based appraisal of the potential effects of minimum pricing for tobacco in Scotland.

Background: Minimum tobacco pricing would set a legal price floor. This study aimed to estimate how five minimum price thresholds could impact smoking behaviour, health and economic outcomes alongside tobacco tax increases in Scotland.

Methods: The Sheffield Tobacco and Alcohol Policy Model was used to estimate effects on tobacco consumption up to the Scottish Government's 'tobacco-free' target of 2034.

Evaluating the effectiveness of the Drink Less smartphone app for reducing alcohol consumption compared with usual digital care: a comprehensive synopsis from a 6-month follow-up RCT.

Background: Digital interventions can be effective for reducing alcohol consumption. However, most digital interventions that have been evaluated are websites and there is little evidence on the effectiveness of smartphone apps, especially in a United Kingdom context. We developed an evidence- and theory-informed app, Drink Less, to help increasing-and-higher-risk drinkers (Alcohol Use Disorders Identification Test score ≥ 8) reduce their alcohol consumption.

Protocol for an economic evaluation alongside a natural experiment to evaluate the impact of later trading hours for bars and clubs in the night-time economy in Scotland: The ELEPHANT study.

Introduction: The night-time economy comprises various sectors, including hospitality, transportation and entertainment, which generate substantial revenues and contribute to employment opportunities. Furthermore, the night-time economy provides spaces for leisure activities, cultural expression and social interaction. On-trade alcohol premises (places where consumers can buy and consume alcohol such as bars, pubs, clubs and restaurants) are a significant component of this night-time economy, functioning as focal points for socialising, entertainment and cultural events.

Trends in alcohol-specific deaths in England, 2001-22: an observational study.

Background: Following the COVID-19 pandemic, many countries saw large increases in rates of alcohol-specific deaths, including England. This study aimed to examine whether there have been changes in the characteristics of those dying by specific cause of death, age, sex, and area-level deprivation.

Methods: Using annual mortality data in England published by the Office for National Statistics, we describe the prevalence and 95% CI of age-standardised rates of alcohol-specific deaths overall and by age, sex, area-level deprivation measured by quintiles of the Index of Multiple Deprivation (IMD), and cause of death between 2001 and 2022.

Evaluating the impact of minimum unit alcohol pricing on purchasing behaviour by different social class and age groups in Wales: A controlled interrupted time series study.

Objectives: Alcohol consumption and its associated harms pose a significant challenge to public health in the UK. To address this issue, Wales implemented a Minimum Unit Price policy (MUP) in February 2020, setting a minimum price of 50p per UK unit of alcohol (10 ml/8 g). In this study we evaluate the policy's impact on alcohol sales metrics to gauge its effectiveness in improving public health outcomes.

Quantile regression of tobacco tax pass-through in the UK 2017-2021: how have manufacturers passed through tax changes for different tobacco products in small retailers? Analysis at the national level and by neighbourhood of deprivation.

Background: The effectiveness of tax increases in reducing tobacco consumption relies on the tobacco retailers and producers passing on increases to consumers (tax pass-through). Previous UK research on supermarkets found heterogeneous levels of tax pass-through across the market segments and price distribution of tobacco products. This study uses data from small retailers across the UK to assess whether recent tax changes have been passed on to consumers and if this varies across the price distribution, between countries of the UK and by neighbourhood deprivation.

Modeling the Potential Health, Health Economic, and Health Inequality Impact of a Large-Scale Rollout of the Drink Less App in England.

Objectives: Alcohol places a significant burden on the National Health Service (NHS); yet, uptake of cost-effective approaches remains low. Digital interventions may overcome some barriers to delivery. The Drink Less app has evidence of being effective at supporting heavier drinkers to reduce their alcohol intake.

Paying the price: Financial hardship and its association with psychological distress among different population groups in the midst of Great Britain's cost-of-living crisis.

Background: Great Britain has been experiencing a cost-of-living crisis since late 2021, with the cost of everyday essentials rising more quickly than the average household income. This study provides up-to-date information on levels of subjective and objective financial hardship during this crisis, differences across population subgroups, and associations with psychological distress.

Methods: We used data from a representative cross-sectional survey of adults (≥16 y) in Great Britain (n = 7,027) conducted January-March 2023.

Trends in alcohol expenditure among risky drinkers: A population study in England, 2014-2023.

Background: This study aimed to estimate time trends in alcohol expenditure among risky drinkers in England over the past decade, to understand whether these trends are driven by changes in prices paid or volumes purchased, and to explore differences between population subgroups.

Methods: Nationally-representative monthly cross-sectional survey. Participants were 44,382 adults (≥18y) drinking at risky levels (AUDIT-C ≥ 5; 'risky drinkers').

Reflectance confocal microscopy in diagnosing basal cell carcinoma in the UK: a prospective observational single-centre trial.

Background: Previous work with reflectance confocal microscopy (RCM) has shown high sensitivity and specificity for basal cell carcinoma (BCC); however, to date, there have been few studies in UK cohorts.

Objectives: To assess the potential of RCM to accurately diagnose BCC in a private UK secondary care, single-clinician setting, and to investigate the potential of RCM as a routine diagnostic procedure.

Methods: In total, 522 lesions where BCC featured in the differential diagnosis after clinical examination were prospectively recruited; 78 lesions were subsequently excluded.

Evaluating the Acceptability of the Drink Less App and the National Health Service Alcohol Advice Web Page: Qualitative Interview Process Evaluation.

Background: The extent to which interventions are perceived as acceptable to users impacts engagement and efficacy.

Objective: In this study, we evaluated the acceptability of (1) the smartphone app Drink Less (intervention) and (2) the National Health Service (NHS) alcohol advice web page (usual digital care and comparator) among adult drinkers in the United Kingdom participating in a randomized controlled trial evaluating the effectiveness of the Drink Less app.

Methods: A subsample of 26 increasing- and higher-risk drinkers (Alcohol Use Disorders Identification Test score≥8) assigned to the intervention group (Drink Less; n=14, 54%; female: n=10, 71%; age: 22-72 years; White: n=9, 64%) or usual digital care group (NHS alcohol advice web page; n=12, 46%; female: n=5, 42%; age: 23-68 years: White: n=9, 75%) took part in semistructured interviews.

Do engagement and behavioural mechanisms underpin the effectiveness of the Drink Less app?

This is a process evaluation of a large UK-based randomised controlled trial (RCT) (n = 5602) evaluating the effectiveness of recommending an alcohol reduction app, Drink Less, compared with usual digital care in reducing alcohol consumption in increasing and higher risk drinkers. The aim was to understand whether participants' engagement ('self-reported adherence') and behavioural characteristics were mechanisms of action underpinning the effectiveness of Drink Less. Self-reported adherence with both digital tools was over 70% (Drink Less: 78.

Effectiveness of a smartphone app (Drink Less) versus usual digital care for reducing alcohol consumption among increasing-and-higher-risk adult drinkers in the UK: a two-arm, parallel-group, double-blind, randomised controlled trial.

Background: Digital interventions, including apps and websites, can be effective for reducing alcohol consumption. However, many are not evidence- or theory-informed and have not been evaluated. We tested the effectiveness of the Drink Less app for reducing alcohol consumption compared with usual digital care in the UK.

Trends in purchasing cross-border, illicit and home-brewed alcohol: A population study in Great Britain, 2020-2023.

Introduction: The last 3 years have seen substantial changes in Great Britain (GB) including the COVID-19 pandemic, cost-of-living crisis and policy changes such as minimum unit pricing. We examined changes in purchasing cross-border, illicit and home-brewed alcohol among risky drinkers over this period.

Methods: Data were used from 22,086 adult (≥18 years) increasing/higher-risk drinkers (AUDIT-C ≥5) participating in a monthly cross-sectional survey between October 2020 and August 2023.

Estimating quality-adjusted life expectancy (QALE) for local authorities in Great Britain and its association with indicators of the inclusive economy: a cross-sectional study.

Objectives: Quantifying area-level inequalities in population health can help to inform policy responses. We describe an approach for estimating quality-adjusted life expectancy (QALE), a comprehensive health expectancy measure, for local authorities (LAs) in Great Britain (GB). To identify potential factors accounting for LA-level QALE inequalities, we examined the association between inclusive economy indicators and QALE.

Geographical differences in the financial impacts of different forms of tobacco licence fees on small retailers in Scotland.

Objective: Retailer licencing fees are a promising avenue to regulate tobacco availability. However, they face strong opposition from retailers and the tobacco industry, who argue significant financial impacts. This study compares the impacts of different forms of tobacco licence schemes on retailers' profits in Scotland.

Modelling the longer-term health and health inequality impacts of changes in alcohol consumption during the COVID-19 pandemic in England.

Background: Alcohol consumption changed substantially during the COVID-19 pandemic for many people. This study quantified how these changes in drinking varied across the population and their potential longer-term impact on health and health inequalities.

Methods: We analyzed data from the Alcohol Toolkit Study to estimate how alcohol consumption changed during the pandemic (April 2020-November 2021) and how these changes varied with age, sex, drinking level and socioeconomic position.

The effect of a minimum price per unit of alcohol in Scotland on alcohol-related ambulance call-outs: A controlled interrupted time-series analysis.

Background And Aims: On 1 May 2018, Scotland introduced a minimum unit price (MUP) of £0.50 for alcohol, with one UK unit of alcohol being 10 ml of pure ethanol. This study measured the association between MUP and changes in the volume of alcohol-related ambulance call-outs in the overall population and in call-outs subsets (night-time call-outs and subpopulations with higher incidence of alcohol-related harm).