Alcohol harms and the NZ reforms

Man, I shouldn't have gotten my hopes up.

The Science Media Centre pointed me to reporting on some new work look at what's happened consequent to National's Sale & Supply of Alcohol Act 2012.

It always felt like a spot where some really good work could be done. Different locales implemented different district licensing plans at different times, so you could run a panel study looking at how different measures worked in different places.

But that isn't what this is. And what it is... well, let's go through it.

So the Science Media Centre points to this Newshub Newsroom (dammit) piece by Farah Hancock. It doesn't start well.

Alcohol industry appeals have “muted” potential benefits of legislation aimed at reducing the estimated $14.5 million a day cost of alcohol harm, a new study finds.

Massey University research shows the only effect of the Sale and Supply of Alcohol Act 2012 (SSAA) is a reduction in alcohol availability after 4am in cities.

The alcohol industry appealed 30 of 32 alcohol policies proposed by councils to reduce harmful drinking.

Lead researcher Stephen Randerson said alcohol related harm was estimated to cost New Zealand $5.3 billion per year.

“That was in 2005, so it’s probably going to have risen since then. The things that feed in to this are the cost of emergency services including police work where alcohol is involved in at least one in three call-outs, the emergency department and the health cost of chronic disease caused by alcohol.”

Recall that the $5.3 billion figure cited was from BERL's decade-old work and was their headline figure for the cost of alcohol and joint alcohol-and-other-drug use. The alcohol-alone figure was $4.8 billion. And that figure was very very wrong. Matt, Brad and I explained the problems in it in this NZMJ piece. A few of those problems:

• Counting as a social cost every dime spent on alcohol by anyone consuming more than about 2 pints of beer per day, including all alcohol excise paid by that cohort;
• Double-counting productivity costs of lost wages and VSL measures of statistical lives lost that encompass productivity costs;
• Counting as social cost every cost incurred by a heavier drinker, but not netting from those costs any benefits experienced by those drinkers.

A bad stat is hard to kill. And folks citing those kinds of stats who should know better, well, it tells me to be careful when reading what they've done.

And that brings us to the piece out in Friday's NZ Medical Journal by Randerson, Casswell and Huckle that's the basis for all this [Why oh Why can't news outlets just link to the study?!]

The piece uses survey methods developed in Casswell's International Alcohol Control study to structure interviews with 36 informants (main sources, according to the article, being police, liquor licensing inspectors, and public health officials) in early 2014 and early 2016, with 26 of the informants interviewed in both rounds of interviews. Plus a few police who do alcohol breathaliser checkpoints. 

Those informants scored a pile of things, like their view of regulatory compliance and enforcement, alcohol availability, trading hours, compliance with hours, difficulty of obtaining new licences, purchase age enforcement, and several other indicators. 

So I guess I'll have to keep hoping somebody credible does the panel data work I've been hoping to see - this is just a survey of what police, public health, and liquor licensing inspectors think about things.

Ok, so where's the evidence on big bad industry thwarting local communities? Here's the relevant section - there's also a bit in the conclusion I'll quote later.

Local alcohol policies

Only five LAPs were in force by the end of 2015, although 32 of 67 territorial authorities had produced a draft or provisional policy by this time (pers. comm. Jackson, 2016). Appeals were the most commonly reported impediment to developing an LAP. Some local authorities halted or deferred developing a LAP until appeals in other districts had been decided. Other difficulties cited were finding a compromise between the commercial goals of businesses and alcohol-related harm in the community; opposition from business interests, including the hospitality industry and supermarket chains; and time and cost.

Now if you've been paying attention to the LAPs, you'd know that there's some truth here. When Nelson-Tasman went for their LAP, they decided to hold back until Wellington's had been decided. But it wasn't industry that was appealing Wellington's LAP, it was the police and medical people who didn't like that Wellington wanted a 5am closing time and were trying to litigate them down to 3am.

Disclosure - I was hired by the Hospitality Association to provide evidence on the international literature on bar closing times. Didn't wind up presenting in Nelson because all that was deferred to the Wellington decision, but I did have a lot of fun presenting in Wellington in 2014. Bottom line: it's a stretch to expect any major changes in harms with a couple hours' difference in closing times, but it's likely a good idea to have bottle shops close before the bars do.

Anyway, the police and medical lobbyists were going to have a tough time getting anything more restrictive than the national default hours in Wellington because, well, Wellington could always just choose not to have an LAP and stick with the default. But at least I got to have a bit of fun.

But all that Casswell's team has in this survey is respondents (police officers, licensing officials, and public health people) complaining that businesses selling alcohol will often object to the licencing plans that police and public health people want.

LAPs have significant potential to restrict trading hours, outlet density and location, but too few were in force in 2015 to affect the alcohol environment nationally. Appeals against LAPs deterred and delayed their implementation. Although medical officers of health and police mounted several appeals, appeals from off-licence alcohol suppliers were more widespread, and most commonly resulted in the relaxation or removal of restrictions from LAPs.29 In light of the substantial commercial conflict of interest which alcohol suppliers have with the SSAA’s aim of minimising harm from the excessive consumption of alcohol,30 steps to protect the LAP development process from their influence appear desirable. This could facilitate policies which are more likely to reduce alcohol-related harm, and reduce development time and cost.

So the problem they've identified with the Act is that tribunals and courts sometimes wind up siding with industry objections to local plans. Like, if industry were just raising objections that wasted time and were never upheld, then you could make an abuse of process case and hope that the courts might start awarding costs or something.

But the big SHORE-team complaint here is that sometimes LAPs are made more liberal after industry appeals. If the Police objected to some bit of criminal law procedure that made it harder for them to get convictions for people the courts wind up finding innocent, or that make it easier for people successfully to appeal convictions, I'd hope we'd want stronger basis for changes than just that observation from some surveyed police officers.

Alcohol marketing and evidence

Two contrasting stories in the weekly mailbag.

Item the first: Sally Casswell takes one look at the evidence in a viewpoint article in the NZMJ and concludes:

Stepping back and looking at the harm alcohol does in our society, the evidence on marketing’s effect on young people’s consumption and the popular support evinced for change, the only reasons to maintain alcohol marketing in its current largely unrestricted state are to: first, protect the profits of the transnational corporate producers by allowing them to appeal to new cohorts of young people with marketing which recruits them as consumers as early as possible and encourages drinking of larger amounts and second, to protect the financial interests of the advertising and media industries.

It is hard to avoid drawing a conclusion that government’s failure to act was based on a decision to protect the interests of these large corporations at the expense of protecting the health and wellbeing of future generations of New Zealanders.

A restriction on alcohol marketing similar to that adopted more than 20 years ago in relation to tobacco (Smoke-free Environments Act, 1990) or specific to alcohol similar to that in France (LoiEvin, 1991) will not impact in any meaningful way on adult consumers’ knowledge of the availability of alcohol.

Significant restrictions on alcohol marketing will, however, likely effect the normalisation of alcohol. Normalisation, the acceptance of ubiquitous and perception of unproblematic use, makes it more difficult for health promotion and social marketing to affect consumption among heavy drinking social networks or for family and whanau to place limitations on access to alcohol by vulnerable young people.

...
The ideal is a complete ban on alcohol marketing. This is feasible and a useful model is available in the Smoke-free Environments Act 1990. It has the advantage of thorough coverage of all marketing and sponsorship and includes internet marketing. 

Casswell's piece argues that the evidence on the harms of alcohol marketing to youths is so obvious, lack of government action means the government must have been subverted by evil evil industry.

Item the Second: Cochrane has been running systematic reviews of all kinds of things. Here's Cochrane on alcohol advertising.

OBJECTIVES: To evaluate the benefits, harms and costs of restricting or banning the advertising of alcohol, via any format, compared with no restrictions or counter-advertising, on alcohol consumption in adults and adolescents.

AUTHORS' CONCLUSIONS: There is a lack of robust evidence for or against recommending the implementation of alcohol advertising restrictions. Advertising restrictions should be implemented within a high-quality, well-monitored research programme to ensure the evaluation over time of all relevant outcomes in order to build the evidence base.

And here's what I'd said at the Ministerial Forum on Alcohol Advertising and Sponsorship back in the fall.

Bans on advertising, in a free society, are only justifiable on solid evidence of substantial net harm reduction. The existing evidence shows only weak associations between exposure to advertising and consumption behaviours.

...

No further restrictions to alcohol advertising are justifiable on current evidence. However, if the government is determined to impose such restrictions, it could at least design them in such a way as to allow for programme evaluation. If you decide to ban billboards, set up a rolling phase-in design across a set of towns to assess whether the ban has had any effect; if it has not, then remove the ban. If you decide to ban alcohol advertising in print, use a similar rolling phase-in design to allow for evaluation.

So Cochrane concluded there was no evidence sufficient for restricting alcohol advertising and said any measures should be done within a research design allowing for evaluation. I said that there was no evidence sufficient for further restricting alcohol advertising in New Zealand and that any measures undertaken should be set up to allow for evaluation.

But Casswell's piece argues that the evidence is so strong that only industry subversion can explain lack of action.

It remains astonishing that a government so deeply in Big Alcohol's pockets somehow keeps giving grants to Casswell's research outfit.

The value of reputation: NZ Public Health edition

So the Ministry of Justice relied on SHORE to produce some sensible estimates of the price elasticity of alcohol demand in New Zealand for its report on minimum alcohol pricing. It didn't go well. Recall what the Ministry of Justice report had to say about the elasticity estimates produced by SHORE:

Another significant concern is that the size of the elasticity estimates generated by AC Nielsen and the SHORE and Whariki Research Centre are very large compared to international estimates, and result in significant changes in consumption when the various pricing options are analysed. The large off-licence elasticities may be driven by the fact that both regular prices and promotional prices are included in the elasticities. The large on-licence elasticities are likely to be a consequence of a reasonably small sample size and cross-sectional data. 

It was decided that the significant reductions in consumption estimated using NZ elasticity estimates are not a realistic representation of what is likely to happen in reality and are contrary to all international evidence of the responsiveness of alcohol consumers to changes in price. 

So SHORE produces estimates that are "not a realistic representation of what is likely to happen in reality and are contrary to all international evidence". I'd discussed the MoJ report here. 

Sally Casswell is Director of SHORE. 

From the latest round of Health Research Council grants:

2014 Funding Round – Project
Professor Sally Casswell
Massey University, Auckland
Alcohol Policy Interventions in New Zealand (APINew Zealand) - effects of change in sale and supply$1,191,469
36 months
Lay summaryThis research investigates alcohol consumption in New Zealand to measure the effects of changes brought about by new legislation regulating the sale and supply of alcohol. It follows the same people over time surveying them not only about their drinking patterns but also issues which may be affected by policy: for example purchasing patterns: time of day they buy alcohol, how far they travel, how much they pay. The research also measures the alcohol environment using available data and key informant interviews to predict how people's behaviour might change. Those who report large changes in their drinking behaviour will be followed up in more depth to explore what policy and non-policy influences have affected their behaviour. This New Zealand study is part of an international collaboration and allows comparisons between different countries. The goal is to inform the development and implementation of effective alcohol policy and reduce alcohol related harm.

$1.1 million to Casswell from the government. SHORE's general survey work at least is more reliable than their attempt at modelling elasticities. Their analysis on the survey work is often pretty bad, but the surveys themselves are potentially useful.

When I'd pointed to declining youth drinking rates a few months ago, Casswell wrote this letter to the NZMJ critical of the much much smaller amount of money that the Brewers Association provided as grant to the University of Canterbury. One-sided skepticism is lovely.

Meanwhile, the University of Otago's temperance crusaders scored another research grant from the government: $1.190 million (a thousand dollars less than Casswell got, for some reason). Here's the HRC summary. I note these bits from Otago's press release on their awarded grant:

Lead investigator Dr Brett Maclennan says the new Act is intended to reduce harm resulting from the excessive consumption of alcohol but it omits almost all of the evidence-based strategies recommended by the Law Commission in its 2010 review.

...Professor Kypros Kypri, a co-investigator on the project, says that “public desire for better alcohol policy is very strong and people were disappointed at the way the Law Commission recommendations for reform were watered down. It is important to know whether the new law is effective and we are delighted to see independent peer-reviewed research funded in this area.”

Well, at least we know their priors. Kypri isn't at Otago but rather at Newcastle, where he argues that the drinking age should increase to 21.

Recall that, in 2008, National ran on an anti-nanny-state ticket. But they keep shovelling funding towards outfits that seem guaranteed to demand ever-tighter controls on alcohol.

Previously:

• On Stillman SHORES
• Increasing alcohol excise is great, if you assume the right things
• Some useful context

Drinking time

Sally Casswell's team has a new paper out on Kiwis' drinking habits. Here was their press release on it. I provided a bit of comment on it for Science Media Centre, copied below.

“The article provides a really interesting survey of drinking habits among New Zealand drinkers. They find that, among Kiwis reporting having consumed alcohol in the past six months, alcohol was reasonably affordable and easily accessible. Drinkers attend pubs reasonably frequently and drink relatively less at pubs than they do on the rarer occasions that they attend nightclubs; I expect this reflects that nightclubs may be more likely to be part of a special event than a visit to the local pub.”

“The authors find that individuals purchasing alcohol after 2 am at an on-licence premise were more likely to have consumed larger amounts of alcohol than those purchasing alcohol before 2 am. I think, though, that they are too quick to conclude that closing times would usefully address heavy drinking. If those at the bar at 12 am include a greater proportion of light drinkers, and the light drinkers tend to go home earlier, we would expect that those purchasing alcohol after 2 am would consist disproportionately of those who were drinking more heavily earlier in the evening and who decided to stay at the bar rather than go home.”

“The authors note correlations between the price of drinks at a venue and the amount consumed; they then argue that lower prices cause differences in quantity consumed at different venues. I wonder about causality here. If you know you only want to have one or two drinks, you might go to the cocktail bar with very expensive and fancy drinks; if you’re interested in a heavier drinking session, you might make sure to hit the venue that you know is cheaper. We then could pretty easily see a relationship between prices at venues and quantities consumed that were due in large part to individuals’ choosing venues appropriate to their intended evening. Similarly, they find drinkers paying lower prices for off-premise alcohol were more likely to drink larger amounts. An equally plausible interpretation is that individuals wishing to drink a larger amount will be more likely to have price in mind when making their purchase, while somebody only intending on having one or two drinks might go for a pricier craft beer or a nicer bottle of wine.”

“Whether their findings on price are causal, or simply correlations, matter for policy. They argue that measures like tax increases or minimum prices would particularly target heavier drinking because individuals are more likely to report having paid less for their alcohol on occasions of heavy drinking. But if people are instead choosing lower cost products for those days when they intend on consuming a larger amount, because they’re budget conscious, price hikes would then have a more limited effect on consumption. Byrnes et al (2012) found that price increases in Australia reduced consumption among lighter drinkers, but did not have much effect on heavy drinking among heavy drinkers. Instead, heavy drinkers saved up money for the weekend binge by drinking less on days in which they would have consumed a smaller amount of alcohol. Wagenaar’s earlier metastudy on prices and consumption showed that a 10% increase in alcohol prices was associated with a 2.8% reduction in heavier drinkers’ consumption, but a 4.4% decrease in average consumption. And while the studies in Wagenaar’s metastudy did not focus on prices in the lower ranges, Stockwell, Auld et al (2012) found that a 10% increase in the minimum price of alcohol in British Columbia reduced overall consumption by 3.4%, a figure entirely in line with the prior Wagenaar study. We then need to worry about whether price measures are appropriately targeted, or whether the costs imposed on moderate drinkers by price measures are worth it. Heavy drinkers aren’t nearly as sensitive to price measures as are lighter drinkers. We could similarly curb speeding by putting the petrol tax up to $6/litre, but it might not be the best way of addressing the harms of speeding.”

Dr. Eric Crampton is Senior Lecturer in Economics at the University of Canterbury. His research on alcohol issues is supported in part by the Brewers Association of Australia and New Zealand, through a grant administered by the University of Canterbury.

I'd be interested in knowing whether till-data from pubs, nightclubs, and dance venues followed the same time pattern as they're suggesting in the survey.

In Casswell's story, everybody starts drinking hard at 2 a.m.: the survey shows heavier drinking among those staying at the pub after 2 a.m. because people start drinking more heavily after 2 a.m.. In that world, earlier closing times might reduce harms from heavy consumption. We would then expect to see, within a bar tab, increasing spend after 2 a.m.. I think you'd need to look at patterns within a tab to make a clean call on this: if we only saw increased per patron expenditures, that's equally consistent with Casswell's story (nothing good happens after2 a.m.) and mine (those who are left in the bar after 2 a.m. were drinking more heavily before 2 a.m. as well, and the lightweights have gone home).

I think it's rather more likely that folks who'd intended on going hard started going hard earlier in the evening and then failed to go home before 2 a.m. - the time series is just picking up cohort effects. If my story's right, then we predict that lighter-drinking tabs are more likely to be closed earlier in the evening, that there isn't any particular increase in within-tab expenditures after 2 a.m., but that per patron consumption increases after 2 a.m. because the patron composition changes over the course of the evening. In that world, closing at 2 a.m. doesn't do tons of good because the heavy drinkers already did most of their heavy drinking; they just otherwise would have stuck around the bar for longer. And, a blanket 2 a.m. closing time would do a lot of harm to all-night dance venues where patrons might not be all that likely to be doing much heavy drinking, other than water, after 2 a.m. anyway (MDMA *cough*).

It's at least testable.

In unrelated news, I look forward to tonight's beer tasting at the University Staff Club.

Love letters

In today's NZMJ:

Marketing and supplying alcohol to young people

The posting of a video of an extremely intoxicated 9-year-old boy resulted in a media furore in recent weeks reflecting the extreme youth of the individual and a heightened focus on Internet postings; it also illustrated increased public concern over alcohol related harm and highlighted some key public health issues which require urgent action.

This case is a ‘tip of the iceberg’ illustration of what our survey data suggests is happening in New Zealand among young people (although data does not cover children as young as 9 years). As controls on sale from licensed premises have become better enforced and compliance has increased—only 9% of 16-year-old drinkers and 14% of drinkers aged 17 purchasing their own alcohol in 2012 (unpublished data, HRC funded Alcohol Policy in New Zealand [APINZ] survey)—social supply has become a major source of alcohol for those under the minimum purchase age. Much supply is from older friends or relatives and, on average, about 11 cans of ready-to-drinks (RTDs) or equivalent are supplied.1

The Sale and Supply of Alcohol Act 2012 introduced greater clarity to the law regarding supplying alcohol to minors. The Act now makes it an offence to supply without ‘express consent’ of the parent or guardian. Charges have been laid against three people in connection with this case providing an opportunity to capitalise on a public health message about the law and the likelihood of prosecution.

The supply of 8 cans of Cody RTDs and 2 shots (about 150 ml of absolute alcohol in total) illustrates the importance of RTDs. In a recent study RTDs were found to be the beverage young suppliers reported supplying most often to those under the minimum purchase age.1

Attempts overseas to introduce specific taxes on RTDs have not been successful because of substitution to alternative beverages2 or amelioration of costs by provision of multipack options3 but evidence shows affordability of alcohol is very important4 and the cost entailed in this supply (about $20.60) was obviously not sufficient to deter the generous spirit of the suppliers.

Increasing excise tax by 50% as recommended by the Law Commission in 2010, but rejected by government, would have increased the cost by only about $3 but would have been a move in the right direction. The results from the APINZ survey show heavier drinkers purchase cheaper alcohol.5 Tax increases are effective to reduce alcohol-related harm and significant tax increases, as have been applied to cigarettes in New Zealand, are urgently needed.

Equally urgent is action to reduce the exposure of young people to the marketing of all alcohol beverages including RTDs. Cody, with the third largest share of the high potency RTD market in NZ, carried out a significant television campaign in 20126 and is prominent in the bottle store displays to which children are exposed.

Then there is the question of distribution: high potency RTDs were to be subject, in the new Act, to greater controls. The original recommendation from the Minister, following the Law Commission review, was to prohibit RTDs above 5% alcohol potency.7 This was reduced to prohibiting sale from off licenses of 6% RTDs while still allowing sale from on-license premises.8 However, after government consulted the producers of RTDs these clauses were withdrawn with a promise the industry would adopt a voluntary code and government would regulate quickly if needed. It is not clear what would trigger regulation or if an organisation independent of the industry will monitor.

Which brings me to a final relevant issue in the media coverage of this story: while there were no comments from the vested interest groups, producers or retailers, one NZ Herald story did quote Dr Eric Crampton, a University of Canterbury economist, who said the video was shocking because ‘rare and sad events are shocking’. He also said ‘while several prominent anti-alcohol commentators have used this tragic case to argue for higher alcohol prices and broader restrictions on where alcohol can be sold, the overall statistics on youth drinking suggest that things are improving’.

Dr Crampton was referring a decrease in the proportion of young drinkers classified as hazardous drinkers or binge drinkers in recent surveys. The Ministry of Health (MoH) NZ Health Survey for example, reported 1 in 5 of those aged 15–17 years were hazardous drinkers (down from about 1 in 4 in 2006/7). There is no doubt there is some improvement but whether enough to argue against improved alcohol control policies is another question.

The University press release and NZ Herald story did not contextualise this ‘expert’ opinion, but in a recent news item it was announced that Dr Crampton and the University of Canterbury had accepted 3 years of funding from the Brewers Association of New Zealand.

In the words of the Director of External Relations of the Brewers Association, Jenny Cameron: “This funding ... will add to the voices in the public debate over alcohol and alcohol policy.”9

Sally Casswell

Director
SHORE and Whariki Research Centre
School of Public Health, Massey University
Auckland, New Zealand

References:

1. SHORE and Whariki. Social Supply of Alcohol to Young People in Taranaki and Mangere. Auckland: Shore and Whariki Research Centre, School of Public Health, Massey University, 2012, December.
2. Müller S, Piontek D, Pabst A, et al. Changes in alcohol consumption and beverage preference among adolescents after the introduction of the alcopops tax in Germany. Addiction. 2010;105(7):1205–13.
3. Jones S, Barrie L. RTDs in Australia: Expensive designer drinks or cheap rocket fuel? Drug Alcohol Rev. 2011;30(1):4–11.
4. Wall M, Casswell S. Affordability of alcohol as a key driver of alcohol demand in New Zealand: a cointegration analysis. Addiction. 2013;8(1):72–9.
5. Wall M, Casswell S, Huckle M, Yeh L-C. Effects of increases in alcohol excise tax: modelling based on results from the IAC survey in New Zealand. Alcohol Clin Exp Res. 2013;submitted.
6. Euromonitor. Rtds/High-Strength Premixes in New Zealand, 2012. http://www.euromonitor.com/rtds-high-strength-premixes-in-new-zealand/report
7. Office of the Minister of Justice. Alcohol Law Reform. 2010. Accessed 20 January, 2014. Available at: http://www.justice.govt.nz/policy/sale-and-supply-of-alcohol/regulation-of-alcohol/alcohol-law-reform-cabinet-paper-final.pdf
8. Ministry of Justice. Regulatory Impact Statement: Alcohol Reform Bill – Policy Amendments for inclusion in the Government Supplementary Order Paper. 2012, 6 September. Accessed Available at: http://www.justice.govt.nz/policy/sale-and-supply-of-alcohol/regulation-of-alcohol/Final%20RIS%20-%20Alcohol%20Reform%20Bill%20-%20Policy%20Amendments%20for%20Inclusion%20in%20the%20Government%20Supplementary%20Order%20Paper.pdf
9. Brewer's Association. Brewers Association to fund Alcohol Policy Research. Scoop; 2013, 6 December. Accessed 20 January, 2014. Available at: http://www.scoop.co.nz/stories/SC1312/S00025/brewers-association-to-fund-alcohol-policy-research.htm

I've just sent this letter to the NZMJ. Perhaps they'll publish it. Their standards on letters seems pretty low. [Update 14 February: it's published here.]

Dear NZMJ,

I note with interest Sally Casswell’s letter in the most recent NZMJ.[1] She writes:

“Which brings me to a final relevant issue in the media coverage of this story: while there were no comments from the vested interest groups, producers or retailers, one NZ Herald story did quote Dr Eric Crampton, a University of Canterbury economist, who said the video was shocking because ‘rare and sad events are shocking’. He also said ‘while several prominent anti-alcohol commentators have used this tragic case to argue for higher alcohol prices and broader restrictions on where alcohol can be sold, the overall statistics on youth drinking suggest that things are improving’.

Dr Crampton was referring a decrease in the proportion of young drinkers classified as hazardous drinkers or binge drinkers in recent surveys. The Ministry of Health (MoH) NZ Health Survey for example, reported 1 in 5 of those aged 15–17 years were hazardous drinkers (down from about 1 in 4 in 2006/7). There is no doubt there is some improvement but whether enough to argue against improved alcohol control policies is another question.

The University press release and NZ Herald story did not contextualise this ‘expert’ opinion, but in a recent news item it was announced that Dr Crampton and the University of Canterbury had accepted 3 years of funding from the Brewers Association of New Zealand.”

Here’s some context, if your readers would be interested.

The University of Canterbury’s media person contacted me requesting a press release on this issue. I was not inclined to comment on the case, knowing nothing of the circumstances of the 9-year-old in the video. But I was then disappointed to hear repeated instances of anti-alcohol commenters suggesting that this case served as exemplar of a worsening trend in youth drinking. I consequently wrote a release focusing on results from the most recent Ministry of Health and Auckland Youth ’12 data that show that youth drinking has been decreasing. I also insisted that the last line of the press release note what might be perceived as a conflict of interest. It reads, “Dr Crampton is a senior lecturer in economics at UC. He also advises the Brewers Association of Australia and New Zealand on alcohol economics and policy.”[2] I forwarded a copy of the release to the Brewers Association as a courtesy; it was the first time that I had talked with them about the matters discussed in the release. They did not request or initiate the release.

It is strictly incorrect for Casswell to insinuate that I was hiding any potential conflicts; they’re noted in the press release. My full disclosure statement has been up on my blog, Offsetting Behaviour[3], since the University entered into this arrangement with the Brewers to facilitate my work, and were also announced in a separate press release in December. It is also incorrect to suggest that my press release pointing to the actual statistics on youth drinking were in any way motivated by this arrangement. I just get annoyed when policy activists try to mislead the public about the underlying statistics. And I continue to be amazed by those who think tax increases are the appropriate way of dealing with those adults who think it hilarious to get 9 year olds drunk.

1. Casswell, S. Marketing and supplying alcohol to young people. New Zealand Medical Journal, 2014;127(1388).
2. The full release is archived at Scoop. http://www.scoop.co.nz/stories/AK1401/S00225/video-showing-a-drunk-nine-year-old-shocking-for-good-reason.htm
3. My disclosures statement is here: http://offsettingbehaviour.blogspot.com/2013/12/alcohol-work.html

Driving your friends to drink

Sally Casswell's latest piece shows that if your friends are more depressed and in worse health, you're more likely to be a heavy drinker. Your friends and family can drive you to drink. Or at least that's the conclusion I drew from her correlations showing that individuals with worse health and lower reported personal well-being were more likely to report knowing heavy drinkers.

She of course frames it as heavy drinkers reducing the quality of life of those around them. But there's no way of sorting out the direction of causation's arrow.

I'd also worry a bit about selection on unobservables - a bunch of demographic covariates also affect the various well-being scores. Such results aren't reported in the paper, but I'd like to know the extent to which the correlation between knowing a heavy drinker and the well-being measures is attenuated by adding in the various covariates. If a big chunk of the correlation is explained by observable differences between cohorts, we'd have to wonder whether other unobservable things that correlate both with hanging out with heavy drinkers and having a generally poor life might explain the rest. For example, suppose that you have very poor personal characteristics such that the best mate you can attract is a heavy drinker. Is your poor reported life satisfaction due to the mate's heavy drinking? Or are your underlying characteristics, only some of which are observable, driving results?

Fortunately, TVNZ sourced its report from Reuters, who seem to know that they need to ask about causality. And so they note:

Casswell acknowledged, however, that the findings do not prove that being around a heavy drinker was the root of study participants' problems, noting that the study is just "a snapshot at one point in time".

"So...some other explanation is possible," she told Reuters, adding that people with poorer well-being may be more likely to attract heavy drinkers into their lives.

Always always ask how the researcher established causality.

HT: Ed.co.nz.