Suchergebnisse

Background and aims There are concerns that national population-based estimates of illicit drug use are underestimated. We investigated this by comparing estimates of illicit substance use at age 24 from the Crime Survey for England and Wales (CSEW) with a birth cohort (Avon Longitudinal Study of Parents and Children, ALSPAC) and also comparing the Smoking and Alcohol Toolkit Studies (STS/ATS) to ALSPAC. Design Cross-sectional household survey, and cross-sectional data from one wave of a longitudinal birth cohort. Setting England and Wales. Participants Young adults aged 23-25 reporting on substance use in 2017 to CSEW (n=1165), ALSPAC (n=3389), and STS/ATS (n=950). Measurements Lifetime and past-year illicit drug use, smoking status and hazardous drinking at age 24. Findings The 2017 CSEW estimate of lifetime illicit drug use was 40.6%, compared with 62.8% in ALSPAC (Risk Difference % (RD%) =22.2% 95% CI 18.9%-25.5%, P≤0.001). The RD in lifetime use between ALSPAC and the CSEW was 23.2% (95% CI 20.0%-26.4%) for cannabis, 16.9% (95% CI 14.4%-19.4%) for powder cocaine and 24.8% (95% CI 22.6%-27.0%) for amphetamine. Past-year drug use was 16.4% in CSEW, compared with 36.7% in ALSPAC (RD%=20.3% 95% CI 17.6%-23.0%, P≤0.001). For past-year substance use, the RD between ALSPAC and the CSEW was 15.4% (95% CI 12.9%-17.9%) for cannabis, 14.8% (95% CI 13.0%-16.6%) for powder cocaine and 15.9% (95% CI 14.5%-17.4%) for amphetamine. Levels of current smoking were similar between STS (27.4%) and ALSPAC (29.4%). Hazardous drinking was substantially higher in ALSPAC (60.3%) than the ATS (32.1%, RD%=28.2% 95% CI 24.8%-31.6%, P≤0.001). Conclusions The Avon Longitudinal Study of Parents and Children provides one source of validation for measurements of drug use in government household surveys and indicates that illicit drug use may be underestimated in the Crime Survey for England and Wales.

BACKGROUND: English alcohol policy is implemented at local government level, leading to variations in how it is put into practice. We evaluated whether differences in the presence or absence of cumulative impact zones and the 'intensity' of licensing enforcement-both aimed at regulating the availability of alcohol and modifying the drinking environment-were associated with harm as measured by alcohol-related hospital admissions. METHODS: Premises licensing data were obtained at lower tier local authority (LTLA) level from the Home Office Alcohol and Late Night Refreshment Licensing data for 2007-2012, and LTLAs were coded as 'passive', low, medium or highly active based on whether they made use of cumulative impact areas and/or whether any licences for new premises were declined. These data were linked to 2009-2015 alcohol-related hospital admission and alcohol-related crime rates obtained from the Local Alcohol Profiles for England. Population size and deprivation data were obtained from the Office of National Statistics. Changes in directly age-standardised rates of people admitted to hospital with alcohol-related conditions were analysed using hierarchical growth modelling. RESULTS: Stronger reductions in alcohol-related admission rates were observed in areas with more intense alcohol licensing policies, indicating an 'exposure-response' association, in the 2007-2015 period. Local areas with the most intensive licensing policies had an additional 5% reduction (p=0.006) in 2015 compared with what would have been expected had these local areas had no active licensing policy in place. CONCLUSIONS: Local licensing policies appear to be associated with a reduction in alcohol-related hospital admissions in areas with more intense licensing policies.