By medical reporter Sophie Scott 30 Jun 2017, 12:44pm

More than three quarters of court cases where local communities are against big alcohol stores being built are being thrown out because judges do not have to consider the health impacts of planning decisions.

Key points:

• Public health and family violence impacts are not considered by courts when deciding whether to approve liquor stores
• Advocates say loophole needs to be closed to prevent stores being built in areas with high domestic violence rates
• Alcohol industry says most licensing authorities already consider public interest

In the first study of its kind, researchers from the Australian Prevention Partnership Centre, based at Sax Institute and the George Institute for Global Health, found that in more than 75 per cent of cases across Australia, the courts found in favour of the alcohol industry.

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By Catharine Paddock PhD

Published 7th  June 2017

The results of a new study have shown that even moderate alcohol intake can have a negative impact on cognitive health.

A new study concludes that even moderate alcohol consumption is linked to a raised risk of faster decline in brain health and mental function. The researchers say that their findings support the United Kingdom's recent tightening of guidance on alcohol and question the limits given in the United States guidelines… The data included information about weekly alcohol consumption and regular measures of brain function and mental performance. The participants also had an MRI brain scan at the end of the study.

When they analyzed the data, the researchers found that higher alcohol intake over the 30-year study period was tied to a higher risk of atrophy or tissue degeneration in the hippocampus, which is a part of the brain that is important for spatial orientation and memory.

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Adolescents who drink alcohol are at increased risk for injury and substance use disorder later in life, even when they do not meet criteria for alcohol use disorder (AUD). This study assessed changes in grey matter volumes over a 10-year period between adolescence and early adulthood in individuals who had alcohol use (as defined by AUDIT-C score), but did not meet criteria for AUD or use other substances.

• The following areas had smaller grey matter volumes in participants with “heavy” drinking when compared with those with “light” consumption* (control): bilateral subgenual anterior cingulate cortex, right orbitofrontal and frontopolar cortex, right superior temporal gyrus, and the right insular cortex.

* Defined by authors as: heavy = AUDIT-C score of ≥4 for males or ≥3 for females; light = AUDIT-C score of ≤2.

Comments: This study demonstrates that even levels of alcohol consumption that may be considered benign “experimentation” during adolescence are associated with smaller grey matter in several brain regions. Functional changes in the insular cortex are associated with propensity to return to substance use; disrupted development in this area may be the basis of the association between early initiation and increased risk of AUD in adulthood. The results underscore the risks of adolescent alcohol use and suggest that AUD diagnostic criteria may not be sensitive enough to identify them in this population.

Sharon Levy, MD, MPH

Reference: Heikkinen N, Niskanen E, Könönen M, et al. Alcohol consumption during adolescence is associated with reduced grey matter volumes. 

Addiction. 2017;112(4):604–613.

INDUSTRIAL EPIDEMICS DEFINED: The concept of an epidemic associated with the commercialization of a dangerous product was first developed in the instance of tobacco [5,6]. Beatrice Majnoni d'Intignano [7–9] extended this concept to epidemics related to the consumption of commercial products (e.g. alcohol, illicit drugs, food, cars, guns). We further modified that concept to cover diseases of consumers, workers and community residents caused by industrial promotion of consumable products, job conditions and environmental pollution, respectively, and to endemic as well as epidemic conditions. In each instance, public health-oriented policies run the risk of being opposed by industrial corporations in a health versus profit trade-off. In this editorial we argue that the term ‘industrial epidemics’ applies to alcohol because alcoholic beverages are industrial products, and alcohol-related problems fit the concept of increased frequency as a marker of epidemics, whether over time, in different places, or among subgroups of particular populations [10]….

There are several ways in which corporate activity may drive an epidemic, either initially when a new product is introduced or as a secondary impetus following an endemic period. ‘Generational epidemics’ derive from the need of corporations to replenish their population of users as old cohorts die out and new cohorts of potential users are moving toward adulthood. For example, as a new generation of potential drinkers comes of age, the alcohol industry competes for the young adult market. An important research question is how much of the recent increase in heavy episodic drinking among young Europeans is due to aggressive marketing by the alcoholic beverage industry? ‘Targeted epidemics’ refer to decisions by industrial corporations to single out particular groups for increased use or consumption of its products, or for the development of new products. In the case of alcohol there is a long history of such targeted epidemics, such as the Gin Epidemic in the 18th century [14,15]. In recent times, one may cite increased use of flavored malt beverages (‘alcopops’) [16,17] by adolescents in many countries as a targeted epidemic. Finally, ‘transnational epidemics’ are a special group of epidemics where the targets are foreign countries. Industries export their products to other countries to augment their markets or to develop new markets that are not yet saturated or subject to stringent regulations. The alcohol industry's global corporations have expanded alcoholic beverage markets in several developing or transitional countries in the past few decades [18], which has been associated with increasing alcohol problem rates. 

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