An evaluation is presented of the impact of a comprehensive population-based alcohol harm reduction programme in the Northern Territory funded by a levy of 5 cents per standard drink which took effect from April 1992. The proceeds of the levy supported increased treatment, public education and other prevention activities. Towards the end of the study period (the first 4 years) other positive initiatives were introduced: the lowering of the legal limit for drivers to 0.05 mg/ml and a special levy on cask wine. Indicators of alcohol-related harm were tracked from 1980 to June 30 1996 and developed from hospital, mortality and road crash data. In each case appropriate control data from the same source was employed to control for other possible confounding effects. Alcohol aetiological fractions for major alcohol-related causes of death were estimated taking account of the level of high-risk alcohol use in the Northern Territory. Multiple linear regression and time-series analyses were employed to test for any effect coinciding with the introduction of LWA. There were reductions in estimated alcohol-caused deaths from acute conditions (road deaths 34.5%, other 23.4%) and in road crash injuries requiring hospital treatment (28.3%). In addition there were substantial reductions in per capita alcohol consumption and self-reported hazardous and harmful consumption via surveys. These reductions were evident immediately from the outset of the introduction of LWA and were largely sustained throughout the 4 years studied. The data reported here suggest that significant health and safety benefits accrued to the people of the Northern Territory during the first 4 years of the Living With Alcohol programme. This benefit is likely to be due to several factors: the effect of the levy on alcohol consumption, other factors depressing alcohol consumption and the effect of the LWA programme itself. (A)
Samenvatting