Prevention Matters

A policy statement released by the Committee on Substance Abuse for the American Academy of Pediatrics recommends that doctors screen all of their young patients, beginning in middle school, about their use of alcohol.

"A remarkable amount of brain development is still occurring for young people through their 20s," said report lead author Patricia Kokotailo of the University of Wisconsin School of Medicine and Public Health. "This policy statement provides better evidence about how alcohol affects the brains of young people and why it is important to screen children."

The revised policy states that "pediatricians should be knowledgeable about substance abuse to be able to recognize risk factors for alcohol and other substance abuse among youth, screen for use, provide appropriate brief interventions, and refer to treatment."

Committee chair Janet Williams of the University of Texas Health Science Center at San Antonio said that most doctors don't routinely ask about youth alcohol use, and need to know how to provide prevention guidance and where to refer young drinkers to treatment.

Christianne Johnson
Program Manager
Partnership for Prevention

Two new studies exemplify the need for alcohol abuse prevention to take on a heightened focus for public health practitioners, healthcare providers, and policymakers. According to a new national survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), more than a quarter of youth aged 12-20 (27.6 percent) drank alcohol in the past month. Underage drinking rates are as high as 40 percent in some states—especially in New England and the upper Midwest. The study also found that nationwide, almost 9 percent of underage drinkers were able to purchase their own alcohol the last time they drank. In an effort to combat this growing epidemic, SAMHSA and the Ad Council launched a new series of national PSAs to encourage parents to talk to their children about drinking alcohol at an early age.

Another study, which appears in the April issue of the Journal of the American Dietetic Association, finds that the more people drink, the worse their food choices. The study found that as alcohol consumption rose, fruit consumption declined and caloric intake increased among men and women. "This finding raises questions about whether the combination of alcohol misuse and poor diet might interact to further increase health risks," said NIAAA acting director Kenneth R. Warren.

Christianne Johnson
Program Manager, Partnership for Prevention

The Obama administration has taken its first stab at crafting its own national drug-control budget priorities (PDF). While it would add new funding for addiction treatment and prevention, critics say the change is incremental and does little to close the huge gap between spending on efforts to reduce the drug supply and those working to reduce demand.

The FY2011 National Drug Control Budget released by the Office of National Drug Control Policy (ONDCP) on Feb. 1 includes a 13.4 percent increase in spending on alcohol and other drug prevention programs and a 3.7 percent increase for addiction treatment. ONDCP Director Gil Kerlikowske says the proposal demonstrates the administration's commitment to "a balanced and comprehensive drug strategy."

"I was hoping for large cuts on the supply side, especially after the previous administration allocated at least $1 billion more each to interdiction and source-country programs that accomplished absolutely nothing," says  drug budget and policy expert John Carnevale. "This nation must stop blaming source countries for our problems and face the fact that we can do more to reduce drug use by focusing on treatment, prevention, and diversion programs."

Changing policies on HIV/AIDS in South Africa and China have been named Partnership for Prevention’s “Best Prevention Idea of the Week,” while a protein-laced vodka that’s being marketed to “health conscious” people was named “Worst Prevention Idea of the Week.”

Billed as "alcohol for the health-conscious" the new, patent-pending Devotion Vodka is being marketed to active, fitness-oriented individuals who also enjoy an active nightlife. But not everybody’s drinking to that. “The health argument this company and its president has latched onto and promoted – that alcohol is good for your health – has been debunked as myth,” says the California-based The Marin Institute: “Yet PR flacks and media outlets continue to push news stories like the introduction of Devotion as another example of the healthy benefits of alcoholic products.”

Billed as "alcohol for the health-conscious" the new, patent-pending Devotion Vodka is being marketed to active, fitness-oriented individuals who also enjoy an active nightlife. But not everybody’s drinking to that. “The health argument this company and its president has latched onto and promoted – that alcohol is good for your health – has been debunked as myth,” says the California-based The Marin Institute: “Yet PR flacks and media outlets continue to push news stories like the introduction of Devotion as another example of the healthy benefits of alcoholic products.”

A firefighting official’s warning against drunk cooking was named Partnership for Prevention’s “Best Prevention Idea of the Week,” while an organization’s decision to stop rating TV health news stories because of their poor quality was named “Worst Prevention Idea of the Week.”

People should get carryout instead of cooking while drunk, a senior fire officer has warned. It follows an early morning rescue from a house fire of a 24-year-old man in Prestatyn, Denbighshire. North Wales Fire Service said the man had been drinking and not heard the smoke alarm during the fire. Neighbours saw the smoke and dialed 999. The fire service said the man had fallen asleep while cooking. Tom Pye from the brigade said: "Our advice is to never cook after drinking - please prepare a sandwich before you go out or get a takeaway instead."

For more than three years, HealthNewsReview.org editor Gary Schwitzer has been methodically reviewing TV health news claims for accuracy and responsibility. But no more; he told NPR's “On the Media” that he's found the vast majority of TV consumer health reports sickening. For example, he says the morning health news segments on network TV unquestioningly promote new drugs and new technologies; feed the “worried well” by raising unrealistic expectations of unproven technologies that may produce more harm than good; fail to ask tough questions; and make a serious discussion of health care reform even more difficult.

A community prevention program that cut teen drinking by more than a third was named Partnership for Prevention's "Best Prevention Idea of the Week," while low reimbursement rates for vaccines that are forcing doctors to opt out of offering them was named “Worst Prevention Idea of the Week.”

The Best/Worst Idea awards are a regular feature of Prevention Matters , the blog of Partnership for Prevention. Each week, Partnership for Prevention's staff will choose the designees based on nominations of items in the previous week's news submitted by members, staff and the public at large. To submit a nomination or for more information, contact Damon Thompson at dthompson@prevent.org.


BEST

Community Prevention System Cuts Teen Binge Drinking Rate by More Than A Third
http://ow.ly/oPO4

Rates of binge drinking were 37 percent lower among eighth-grade students in communities in seven states that used a prevention system designed to reduce drug use and delinquent behavior compared to teenagers in communities that did not use the system. Eighth graders in the towns that offered the Communities That Care prevention system also had significantly lower levels of alcohol and smokeless tobacco use and engaged in fewer delinquent behaviors. Under the program, each town assesses the risk factors that contribute to local drug use and delinquency and select two to five of them as their top priorities. They were then given information about scientifically tested programs that addressed each of their priority risk factors, selected programs they would use, and were trained in implementation.


WORST

Rising Vaccine Costs Force Doctors to Slash Vaccines Use
http://money.cnn.com/2009/09/08/news/economy/health_care_vaccinations/index.htm?cnn=yes

CNN recently reported that the nation’s pediatricians are increasingly not offering vaccines because their costs have risen above the reimbursement offered by most insurers. For example, one doctor says the chicken pox vaccine runs about $115, but insurers only cover between $68 to $83 of that. “It's not clear exactly how widespread vaccine cutbacks are, but in a recent industry survey, 5% of pediatricians and 11% of physicians indicated that they're seriously considering no longer offering immunizations,” CNN reported.

When college-town bars offer special prices on drinks, the result is an increase in drunk college students. That's the conclusion of recent research, and it didn't come from the "Univeristy of DUH!"

Alcohol researchers from the University of Florida and San Diego State University decided to study the relationship between drink specials and the quantity of alcohol consumed. According to the New York Times' Tara Parker-Pope, they were spurred by long-time claims from bar owners that special drink prices attract more people to the bar, but don't result in people drinking more.

The researchers collectied data on 495 men and 309 women leaving seven bars near a university campus. The bar patrons were given breath alcohol concentration tests and also told researchers what they drank and spent during their time at the bar. For every $1.40 hike in drink price, the bar goer was 30 percent less likely to leave the bar legally drunk.

The findings will be published in the November issue of Alcoholism: Clinical and Experimental Research.

College classes are starting and another cohort of students is arriving on campus. Some of them will pack on the so-called "freshman 15"—the extra pounds gained during college that can last a lifetime.

It’s been assumed this rapid weight gain is related to sitting in the all-you-can-eat cafeteria on campus having long philosophical conversations. Research from the University of Minnesota, School of Public Health indicates that heavy drinking is associated with weight gain during college years in complex ways.

Among 3206 Minnesota college students, binge drinking was associated with a 7 to 32% increase in a wide variety of unhealthy eating behaviors--infrequent breakfast consumption, eating few fruit and vegetables, high fast food consumption, unhealthy weight control behaviors, and some sedentary behavior. These associations held throughout the college years.　

The study authors wonder if health messages are inadvertently competing with each other. Perhaps healthy eating messages do not fully account for ways a campus drinking context influences eating and, on the flip side, that the adage to never drink on an empty stomach may subtly contribute to weight gain. Now that’s food (and drink) for thought.

Susan Maloney
Managing Senior Fellow
& Senior Program Officer

Partnership for Prevention is urging chairmen of the three congressional committees crafting the House version of a health care reform bill to raise the federal excise tax on alcoholic beverages and apply those revenues to a special fund to finance prevention and wellness initiatives.

“Higher alcohol excise taxes are an important tool in reducing the public health toll of alcohol abuse, while also providing a viable and appropriate source of funding to finance reform of our nation’s health system,” Partnership President Robert J. Gould said in a letter to Reps. Charles B. Rangel (D-NY), Henry A. Waxman (D-CA), and George Miller (D-CA). Rangel, Waxman and Miller are chairmen, respectively, of the House Ways and Means Committee, the House Energy and Commerce Committee and the House Education and Labor Committee.

In his letter, Gould cited a review of scientific studies by the U.S. Task Force on Community Health Services that found increased taxes or prices on alcoholic beverages are consistently related to a reduction in motor vehicle crashes and deaths, alcohol-impaired driving and death from liver cirrhosis as well as deaths from other causes. Higher alcohol taxes were also demonstrated to reduce the incidence of violence, sexually transmitted diseases, and alcohol dependence.

He also noted that federal alcohol excise taxes were last raised in 1991 and have not kept pace with inflation. Meanwhile, the Congressional Budget Office estimates that a 20% tax hike on distilled spirits and equalizing the tax rates on other alcoholic beverages would provide $60 billion in new revenue over a decade.

Economic Inquiry has some interesting articles on the vices of drinking and smoking:

• Nationwide adoption of a minimum legal drinking age (MLDA) appears to have had only a minor impact on teen drinking and traffic fatalities. Even in early-adopting states, the impact of the MLDA did not persist much past the year of adoption.
• Fraternity membership significantly increases drinking intensity, frequency, and recency, as well as the prevalence of many deleterious drinking consequences that potentially carry negative externalities.
• Rising cigarette taxes have not significantly contributed to rising obesity rates.

There's been some buzz on Capitol Hill of late about increasing alcohol taxes to help pay for health care reform. The Marin Institute, and alcohol industry watchdog group, has developed an online calculator that allows you to calculate the new revenues that could be earned in anyindividual state through an increase in alcohol taxes or fees.

Starting today, Partnership for Prevention begins a weekly feature on this blog in which we recognize the best and worst prevention ideas that made news within the past week. We solicit nominations from the Partnership staff, which then votes on the weekly winners. If you should come across anything that you feel is worthy of a nomination, please e-mail it to us at dthompson@prevent.org.

This week's winners:

BEST IDEA:

The Prevention and Wellness Fund - The economic stimulus package signed into law on Tuesday included included $1 billion for a Prevention and Wellness Fund, which will be used to fund key initiatives related to disease prevention and health promotion. While it was much less than the $5.8 billion sought in the Senate's original version of the bill, it still represents the single largest one-time infusion of resources into the U.S. public health system. Partnership for Prevention’s recommendations to Congress that were unveiled in December included the creation of a discrete, sustainable funding source to support state and local core public health activities and provide incentives for states to meet specified public health objectives.


WORST IDEA:

We actually had a tie between two alcohol-related stories:

Wasteful Whiskey Rebellion: Distillery executives in Kentucky recently poured bottles of bourbon on the steps of the state capitol to protest a proposed 6 percent sales tax increase on alcohol. Despite their objections, the legislature approved the tax hike and the governor signed it into law on Saturday. Studies show that taxing alcoholic beverages is an effective public health strategy for reducing the burden of alcohol-related disease. In the February 11th issue of Join Together, Cambridge Quarterly of Healthcare Ethics co-editor Steve Heilig noted that alcohol taxes have been largely ignored in recent years while the public has turned its attention to taxing tobacco to fund health initiatives. So the most recent "whiskey rebellion" not only ran counter to good science and good public health, but it was a waste of good bourbon.

Rise of the "Beer Pong Lobby:" An impassioned online campaign by leagues of beer-pong players led a veteran state senator in Maryland to abandon his effort to ban drinking games such as beer pong and flip cup in Baltimore bars. Sen. George W. Della Jr., a Baltimore Democrat, felt such games encourage excessive drinking and led to raucous behavior in city neighborhoods. "We had a campaign going to get everybody to contact the senator, and I was really happy to see all the people that came together," said Jim Reiter, co-founder of MD Beer Pong, which bills itself as the state's largest beer-pong league.

Opponents might argue that it’s beckoning back to the days of prohibition, but increasing the alcohol excise tax is a valid strategy to improve the nation’s economy and health status. Tobacco taxes have been increased several times over the last few years for the very same reasons, yet it has been more than 18 years since the taxes on alcohol were raised. A commentary by Steve Heilig in the February 11th issue of Join Together provides a solid argument on the importance of increasing the alcohol tax—at both the state and federal levels.

UPDATE: Kentucky bourbon industry officials emptied bottles of bourbon on the state Capitol's front steps Tuesday to protest a proposed 6-percent sales tax on all distilled spirits. Despite this attempt at a new "whiskey rebellion," the state House Appropriations and Revenue Committee approved the proposal in an effort to offset a projected $456 million revenue shortfall in the fiscal year that ends June 30.