Can alcohol control policies reduce cirrhosis mortality? An interrupted time-series analysis in Lithuania
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Can alcohol control policies reduce cirrhosis mortality? An interrupted time-series analysis in Lithuania. / Tran, Alexander; Jiang, Huan; Lange, Shannon; Manthey, Jakob; Štelemėkas, Mindaugas; Badaras, Robertas; Petkevičienė, Janina; Radišauskas, Ričardas; Room, Robin; Rehm, Jürgen.
In: LIVER INT, Vol. 42, No. 4, 04.2022, p. 765-774.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Can alcohol control policies reduce cirrhosis mortality? An interrupted time-series analysis in Lithuania
AU - Tran, Alexander
AU - Jiang, Huan
AU - Lange, Shannon
AU - Manthey, Jakob
AU - Štelemėkas, Mindaugas
AU - Badaras, Robertas
AU - Petkevičienė, Janina
AU - Radišauskas, Ričardas
AU - Room, Robin
AU - Rehm, Jürgen
N1 - © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2022/4
Y1 - 2022/4
N2 - BACKGROUND AND AIMS: The relationship between alcohol consumption and cirrhosis is well established. Policies that can influence population-level use of alcohol should, in turn, impact cirrhosis. We examined the effect of population-level alcohol control policies on cirrhosis mortality rates in Lithuania - a high-income European Union country with high levels of alcohol consumption.METHODS: Age-standardized, monthly liver mortality data (deaths per 100,000 adults, aged 15+) from Lithuania were analysed from 2001 to 2018 (n = 216 months) while controlling for economic confounders (gross domestic product and inflation). An interrupted time-series analysis was conducted to estimate the effect of three alcohol control policies implemented in 2008, 2017 and 2018 and the number of cirrhosis deaths averted.RESULTS: There was a significant effect of the 2008 (P < .0001) and 2017 (P = .0003) alcohol control policies but a null effect of the 2018 policy (P = .40). Following the 2008 policy, the cirrhosis mortality rate dropped from 4.93 to 3.41 (95% CI: 3.02-3.80) deaths per 100,000 adults, which equated to 493 deaths averted. Further, we found that following the 2017 policy, the mortality rate dropped from 2.85 to 2.01 (95% CI: 1.50-2.52) deaths per 100,000 adults, corresponding to 245 deaths averted.CONCLUSIONS: Our findings support the hypothesis that alcohol control policies can have a significant, immediate effect on cirrhosis mortality. These policy measures are cost-effective and aid in reducing the burden of liver disease.
AB - BACKGROUND AND AIMS: The relationship between alcohol consumption and cirrhosis is well established. Policies that can influence population-level use of alcohol should, in turn, impact cirrhosis. We examined the effect of population-level alcohol control policies on cirrhosis mortality rates in Lithuania - a high-income European Union country with high levels of alcohol consumption.METHODS: Age-standardized, monthly liver mortality data (deaths per 100,000 adults, aged 15+) from Lithuania were analysed from 2001 to 2018 (n = 216 months) while controlling for economic confounders (gross domestic product and inflation). An interrupted time-series analysis was conducted to estimate the effect of three alcohol control policies implemented in 2008, 2017 and 2018 and the number of cirrhosis deaths averted.RESULTS: There was a significant effect of the 2008 (P < .0001) and 2017 (P = .0003) alcohol control policies but a null effect of the 2018 policy (P = .40). Following the 2008 policy, the cirrhosis mortality rate dropped from 4.93 to 3.41 (95% CI: 3.02-3.80) deaths per 100,000 adults, which equated to 493 deaths averted. Further, we found that following the 2017 policy, the mortality rate dropped from 2.85 to 2.01 (95% CI: 1.50-2.52) deaths per 100,000 adults, corresponding to 245 deaths averted.CONCLUSIONS: Our findings support the hypothesis that alcohol control policies can have a significant, immediate effect on cirrhosis mortality. These policy measures are cost-effective and aid in reducing the burden of liver disease.
KW - Adolescent
KW - Adult
KW - Alcohol Drinking/epidemiology
KW - Ethanol
KW - Humans
KW - Lithuania/epidemiology
KW - Liver Cirrhosis
KW - Public Policy
U2 - 10.1111/liv.15151
DO - 10.1111/liv.15151
M3 - SCORING: Journal article
C2 - 35023617
VL - 42
SP - 765
EP - 774
JO - LIVER INT
JF - LIVER INT
SN - 1478-3223
IS - 4
ER -