BACKGROUND: Availability of alcohol has been associated with alcohol consumption in cross-sectional studies. We examined longitudinally whether change in proximity to off-premise (i.e., no consumption on the premises) beer and liquor outlets is associated with heavy alcohol consumption. METHODS: Distances from 54,778 Finnish Public Sector study participants' homes to the nearest off-premise beer and liquor outlets were calculated using Global Positioning System-coordinates. Between-individual analyses were used to study the effects of distance to the nearest outlet on heavy alcohol use, and within-individual analyses to study the effects of a change in distance on change in heavy use. RESULTS: Mean follow-up time in 2000-2009 was 6.8 (standard deviation 2.0) years. In a between-individual analysis, decrease from ≥500 m to <500 m (vs. remained ≥500 m) in the distance to the nearest beer outlet increased the likelihood of incident heavy alcohol use in women (odds ratio 1.23, 95% CI 1.05-1.44), but not in men. In a within-individual analysis decrease from 500 m to 0m in log-transformed continuous distance to the nearest beer outlet increased the odds of heavy alcohol consumption in women by 13% (odds ratio 1.13, 95% CI 1.01-1.27). For the corresponding change in distance to liquor outlet the increase was 3% (odds ratio 1.03, 95% CI 0.97-1.09). CONCLUSIONS: Change in distance from home to the nearest off-premise alcohol outlet affects the risk of heavy alcohol consumption in women. This evidence supports policies that restrict physical availability of alcohol.
BACKGROUND: Availability of alcohol has been associated with alcohol consumption in cross-sectional studies. We examined longitudinally whether change in proximity to off-premise (i.e., no consumption on the premises) beer and liquor outlets is associated with heavy alcohol consumption. METHODS: Distances from 54,778 Finnish Public Sector study participants' homes to the nearest off-premise beer and liquor outlets were calculated using Global Positioning System-coordinates. Between-individual analyses were used to study the effects of distance to the nearest outlet on heavy alcohol use, and within-individual analyses to study the effects of a change in distance on change in heavy use. RESULTS: Mean follow-up time in 2000-2009 was 6.8 (standard deviation 2.0) years. In a between-individual analysis, decrease from ≥500 m to <500 m (vs. remained ≥500 m) in the distance to the nearest beer outlet increased the likelihood of incident heavy alcohol use in women (odds ratio 1.23, 95% CI 1.05-1.44), but not in men. In a within-individual analysis decrease from 500 m to 0m in log-transformed continuous distance to the nearest beer outlet increased the odds of heavy alcohol consumption in women by 13% (odds ratio 1.13, 95% CI 1.01-1.27). For the corresponding change in distance to liquor outlet the increase was 3% (odds ratio 1.03, 95% CI 0.97-1.09). CONCLUSIONS: Change in distance from home to the nearest off-premise alcohol outlet affects the risk of heavy alcohol consumption in women. This evidence supports policies that restrict physical availability of alcohol.
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