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The Association between the Australian Alcopops Tax and National Chlamydia Rates among Young People—an Interrupted Time Series Analysis

A national tax increase, which became known as the “alcopops tax”, was introduced in Australia on the 27th April 2008 on ready-to-drink alcoholic beverages, which are consumed predominantly by young people. The affordability of alcohol has been identified as the strongest environmental driver of alc...

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Autores principales: Gilmore, William, Chikritzhs, Tanya, McManus, Hamish, Kaldor, John, Guy, Rebecca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068511/
https://www.ncbi.nlm.nih.gov/pubmed/32093092
http://dx.doi.org/10.3390/ijerph17041343
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author Gilmore, William
Chikritzhs, Tanya
McManus, Hamish
Kaldor, John
Guy, Rebecca
author_facet Gilmore, William
Chikritzhs, Tanya
McManus, Hamish
Kaldor, John
Guy, Rebecca
author_sort Gilmore, William
collection PubMed
description A national tax increase, which became known as the “alcopops tax”, was introduced in Australia on the 27th April 2008 on ready-to-drink alcoholic beverages, which are consumed predominantly by young people. The affordability of alcohol has been identified as the strongest environmental driver of alcohol consumption, and alcohol consumption is a well-known risk factor in the spread of sexually transmitted infections via its association with sexual risk-taking. We conducted a study to investigate whether there was any association between the introduction of the tax and changes in national chlamydia rates: (i) notification rates (diagnoses per 100,000 population; primary outcome and standard approach in alcohol taxation studies), and (ii) test positivity rates (diagnoses per 100 tests; secondary outcome) among 15–24 and 25–34-year-olds, using interrupted time series analysis. Gender- and age-specific chlamydia trends among those 35 and older were applied as internal control series and gender- and age-specific consumer price index-adjusted per capita income trends were controlled for as independent variables. We hypothesised that the expected negative association between the tax and chlamydia notification rates might be masked due to increasing chlamydia test counts over the observation period (2000 to 2016). We hypothesised that the association between the tax and chlamydia test positivity rates would occur as an immediate level decrease, as a result of a decrease in alcohol consumption, which, in turn, would lead to a decrease in risky sexual behaviour and, hence, chlamydia transmission. None of the gender and age-specific population-based rates indicated a significant immediate or lagged association with the tax. However, we found an immediate decrease in test positivity rates for 25–34-year-old males (27% reduction—equivalent to 11,891 cases prevented post-tax) that remained detectable up to a lag of six months and a decrease at a lag of six months for 15–24-year-old males (31% reduction—equivalent to 16,615 cases prevented) following the tax. For no other gender or age combination did the change in test positivity rates reach significance. This study adds to the evidence base supporting the use of alcohol taxation to reduce health-related harms experienced by young people and offers a novel method for calculating sexually transmitted infection rates for policy evaluation.
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spelling pubmed-70685112020-03-19 The Association between the Australian Alcopops Tax and National Chlamydia Rates among Young People—an Interrupted Time Series Analysis Gilmore, William Chikritzhs, Tanya McManus, Hamish Kaldor, John Guy, Rebecca Int J Environ Res Public Health Article A national tax increase, which became known as the “alcopops tax”, was introduced in Australia on the 27th April 2008 on ready-to-drink alcoholic beverages, which are consumed predominantly by young people. The affordability of alcohol has been identified as the strongest environmental driver of alcohol consumption, and alcohol consumption is a well-known risk factor in the spread of sexually transmitted infections via its association with sexual risk-taking. We conducted a study to investigate whether there was any association between the introduction of the tax and changes in national chlamydia rates: (i) notification rates (diagnoses per 100,000 population; primary outcome and standard approach in alcohol taxation studies), and (ii) test positivity rates (diagnoses per 100 tests; secondary outcome) among 15–24 and 25–34-year-olds, using interrupted time series analysis. Gender- and age-specific chlamydia trends among those 35 and older were applied as internal control series and gender- and age-specific consumer price index-adjusted per capita income trends were controlled for as independent variables. We hypothesised that the expected negative association between the tax and chlamydia notification rates might be masked due to increasing chlamydia test counts over the observation period (2000 to 2016). We hypothesised that the association between the tax and chlamydia test positivity rates would occur as an immediate level decrease, as a result of a decrease in alcohol consumption, which, in turn, would lead to a decrease in risky sexual behaviour and, hence, chlamydia transmission. None of the gender and age-specific population-based rates indicated a significant immediate or lagged association with the tax. However, we found an immediate decrease in test positivity rates for 25–34-year-old males (27% reduction—equivalent to 11,891 cases prevented post-tax) that remained detectable up to a lag of six months and a decrease at a lag of six months for 15–24-year-old males (31% reduction—equivalent to 16,615 cases prevented) following the tax. For no other gender or age combination did the change in test positivity rates reach significance. This study adds to the evidence base supporting the use of alcohol taxation to reduce health-related harms experienced by young people and offers a novel method for calculating sexually transmitted infection rates for policy evaluation. MDPI 2020-02-19 2020-02 /pmc/articles/PMC7068511/ /pubmed/32093092 http://dx.doi.org/10.3390/ijerph17041343 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gilmore, William
Chikritzhs, Tanya
McManus, Hamish
Kaldor, John
Guy, Rebecca
The Association between the Australian Alcopops Tax and National Chlamydia Rates among Young People—an Interrupted Time Series Analysis
title The Association between the Australian Alcopops Tax and National Chlamydia Rates among Young People—an Interrupted Time Series Analysis
title_full The Association between the Australian Alcopops Tax and National Chlamydia Rates among Young People—an Interrupted Time Series Analysis
title_fullStr The Association between the Australian Alcopops Tax and National Chlamydia Rates among Young People—an Interrupted Time Series Analysis
title_full_unstemmed The Association between the Australian Alcopops Tax and National Chlamydia Rates among Young People—an Interrupted Time Series Analysis
title_short The Association between the Australian Alcopops Tax and National Chlamydia Rates among Young People—an Interrupted Time Series Analysis
title_sort association between the australian alcopops tax and national chlamydia rates among young people—an interrupted time series analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068511/
https://www.ncbi.nlm.nih.gov/pubmed/32093092
http://dx.doi.org/10.3390/ijerph17041343
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