Access to the supply of alcohol is an important factor influencing adolescent alcohol consumption. Although alcohol sales outlets are prohibited from selling alcohol to underage youth, there has been limited research investigating compliance. The present study sought to estimate the extent to which adolescents that appeared underage were successfully able to purchase alcohol from packaged liquor outlets in Australia; and to identify store and sales characteristics associated with illegal purchasing. In 2012, purchase surveys were conducted (n= 310) at packaged liquor outlets in 28 urban and rural communities across three states of Australia: Western Australia, Queensland and Victoria. Confederates successfully purchased alcohol at 60% (95% CI: 55-66) of outlets. The density of general alcohol outlets in the surrounding area and the type of liquor outlet were predictors of successful alcohol purchases; however, this was moderated by the state in which the purchase was made. Regional geographical location was also found to predict underage alcohol purchase. The majority of alcohol sales outlets in Australia breach regulations prohibiting sales to underage youth. Consistent enforcement of policies across the states of Australia, and reducing the number of alcohol outlets, will help prevent alcohol outlets illegally selling alcohol to underage adolescents.

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IntroductionThroughout the world, alcohol consumption is common among adolescents. Adolescent alcohol use and misuse have prognostic significance for several adverse long-term outcomes, including alcohol problems, alcohol dependence, school disengagement and illicit drug use. The aim of this study was to evaluate whether randomisation to a community mobilisation and social marketing intervention reduces the proportion of adolescents who initiate alcohol use before the Australian legal age of 18, and the frequency and amount of underage adolescent alcohol consumption.Method and analysisThe study comprises 14 communities matched with 14 non-contiguous communities on socioeconomic status (SES), location and size. One of each pair was randomly allocated to the intervention. Baseline levels of adolescent alcohol use were estimated through school surveys initiated in 2006 (N=8500). Community mobilisation and social marketing interventions were initiated in 2011 to reduce underage alcohol supply and demand. The setting is communities in three Australian states (Victoria, Queensland and Western Australia). Students (N=2576) will complete school surveys in year 8 in 2013 (average age 12). Primary outcomes: (1) lifetime initiation and (2) monthly frequency of alcohol use. Reports of social marketing and family and community alcohol supply sources will also be assessed. Point estimates with 95% CIs will be compared for student alcohol use in intervention and control communities. Changes from 2006 to 2013 will be examined; multilevel modelling will assess whether random assignment of communities to the intervention reduced 2013 alcohol use, after accounting for community level differences. Analyses will also assess whether exposure to social marketing activities increased the intervention target of reducing alcohol supply by parents and community members.Trial registrationACTRN12612000384853.

This study indicates the need for more rigorous enforcement of alcohol sales regulations in community sporting clubs. Community health agencies could work with sporting clubs to assist them to improve compliance with alcohol sales regulations and to provide information on the significant role clubs play in shaping the adolescent alcohol culture.

Rowland B, Toumbourou JW, Osborn A, et al. BMJ Open 2013;3:e002423. doi:10.1136/bmjopen-2012-002423.

BackgroundThis cluster randomised control trial is designed to evaluate whether the Communities That Care intervention (CTC) is effective in reducing the proportion of secondary school age adolescents who use alcohol before the Australian legal purchasing age of 18 years. Secondary outcomes are other substance use and antisocial behaviours. Long term economic benefits of reduced alcohol use by adolescents for the community will also be assessed.MethodsFourteen communities and 14 other non-contiguous communities will be matched on socioeconomic status (SES), location, and size. One of each pair will be randomly allocated to the intervention in three Australian states (Victoria, Queensland and Western Australia). A longitudinal survey will recruit grade 8 and 10 students (M = 15 years old, N = 3500) in 2017 and conduct follow-up surveys in 2019 and 2021 (M = 19 years old). Municipal youth populations will also be monitored for trends in alcohol-harms using hospital and police administrative data.DiscussionCommunity-led interventions that systematically and strategically implement evidence-based programs have been shown to be effective in producing population-level behaviour change, including reduced alcohol and drug use. We expect that the study will be associated with significant effects on alcohol use amongst adolescents because interventions adopted within communities will be based on evidence-based practices and target specific problems identified from surveys conducted within each community.Trial registrationThe trial was retrospectively registered in September, 2017 (ACTRN12616001276448), as communities were selected prior to trial registration; however, participants were recruited after registration. Findings will be disseminated in peer-review journals and community fora.

Abstracts A6J Epidemiol Community Health 2012;66(Suppl I):A1-A66household socioeconomic position (SEP) and sedentary behaviour are associated in children and adolescents. The aim of this study was to assess the associations between SEP (including area-level deprivation) and sedentary behaviour in school-age children and adolescents. Methods The study sample was 4034 participants aged 5-15 yrs participated in the 2008 Health Survey for England which collected information on SEP (household income, Registrar General's social class of the household reference person) and neighbourhood deprivation. Sedentary behaviour assessment (proxy parental measures for 5-12yrs; self-reported for 13-15yrs) included television viewing and other sitting during non-school times. Total sitting time was measured in a sub-sample (N=611) using accelerometers. We examined the multivariable associations between each SEP indicator and each sedentary time indicator using generalised linear models. Whenever appropriate, models were adjusted for age, sex, body mass index (BMI), physical activity, accelerometer wear time and mutually adjusted for the other SEP indicators.Results The mean age of the sample was 10 yrs (±3), 2922 participants were aged 5-12 and 1112 were aged 13-15yrs. Household income and social class were inversely associated with daily television times (i.e. the higher the SEP the lower the television viewing times), e.g. compared to participants from households in the bottom income quartile, those in the top quartile had 14 minutes /day less (95% CI: 3 to 25, p=0.009) of television viewing. Non-TV sitting during non-school time was higher in nonmanual than in manual social class households by 14 minutes/day (7 to 20, p<0.001). Total (accelerometry-assessed) sitting time was higher among participants from households in the top income half (≥£23135/year) by 22 minutes/day (7 to 37, p<0.00) compared to those in the bottom half. Area deprivation was not associated with sedentary behaviour. Conclusion Low socioeconomic position is linked with higher television times but with lower total (accelerometry-assessed) sitting, and non-TV sitting during non-school time in children and adolescents. Inferences from studies looking at socioeconomic position and specific indices of sedentary behaviour (e.g., TV time) in children and adolescents may not be generalizable to total sitting time. Background Neighbourhood deprivation is associated with physical activity but it is not known whether the locations where physical activity takes place also varies by deprivation. The Forty Area Study (FAST) combined Global Positioning Systems (GPS) technology with accelerometery in UK adults to measure actual locations in which physical activity takes place. We evaluate what proportion of moderate to vigorous intensity physical activity (MVPA) is spent in different locations according to neighbourhood deprivation. Methods 1084 adults from Northwest England took part. Each participant's activity levels were recorded for 7 days using an accelerometer. A qua...

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