title: Proximity of off-premise alcohol outlets and heavy alcohol consumption: a cohort study.
abstract: 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.
authors.affiliation: Finnish Institute of Occupational Health, PO Box 310, 70101 Kuopio, Finland. jaana.halonen@ttl.fi
authors.forename: Jaana I
authors.initials: JI
authors.lastname: Halonen
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.forename: Jaana
authors.initials: J
authors.lastname: Pentti
authors.forename: S V
authors.initials: SV
authors.lastname: Subramanian
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000434:Alcoholic Beverages; D000437:Alcoholism / Q000191:economics* / Q000453:epidemiology*; D001515:Beer; D002492:Central Nervous System Depressants / Q000191:economics*; D015331:Cohort Studies; D000431:Ethanol / Q000191:economics*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007206:Individuality; D008297:Male; D008875:Middle Aged; D009790:Occupations; D012737:Sex Factors; D012959:Socioeconomic Factors; D014505:Urban Population
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol
keywords: Alcohol consumption; Alcohol policy; Availability; Distance; Finnish Public Sector study; Longitudinal