title: Impact of Cross-Sectoral Alcohol Policy on Youth Alcohol Consumption.
abstract: Cross-sectoral alcohol policy is recommended to reduce youth alcohol consumption, but little evidence is available on its effectiveness. Therefore, we examined whether regions and municipalities in the Dutch province of Noord-Brabant with stronger cross-sectoral alcohol policy showed larger reductions in alcohol consumption among adolescents aged 12-15.
  
  
  
  Strong regional cross-sectoral alcohol policy was defined as participation in a regional alcohol prevention program. Strong municipal cross-sectoral alcohol policy was operationalized by measures on (a) sector variety: involvement of different policy sectors, and (b) strategy variety: formulation of different policy strategies. Relevant data from policy documents were searched for on the Internet. Data on trends in alcohol consumption were extracted from the 2007 and 2011 cross-sectional Youth Health Monitor that includes a random subset of adolescents aged 12-15 (n = 15,380 in 2007 and n = 15,437 in 2011). We used multilevel regression models.
  
  
  
  Two of the three regions in which municipalities participated in a regional alcohol prevention program showed a larger reduction in weekly drinking than the region in which municipalities did not participate (-12.2% and -13.4% vs. -8.3%). Municipalities with strong compared to weak sector variety showed a larger increase in adolescents' age at consuming their first alcoholic drink (0.63 vs. 0.42 years). Municipalities with strong strategy variety showed a decrease (-3.8%) in heavy weekly drinking, whereas those with weak variety showed an increase (5.1%). Cross-sectoral alcohol policy did not affect trends in other alcohol outcomes.
  
  
  
  Our results suggest that strong cross-sectoral alcohol policy may contribute to reducing some aspects of youth alcohol consumption. Monitoring policy implementation is needed to assess the full impact.
authors.affiliation: Academic Medical Center (AMC)-University of Amsterdam, Department of Public Health, Amsterdam, the Netherlands.
authors.forename: Moniek C M
authors.initials: MC
authors.lastname: de Goeij
authors.affiliation: Public Health Service Hart voor Brabant, 's-Hertogenbosch, the Netherlands.
authors.forename: Monique A M
authors.initials: MA
authors.lastname: Jacobs
authors.affiliation: Public Health Service Brabant-Zuidoost, Eindhoven, the Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: van Nierop
authors.affiliation: Public Health Service West-Brabant, Breda, the Netherlands.
authors.forename: Ivanka A G
authors.initials: IA
authors.lastname: van der Veeken-Vlassak
authors.affiliation: IVO Addiction Research Institute, Rotterdam, the Netherlands.|Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.|Maastricht University, Department of Health Promotion, Maastricht, the Netherlands.
authors.forename: Dike
authors.initials: D
authors.lastname: van de Mheen
authors.affiliation: IVO Addiction Research Institute, Rotterdam, the Netherlands.|Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands.
authors.forename: Tim M
authors.initials: TM
authors.lastname: Schoenmakers
authors.affiliation: Academic Medical Center (AMC)-University of Amsterdam, Department of Public Health, Amsterdam, the Netherlands.
authors.forename: Janneke
authors.initials: J
authors.lastname: Harting
authors.affiliation: Academic Medical Center (AMC)-University of Amsterdam, Department of Public Health, Amsterdam, the Netherlands.
authors.forename: Anton E
authors.initials: AE
authors.lastname: Kunst
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000331:legislation & jurisprudence* / Q000639:trends; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D057766:Policy; D000066608:Underage Drinking / Q000517:prevention & control*