title: Alcohol policy changes and 22-year trends in individual alcohol consumption in a Swiss adult population: a 1993-2014 cross-sectional population-based study.
abstract: Evidence on the impact of legislative changes on individual alcohol consumption is limited. Using an observational study design, we assessed trends in individual alcohol consumption of a Swiss adult population following the public policy changes that took place between 1993 and 2014, while considering individual characteristics and secular trends.
  
  
  
  Cross-sectional study.
  
  
  
  Swiss general adult population.
  
  
  
  Data from 18 963 participants were collected between 1993 and 2014 (aged 18-75 years).
  
  
  
  We used data from the 'Bus Santé' study, an annual health survey conducted in random samples of the adult population in the State of Geneva, Switzerland. Individual alcohol intake was assessed using a validated food frequency questionnaire. Individual characteristics including education were self-reported. 7 policy changes (6 about alcohol and 1 about tobacco) that occurred between 1993 and 2014 defined 6 different periods. We predicted alcohol intake using quantile regression with multivariate analysis for each period adjusting for participants' characteristics and tested significance periods. Sensitivity analysis was performed including drinkers only, the 10th centile of highest drinkers and smoker's status.
  
  
  
  Between 1993 and 2014, participants' individual alcohol intake decreased from 7.1 to 5.4 g/day (24% reduction, p<0.001). Men decreased their alcohol intake by 34% compared with 22% for women (p<0.001). The decrease in alcohol intake remained significant when considering drinkers only (28% decrease, p<0.001) and the 10th centile highest drinkers (24% decrease, p<0.001). Consumption of all alcoholic beverages decreased between 1993 and 2014 except for the moderate consumption of beer, which increased. After adjustment for participants' characteristics and secular trends, no independent association between alcohol legislative changes and individual alcohol intake was found.
  
  
  
  Between 1993 and 2014, alcohol consumption decreased in the Swiss adult population independently of policy changes.
authors.affiliation: University of Geneva Faculty of Medicine, Geneva, Switzerland.
authors.forename: Shireen
authors.initials: S
authors.lastname: Dumont
authors.affiliation: Department of Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.affiliation: Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Thierry
authors.initials: T
authors.lastname: Favrod-Coune
authors.affiliation: Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Theler
authors.affiliation: Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gaspoz
authors.affiliation: Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Broers
authors.affiliation: Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland.|Department of Ambulatory Care and Community Medicine, Lausanne University Hospital, Lausanne, Switzerland.|Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors.forename: Idris
authors.initials: I
authors.lastname: Guessous
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000639:trends*; D000434:Alcoholic Beverages; D003430:Cross-Sectional Studies; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D057766:Policy; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013557:Switzerland
chemical_list: D000431:Ethanol
keywords: Switzerland; alcohol; individual alcohol consumption; policy changes; population based-study; trends