Introduction While developed countries have either introduced, or are considering, legislation to restrict the number of alcohol outlets, there is little evidence to support this strategy except in the USA.
Methods Multilevel study of 2334 adults aged 18 to 75 years from 49 census collector districts (the smallest spatial unit in Australia at the time of survey) in Melbourne, Australia. Alcohol outlet density was defined as the number of outlets within a one kilometre road network of respondents' homes and proximity was the shortest road network distance to the closest outlet from their home. Using multilevel logistic regression we estimated the association between outlet density and proximity and four measures of harmful alcohol consumption: drinking at levels associated short-term harm at least weekly and monthly; drinking at levels associated with long-term harm and frequency of consumption.
Results Density of outlets was associated with increased risk of alcohol related harm with the strongest association evident for drinking at levels associated with short term harm at least weekly (OR 1.10, 95% CI 1.04 to 1.16). When density was fitted as a categorical variable, the highest risk of drinking at levels associated with short-term harm was when there were eight or more outlets (short-term harm weekly: OR 2.36, 95% CI 1.22 to 4.54 and short-term harm monthly: OR 1.80, 95% CI 1.07 to 3.04). We found no evidence to support an association between proximity and harmful alcohol consumption.
Conclusion Restricting the number of off-premise alcohol outlets is likely to reduce levels of harmful alcohol consumption.
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