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Ontario Cancer Facts

Off-premise alcohol retailer location in Toronto is associated with neighbourhood-level alcohol consumption

Sep 2020

Highlights

 

  • In Toronto, higher alcohol consumption was found in neighbourhoods where the nearest off-premise alcohol retailers (stores where alcohol is purchased and then consumed elsewhere) were within 500 m, compared with neighbourhoods with retailers over 1 kilometre away.
  • Access to off-premise alcohol retailers was related to excess alcohol consumption in Toronto neighbourhoods, regardless of neighbourhood socio-economic status.
  • Access to on-premise alcohol retailers (establishments where people both buy alcohol and consume it) was not strongly related to neighbourhood levels of excess alcohol consumption.
  • Toronto Public Health supports Canada's Low-Risk Alcohol Drinking Guidelines and the Toronto Board of Health has called for a provincial alcohol strategy to mitigate alcohol-related harms in Ontario.

A recent analysis done using the Cancer Risk Factors Atlas of Ontario showed that living close to off-premise alcohol retailers in Toronto (stores where alcohol is bought and then consumed elsewhere, such as the Liquor Control Board of Ontario [LCBO]) was associated with higher alcohol consumption in males and females.

As the distance to the nearest off-premise retailer decreased from over 1 kilometre away to within 500 metres, 30% more males and 40% more females at the neighbourhood level exceeded the recommended alcohol consumption limit after accounting for socio-economic status. The higher percentage of females exceeding the threshold may be due to their lower recommended alcohol consumption limit, which is 1 drink per day. The recommended alcohol consumption limit for cancer prevention for males is 2 drinks per day.

These consumption patterns exist independent of socio-economic status, which is associated with alcohol consumption (see Figure) and was measured for the analysis using the Ontario Marginalization Index.

Distance to the nearest alcohol retailer and relative risk of exceeding the recommended limits for cancer prevention in Toronto neighbourhoods, independent of socio-economic status

The nearest alcohol retailer and relative risk of exceeding the recommended limits

Source: Liquor Control Board of Ontario (LCBO) (2014–16). LCBO Store and LCBO Agency store locations. Alcohol and Gaming Commission of Ontario (2014–16). The Beer Store, farmers’ markets, grocery stores, wineries, breweries, distilleries and on-premise locations.

Notes: The comparison group (comp grp) was neighbourhoods where the nearest retailer was the farthest away (more than 1 kilometre) and is represented by the black dot. A relative risk of 1.3 corresponds to a 30% increase in the risk of exceeding the guidelines compared to neighbourhoods where the nearest alcohol retailer is more than 1 kilometre away. The vertical bars above and below the coloured dots represent the statistical precision (95% confidence interval). Statistically significant estimates do not include 1.0.

Distance to the nearest alcohol retailer and relative risk of exceeding the recommended limits for cancer prevention in Toronto neighbourhoods, independent of socio-economic status
Distance Males, on-premise estimate Males, on-premise (95% lower confidence limit) Males, on-premise (95% upper confidence limit) Males, off-premise estimate Males, off-premise (95% lower confidence limit) Males, off-premise (95% upper confidence limit) Females, on-premise estimate Females, on-premise (95% lower confidence limit) Females, on-premise (95% upper confidence limit) Females, off-premise estimate Females, off-premise (95% lower confidence limit) Females, off-premise (95% upper confidence limit)
>1000 m (comparison group) 1 N/A N/A 1 N/A N/A 1 N/A N/A 1 N/A N/A
500–1000 m 0.93 0.88 0.97 1.16 1.13 1.18 0.94 0.88 1 1.24 1.21 1.28
0–499 m 0.99 0.94 1.04 1.27 1.24 1.3 1.03 0.97 1.1 1.4 1.36 1.45

Source: Liquor Control Board of Ontario (LCBO) (2014–16). LCBO Store and LCBO Agency store locations. Alcohol and Gaming Commission of Ontario (2014–16). The Beer Store, farmers’ markets, grocery stores, wineries, breweries, distilleries and on-premise locations.

Notes: The comparison group (comp grp) was neighbourhoods where the nearest retailer was the farthest away (more than 1 kilometre) and is represented by the black dot. A relative risk of 1.3 corresponds to a 30% increase in the risk of exceeding the guidelines compared to neighbourhoods where the nearest alcohol retailer is more than 1 kilometre away. The vertical bars above and below the coloured dots represent the statistical precision (95% confidence interval). Statistically significant estimates do not include 1.0.

There was no strong relationship between distance to the nearest on-premise retailer (establishments where alcohol is both bought and consumed, such as bars) in a neighbourhood and exceeding the recommended alcohol consumption limits after accounting for socio-economic status. This may be because the distance to the nearest on-premise retailers is very similar across Toronto neighbourhoods. Only 3.8% of Toronto neighbourhoods had an on-premise alcohol retailer more than 1 kilometre away, but 70.1% had an on-premise retailer within 500 metres. In contrast, an approximately equal percentage of Toronto neighbourhoods had an off-premise outlet farther than 1 kilometre away (33.5%) and within 500 metres (32.4%).

Information on the location of alcohol outlets was provided by the Alcohol and Gaming Commission of Toronto, and 4,272 on-premise and 268 off-premise alcohol retailers were mapped for the analysis. Neighbourhood-level alcohol consumption rates among the population age 12 and over were from the Cancer Risk Factors Atlas of Ontario.

Alcohol use increases the risks of several cancers, including breast, colorectal, stomach, liver, esophagus, larynx, oral cavity and pharynx.In Ontario, it is estimated that up to 3,000 new cases of cancer diagnosed in 2010 were from alcohol use.Policies directed at limiting off-premise retailers may be an important strategy to reduce alcohol-related harms, including cancer.

Toronto Public Health promotes responsible alcohol use, and supports Canada's Low-Risk Alcohol Drinking Guidelines, which provide adults ages 25 to 65 who choose to drink with information on alcohol and related health risks so they can make an informed choice about drinking. The Toronto Board of Health has called for the development of a provincial alcohol strategy to mitigate alcohol-related harms in Ontario.

Learn more about the Cancer Risk Factors Atlas of Ontario.

References

  1. Shams-White MM, Brockton NT, Mitrou P, et al. Operationalizing the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations: A Standardized Scoring System. Nutrients. 2019;11(7):1572.
  2. Leung A, Law J, Cooke M, Leatherdale S. Exploring and visualizing the small-area-level socioeconomic factors, alcohol availability and built environment influences of alcohol expenditure for the City of Toronto: a spatial analysis approach. Health Promot Chronic Dis Prev Can. 2019;39(1):15–24.
  3. Myran DT, Chen JT, Bearnot B, et al. Alcohol Availability Across Neighborhoods in Ontario Following Alcohol Sales Deregulation, 2013–2017. Am J Public Health. 2019;109(6):899–905.
  4. Stockwell T, Zhao J, Martin G, et al. Minimum alcohol prices and outlet densities in British Columbia, Canada: estimated impacts on alcohol-attributable hospital admissions. Am J Public Health. 2013;103(11):2014–20.
  5. Matheson FI, Dunn JR, Smith KL, et al. Development of the Canadian Marginalization Index: a new tool for the study of inequality. Can J Public Health. 2012;103(8 Suppl 2):S12–6.
  6. World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project, Expert Report 2018. Alcoholic drinks and the risk of cancer. Available at dietandcancerreport.org. Accessed October 2019.
  7. Cancer Care Ontario. Cancer Risk Factors in Ontario: Alcohol. Toronto: Queen’s Printer for Ontario; 2014.
  8. Board of Health meeting. (April 8, 2019). Item HL4.4: Health Impacts of Alcohol Consumption Update. http://app.toronto.ca/tmmis/viewAgendaItemHistory.do?item=2019.HL4.4 [Accessed Nov 27, 2019].