Although long-term alcohol and tobacco use have widely been recognised as important risk factors for cancer, the impacts of alcohol and tobacco health policies on cancer mortality have not been examined in previous studies. This study aims to estimate the association of key alcohol and tobacco policy or events in Australia with changes in overall and five specific types of cancer mortality between the 1950s and 2013. Annual population-based time-series data between 1911 and 2013 on per capita alcohol and tobacco consumption and head and neck (lip, oral cavity, pharynx, larynx and oesophagus), lung, breast, colorectum and anus, liver and total cancer mortality data from the 1950s to 2013 were collected from the Australian Bureau of Statistics and Cancer Council Victoria, the WHO Cancer Mortality Database and the Australian Institute of Health and Welfare. The policies with significant relations to changes in alcohol and tobacco consumption were identified in an initial model. Intervention dummies with estimated lags were then developed based on these key alcohol and tobacco policies and events and inserted into time-series models to estimate the relation of the particular policy changes with cancer mortality. Liquor licence liberalisation in the 1960s was significantly associated with increases in the level of population drinking and thereafter of male cancer mortality. The introduction of random breath testing programs in Australia after 1976 was associated with a reduction in population drinking and thereafter in cancer mortality for both men and women. Meanwhile, the release of UK and US public health reports on tobacco in 1962 and 1964 and the ban on cigarette ads on TV and radio in 1976 were found to have been associated with a reduction in Australian tobacco consumption and thereafter a reduction in mortality from all cancer types except liver cancer. Policy changes on alcohol and tobacco during the 1960s–1980s were associated with greater changes for men than for women, particularly for head and neck, lung and colorectum cancer sites. This study provides evidence that some changes to public health policies in Australia in the twentieth century were related to the changes in the population consumption of alcohol and tobacco, and in subsequent mortality from various cancers over the following 20 years.

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关于烟酒的公共卫生政策可以减少癌症的流行吗？澳大利亚的经验

尽管长期饮酒和吸烟已被公认为是癌症的重要危险因素，但在以前的研究中并未研究烟酒健康政策对癌症死亡率的影响。这项研究的目的是估计1950年代至2013年之间，澳大利亚的主要酒精和烟草政策或事件与总体和五种特定癌症死亡率变化之间的关联。1911年至2013年之间基于人均酒精的年度人口时序数据并从澳大利亚统计局和癌症理事会收集了1950年代至2013年的烟草消耗量和头颈（嘴唇，口腔，咽，喉和食道），肺，乳腺，结直肠和肛门，肝脏和总癌症死亡率的数据维多利亚 世卫组织癌症死亡率数据库和澳大利亚卫生与福利研究所。在最初的模型中确定了与烟酒消费变化密切相关的政策。然后，根据这些关键的烟酒政策和事件，开发出具有估计滞后的干预假人，并将其插入到时间序列模型中，以评估特定政策变化与癌症死亡率之间的关系。1960年代酒类许可证的放开与人口饮酒量的增加以及其后男性癌症死亡率的增加显着相关。1976年后在澳大利亚引入了随机呼气测试程序，这与减少饮酒量以及随后降低男性和女性的癌症死亡率有关。同时，据发现，英国和美国分别于1962年和1964年发布了有关烟草的公共卫生报告以及1976年在电视和广播中禁止吸烟的广告，这与澳大利亚减少了烟草消费量，此后降低了所有癌症类型的死亡率有关除了肝癌。在1960年代至1980年代，烟酒政策的变化与男性相比女性的变化更大，特别是对于头颈部，肺部和结肠直肠癌部位的变化。这项研究提供了证据，表明二十世纪澳大利亚公共卫生政策的某些变化与烟酒人口消费的变化以及随后20年各种癌症的后续死亡率有关。