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Control State News March 14, 2019

UT: Agreement reached to increase limits on SAVE THE DATE in Utah WY: 24/7 : Legislation updates fundamentals of March 17-19, 2019 26th Annual Symposium on alcohol compliance program Alcohol Beverage Law and Regulation AL: The Craft Beer Industry Is Brewing Up Big Bucks For Registration is open for NABCA’s 2019 Legal Alabama Symposium. For program details, travel information and to register online at www.nabca.org\meetings. License State News NE: Myths persist over facts about underage drinking, NABCA HIGHLIGHTS coalition leader says The Public Health Considerations of Fetal IL: Want liquor delivered to your house? Illinois Senate Alcohol Spectrum Disorders (White Paper) committee advances legislation Native American Nations & State Alcohol Policies: An Analysis (White Paper) International News Alcohol Technology in the World of Tomorrow - (White Paper) France: What you risk if you drink and drive in France The Control State Agency Info Sheets. Please Public Health News view website for more information. NABCA Survey Database (members only) Varieties of Cancers Brought about by Consuming Too a lot Upcoming NABCA Meetings Alcohol Statistical Data Reports Moderate Drinking Tied to Risk of Stage 1, 2 Hypertension www.NABCA.org Industry News

Top 10 Biggest US Craft Brewers of 2018

Education News New concern on college campuses: ',' a combination drinking and Daily News New WHO study shows more action needed to monitor and limit digital marketing of unhealthy products to children

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CONTROL STATE NEWS UT: Agreement reached to increase alcohol limits on beer in Utah Star Tribune By Lindsay Whitehurst, Associated Press March 13, 2019 SALT LAKE CITY — Alcohol limits for beer at Utah grocery stores inched closer to the rest of the country Wednesday under a legislative compromise in the state where the predominant faith teaches abstinence from alcohol. The agreement would raise alcohol limits to 4 percent starting in November, a level that's still lower than almost all other states but would allow like Bud Light and Corona to be sold, Republican Sen. Jerry Stevenson said. The agreement breaks a stalemate over a proposed larger increase that was supported by big retailers like Wal- Mart but opposed by The Church of Jesus Christ of Latter-day Saints, which counts most lawmakers as members. The 4-percent-by-weight limit would allow most, but not all, regular-strength beers in private stores and on tap, said Kate Bradshaw, a lobbyist with the Responsible Beer Choice Coalition, a group of manufacturers, distributers and sellers. "It's the biggest change in Utah alcohol history in 86 years, since ended," she said. A task force would also be assigned to study whether to raise the limits again. Higher-strength beer, wine and spirits are only available at state-owned liquor stores in Utah. The compromise is palatable for the church as well. Marty Stephens, director of government relations, said the faith still had concerns but considers the compromise an improvement and won't oppose it. The deal cleared its biggest hurdle, the state House of Representatives, Wednesday night, and it is expected to fare well in the state Senate. Utah now limits beer to 3.2 percent alcohol at grocery and convenience stores, which stock weaker versions of popular beers. Large have been discontinuing those products, though, because the market is shrinking as other states like Oklahoma, Colorado and Kansas abandon similar limits. The emptier shelves are difficult for stores that depend on revenue from beer sales, Stevenson has said. He originally wanted to raise alcohol limits to 4.8 percent, but The Church of Jesus Christ of Latter-day Saints opposed the idea. The state Senate passed it anyway, but it stalled in the House amid concern about the potential side effects. If passed, the deal would also avoid the possibility of a ballot initiative seeking the approval of higher alcohol limits from voters who have bucked state lawmakers on other hot-button issues like medical marijuana and Medicaid expansion. Utah also hosts an active microbrewery community, and many brewers had opposed the incremental 4.8 increase that they said would benefit big companies over locals. The Utah Brewers Guild did not take a position on the compromise deal.

WY: 24/7 Sobriety: Legislation updates fundamentals of alcohol compliance program The Sheridan Press By Ashleigh Fox March 13, 2019 SHERIDAN — A law that took four years to pass through the Wyoming Legislature might keep drunk drivers from reoffending in the future. NABCA Daily News Update (3/14/2019) 3

Four years ago, Sen. Dave Kinskey, R-Sheridan, helped work on a bill that revised the existing 24/7 sobriety program in the state. The current program, signed into law by former governor Matt Mead, is designed for repeat offenders driving under the influence. “The 24/7 Sobriety Project sets the standard of no use of alcohol and no use of illegal drugs as a condition of continuing to drive and remaining in the community, rather than being incarcerated,” according to the Governor’s Council on Impaired Driving website. The standard is enforced by intensive monitoring by law enforcement with alcohol and drug testing mandated for each participant, the website continues. Violation of program rules leads to immediate and usually brief incarceration of the offender. The combination of strict monitoring and a no-use standard with swift, consequences has been extremely successful, all according to the website. For offenders who have their driver’s license suspended due to driving while impaired by alcohol, the new legislation allows them access to a restricted driver’s license, but they can only drive vehicles that have an ignition interlock device. Changes to the law allow offenders to immediately apply for the license, removing the sunset provision of having to serve 45 days of suspension or revocation before applying. Existing law requires those re-offending to be arrested by law enforcement immediately and without warrant after receiving a written statement by either a probation and parole officer or law enforcement establishing the offense. Practically speaking, it will not change law enforcement’s role too much in dealing with alcohol offenders on the road. Sheridan County Sheriff’s Office staff and Lt. Emily Hizer, who oversees the Sheridan County Detention Center, is in the process of writing policy to help with the transition of the “quick dip,” — a short amount of time spent in jail before seeing a judge as soon as possible — into the judicial system. From now until July, when the law is enacted, law enforcement will continue its system of sharing the burden of testing for alcohol compliance. The 24/7 Sobriety Project is authorized and run under the direction of the county sheriff, but Sheriff Allen Thompson said his deputies and the Sheridan Police Department officers share the duties. “Our biggest shortage on that is manpower on the sheriff’s office side,” Thompson said. “Being able to actually implement that and do it is manpower-intensive for a couple to four hours a day.” The SPD helps conduct preliminary breath tests Monday through Friday in conjunction with SCSO. “Should there be a violation, then we have our staff on site here in the detention center all the time that can come take somebody in the lobby into custody and follow through with the report or additional test or whatever needs to be done,” Thompson said. The next step for Hizer and SCSO to move from policy writing into full implementation are discussions with judges and county attorneys. For now, operations will stay the same until agencies can settle on policy for the immediate judicial review of alcohol offenders, but Thompson anticipates full implementation later this year.

AL: The Craft Beer Industry Is Brewing Up Big Bucks for Alabama Direct sales from the brewers are only a small percent of the money generated from the growing industry. WAAY 31 ABC Posted by Bill Young March 13, 2019 The craft beer industry continues to grow and generate more and more money for the state of Alabama. Numbers released by the Alabama Brewers Guild show the craft beer industry had a $616 million impact on the state. This not only includes sales, but money generated through breweries, wholesalers, retailers, and things like NABCA Daily News Update (3/14/2019) 4 food and merchandise sold at restaurants attached to brewpubs and taprooms. The news wasn't surprising to Matt Broadhurt, the operations manager at the Huntsville-based Straight to Brewers. "When we left Leeman Ferr, we had 8 employees. Now, we have 81. We're paying taxes, we distill - pay taxes on that. The economic growth - it is the sky is the limit," said Broadhurst. Straight to Ale could be a case study in the success of craft beer in Alabama. The company brewed its first batch 9 years ago, just after Alabama made it legal to make beer in the state greater than 6 percent . Evolving laws have allowed for the sale of pints from a taproom, then the sale of beer-to-go, then in bottles larger than 16 ounces. The evolving laws also mean evolving success for breweries just like Straight to Ale. WAAY 31 asked Broadhurst if he knows how many outlets sell the company's products. "Gosh, I couldn't begin to guess. I think the last time I counted, it was 1,000 outlets in Alabama that sell our beer." There are still issues the Brewers Guild wants to take on in Alabama to further evolve the craft beer industry. This includes allowing for multiple locations and eliminating regulations that prevent brewery and distillery owners from participating in non-profits that also host licensed special events.

LICENSE STATE NEWS NE: Myths persist over facts about underage drinking, coalition leader says Star Herald By Irene North Star-Herald March 14, 2019 SCOTTSBLUFF — Even with continued education, myths surrounding underage drinking continue to persist. Lanette Richards, project coordinator of Monument Prevention Coalition, attempted to dispel several of those myths on Monday. A myth she says she hears often is that the only kids who drink are those with psychological issues, are poor or are bad kids. “Everyone in our line of work knows that’s not true,” Richards said. “It doesn’t matter what your race, ethnicity or economic position is.” Richards said Scotts Bluff County ranks high in excessive use and Nebraska ranks high in the nation. At meetings and in conversations, people will often state that everyone drinks alcohol. Richards said studies have found 35 percent of Americans do not drink alcohol at all and that 20 percent of people are drinking about 85 percent of alcohol consumed in the nation. “It’s a small minority of the adult population that drink the majority of alcohol,” Richards said. Richards said recent studies have also shown that about 11 percent of all alcohol consumed in the United States was consumed by youth under 21. “More than 90 percent of the alcohol consumed by youth is done in the form of ,” Richards said. Richards says those youth aren’t getting their alcohol from strangers. They are getting it from people they know. It is often obtained from a friend, older sibling, their home or the home of a friend. This trend spikes when older siblings are home during school breaks. A recent defense to curb underage drinking includes the myth that lowering the drinking age would solve the underage drinking problem. Some believe that people overseas have lower drinking ages and do not have problems. Richards said this was not the case.

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“A large majority of European countries have higher intoxication rates among youth,” Richards said. “Easy access to alcohol seems to allow young people to drink heavily and in a risky fashion whether they live in Europe or the U.S.” There are also risk factors for youth, whose brains will not be fully developed until about age 24. According to the American Medical Association, a higher minimum is effective in preventing alcohol-related deaths and injuries among youth. People who drink before age 15 are four times more likely to develop alcohol dependency versus those who wait until they are 21. Lisa Peden, with the DOVES Program, offered youth some practical advice she learned from her mother. “If you ever think you have a reason to drink, don’t,” Peden said. “If you are giving yourself a reason to drink, then that’s when you choose not to.” The advice made sense to her. It is ingrained in society that, for example, if you have had a tough day and need to unwind, you can reward yourself with a drink. In addition to advertising targeted at youth, society provides mixed messages. “We have marathons, which is about being healthy and then have a beer garden at the end,” said John Marshall, MPC board member. While adults can choose when they can drink and when they cannot, Richards cautioned about giving youth alcohol as a reward. “Mixing underage youth and alcohol is a recipe for disaster in any environment,” she said. Richards said many youth already do not drink for a variety of reasons. One large factor is the youth will no longer be able to participate in activities they enjoy, the American Medical Association said. “The most common reason I hear is ‘my parents will kill me,’” she said. Being consistent matters, Richards said. “We have to have adults give that consistent message that 21 is 21,” she said. “We shouldn’t be giving them permission to break the law.” The Monument Prevention Coalition meets on the first Monday of each month in the Scotts Bluff County Administration Building. For more information, contact Lanette Richards at 308-635-6162.

IL: Want liquor delivered to your house? Illinois Senate committee advances legislation Herald & Review Capitol News Illinois March 14, 2019 SPRINGFIELD — A bill allowing for the home-delivery of liquor passed the Senate Executive Committee Wednesday, with its sponsor promising to bring an amended proposal back for further discussion. State Sen. Don Harmon’s Senate Bill 54 passed unanimously. Harmon said he was still working with the liquor control commission and other groups to fine-tune the bill before it comes to a vote before the full chamber. The bill allows retail liquor licensees to deliver alcohol straight to a consumer’s door, provided certain conditions such as age verification and training are met. “In this new world of innovation where we now are able to order our groceries for delivery, this is an effort to ensure when we order our bread and meat we can also order of bottle of wine,” Harmon, an Oak Park Democrat, said. Other alcoholic beverages, such as beer and liquor, would be included under the bill as well. The deliverer of the beverages would be required to verify that the person accepting it was of legal drinking age. NABCA Daily News Update (3/14/2019) 6

The bill also allows the retail licensee to use a third-party facilitator to deliver the beverages, and establishes the cost of a license fee for such a facilitator to be $1,100.

INTERNATIONAL NEWS France: What you risk if you drink and drive in France The Local March 13, 2019 A new punishment for drink driving is being rolled out across France in a bit to cut the number of road deaths linked to alcohol. Here’s what you need to know about what's at stake if you drive whilst under the influence in France. France is introducing a new law that will apply to all those caught drink-driving. From now on drivers will have to pick between either having their licence suspended or having a vehicle ignition breathalyser installed in their cars. The ignition breathalyser means the car cannot be started unless you first pass a breathalyser test that involves blowing into a device installed in the car. The devices known as EADs in French (ethylotest anti-démarrage) have been compulsory in France since 2015 on buses. They require the driver's alcohol level to be below 0.2 grams per litre of blood in order for the vehicle to start. The legal limit for everyone else is 0.5 g/l, with drivers with less than three years of experience begin limited to 0.2 g/l. The new measure will apply to those drivers caught with more than 0.8g/l of alcohol in their blood. Drivers will have to pay out of their own pocket for the devices which cost more than €1,000 and will have to remain in the car for at least five years. Drink driving is still seen as socially acceptable by many in France, but road safety charities say that it caused the deaths of 1,035 people in 2017. Police say that they recorded 123,926 drink driving offences that year, which represents 20 percent of all traffic offences. Alcohol is also said to be behind 58 percent of all road deaths at weekends. Twenty-nine percent of the people surveyed by France’s Prévention Routière et Assureurs Prévention in 2014 admitted they had driven with more than the legal 0.5 grams/ litre of alcohol in their blood stream. According to the study titled “Going out, drinking alcohol and driving: the French take too many risks”, 27 percent also claimed they had gotten in a vehicle even though they thought the driver was over the limit. The head of France's leading motorists group said France had failed to make the same progress as the UK. "In contrast to the UK drink-driving is not yet socially unacceptable in France," Pierre Chasseray, the head of driver's group "40 million d'automobilistes" told The Local at the time. Here are the rules about drinking before you drive, but in general the official advice is that it's better to shun alcohol altogether if you’re about to hit the road. With the limit being just one or glass or wine - and even that can sometimes put you over the permitted level - full sobriety is the best way to go when you get behind the wheel. These are the most severe punishments possible, but judges can and do impose lesser ones. Their punishments may depend on the consequences of the driver's actions, such as whether there was an accident and whether people were hurt or even killed. NABCA Daily News Update (3/14/2019) 7

• Driving with more than 0.8g/l of alcohol in the blood can lead to a two-year jail sentence, a three-year driving ban or installing an EAD in the vehicle, and a fine of up to €4,500. • The above punishment can also be handed out to anyone who refuses to take a breathalyser test. • Any subsequent drink driving offence can land you four years in jail, a fine of €9,000, and a three-year driving ban (or getting an EAD installed) • All of the above offences will make you lose up to six of the 12 points on your licence, and you vehicle may be confiscated. • Driving under the influence of drugs or failing to cooperate with a drugs test will land you up to two years in jail, a €4,500 fine and a three-year driving ban. • Driving with between from 0.5g/l and 0.8g/l of alcohol in your blood can leave you with a fine of €135 (reduced to €90 if you pay within days of receiving the fine), the loss of six licence points, and a three- year suspension of your licence. While you might escape paying a fine if you are caught by a speed camera driving in France in a foreign-registered car, this will of course not apply if you are caught drink driving, as this entails contact with a police officer who has stopped you.

PUBLIC HEALTH NEWS Varieties of Cancers Brought about by Consuming Too A lot Alcohol Brinkwire March 14, 2019 There is strong scientific evidence that drinking too much alcohol can lead to certain types of cancer. The risk factors increase the more a person drinks, in addition to developing other diseases that can be debilitating or deadly. According to the National Toxicology Program of the U.S. Department of Health and Human Services, even light drinkers, or those who have at least one drink per day, are exposed to significant cancer risks; so those who are considered binge drinkers are in greater danger. In fact, 2009 statistics show that 3.5 percent of the cancer-related deaths in the country, roughly 19,500, were related to alcohol use. Of the studies on , these types have emerged to be the most common results. Esophageal Cancer Esophageal squamous cell carcinoma is common among those who are heavy alcohol drinkers. Compared to non- drinkers, those who drank moderately were 1.3 times more at risk for cancer while those who drank heavily were 5 times more at risk. Colorectal Cancer Moderate to heavy consumption of alcoholic drinks exposes a person 1.2 times to 1.5 times more to rectal and colon cancers, compared to people who do not drink. Liver Cancer The risk for liver cancer is two-fold in people who are heavy drinkers. The problem is evident in two types of liver cancer: intrahepatic cholangiocarcinoma and hepatocellular carcinoma. Head and Neck Cancer Moderate alcohol drinkers are 1.8 times more at risk for cancer, particularly of the oral cavity, pharynx (throat) and larynx (voice box). Binge drinkers are 5 times more exposed, and this is even more heightened if the person also smokes tobacco. NABCA Daily News Update (3/14/2019) 8

Breast Cancer Light drinkers have a 1.04-fold increased risk for breast cancer, while moderate and heavy drinkers have a 1.23- fold and 1.6-fold increased risk, respectively. It is important to note that it does not matter what type of alcohol is consumed because it is the drink itself that is proven to cause cancer. The best course of action is to reduce your risk by also reducing consumption, if it cannot be helped, or just cutting it out of your lifestyle completely. While drinking in small amounts has a much lower risk, the fact that the risk is still there remains.

Moderate Drinking Tied to Risk of Stage 1, 2 Hypertension MedScape By Marlene Busko March 13, 2019 NEW ORLEANS — Studies have established that heavy drinkers are more likely to have hypertension compared with non-drinkers, and now new research confirms the link to high blood pressure and extends the finding to those consuming moderate amounts of alcohol. In a snapshot of a national sample of adult Americans, researchers found that compared to abstainers, men and women who drank 7 to 13 alcoholic drinks a week (moderate drinkers) were 1.5 times as likely to have stage 1 hypertension and twice as likely to have stage 2 hypertension, based on criteria in the new 2017 ACC/AHA hypertension guidelines. Heavy drinkers (14 or more drinks per week) had a similar, slightly higher risk of having stage 1 or stage 2 hypertension vs abstainers. Lead author Amer I. Aladin, MD, a cardiology fellow at Wake Forest School of Medicine, Winston-Salem, North Carolina, presented these findings in a media briefing and will present the results at this weekend's American College of Cardiology (ACC) 2019 Annual Scientific Session. "Moderate drinking in our study was associated with risk of hypertension, whereas in previous studies [it] showed moderate drinking was beneficial," Aladin told theheart.org | Medscape Cardiology in an email. The public health message is that people should ask their providers to check their blood pressure at each visit, especially if they are moderate or heavy drinkers, he said. Invited to comment for Medscape Medical News, Michael Roerecke, PhD, a scientist at the Centre for Addiction and Mental Health (CAMH) and an assistant professor at the University of Toronto in Canada, similarly noted that "screening for both alcohol consumption and elevated blood pressure are not done regularly and should be conducted more often in clinical practice." "Heavy drinkers should talk to their clinician about their risk and reduce drinking in consultations with their physician," he told theheart.org | Medscape Cardiology in an email. Furthermore, although light drinking (1-6 drinks per week) was not associated with elevated blood pressure in this study, "binge drinking episodes (in the US defined as 4 or more drinks within a 2-hour period for women, and 5 or more drinks for men), may increase the risk for hypertension even when the average drinking over the week is low," he pointed out. Alcohol has many effects on the body and mind, Roerecke noted. It is a known carcinogenic, hepatotoxin, and neurotoxin in humans. "Safe [consumption] may reduce the risk of myocardial infarction or type 2 diabetes; however, the risk for other diseases is elevated for any amount of drinking, which is the reason that no level of drinking is safe."

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INDUSTRY NEWS Top 10 Biggest US Craft Brewers of 2018 the drinks business By Lauren Eads March 14, 2019 US trade body the Brewers Association (BA) has released its annual list of the country’s biggest brewers based on sales volumes in 2018. while also revealing the biggest “craft” brewers. Of the top 50 overall brewing companies, 40 were small and independent craft brewing companies, highlighting the decreasing gap between craft and big beer. “Although the market has grown more competitive, particularly for regional craft breweries with the widest distribution, these 50 small and independent brewing companies continue to lead the craft brewing market in sales through strong brands, quality, and innovation,” said Bart Watson, chief economist of the Brewers Association. DEFINITION OF CRAFT The BA’s definition of craft covers those brewers deemed to be “small, independent and traditional”. Small means that the brewer has an annual production of six million barrels of beer or less, “flavoured malt beverages are not considered beer for purposes of this definition”.The association describes an American craft brewer as “small, independent and traditional”. Independent means that “less than 25% of the craft brewery is owned or controlled by an alcoholic beverage industry member who is not themselves a craft brewer”. Traditional relates to “a brewer who has either an all malt flagship (the beer which represents the greatest volume among that brewers brands) or has at least 50% of its volume in either all malt beers or in beers which use to enhance rather than lighten flavour.” NB: Specific sales data has not been disclosed by the BA. Companies are ranked in order of volume produced or sold in the US (including imports). The top 10 overall biggest brewers in the US (including craft) are as follows:

1 Anheuser-Busch Inc. St. Louis MO 2 MillerCoors Chicago IL 3 Constellation Chicago IL 4 Heineken White Plains NY 5 Pabst Brewing Co. Los Angeles CA 6 D. G. Yuengling & Son Inc. Pottsville PA 7 Diageo Norwalk CT 8 FIFCO USA Rochester NY 9 Boston Beer Co. Boston MA 10 Sierra Nevada Brewing Co. Chico CA

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EDUCATION NEWS New concern on college campuses: 'drunkorexia,' a combination drinking and eating disorder Live Well Nebraska By Cara Rosenbloom / Special To The Washington Post March 14, 2019 My college experience included this life-skills lesson: Drink alcohol on a full stomach, so you don't get inebriated too quickly. Of course, most college students shouldn't be drinking at all, but we know from the National Institute on and that close to 60 percent of college students ages 18 to 22 do consume alcohol, which makes harm-reducing approaches important. Unfortunately, campus authorities and researchers are reporting a practice that turns the full-stomach drinking strategy on its head: Rather than filling up before a night of partying, significant numbers of students refuse to eat all day before consuming alcohol. This is a high-risk behavior colloquially called "drunkorexia," which is one part eating disorder, one part alcoholism - a very dangerous combination for college-age students. The term drunkorexia, which can also include excessive exercise or purging before consuming alcohol, was coined about 10 years ago, and it started showing up in medical research around 2012. Drunkorexia addresses the need to be the life of the party while staying extremely thin, pointing to a flawed mind-set about body image and alcoholism among college students, mostly women. Imagine this scenario: A female college freshman doesn't eat anything all day, exercises on an empty stomach, then downs five shots of tequila in less than two hours. Because there's no food in her system to help slow the absorption of alcohol, those shots affect her rapidly, leading to inebriation and possibly passing out, vomiting or suffering alcohol poisoning. That's drunkorexia. Tavis Glassman, professor of health education and public health at University of Toledo in Ohio, researches drunkorexia and worries about scenarios such as the one described above: "With nothing in her system, alcohol hits quickly, and that brings up the same issues as with any high-risk drinking: getting home safely, sexual assault, unintentional injury, fights, blackouts, hangovers that affect class attendance and grades, and possibly ending up in emergency because the alcohol hits so hard," he says. From a medical point of view, Seattle-based registered dietitian Ginger Hultin points out that if alcohol is prioritized over food, it could result in nutrient deficiencies such as calcium, B-vitamins, magnesium, fiber and protein. "Alcohol can negatively affect the liver or gastrointestinal system, it can interfere with sleep, lower the immune system and is linked to several types of cancers," Hultin says. With all of the noted harms, why would a promising college freshman choose this unhealthy pattern? Well, likely it's not a choice, but mental health and addiction issues mixed together. Studies show that having a preexisting eating disorder or alcoholism are predictors of drunkorexia. There are no national statistics on the prevalence of campus drunkorexia, and surveys from colleges range widely: One report concluded that 34 percent of all students surveyed had engaged in this behavior; another said 81 percent of students who drink heavily had done so. What experts and researchers do agree on is the seriousness of the practice. "As soon as this behavior is identified, it could actually be considered a problem," Hultin says. There's no safe level of starvation paired with binge drinking. Glassman and his colleagues are seeking to have drunkorexia - or a more aptly named 'alcoholimia' - added as an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM), as a subcategory of Other Specified Feeding and Eating Disorders. They hope for guidelines to help practitioners identify the condition in people who engage in high risk drinking; are very concerned with their body shape; and engage in either laxative use, vomiting, weight control stimulants, meal skipping, food restriction or excessive exercise. Adding drunkorexia to the DSM would increase the likelihood that a person with this condition can receive insurance coverage for treatment. That's an important consideration, since treatment may include a costly team NABCA Daily News Update (3/14/2019) 11 approach, including dietitians, psychologists and medical doctors who are able to care for the "" - a medical term for a practice that treats people who suffer from both an addiction and a psychiatric disorder. At the University of Toledo, Glassman and his team are trying to prevent drunkorexia with body image education and are raising awareness about the harms of body shaming. "We try to emphasize that the human body comes in different shapes and sizes, and remind students that when they look at the media, with computer enhancement and airbrushing, even the model may not really look like a model," Glassman says. "We remind students to value people based on things besides their appearance." Their campaign focuses on health factors, by reminding students that they only have one body, and it's time to take care of it instead of abusing, hating or shaming it. "Some students perceive drunkorexia to be harmless when in fact the behavior is extremely dangerous," Glassman says. "Once they recognize that it's unhealthy, a lot of students make the decision to change their behavior and get help as necessary." Hultin says parents, educators, school counselors and medical professionals can help identify drunkorexia in students, and adds that "if students see friends engaging in this type of behavior, they can intervene and encourage different choices or offer support or resources to address a potential problematic relationship with alcohol and/or food." Help is always available. An on-campus medical or counseling center is a good place to start.

DAILY NEWS New WHO study shows more action needed to monitor and limit digital marketing of unhealthy products to children World Health Organization (Europe) By Ashan Pathirana March 13, 2019 A new report from WHO/Europe calls for greater monitoring of the digital marketing of alcohol, tobacco and unhealthy food products, especially those high in salt, sugar and fat. It comes amid the advertising industry’s continued efforts to target children and adolescents on social media and on difficult-to-track mobile devices. “The overriding concern is that nearly a decade after introducing the 2010 WHO recommendations on the marketing of foods and non-alcoholic beverages to children, exposure of children to the online marketing of unhealthy food products, tobacco and alcohol remains commonplace,” said Dr João Breda, Head of the WHO European Office for the Prevention and Control of Noncommunicable Diseases. Monitoring the online advertising of unhealthy products to children is critical, as noncommunicable diseases such as heart disease, cancer, obesity and chronic respiratory disease are linked to smoking, alcohol abuse and the consumption of unhealthy food products. The onset of these diseases can be slowed or prevented if major risk factors and behaviours are addressed during childhood. Despite this, the new report “Monitoring and restricting the digital marketing of unhealthy products to children and adolescents” confirms that data on the digital lives of children are scarce. It points out that children’s time spent online, including on social media, has steadily grown, meaning that their exposure to digital marketing has also increased. The report urgently calls for developing and implementing a set of tools for monitoring the exposure of children to digital marketing. Data on children’s exposure to digital marketing This report builds on a June 2018 expert meeting on the monitoring of digital marketing of unhealthy products to children and adolescents. The meeting provided clear steps forward in this area. The idea is to establish a panel-based methodology that can be implemented in a standard way across Member States to benchmark and highlight issues to regulators and policy-makers. With this in mind, WHO has begun promoting the need for a monitoring method known as the CLICK Tool, which would assess the extent of children’s actual exposure to digital marketing on a regular basis. NABCA Daily News Update (3/14/2019) 12

Findings from such a tool, WHO believes, could help strengthen the case to national governments for action to protect children not just from advertisements for unhealthy foods, but also from those for tobacco and alcohol. The tool focuses on the following 5 key components. C – Comprehend the digital ecosystem: Map the global, regional and national digital marketing ecosystem and children’s website and digital application usage, and supplement this with focus groups to gauge the thoughts, experiences and awareness of children (and parents/guardians) about marketing techniques and campaigns. L – Landscape of campaigns: Assess campaigns of leading national brands by collecting information from advertising agencies and by sampling whole-country social media for relevant content to ascertain what is viewed by different age groups. I – Investigate exposure: Map exposure to a selection of paid digital marketing among a panel of children in each age bracket using an installed smartphone application that (with consent) monitors and aggregates data on children’s interaction with advertisements in some websites and social media. C – Capture on-screen: Use real-time screen-capture software on a subgroup of devices to assess what a representative sample of children actually sees online on their devices to better understand wider marketing techniques, including user-generated content and product placement. K – Knowledge sharing: Create user-friendly materials from the research data and develop partnerships with young people, parents, policy-makers and members of civil society who together can advocate for change, raise awareness and influence policy.

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