Assessing the association between tourism and the alcohol urban environment in Barcelona: a cross-sectional study

Objectives Alcohol availability and promotion are not distributed equally in the urban context. Evidence shows that the socioeconomic level seems to influence the amount of alcohol-related elements in an area. Some studies suggest that tourism could also affect the distribution of these elements. We...

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Main Authors: Xisca Sureda, Manuel Franco, Susanna Puigcorbé, Joan R Villalbí, Marina Bosque-Prous, Ester Teixidó-Compañó, Montserrat Bartroli, Albert Espelt
Format: Article
Language:English
Published: BMJ Publishing Group 2020-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/9/e037569.full
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author Xisca Sureda
Manuel Franco
Susanna Puigcorbé
Joan R Villalbí
Marina Bosque-Prous
Ester Teixidó-Compañó
Montserrat Bartroli
Albert Espelt
author_facet Xisca Sureda
Manuel Franco
Susanna Puigcorbé
Joan R Villalbí
Marina Bosque-Prous
Ester Teixidó-Compañó
Montserrat Bartroli
Albert Espelt
author_sort Xisca Sureda
collection DOAJ
description Objectives Alcohol availability and promotion are not distributed equally in the urban context. Evidence shows that the socioeconomic level seems to influence the amount of alcohol-related elements in an area. Some studies suggest that tourism could also affect the distribution of these elements. We explore with a valid instrument in a large city whether there is an association between high tourism pressure and a greater presence of alcohol-related elements in the urban environment.Design Observational ecological study.Setting The study was conducted in Barcelona during 2017–2018.Participants We assessed urban exposure to alcohol by performing social systematic observation using the OHCITIES Instrument in a stratified random sample of 170 census tracts within the city’s 73 neighbourhoods.Primary and secondary outcome measures For each census tract we calculated the density of alcohol premises, and of promotion in public places per 1000 residents. We estimated tourism pressure using the number of tourist beds per 1000 residents in each neighbourhood and calculated quartiles. To assess the relationship between rate ratios of elements of alcohol urban environment and tourism pressure, we calculated Spearman correlations and fitted Poisson regression models with robust error variance.Results The median densities obtained were of 8.18 alcohol premises and of 7.59 alcohol advertising and promotion elements visible from the public space per 1000 population. Census tracts with the highest tourism pressure had 2.5 (95% CI: 1.85–3.38) times more outlets and 2.3 (95% CI: 1.64–3.23) times more promotion elements per 1000 residents than those in the lowest tourism pressure quartile.Conclusions We observed a strong association between tourism pressure and alcohol exposure in the city of Barcelona.
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spelling doaj-art-69f993d3b58d4e1fb02dcca5f2ccf7242025-01-07T10:50:09ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-037569Assessing the association between tourism and the alcohol urban environment in Barcelona: a cross-sectional studyXisca Sureda0Manuel Franco1Susanna Puigcorbé2Joan R Villalbí3Marina Bosque-Prous4Ester Teixidó-Compañó5Montserrat Bartroli6Albert Espelt7Public Health and Epidemiology Research Group. School of Medicine, University of Alcalá, Alcalá de Henares, SpainDepartment of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, United StatesAgència de Salut Pública de Barcelona, Barcelona, SpainCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, SpainFaculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, SpainFacultat de Ciències de la Salut de Manresa, Universitat de Vic - Universitat Central de Catalunya (UVicUCC), Manresa, SpainAgència de Salut Pública de Barcelona, Barcelona, SpainCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, SpainObjectives Alcohol availability and promotion are not distributed equally in the urban context. Evidence shows that the socioeconomic level seems to influence the amount of alcohol-related elements in an area. Some studies suggest that tourism could also affect the distribution of these elements. We explore with a valid instrument in a large city whether there is an association between high tourism pressure and a greater presence of alcohol-related elements in the urban environment.Design Observational ecological study.Setting The study was conducted in Barcelona during 2017–2018.Participants We assessed urban exposure to alcohol by performing social systematic observation using the OHCITIES Instrument in a stratified random sample of 170 census tracts within the city’s 73 neighbourhoods.Primary and secondary outcome measures For each census tract we calculated the density of alcohol premises, and of promotion in public places per 1000 residents. We estimated tourism pressure using the number of tourist beds per 1000 residents in each neighbourhood and calculated quartiles. To assess the relationship between rate ratios of elements of alcohol urban environment and tourism pressure, we calculated Spearman correlations and fitted Poisson regression models with robust error variance.Results The median densities obtained were of 8.18 alcohol premises and of 7.59 alcohol advertising and promotion elements visible from the public space per 1000 population. Census tracts with the highest tourism pressure had 2.5 (95% CI: 1.85–3.38) times more outlets and 2.3 (95% CI: 1.64–3.23) times more promotion elements per 1000 residents than those in the lowest tourism pressure quartile.Conclusions We observed a strong association between tourism pressure and alcohol exposure in the city of Barcelona.https://bmjopen.bmj.com/content/10/9/e037569.full
spellingShingle Xisca Sureda
Manuel Franco
Susanna Puigcorbé
Joan R Villalbí
Marina Bosque-Prous
Ester Teixidó-Compañó
Montserrat Bartroli
Albert Espelt
Assessing the association between tourism and the alcohol urban environment in Barcelona: a cross-sectional study
BMJ Open
title Assessing the association between tourism and the alcohol urban environment in Barcelona: a cross-sectional study
title_full Assessing the association between tourism and the alcohol urban environment in Barcelona: a cross-sectional study
title_fullStr Assessing the association between tourism and the alcohol urban environment in Barcelona: a cross-sectional study
title_full_unstemmed Assessing the association between tourism and the alcohol urban environment in Barcelona: a cross-sectional study
title_short Assessing the association between tourism and the alcohol urban environment in Barcelona: a cross-sectional study
title_sort assessing the association between tourism and the alcohol urban environment in barcelona a cross sectional study
url https://bmjopen.bmj.com/content/10/9/e037569.full
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