New Annotated Bibliography of 2017 Articles on FASD Prevention

Each year since 2013, researchers associated with the Prevention Network Action Team (pNAT) of the CanFASD Research Network search the academic literature for articles related to prevention of fetal alcohol spectrum disorder (FASD). Articles are reviewed for relevancy, identified by topic and country, and the findings briefly summarized. For this year’s Annotated Bibliography of Articles Published in 2017, a total of 113 articles were identified from 17 countries. Countries with highest number of published articles were USA, (51 articles) Canada (26 articles), Australia (10 articles).

Findings are organized using a four-level prevention framework used by the pNAT to describe the wide range of work that comprises FASD prevention (see panel at left for more information). This year a record 32 articles pertained to Level 2 which involves discussion of alcohol use with all women of childbearing age and their partners/support systems. Articles pertaining to Prevalence of alcohol use in pregnancy, Influences on women’s drinking, and Preconception interventions were also well represented.

The annual literature search is intended to update those involved in FASD prevention in Canada, to inform their practice and policy work with current evidence. The members of the pNAT also have the opportunity to discuss the implications for their work of the findings of selected articles, in monthly web meetings.

Find earlier Annotated Bibliographies below and on the CanFASD Prevention page under “Bibliographies”.

FASD Prevention: An Annotated Bibliography of articles published in 2016

FASD Prevention: An Annotated Bibliography of articles published in 2015

FASD Prevention: An Annotated Bibliography of articles published in 2014

FASD Prevention: An Annotated Bibliography of articles published in 2013

Liquor Policy Review in British Columbia: will FASD-related policies be part of the discussion?

liquor policy review

The Government of British Columbia started a review process in August 2013 to update current alcohol policies.

The first stage of the review has started with feedback from key industry groups and stakeholders. In the next few weeks, all citizens will be invited to share their thoughts through a Liquor Policy Review website.  A report is to be submitted to the Attorney General and Minister of Justice by November 25, 2013; BC’s cabinet will consider the report in early 2014.

There are numerous opportunities to get involved in these discussions. Alcohol policy discussions usually include a discussion of how to balance consumer freedom and economic considerations with reducing alcohol-related harms and costs. Historically, FASD has not been part of alcohol policy discussions, even though increased alcohol consumption in the population has implications for numbers of alcohol-exposed pregnancies and FASD rates.

The Centre for Addictions Research of BC (which conducts evidence-based research on alcohol policy) will be following the review process and posting commentaries and discussion by researchers, students and others associated with the Centre. Check out their website here.

For more on the links between alcohol policy and FASD prevention, see earlier posts:

You might also be interested in this eight minute video from the 5th International Conference on FASD in February 2013. Denise De Pape from the BC Ministry of Health talks about how alcohol policies can prevent FASD. She comments: “People living in communities who are dealing with FASD need to find ways to engage the Ministry of Finance and other parts of government that are putting in policies around price of alcohol and so on.” She discusses how anti-tobacco efforts can inform FASD prevention efforts. Check out the video here.

Women’s health and FASD prevention in a special issue of the International Journal of Circumpolar Health

IJCH cover

The International Journal of Circumpolar Health is a multidisciplinary journal that specializes in Arctic and Antarctic health issues, with a particular interest in the health of indigenous peoples.

The journal has just published a special supplement (Supplement 1, 2013) which includes 100 full length papers, 90 extended abstracts and nearly 100 short abstracts from the 15th International Congress on Circumpolar Health held in August 2012.

This issue has a number of full length and brief papers related to FASD, women’s addictions, and indigenous health. Here are some of the papers you might be interested in taking a look at:

Perceptions of needs regarding FASD across the province of British Columbia, Canada – Anne George, Cindy Hardy, Erica Clark (p. 91)

This study describes the perceived needs for services for people affected by FASD in rural and urban British Columbia.

Prenatal alcohol exposure among Alaska Native/American Indian infants – Burhan A. Khan, Renee F. Robinson, Julia J. Smith, Denise A. Dillard (p. 147)

A survey which found that rates of prenatal alcohol use are primarily limited to pre-conception and the 1st trimester, with a dramatic decrease in the 2nd and 3rd trimesters.

An examination of the social determinants of health as factors related to health, healing and prevention of foetal alcohol spectrum disorder in a northern context – the Brightening Our Home Fires Project, Northwest Territories, Canada – Dorothy Badry, Aileen Wight Felske (p. 169)

An exploratory study of the issue of the prevention of FASD from a women’s health perspective in the Northwest Territories of Canada.

Resituating the ethical gaze: government morality and the local worlds of impoverished Indigenous women – Caroline L. Tait (p. 200)

Drawing from a project documenting 100 life histories of Indigenous women with addictions and who have involvement with the child welfare system, as children or adults, this paper explores the influence of government policies and programs in Canada on recovery and healing.

Coordinating foetal alcohol syndrome interventions in Alaska – Kris Broom, Wendy Getchell, Chantelle Hardy, Garrett Hartley and Jessica Olson (p. 241)

A review of current Alaska FAS policies and interventions.

The healing constellation: a framework for understanding and treating trauma in Alaska Native women – Wendy H. Arundale (p. 243)

Connecting theory, research, and treatment approaches, a look at indigenous women’s substance use in relation to mental health, intergenerational trauma and other factors.

Community-driven alcohol policy and foetal alcohol spectrum disorder prevention: implications for Canada’s North? – Nancy Poole, Tasnim Nathoo and Arlene Hache (p. 250)

An exploration of the potentially important role of alcohol policy in northern communities in influencing alcohol use in pregnancy and risk of FASD.

The full publication is freely available for download here.

For more on FASD prevention in northern regions, see earlier posts:

Report on alcohol policy in Canada: How do the provinces stack up?


A few weeks ago, the Centre for Addiction and Mental Health (CAMH) released a report that took a look at 10 different evidence-based alcohol policies designed to reduce individual and societal harm from alcohol misuse and gave each province a score based on the degree to which each has implemented these policies.

Alcohol policies, when widely implemented, have considerable potential to reduce the health and social harms from alcohol, including influencing rates of FASD.

Some of the policy areas particularly relevant to FASD prevention that were examined include:

  • Marketing and advertising
  • Screening, Brief Intervention and Referrals
  • Warning Labels and Signs

The research team commented on how evidence from more than several hundred empirical studies has shown that the use of screening, brief interventions and referrals (SBIR) in health care settings is an effective method for reducing alcohol consumption and associated problems. They looked at the inclusion of SBIR in provincial strategies and plans (e.g., encouraging health care providers to screen for alcohol misuse with pregnant women or in the general population), fee for service codes which allow physicians to receive payment for conducting SBIR, and the inclusion of SBIR in health professional guidelines.

The report found that British Columbia and Ontario had perfect to almost perfect scores while other provinces had little or no activity on SBIR. Notably, British Columbia has a fee for service code specific to SBIR.

While the authors comment on the limited evidence of effectiveness for warning labels when used in isolation, they comment that warning labels on alcohol containers and point of sale warning signs are a good policy practice because of their potential to raise awareness of alcohol as a health issue and to support the adoption of other more directly effective policies.

While Ontario has legislated mandatory warning signs for both off-premise and on-premise outlets with a clear and direct health message pertaining to the risks of consuming alcohol while pregnant, most other provinces do have strong health oriented warning messages about alcohol use, including alcohol use during pregnancy.

You can view the press release here (March 6, 2013) and download the full report Strategies to Reduce Alcohol-Related Harms and Costs in Canada: A Comparison of Provincial Policies here.

Executive Summary_ENG_FINALrevised2_Page_1

For more on alcohol policy and FASD prevention, see earlier posts:

Minimum Alcohol Pricing Policies: Making the Connection to FASD Prevention

ottawa parliament

As approximately 4% of all deaths worldwide can be attributed to alcohol consumption, governments around the world are looking for policy approaches that can reduce the harms of alcohol use and misuse at a population level.

One policy approach that governments are increasingly looking at is minimum alcohol pricing. Minimum alcohol prices help to avoid situations where very low prices entice individuals into purchasing and consuming more alcohol than they otherwise might. Minimum price policies can also help set prices in relation to the percentage of alcohol content that a product has — higher prices for higher alcohol content.

There is strong and growing evidence that:

  • reduced alcohol consumption lowers rates of alcohol-related illnesses, injuries and social problems;
  • high-strength products are associated with risky patterns of alcohol consumption;
  • younger and heavier drinkers tend to choose cheaper alcohol.

So, what does minimum pricing have to do with FASD prevention? Quite a lot actually. An individual woman’s pattern of alcohol consumption is deeply connected to the context in which she lives. A woman’s drinking patterns can be affected by the drinking patterns of her friends and partner, the typical drinking practices in the part of the country where she lives, the packaging size of alcoholic beverages, alcohol advertising legislation, and the geographic density of outlets that sell alcoholic beverages – just to name a few things. Many of these factors can be greatly influenced by policy.

Looking at alcohol policy as a solution to FASD prevention also allows us to shift from focusing on individual women (which often results in a lot of blaming, guilt, and pressure on pregnant women) and to find broader solutions that affect communities and populations and have many positive outcomes, not just a reduction in FASD.

Nootka Sound

A research study published this week in the journal Addiction provides more evidence to support minimum alcohol prices. Researchers from the Centre for Addictions Research of BC at the University of Victoria found that between 2002 and 2009, the percentage of deaths caused by alcohol in British Columbia dropped more than expected when the minimum alcohol price was increased. A 10% increase in the average minimum price for all alcoholic beverages was associated with a 32% reduction in wholly alcohol attributable deaths (this includes things such as alcohol abuse, poisonings due to alcohol, excess alcohol blood level). You can take a look at the press release (Feb 7 2013) for the study here.

This latest study shows that even the heaviest of drinkers reduce their alcohol consumption when minimum alcohol prices increase – an important finding for those concerned with FASD prevention. You could think of it as a different form of harm reduction.

The study is also interesting as it gives some insight into debates about how alcohol is sold. Over the time period for this study, policies changed to allow for the partial privatization of alcohol retail sales resulting in a substantial expansion of private liquor stores. (Previously in British Columbia, alcohol could only be sold directly to the public in government-owned stores, unlike in Europe or the USA where it is often widely available in supermarkets, gas stations, etc.). The researchers found that a 10% increase in private liquor stores was associated with a 2% increase in acute, chronic, and total alcohol attributable deaths mortality rates.

For more on alcohol policy and FASD prevention, see earlier posts:


Stockwell T, Auld MC, Zhao JH, Martin G. (2012). Does minimum pricing reduce alcohol consumption? The experience of a Canadian province. Addiction, 107(5):912- 920.

Stockwell T, Zhao J, Giesbrecht N, Macdonald S, Thomas G, Wettlaufer A (2012). The raising of minimum alcohol prices in Saskatchewan, Canada: Impacts on consumption and implications for public health. American Journal of Public Health, 102(12): e103-10. doi: 10.2105/AJPH.2012.301094. Epub 2012 Oct 18. See the press release for this study here.

Zhao J, Stockwell T, Martin G, Macdonald S, Vallance K, Treno A, Ponicki W, Tu A, and Buxton J. (2013) The relationship between changes to minimum alcohol prices, outlet densities and alcohol attributable deaths in British Columbia in 2002-2009. Addiction, 108: doi:  10.1111/add.12139

Debates about ending alcohol bans in Aboriginal communities in Queensland, Australia

There have been recent debates about lifting alcohol bans in Aboriginal communities in Queensland, Australia. The governments in Queensland and Northern Territories have proposed to lift “grog bans” based on the idea that Aborigines should have the same rights as all Australians, including the right to drink.

This news clip interviews indigenous academic, Marcia Langton, who says the evidence supports keeping restrictions in place. “The fact of the matter is is that all Australians are subject to alcohol restrictions in one form or another. We can’t go and buy alcohol at any time of the day or night. There are restrictions on hours. There are restrictions everywhere in Australia now on drinking in public places and specified places. So, it is not true that Aborigines are the only people who are subject to restrictions on alcohol.”

For more on the history of alcohol bans in Queensland, check out this news article Bans on alcohol spawn generation of lucky children (The Australian, October 13, 2012).

For more on local alcohol policies and FASD prevention, see earlier posts: