Distances from 54,778 Finnish Public Sector study participants¡¯ homes to the nearest off-premise beer and liquor outlets were calculated using Global Positioning System-coordinates. Between-individual analyses were used to study the effects of distance to the nearest outlet on heavy alcohol use, and within-individual analyses to study the effects of a change in distance on change in heavy use.
Mean follow-up time in 2000-2009 was 6.8 (standard deviation 2.0) years. In a between-individual analysis, decrease from ¡Ý500 m to <500 m (vs. remained ¡Ý500 m) in the distance to the nearest beer outlet increased the likelihood of incident heavy alcohol use in women (odds ratio 1.23, 95 % CI 1.05-1.44), but not in men. In a within-individual analysis decrease from 500 m to 0 m in log-transformed continuous distance to the nearest beer outlet increased the odds of heavy alcohol consumption in women by 13 % (odds ratio 1.13, 95 % CI 1.01-1.27). For the corresponding change in distance to liquor outlet the increase was 3 % (odds ratio 1.03, 95 % CI 0.97-1.09).
Change in distance from home to the nearest off-premise alcohol outlet affects the risk of heavy alcohol consumption in women. This evidence supports policies that restrict physical availability of alcohol.