PONE-D-25-31774Modelling Alcohol Consumption Patterns to Enable Policy Impact AssessmentPLOS ONE

Dear Dr. ten Dam,

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Kind regards,

Pengpeng Ye

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

Reviewer #3: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Introduction - Quantify the Dutch disease burden attributable to excessive and heavy drinking. Add statistics to address the urgency of policy evaluation.

Methods - The paper states the National Health Survey uses "weighting variables" it doesn’t include details. Add a table detailing weighting methodology and its effect on prevalence estimates.

Methods- consider adding Sensitivity Analysis for Trend Breaks.

Methods - The paper removes individuals with "inconsistent" heavy drinking status (0.4%). This introduces selection bias. Acknowledge it.

Outline data needs for real-world monitoring of model predictions. create an early warning system for policy adjustments that can flag when things start to go off course. Include clear thresholds so you know when it’s time to step in and adjust policies or ramp up interventions.

Reviewer #2: Thank you for the opportunity to review this paper. The authors have undertaken a modeling study to develop predictive models of alcohol consumption patterns including weekly consumption, excessive consumption, and heavy episodic drinking using a representative sample of the Dutch population. Below I include minor comments to help clarify some elements in the manuscript.

Lines 78:81: The sentence beginning “Models that predict…” appears to be missing a word as the sentence is difficult to follow.

There are several places in the manuscript where the authors refer to incorrect figures. For example, Line 135 includes a reference to Figure 2 as a histogram, but this is actually Figure 3.

Line 136: Please include the specific version of R used for the analysis as the software does update and functions are sometimes deprecated.

Reviewer #3: Thank you for the opportunity to review this manuscript. This study proposes a new alcohol consumption predictive model based on data from The Netherlands. This study would be beneficial for the policy measure. The manuscript was well written. The methods were well designed. There are a few small points that might improve the manuscript:

- Line 95: Please give examples for number of alcoholic beverages. Is this equal to standard drink? Are both a can of beer and a bottle of wine counted as one alcoholic beverage, even their alcohol contents are different?

- Line 106-107: Please clarify the levels of education used in this study. Which levels are consider low, middle and high?

- Line 107 “year”: I think that “year” would indicate survey year. If so, please add detail for clarity.

- Line 361-366: Please explain in more details on how the missing data was handled.

- These models include demographics as the predictors of the alcohol consumption. I would like the ask if authors think that the changes in alcohol policy would influence the alcohol consumption. As for future studies, is it possible to incorporate modifiable factors or the factors that can be influenced by alcohol policy in the models?

- Regarding the generalizability of the study, please give us insights on whether this model would be able to be used outside of the Netherlands. If it is possible, please give some details on the potential conditions.

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Reviewer #1: Yes: Mohsin Raza

Reviewer #2: Yes: Naomi K. Greene

Reviewer #3: No

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Modelling Alcohol Consumption Patterns to Enable Policy Impact Assessment

PONE-D-25-31774R1

Dear Dr. ten Dam,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Pengpeng Ye

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #3: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #3: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #3: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #3: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

Reviewer #3: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Mohsin Raza

Reviewer #3: No

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