Characteristics of binge drinkers in Europe

Effects of socialization and family factors on adolescent excessive drinking in Spain

Adolescent drinking has an important health and social impact in many countries. In Spain, this behavior often takes place in groups and in open areas (known as "botellón"). The aim of this study is to describe the prevalence of excessive drinking among Spanish adolescents and its association with socialization and family factors. A national school survey was conducted in 2006 among 26,454 students aged 14-18 years who were selected by two-stage cluster sampling (schools and classrooms). The questionnaire was self-completed with paper and pencil. The outcomes were: habitual excessive drinking or HED (average consumption ≥30 g/day of alcohol among men, and ≥20 g/day among women), binge drinking (drinking 5 or more standard alcohol units in a 2-hour interval), and drunkenness. Logistic regression models were used to estimate the effect of socialization and family factors. Monthly prevalence of HED, binge drinking and drunkenness was 11.2%, 30.9% and 25.6%, respectively. The main factors positively associated with HED were: frequently going out for fun in the evenings, high proportion of friends who drink or get drunk, early onset of alcohol use, low perceived risk of drinking, truancy, illegal drug use, and amount of money spent for personal needs. Family factors were weakly associated with outcomes. Socialization in leisure environments with friends who drink excessively is an important predictor of adolescent excessive drinking in Spain. Thus, prevention must also focus on the community level, limiting alcohol access, building socialization environments without alcohol, and increasing adolescents' risk perception of drinking.

Adolescent alcohol intoxication in Dutch hospital centers of pediatrics: characteristics and gender differences

Gender differences in alcohol intoxication among adolescents are still largely unknown, whereas these differences have been studied in adults. To investigate possible differences, this study analyzed pediatric admissions for alcohol intoxication to the majority of Dutch hospitals between 2007 and 2009. Another aim was to explore key characteristics (e.g. blood alcohol concentration, duration of reduced consciousness, and age) and trends of alcohol intoxication among adolescents in the period 2007-2009. We analyzed data from the Dutch Pediatric Surveillance system, which monitors alcohol intoxication among children in pediatric departments of Dutch hospitals. Patients aged 11-17 years with reduced consciousness due to alcohol intoxication were included. The number of adolescents admitted with alcohol intoxication increased sharply from 2007 to 2009. The average age of the patients treated for alcohol intoxication increased from 15.3 years in 2007 and 15.4 years in 2008 to 15.7 years in 2009. The duration of reduced consciousness due to alcohol intoxication also increased over the 3-year period: from 2.2 to 3.1 h. Gender differences were observed regarding alcohol intoxication characteristics. Most strikingly, intoxicated girls were younger (15.3 vs. 15.7 years), had a lower blood alcohol concentration (1.79 vs. 1.94 g/l) and were hospitalized for shorter times than boys. No association was found between alcohol intoxication and other, possibly illicit drug use. The drinks most consumed prior to hospital admission were spirits and beer. Alcohol intoxication among adolescents is an emerging problem. Differences in intoxication characteristics between boys and girls were observed. These findings are important for future prevention and intervention strategies. In the Netherlands, special policlinics for children with alcohol intoxication have already been established.

Lymphocyte measures in treatment-naïve 13-15-year old adolescents with alcohol use disorders

Many adolescents have chronic exposure to hazardous levels of alcohol. This is likely to be a significant predictor of health outcomes, including those related to immunity. We assessed substance use and biochemical immunological parameters in heavy drinking adolescents (meeting DSM-IV criteria for alcohol dependence) and light/nondrinking control adolescents in Cape Town. Lifetime alcohol dose, measured in standard units of alcohol, was orders of magnitude higher in alcohol-dependent (AD) participants than controls. All adolescent AD had a "weekends-only" style of alcohol consumption. The AD group was chosen to represent relatively "pure" AD, with minimal other drug use and no psychiatric diagnoses. With these narrow parameters in place, we found that AD adolescents were lymphopenic compared with controls, with significantly lower mean numbers of absolute circulating CD3+, CD4+, and CD8+ T-lymphocytes. On conclusion, we found that adolescent AD individuals with excessive alcohol intake, in a weekend binge-drinking style but without comorbid drug or psychiatric disorders, may be at increased risk of lymphopenia. This alcohol misuse may increase infectious disease susceptibility (including TB and HIV) by reducing immune system capabilities. Complex interactions of alcohol with other documented high-risk activities may further compound health risks.

Heavy episodic drinking in Europe: a cross section study in primary care in six European countries

AIMS

We examined the prevalence of heavy episodic drinking in general practice attenders who were non-hazardous drinkers, the associated risk factors and the outcome over 6 months.

METHODS

Consecutive attenders aged 18-75 were recruited from the UK, Spain, Slovenia, Estonia, the Netherlands and Portugal and followed up after 6 months. Data were collected on alcohol use using the Alcohol Use Disorder Identification test (at recruitment and 6 months) and risk factors for heavy episodic alcohol use at recruitment.

RESULTS

The prevalence of heavy episodic drinking in non-hazardous drinkers was 4.5% across Europe [lowest in Portugal (1.5%); highest Netherlands (8.4%)]. It was less frequent in Spain, Slovenia, Estonia and Portugal compared with the UK and Netherlands. It was higher in men [odd ratio (OR) 4.4, 95% confidence interval (CI) 3.3, 5.9], people between 18 and 29 years of age, those employed (OR 1.8, 95% CI 1.3, 2.6) and those using recreational drugs (OR 2.1, 95% CI 1.4, 3.3). It was lower in people with existing DSMIV major depression (OR 0.54, 95% CI 0.31, 0.96). Heavy episodic drinkers were more likely to become hazardous drinkers at 6 months (male: OR 7.2, 95% CI 4.1, 12.7; female: OR 9.4, 95% CI 4.3, 20.6).

CONCLUSION

Women and men in the UK, men in the Netherlands and younger people in all countries are at the greatest risk of exhibiting heavy episodic drinking behaviours even in the absence of hazardous alcohol use. There is hence an urgent need for general practitioners to consider early detection and management of heavy episodic drinking behaviour in this population.

Associations between drinking motives and changes in adolescents' alcohol consumption: a full cross-lagged panel study

AIMS

Longitudinal full cross-lagged models are essential to test causal relationships. This study used such a model to test the predictive value of internal (enhancement and coping) and external (conformity and social) drinking motives for changes in alcohol use over time, and tested possible reversed causality (i.e. alcohol use explains later drinking motives).

DESIGN

Longitudinal data consisting of two waves (separated by 1 year) were used to estimate cross-lagged structural equation models.

SETTING

Three comparable (regarding urbanization and social stratification) Dutch communities.

PARTICIPANTS

A total of 454 alcohol-using adolescents aged 13-16 years (mean = 14.8 years, SD = 0.78) at wave 1.

MEASUREMENTS

Standardized questionnaires including the Drinking Motive Questionnaire-revised, and items on total weekly consumption and frequency of heavy episodic drinking.

FINDINGS

In adolescence, drinking motive preferences are already relatively stable over time. Also, only social motives significantly predicted increases in total weekly consumption and frequency of heavy episodic drinking. No feedback mechanisms by which alcohol consumption explains later drinking motives scores were found.

CONCLUSIONS

Among drinking adolescents in a wet drinking culture, such as the Dutch drinking culture, social drinking motives, rather than enhancement or coping motives for drinking, appear to predict overall consumption and frequency of heavy episodic use a year later. Parents and other important social actors have an active role in reducing alcohol availability and monitoring adolescents' drinking.

Risky single-occasion drinking: bingeing is not bingeing

AIMS

To review the concept of binge drinking as a measure of risky single occasion drinking (RSOD), to illustrate its differential impact on selected health outcomes and to identify research gaps.

METHODS

Narrative literature review with focus on conceptual and methodological differences, trajectories of RSOD and effects of RSOD on fetal outcomes, coronary heart disease (CHD) and injuries.

RESULTS

Effects ascribed commonly to RSOD may often be the effects of an undifferentiated mixture of risky single occasions and regular heavy volume drinking, constituted by frequent, successive RSOD. This leads to the problem that additional risks due to RSOD are mis-specified and remain unidentified or underestimated in some cases, such as for injuries or CHD, but are probably overstated for some chronic consequences or for effects of maternal drinking on newborns.

CONCLUSION

A stronger focus should be placed upon methods that can differentiate the effects of RSOD from those due to frequent occasions of heavy drinking that result in heavy volume drinking.

The influence of behavioural and health problems on alcohol and drug use in late adolescence - a follow up study of 2 399 young Norwegians

BACKGROUND

Both early alcohol debut, behavioural and health problems are reported to enhance adolescence substance use. This prospective study investigate the influence of behavioural and health problems on adolescents' alcohol and drug use.

METHOD

Prospective population based cohort study of 2 399 adolescents attending the Young-HUNT study, aged 13-15 at baseline in 1995/97, and 17-19 at follow-up 4 years later. Exposure variables were self reported conduct problems, attention problems, anxiety and depressive symptoms, and muscular pain and tension. Outcome variables at follow-up were frequent alcohol use and initiation of drug use. Associations were estimated by logistic regression models, influence of gender and drinking status at baseline were controlled for by stratification.

RESULTS

At follow-up 19% of the students drank alcohol once a week or more frequently. Baseline conduct problems (OR 2.2, CI 1.7-3.0) and attention problems (OR 1.5, CI 1.2-2.0) increased the risk for frequent alcohol use at follow-up in the total population. Girls who had experienced alcohol-intoxications at baseline showed strong association between baseline problems and frequent alcohol use at follow-up. Conduct problems (OR 2.5, CI 1.3-4.8), attention problems (OR 2.1, CI 1.2-3.4), anxiety/depressive symptoms (OR 1.9, CI 1.1-3.1) and muscular pain and tension (OR 1.7, CI 1.0-2.9) all were associated with frequent alcohol use among early intoxicated girls.14% of the students had tried cannabis or other drugs at follow-up. Conduct problems at baseline increased the odds for drug use (OR 2.6, CI 1.9-3.6). Any alcohol intoxications at baseline, predicted both frequent alcohol use (boys OR 3.6, CI 2.4-5.2; girls OR 2.8, CI 1.9-4.1), and illegal drug use (boys OR 4.7; CI 3.2-7.0, girls OR 7.7, CI 5.2-11.5) within follow-up.

CONCLUSIONS

Conduct problems in high-school more than doubles the risk for both frequent alcohol use and initiation of drug use later in adolescence. The combination of health problems and alcohol intoxication in early adolescence was closely associated with more frequent drinking later in adolescence among girls.Overall, early alcohol intoxication was closely associated with both frequent alcohol use and drug use at follow up in both genders.

The theory of planned behavior and binge drinking among undergraduate students: assessing the impact of habit strength

The present study sought to apply the theory of planned behavior (TPB) to the prediction of binge drinking intentions and behavior among undergraduate students and to test whether habit strength explains additional variance in binge drinking behavior. Undergraduate students (N=137) completed measures of the TPB (i.e., attitude, subjective norm, self-efficacy, perceived control, and intention) and habit strength (Self-Report Habit Index) in relation to binge drinking. Frequency of binge drinking was assessed one month later (n=109). The TPB explained 75% of the variance in binge drinking intentions, with attitude and self-efficacy making significant contributions, and 35% of the variance in binge drinking behavior at one-month follow-up, with only intention making a significant contribution. Habit strength explained additional variance in binge drinking behavior (∆R(2)=.06), although intention remained as a significant predictor. The results suggest that binge drinking among undergraduate students is under the control of both intentional and habitual processes. Interventions to reduce binge drinking should therefore focus on the motivational determinants (e.g., perceived positive and negative consequences) of binge drinking as well as the environmental factors (i.e., contextual cues) that promote binge drinking.

Is there an association between seeing incidents of alcohol or drug use in films and young Scottish adults' own alcohol or drug use? A cross sectional study

BACKGROUND

As the promotion of alcohol and tobacco to young people through direct advertising has become increasingly restricted, there has been greater interest in whether images of certain behaviours in films are associated with uptake of those behaviours in young people. Associations have been reported between exposure to smoking images in films and smoking initiation, and between exposure to film alcohol images and initiation of alcohol consumption, in younger adolescents in the USA and Germany. To date no studies have reported on film images of recreational drug use and young people's own drug use.

METHODS

Cross sectional multivariable logistic regression analysis of data collected at age 19 (2002-4) from a cohort of young people (502 boys, 500 girls) previously surveyed at ages 11 (in 1994-5), 13 and 15 in schools in the West of Scotland. Outcome measures at age 19 were: exceeding the 'sensible drinking' guidelines ('heavy drinkers') and binge drinking (based on alcohol consumption reported in last week), and ever use of cannabis and of 'hard' drugs. The principle predictor variables were an estimate of exposure to images of alcohol, and of drug use, in films, controlling for factors related to the uptake of substance use in young people.

RESULTS

A third of these young adults (33%) were classed as 'heavy drinkers' and half (47%) as 'binge drinkers' on the basis of their previous week's consumption. Over half (56%) reported ever use of cannabis and 13% ever use of one or more of the 'hard' drugs listed. There were linear trends in the percentage of heavy drinkers (p = .018) and binge drinkers (p = 0.012) by film alcohol exposure quartiles, and for ever use of cannabis by film drug exposure (p = .000), and for ever use of 'hard' drugs (p = .033). The odds ratios for heavy drinking (1.56, 95% CI 1.06-2.29 comparing highest with lowest quartile of film alcohol exposure) and binge drinking (1.59, 95% CI 1.10-2.30) were attenuated by adjustment for gender, social class, family background (parental structure, parental care and parental control), attitudes to risk-taking and rule-breaking, and qualifications (OR heavy drinking 1.42, 95% CI 0.95-2.13 and binge drinking 1.49, 95% CI 1.01-2.19), and further so when adjusting for friends' drinking status (when the odds ratios were no longer significant). A similar pattern was seen for ever use of cannabis and 'hard' drugs (unadjusted OR 1.80, 95% CI 1.24-2.62 and 1.57, 95% CI 0.91-2.69 respectively, 'fully' adjusted OR 1.41 (0.90-2.22 and 1.28 (0.66-2.47) respectively).

CONCLUSIONS

Despite some limitations, which are discussed, these cross-sectional results add to a body of work which suggests that it is important to design good longitudinal studies which can determine whether exposure to images of potentially health-damaging behaviours lead to uptake of these behaviours during adolescence and early adulthood, and to examine factors that might mediate this relationship.

Experimental use of alcohol in early adolescence: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study

The aim of this study was to estimate the prevalence of experimental alcohol intake and associated factors in early adolescence. The overall sample consisted of 4,452 adolescents (mean age = 11.3 years; SD = 0.3) from the 1993 birth cohort in Pelotas, Rio Grande do Sul State, Brazil. Experimental use of alcohol was reported by 17.5% of the interviewees (95%CI: 16.3-18.6), and 5% reported having tried alcohol at nine years of age or younger. Prevalence of experimental alcohol use was higher among adolescents whose mothers had consumed alcohol during pregnancy, whose parents consumed alcohol, who worked outside the home themselves, and who had ever tried smoking. Family strife, parental alcohol intake, and adolescent smoking were strong predictors of experimental alcohol use in early adolescence. Special attention should be targeted to these groups in order to avoid heavy and premature alcohol use in early adolescence.

Are mental health and binge drinking associated in Dutch adolescents? Cross-sectional public health study

Background

Depression and anxiety disorders have a high disease burden and as many as 15% of young people report mental health problems. Binge drinking, which is a particularly harmful way of consuming alcohol, is common among secondary school students. The aim of this study was to examine the association between binge drinking and self-reported mental health in boys and girls aged 12 to 18 years.

Findings

This cross-sectional analysis was performed on data collected by the Community Health Service (GGD) Brabant Zuidoost, the Netherlands, in 2007. In this Youth Survey, 10 090 randomly selected adolescents aged 12 tot 18 years were each sent a letter, a questionnaire, and a user name and log-in code for if they preferred to complete the Internet version of the questionnaire. Mental health was assessed using the Mental Health Inventory (MHI-5), a short 5-item questionnaire to detect feelings of depression and anxiety. Participants were asked about current alcohol consumption, their relationship with their parents, drug use, and sociodemographic data.

Corrected for confounders, binge drinking and mental health problems were associated in the 12 to 15 year old girls (OR 2.43; 95% CI 1.86-3.17, p = 0.000) and boys (OR 1.64, 95% CI 1.19-2.27, p = 0.003). The majority of the 16 to 18 year old adolescents had been binge drinking in the previous 4 weeks (69.6% boys and 56.8% girls). In this age group, boys with mental health problems were less likely to be classified as binge drinkers than were boys without mental health problems (OR 0.63, 95% CI 0.45-0.87, p = 0.005). No such association between binge drinking and mental health was found in girls of this age.

Conclusion

Girls and boys aged 12-15 years were classified as binge drinkers significantly more often when they reported poor mental health. Because binge drinking damages the brain, especially at a young age, it is important that health professionals are alert to possible binge drinking when young adolescents report mental health problems and should ask their patients about their drinking behaviour. Likewise, if youngsters under 16 present with binge drinking, they should be asked whether they are anxious or depressed.

Social factors associated to binge drinking: a cross-sectional survey among Brazilian students in private high schools

BACKGROUND

Binge drinking (BD) seems to be related to health and social complications among adolescents. Considering that knowledge about BD in developing countries is limited and that in Brazil high socioeconomic status is a risk factor for alcohol abuse, this study sheds light about this phenomenon among adolescents from a different cultural background than prior North-American and European studies.

METHODS

Brazilian students (n = 2691) selected through a representative, stratified and clustered sampling method were asked to answer a self-report questionnaire. The questionnaire contained questions about patterns of alcohol consumption, religious beliefs, leisure activities, family structure and relationships. Data were analyzed with basic contingency tables with Chi-square tests followed by a decision tree analysis and weighted logistic regression.

RESULTS

Almost thirty-five percent of the students reported recent binge drinking. BD in the past month was positively associated with older age (aOR = 1.5[1.2-1.7]), male gender (aOR = 1.5[1.2-2.0]) going out with friends almost every night (aOR = 33.9[14.2-80.7]), not living with mother (aOR = 2.4[1.3-4.7]), believing in God with little conviction (aOR = 1.6[1.2-2.0]) and rarely talking to parents about anything (aOR = 1.7[1.3-2.2]) or always about drugs (aOR = 1.8[1.3-2.5]). Factors inversely associated with BD were: paying lower monthly tuition fees (aOR = 0.5[0.4-0.9]), living with people who do not get drunk (aOR = 0.6[0.4-0.7]) and frequent engagement in worships (aOR = 0.7[0.5-0.9]).

CONCLUSION

The habit of BD in adolescents enrolled in private high schools in Brazil is strongly linked to the frequency with which they go out with friends at night. Factors such as religiosity, expressed by trust in God and participation in worship, and being enrolled in a school with cheaper tuition fees were associated with avoidance of BD in this population.

Differential relationships of family drinking with alcohol expectancy among urban school children

Background

Positive alcohol outcome expectancy has consistently been linked with problematic drinking, but there is little population-based evidence on its role on early stages of drinking in childhood. The present study seeks to understand the extent to which drinking of family members is differentially associated with the endorsement of alcohol expectancy in late childhood.

Methods

A representative sample of 4th and 6th graders (N = 2455) drawn from 28 public schools in an urban region of Taiwan completed a self-administered paper-and-pencil questionnaire. Each student provided information on alcohol expectancy, drinking experiences, and individual and family attributes. Complex survey analyses were performed to evaluate the relationship, with stratification by children's alcohol drinking history.

Results

An estimated 29% of the 4^th graders and 43% of the 6^th graders had initiated alcohol consumption (over 40% of them had drank on three or more occasions). Alcohol drinking-related differences appear in both the endorsement and the correlates of alcohol expectancy. Positive alcohol expectancy was strongly associated with family drinking, particularly the dimension of "enhanced social behaviors"; negative alcohol expectancy was inversely associated with drinking frequency. Among alcohol naïve children, significant connections appear between paternal drinking and three dimensions of positive alcohol expectancy (i.e., enhanced social behaviors:β_wt = 0.15, promoting relaxation or tension reduction:β_wt = 0.18, and global positive transformation:β_wt = 0.22).

Conclusions

Individual tailored strategies that address family influences on alcohol expectancy may be needed in prevention programs targeting drinking behaviors in children.

Effects of a school-based prevention program on European adolescents' patterns of alcohol use

PURPOSE

School-based substance abuse prevention programs are widespread but are rarely evaluated in Europe. We aimed to evaluate the effect of a new school-based prevention program against substance use on the frequency of alcohol consumption and alcohol-related problem behaviors among European students.

METHODS

During the school year 2004-2005, a total of 7,079 students aged 12-14 years from 143 schools in seven European countries participated in this cluster randomized controlled trial. Schools were randomly assigned to either control (65 schools, 3,532 students) or to a 12-session standardized program based on the comprehensive social influence model (78 schools, 3,547 students). Alcohol use and frequency of alcohol-related problem behaviors were investigated through a self-completed anonymous questionnaire at baseline and 18 months thereafter. The association between intervention and changes in alcohol-related outcomes was expressed as odds ratio (OR), estimated by multilevel regression model.

RESULTS

The preventive program was associated with a decreased risk of reporting alcohol-related problems (OR = .78, 95% confidence intervals [CI] = .63-.98), although this reduction was not statistically significant in the subgroup of 743 current drinkers at baseline. The risk for alcohol consumption was not modified by exposure to the program (OR = .93, 95% CI = .79-1.09). In the intervention group, nondrinkers and occasional drinkers at baseline progressed toward frequent drinking less often than in the control group.

CONCLUSIONS

School curricula based on the comprehensive social-influence model can delay progression to frequent drinking and reduce occurrence of alcohol-related behavioral problems in European students. These results, albeit moderate, have potentially useful implications at the population level.

Heavy episodic drinking in early adolescence: gender-specific risk and protective factors

This longitudinal study examined possible gender differences regarding risk and protective factors for heavy episodic drinking among 1,222 seventh-grade students (aged 13) in the City of Stockholm, Sweden, with follow-up 2 years later. Logistic regression analyses showed that several factors predicted heavy episodic drinking. The strongest predictors for boys' heavy episodic drinking in the ninth grade were heavy episodic drinking (odds ratio [OR] = 5.30) and smoking in the seventh grade (OR = 5.80). Drinking peers (OR = 2.47) and smoking (OR = 2.44) in the seventh grade showed the strongest association for girls. Furthermore, high parental monitoring and having a secure attachment to parents may have a protective effect when risk factors are present. Our results lend support to prevention initiatives to strengthen the parent-child relation and focus on adolescents' ability to resist peer pressure and of limiting parental provision of alcohol. The study's limitations are noted.

Patterns of alcohol consumption and ischaemic heart disease in culturally divergent countries: the Prospective Epidemiological Study of Myocardial Infarction (PRIME)

OBJECTIVE

To investigate the effect of alcohol intake patterns on ischaemic heart disease in two countries with contrasting lifestyles, Northern Ireland and France.

DESIGN

Cohort data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) were analysed. Weekly alcohol consumption, incidence of binge drinking (alcohol >50 g on at least one day a week), incidence of regular drinking (at least one day a week, and alcohol <50 g if on only one occasion), volume of alcohol intake, frequency of consumption, and types of beverage consumed were assessed once at inclusion. All coronary events that occurred during the 10 year follow-up were prospectively registered. The relation between baseline characteristics and incidence of hard coronary events and angina events was assessed by Cox's proportional hazards regression analysis.

SETTING

One centre in Northern Ireland (Belfast) and three centres in France (Lille, Strasbourg, and Toulouse).

PARTICIPANTS

9778 men aged 50-59 free of ischaemic heart disease at baseline, who were recruited between 1991 and 1994.

MAIN OUTCOME MEASURES

Incident myocardial infarction and coronary death ("hard" coronary events), and incident angina pectoris.

RESULTS

A total of 2405 men from Belfast and 7373 men from the French centres were included in the analyses, 1456 (60.5%) and 6679 (90.6%) of whom reported drinking alcohol at least once a week, respectively. Among drinkers, 12% (173/1456) of men in Belfast drank alcohol every day compared with 75% (5008/6679) of men in France. Mean alcohol consumption was 22.1 g/day in Belfast and 32.8 g/day in France. Binge drinkers comprised 9.4% (227/2405) and 0.5% (33/7373) of the Belfast and France samples, respectively. A total of 683 (7.0%) of the 9778 participants experienced ischaemic heart disease events during the 10 year follow-up: 322 (3.3%) hard coronary events and 361 (3.7%) angina events. Annual incidence of hard coronary events per 1000 person years was 5.63 (95% confidence interval 4.69 to 6.69) in Belfast and 2.78 (95% CI 2.41 to 3.20) in France. After multivariate adjustment for classic cardiovascular risk factors and centre, the hazard ratio for hard coronary events compared with regular drinkers was 1.97 (95% CI 1.21 to 3.22) for binge drinkers, 2.03 (95% CI 1.41 to 2.94) for never drinkers, and 1.57 (95% CI 1.11 to 2.21) for former drinkers for the entire cohort. The hazard ratio for hard coronary events in Belfast compared with in France was 1.76 (95% CI 1.37 to 2.67) before adjustment, and 1.09 (95% CI 0.79 to 1.50) after adjustment for alcohol patterns and wine drinking. Only wine drinking was associated with a lower risk of hard coronary events, irrespective of the country.

CONCLUSIONS

Regular and moderate alcohol intake throughout the week, the typical pattern in middle aged men in France, is associated with a low risk of ischaemic heart disease, whereas the binge drinking pattern more prevalent in Belfast confers a higher risk.

Drinking at European universities? A review of students' alcohol use

BACKGROUND

High volumes of alcohol consumption and risky single occasion drinking (RSOD) among university students have been shown to be associated with considerable harm to both those who consume alcohol and their fellow students. The vast majority of these studies are based on US and Canadian samples.

AIM

The present article provides an overview of the characteristics of alcohol-consuming university students in Europe.

METHOD

65 relevant articles published within the last 20years using European student populations could be identified.

RESULTS

Sociodemographic, individual, social, and university-related characteristics associated with alcohol consumption patterns could be identified. Male students, in particular, tended to consume alcohol more often and in higher quantities, including RSOD. Students consumed alcohol chiefly during social gatherings and for social and enhancement motives. Those without family obligations and those living alone, with roommates or in areas with a high density of students were more likely to consume alcohol in higher quantities, and to engage in RSOD. Students tend to overestimate the extent of their fellow students' alcohol consumption.

CONCLUSIONS

Health promotion and prevention efforts which focus on these characteristics (i.e., gender, drinking motives, living conditions and social norms), and which have been successful and evaluated among university students in the US and Canada, may also be very promising for their European counterparts.

Drinking to have fun and to get drunk: motives as predictors of weekend drinking over and above usual drinking habits

Most evidence on the motives-alcohol use link has come from cross-sectional research using retrospective assessments. It remains also to be demonstrated whether motives predict drinking in particular circumstances. In the present study, drinking motives assessed 2 weeks prior to a diary study were used to predict the number of drinks on weekend days as reported via short message service (SMS). Multilevel regression models were estimated based on 391 reports from 55 participants (mean age 22.7). The results revealed that enhancement motives but not gender, age, or social, coping, or conformity motives predicted weekend drinking over and above usual consumption. Consumption and motives together explained more than three-quarters of the inter-individual variance in weekend drinking. To conclude, this study points to a heavy episodic weekend drinking culture of young people who drink large quantities on Friday and Saturday nights apparently because they are seeking fun and excitement. Preventive measures should aim to counteract young people's drinking at peak times and in high-risk situations.

Family history of alcohol abuse associated with problematic drinking among college students

Studies examining family history of alcohol abuse among college students are not only conflicting, but have suffered various limitations. The current report investigates family history of alcohol abuse (FH+) and its relationship with alcohol expectancies, consumption, and consequences. In the current study, 3753 student participants (35% FH+), completed online assessments. Compared to FH- same-sex peers, FH+ males and FH+ females endorsed greater overall positive expectancies, consumed more drinks per week, and experienced more alcohol-related negative consequences. Further, FH+ females evaluated the negative effects of alcohol to be substantially worse than FH- females. An ANCOVA, controlling for age, GPA, race, and alcohol expectancies, resulted in family history main effects on both drinking and consequences. An interaction also emerged between gender and family history, such that FH+ males were especially vulnerable to high levels of alcohol consumption. Results reveal the scope of FH+ individuals in the college environment and the increased risk for these students, particularly male FH+ students, suggesting a need for researchers and college health personnel to focus attention and resources on this issue.

A Qualitative Assessment of South African Adolescents' Motivations For and Against Substance Use and Sexual Behavior

Focus groups (N = 15 groups; eight with girls, seven with boys) with adolescents in high schools near Cape Town, South Africa were used to conduct a qualitative investigation of reported reasons for using and not using substances, and for having and not having sex. Adolescents reported Enhancement, Negative States, Social, and Aversive Social motivations for both substance use and sexual behavior. In addition, being addicted as a reason for using drugs and rape as a context for sexual behavior were frequently reported. Motivations against behaviors included Physical/Behavioral Consequences, Ethical Objections, Social Disapproval, and Activities or Future Orientation reasons. Preventive interventions should address existing motivations for and against substance use and sexual behavior to acknowledge adolescents' experiences in context.

Education, alcohol use and abuse among young adults in Britain

In this article we explore the relationship between education and alcohol consumption. We examine whether the probability of abusing alcohol differs across educational groups. We use data from the British Cohort Study, a longitudinal study of one week's birth in Britain in 1970. We analysed data collected at age 34 (in 2004) and complement it with information gathered at previous sweeps. Measures of alcohol abuse include alcohol consumption above NHS guidelines, daily alcohol consumption and problem drinking. We found that higher educational attainment is associated with increased odds of daily alcohol consumption and problem drinking. The relationship is stronger for females than males. Individuals who achieved high educational test scores in childhood are at a significantly higher risk of abusing alcohol across all dimensions. Our results also suggest that educational qualifications and academic performance are associated with the probability of belonging to different typologies of alcohol consumers among women while this association is not present in the case of educational qualifications and is very weak in the case of academic performance among males.

Psychiatric disorders in students in six French universities: 12-month prevalence, comorbidity, impairment and help-seeking

PURPOSE

Few studies have explored the prevalence of psychiatric disorders (PD) among university students. This article aims to study 12-month prevalence of PD in university students, their socio-economic correlates, impairment in daily life and help-seeking behaviours.

METHODS

Cross-sectional study of randomly selected first-year students aged 18-24 years, enrolled in one of the six universities in south-eastern France in 2005-2006. We used the WHO CIDI-Short Form to derive DSM-IV diagnoses and the Sheehan disability scale to evaluate impairment. We studied their correlates with multiple logistic regressions.

RESULTS

The 12-month prevalence of major depressive disorder (MDD), anxiety disorders (AD) and substance use disorders (SUD) were 8.9% (95% CI: 7.2-10.9), 15.7% (95% CI: 13.5-18.2) and 8.1% (95% CI: 6.7-9.8), respectively. MDD was associated with precarious economic situation (OR = 1.83; 95% CI: 1.03-3.23), AD with a precarious job or unemployment of the father (OR = 2.08; 95% CI: 1.04-4.14) and SUD with higher educational level of father (OR = 2.17; 95% CI: 1.28-3.67) or having a paid job (OR = 1.82; 95% CI: 1.06-3.13). "Marked" or "extreme" impairment (score > or =7 for at least one of the domains in the Sheehan scale) was noted for 51.7% of students presenting a PD and was even more frequent in the presence of MDD/AD comorbidity. Only 30.5% of the students with a PD had sought professional help in the past 12 months.

CONCLUSIONS

This study provides new results regarding university students suggesting a link between precarious economic situations and MDD. The frequent impairment arising from PD alongside low rates of help-seeking suggests that PD could be one of the factors in academic failure in first year of university. These results should be used to improve prevention and care of PD in university students in France.

Mechanisms involved in the neurotoxic, cognitive, and neurobehavioral effects of alcohol consumption during adolescence

Studies over the last decade demonstrate that adolescence is a brain maturation period from childhood to adulthood. Plastic and dynamic processes drive adolescent brain development, creating flexibility that allows the brain to refine itself, specialize, and sharpen its functions for specific demands. Maturing connections enable increased communication among brain regions, allowing greater integration and complexity. Compelling evidence has shown that the developing brain is vulnerable to the damaging effects of ethanol. It is possible to infer, therefore, that alcohol exposure during the critical adolescent developmental stages could disrupt the brain plasticity and maturation processes, resulting in behavioral and cognitive deficits. Recent neuroimaging studies have provided evidence of the impact of human adolescent drinking in brain structure and functions. Findings in experimental animals have also given new insight into the potential mechanisms of the toxic effects of ethanol on both adolescent brain maturation and the short- and long-term cognitive consequences of adolescent drinking. Adolescence is also characterized by the rapid maturation of brain systems mediating reward and by changes in the secretion of stress-related hormones, events that might participate in the increasing in anxiety and the initiation pattern of alcohol and drug consumption. Studies in human adolescents demonstrate that drinking at early ages can enhance the likelihood of developing alcohol-related problems. Experimental evidence suggests that early exposure to alcohol sensitizes the neurocircuitry of addiction and affects chromatin remodeling, events that could induce abnormal plasticity in reward-related learning processes that contribute to adolescents' vulnerability to drug addiction. In this article, we review the potential mechanisms by which ethanol impacts brain development and lead to brain impairments and cognitive and behavioral dysfunctions as well as the neurobiological and neurochemical processes underlying the adolescent-specific vulnerability to drug addiction.

Liquid Drugs and High Dead Space Syringes May Keep HIV and HCV Prevalence High – A Comparison of Hungary and Lithuania

Despitevery similar political, drug policy and HIV prevention backgrounds, HIV and HCV prevalence is considerably different in Hungary (low HIV and moderate HCV prevalence) and Lithuania (high HCV and moderate HIV prevalence). Wecompared the drug use profile of Hungarian (n = 215) and Lithuanian (n = 300) injecting drug users (IDUs). Overall, compared with IDUs in Hungary, IDUs in Lithuania often injected opiates purchased in liquid form ('shirka'), used and shared 2-piece syringes (vs. 1-piece syringes) disproportionately more often, were less likely to acquire their syringes from legal sources and had significantly more experience with injected and less experience with non-injected drugs. It may not be liquid drugs per se that contribute to a higher prevalence of HCV and/or HIV, but it is probably factors associated with the injecting of liquid drugs, such as the wide-spread use and sharing of potentially contaminated 2-piece syringes acquired often from non-legal sources, and syringe-mediated drug sharing with 2-piece syringes. Scaling up substitution therapy, especially heroin replacement, combined with reducing the supply of liquid drugs may decrease the prevalence of high-risk injecting behaviours related to the injecting of liquid drugs and drug injecting-related infections among IDUs in Lithuania.

Gender and alcohol consumption: patterns from the multinational GENACIS project

AIMS

To evaluate multinational patterns of gender- and age-specific alcohol consumption.

DESIGN AND PARTICIPANTS

Large general-population surveys of men's and women's drinking behavior (n's > 900) in 35 countries in 1997-2007 used a standardized questionnaire (25 countries) or measures comparable to those in the standardized questionnaire.

MEASUREMENTS

Data from men and women in three age groups (18-34, 35-49, 50-65) showed the prevalence of drinkers, former drinkers, and lifetime abstainers; and the prevalence of high-frequency, high-volume, and heavy episodic drinking among current drinkers. Analyses examined gender ratios for prevalence rates and the direction of changes in prevalence rates across age groups.

FINDINGS

Drinking per se and high-volume drinking were consistently more prevalent among men than among women, but lifetime abstention from alcohol was consistently more prevalent among women. Among respondents who had ever been drinkers, women in all age groups were consistently more likely to have stopped drinking than men were. Among drinkers, the prevalence of high-frequency drinking was consistently greatest in the oldest age group, particularly among men. Unexpectedly, the prevalence of drinking per se did not decline consistently with increasing age, and declines in high-volume and heavy episodic drinking with increasing age were more typical in Europe and English-speaking countries.

CONCLUSIONS

As expected, men still exceed women in drinking and high-volume drinking, although gender ratios vary. Better explanations are needed for why more women than men quit drinking, and why aging does not consistently reduce drinking and heavy drinking outside Europe and English-speaking countries.

Alcohol intoxication and mental health among adolescents--a population review of 8983 young people, 13-19 years in North-Trøndelag, Norway: the Young-HUNT Study

BACKGROUND

The aims of this study were to describe alcohol use among Norwegian teenagers and investigate the associations between mental health problems and alcohol intoxications with focus on age and gender.

METHODS

Population based, cross-sectional survey addressing all adolescents aged 13-19 years, attending secondary or high school in North - Trøndelag County, Norway. 8983 youths (91%) answered the Young-HUNT questionnaire in the 1995-1997 survey. Logistic regression models were used to study associations.

RESULTS

80% of the respondents reported that they had tried drinking alcohol, and 57% had been intoxicated at least once. The proportion of the students, which had tried alcohol, was equal in both genders and increased with age. Attention problems and conduct problems were strongly associated with frequent alcohol intoxications in both genders. Anxiety and depressive symptoms among girls were also related to high numbers of intoxications

CONCLUSION

Gender differences in number of alcohol intoxications were small. There was a close association between both conduct and attention problems and high alcohol consumption in both genders. Girls with symptoms of anxiety and depression reported more frequent alcohol intoxications.

Binge drinking in childhood and adolescence: epidemiology, consequences, and interventions

BACKGROUND

Episodic excessive alcohol consumption ("binge drinking") among children and adolescents has become a serious public health problem in Germany and is associated with a variety of risks.

METHODS

Selective literature search of the Ovid Medline database from 1998 to 2008.

RESULTS

Episodic excessive alcohol consumption is associated not only with somatic complications, but also with traffic accidents and other types of accident, violent behavior, and suicide. The more frequently a child or adolescent drinks to excess, and the younger he or she is, the greater is the risk of developing an alcohol-related disorder (alcohol misuse or dependence syndrome). In the USA, brief motivational interventions have been shown to have a small to medium-sized beneficial effect in reducing further binge drinking and its complications.

CONCLUSIONS

The intervention HaLT ("Stop," also an acronym for Hart am Limit--"near the limit") is performed in a number of regions in Germany. Further types of brief motivating intervention should be developed and evaluated to prevent the development of alcohol-related disorders, where indicated, in children and adolescents that engage in binge drinking.

Addiction research centres and the nurturing of creativity: The Swiss Institute for the Prevention of Alcohol and Drug Problems. Past, present and future

The aim of this paper is to offer an account of the history, the current status and the future of substance use research at the Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA). Although founded originally by the temperance movement in 1901, its policy has shifted over time towards one which accepts an alcohol-consuming culture made up of self-determined but well-informed consumers, while still supporting those who choose to live an abstinent life. In the beginning, SIPA was involved primarily in collecting alcohol-related information and making it available to professionals and the general public. From the late 1960s SIPA began conducting its own research projects; by the mid-1970s it had set up its own in-house research department. In 2001, SIPA was appointed a World Health Organization (WHO) Collaborating Centre for Substance Abuse, Research, Prevention and Documentation. As a private non-governmental organization, most of its funding comes from external research commissions. SIPA participates in a variety of international projects [e.g. Gender Alcohol and Culture: An International Study (GenACIS), European School Survey Project on Alcohol and Drugs (ESPAD) and Health Behaviour in School-aged Children (HBSC)] and contributes to numerous national research projects dealing with substance use. It has also forged close links with more than 50 other research institutions in Switzerland and world-wide. Thanks to its work over the last 30 years, SIPA has become a chief port of call for alcohol use research in Switzerland. In the future, SIPA will continue to monitor substance use, while stepping up its prevention research activities and ensuring that it is able to react more promptly to emerging phenomena.

[Socioeconomic inequalities in mortality in Europe]

In all European countries, the rates of death were higher in groups of lower socioeconomic status, but the magnitude of the inequalities between groups of higher and lower socioeconomic status was much larger in some countries than in others. Inequalities in mortality were small in some Southern European countries and very large in most countries in the eastern and Baltic regions. These variations among countries appeared to be attributable in part to causes of death related to smoking or alcohol use or amenable to medical intervention. These results imply that there is opportunity to reduce inequalities in mortality. Developing policies and interventions that effectively target the structural and immediate determinants of inequalities in health is an urgent priority for public health research.

Why My Classmates Drink

A structural equation model was estimated based on a Swiss national sample of 5649 12- to 18-year-olds to test whether individual drinking motives mediate the link between classmates' motives and individual alcohol use. Results showed that the social, enhancement, coping and conformity motives of individual students are associated with the corresponding motive dimension of other students in the class. No direct effect of the four classmates' motives on individual drinking, but an indirect effect via individual motives was observed. It appears that drinking motives within the adolescent social environment exert their influence on drinking by way of shaping individual motives.

Lifestyle risk factors for oral cancer

The "style of life is the unique way in which individuals try to realize their fictional final goal and meet or avoid the three main tasks of life: work, community, love" (Alfred Adler, founder of the Individual Psychology). Lifestyle refers to the way individuals live their lives and how they handle problems and interpersonal relations. The lifestyle behaviours associated to oral cancer with convincing evidence are tobacco use, betel quid chewing, alcohol drinking, low fruit and vegetable consumption (the detrimental lifestyle is high fat and/or sugar intake, resulting in low fruit and/or vegetable intake). Worldwide, 25% of oral cancers are attributable to tobacco usage (smoking and/or chewing), 7-19% to alcohol drinking, 10-15% to micronutrient deficiency, more than 50% to betel quid chewing in areas of high chewing prevalence. Carcinogenicity is dose-dependent and magnified by multiple exposures. Conversely, low and single exposures do not significantly increase oral cancer risk. These behaviours have common characteristics: (i) they are widespread: one billion men, 250 million women smoke cigarettes, 600-1200 million people chew betel quid, two billion consume alcohol, unbalanced diet is common amongst developed and developing countries; (ii) they were already used by animals and human forerunners millions of years ago because they were essential to overcome conditions such as cold, hunger, famine; their use was seasonal and limited by low availability, in contrast with the pattern of consumption of the modern era, characterized by routine, heavy usage, for recreational activities and with multiple exposures; (iii) their consumption in small doses is not recognized as detrimental by the human body and activates the dopaminergic reward system of the brain, thus giving instant pleasure, "liking" (overconsumption) and "wanting" (craving). For these reasons, effective Public Health measures aimed at preventing oral cancer and other lifestyle-related conditions fail to realize their final goal to eradicate these lifestyles. Following Adler's theory and the principles of the "Ottawa Charter for Health Promotion", conditions such as education, sustainable resources, social justice, and equity must be satisfied before the implementation of physical health promotion campaigns.

Drug exposure opportunities and use patterns among college students: results of a longitudinal prospective cohort study

Underage drinking and drug use among college students are major public health concerns, yet few studies have examined these behaviors and their associated risk factors and consequences prospectively. This paper describes the sampling and recruitment methods of a longitudinal study of 1253 college students at a large, mid-Atlantic university. Incoming first-year students were screened during the unique window between high school and college in order to oversample drug users for longitudinal follow-up. Intensive recruitment strategies yielded a 95% cumulative response rate in annual interviews and semiannual surveys. The authors report preliminary results on exposure opportunity, lifetime prevalence, initiation, continuation, and cessation of substance use for alcohol, tobacco, and 10 illicit and prescription drugs during the first 2 years of college. Findings suggest that although some substance use represents a continuation of patterns initiated in high school, exposure opportunity and initiation of substance use frequently occur in college. Implications for prevention and early intervention are discussed.

Differential drinking patterns of family history positive and family history negative first semester college females

OBJECTIVE

This study compares the natural drinking patterns of family history positive and family history negative women during their first semester of college, a transitional period known to coincide with considerable alcohol-related risks.

METHOD

Seventy-two incoming undergraduate females, approximately half of whom reported a family history of alcohol misuse, completed initial questionnaires as well as Timeline Followback assessments. In addition, participants completed five successive weeks of online behavioral diaries measuring three categories of prospective alcohol consumption: total drinks, maximum drinks, and heavy episodic drinking events. Repeated measures ANCOVA models, controlling for prior alcohol consumption, examined participants' drinking behavior.

RESULTS

Over the course of the five assessed weeks, first semester females with a genetic predisposition to alcohol problems were found to consume significantly more total drinks (p<.05), maximum drinks (p<.05), and were more likely to drink heavily (p<.05) than family history negative peers.

CONCLUSIONS

Findings highlight increased alcohol-related risks faced by incoming first-year college females with a reported family history of problematic drinking and, thus, emphasize the need for early interventions targeted toward this at-risk group.

Binge-drinking in Britain as a Social and Cultural Phenomenon

Techniques and procedures of Strauss and Corbin's grounded theory were used to develop a conditional matrix on binge-drinking in Britain, reflecting data of 32 participants, aged between 22 and 58. The core category was `binge-drinking as a social and cultural phenomenon'. Results show the value of binge-drinking as an enjoyable way of socializing and counter-balancing the demands of daily hassles and routines. Intervening and contextual factors indicate fluctuations in binge-drinking behaviour and the social and cultural constraints that may operate, such as `no drink-driving', `not when the next day is a work day' and `not on one's own'.

Teenage alcohol use and educational attainment

OBJECTIVE

Using data from the National Child Development Study, an ongoing longitudinal birth cohort study of British youth born in 1958 (N = 9,107), we investigated the long-term impact of heavy alcohol use at age 16 years on educational qualifications in adulthood.

METHOD

We used a propensity score matching approach to examine whether and for whom heavy alcohol use predicted reduced adult educational attainment. Because of gender differences in both heavy drinking and adult socioeconomic attainment, we examined the effects of heavy drinking on educational outcomes separately for females and males.

RESULTS

Heavy drinking in adolescence (measured in 1974) had a direct negative effect on the receipt of postsecondary educational credentials by age 42 years among males but not females, independent of child and adolescent risk factors correlated with both heavy drinking and educational attainment. In particular, males from working-class backgrounds were most affected by heavy drinking.

CONCLUSIONS

Drawing on a life span developmental contextual approach, we find that heavy teenage alcohol use and disadvantaged social origins combined to diminish male educational attainment. In contrast, heavy alcohol use had little effect on female educational attainment.

Changes in alcohol-related mortality and its socioeconomic differences after a large reduction in alcohol prices: a natural experiment based on register data

The authors examined the effect of a large reduction in the price of alcohol in Finland in 2004 on alcohol-related mortality by age and socioeconomic group. For this register-based study of Finns aged >or=15 years, data on independent variables were extracted from the employment statistics of Statistics Finland. Mortality follow-up was carried out for 2001-2003 (before the price reduction) and 2004-2005 (after). Alcohol-related causes were defined using both underlying and contributory causes of death. Alcohol-related mortality increased by 16% among men and by 31% among women; 82% of the increase was due to chronic causes, particularly liver diseases. The increase in absolute terms was largest among men aged 55-59 years and women aged 50-54 years. Among persons aged 30-59 years, it was biggest among the unemployed or early-age pensioners and those with low education, social class, or income. The relative differences in change between the education and social class subgroups were small. The employed and persons aged <35 years did not suffer from increased alcohol-related mortality during the 2 years after the change. These results imply that a large reduction in the price of alcohol led to substantial increases in alcohol-related mortality, particularly among the less privileged, and in chronic diseases associated with heavy drinking.

Identification of novel bone-specific molecular targets of binge alcohol and ibandronate by transcriptome analysis

BACKGROUND

Our laboratory established that binge alcohol-related bone damage is prevented by aminobisphosphonates, suggesting bone resorption increases following binge exposure. We examined the effects of binge alcohol and antiresorptive therapy on the relationship between bone damage and modulation of the vertebral transcriptome, in an attempt to determine how alcohol-induced bone damage and its prevention modulate bone-related biological pathways.

METHODS

Male Sprague-Dawley rats were assigned to 1 of 6 treatment groups (n = 12/group). (C1) saline ip 3 d/wk for 1 week, (A1) binge alcohol, 3 g/kg, ip 3 d/wk for 1 week, (C4) saline ip, 3 d/wk for 4 weeks, (A4) binge alcohol, ip, 3 g/kg 3 d/wk for 4 weeks, (I4) ibandronate, saline ip 3 d/wk for 4 weeks, plus a single ip injection of ibandronate at 120 microg/animal, and (AI4) binge alcohol plus ibandronate as above. After 1 or 4 weeks, adjacent lumbar vertebrae were assayed for bone damage or transcriptional changes.

RESULTS

Bone loss was not observed after 1 week of binge alcohol treatment. After 4 weeks, binge alcohol decreased vertebral BMD by 23% (p < 0.05) and compressive strength by 18% compared to saline controls (p < 0.05). Concurrent ibandronate prevented bone loss, increasing these parameters by 145 and 134% respectively compared to binge alcohol. (p < 0.05). Analysis of the vertebral transcriptome identified gene clusters specific for acute and chronic binge alcohol-related bone damage. Acute binge alcohol modulated the expression of integrin signaling-specific genes, while chronic binge alcohol modulated canonical Wnt signaling gene expression. Ibandronate normalized the expression of approximately 20% of the genes affected by chronic binge alcohol, allowing the identification of a unique subset of alcohol-sensitive, ibandronate-responsive genes.

CONCLUSIONS

Identification of bone-specific gene expression clusters associated with acute and chronic binge alcohol treatment allowed for the identification of cellular pathways affected by binge treatment with known involvement in bone remodeling (Integrin, Canonical Wnt signaling) not previously identified as alcohol-sensitive. This data provides a basis for a plausible mechanistic explanation for the known detrimental effects of alcohol on bone formation and resorption.

Problem drinking and exceeding guidelines for 'sensible' alcohol consumption in Scottish men: associations with life course socioeconomic disadvantage in a population-based cohort study

BACKGROUND

With surveys suggesting that exceeding guidelines for 'sensible' alcohol intake is commonplace, the health and social impact of modifying intake on a population level is potentially considerable. If public health interventions are to be successfully implemented, it is first important to identify correlates of such behaviours, including socioeconomic disadvantage. This was the aim of the present study.

METHODS

Population-representative cohort study of 576 men from the West of Scotland. Data on life course socioeconomic position were collected in 1988 (at around 55 years of age). Alcohol consumption patterns (detailed seven day recall) and problem drinking (CAGE questionnaire) were ascertained in 1990/2 (at around 59 years of age). A relative index of inequality was computed to explore the comparative strength of different indicators of social circumstances from different periods of the life course.

RESULTS

Socioeconomic adversity in both early life and in adulthood was related to an increased risk of exceeding the weekly and daily alcohol guidelines, with adult indicators of socioeconomic position revealing the strongest associations. Of these, material indicators of socioeconomic deprivation in adulthood - car ownership, housing tenure - were marginally more strongly related to heavy alcohol intake and problem drinking than education, income and occupational social class. A substantial proportion of the influence of early life deprivation on alcohol intake was mediated via adult socioeconomic position. Similar results were apparent when problem drinking was the outcome of interest.

CONCLUSION

In men in this cohort, exposure to disadvantaged social circumstances across the lifecourse, but particularly in adulthood, is associated with detrimental patterns of alcohol consumption and problem drinking in late middle age.

Who drinks most of the total alcohol in young men--risky single occasion drinking as normative behaviour

AIMS

The objectives of this study were to analyse (a) the distribution of risky single-occasion drinking (RSOD) among 19-year-old men in Switzerland and (b) to show the percentage of all alcohol consumption in the form of RSOD.

METHODS

The study was based on a census of Swiss francophone 19-year-old men consecutively reporting for processing. The study was conducted at Army Recruitment Center. The participants were 4116 recruits consecutively enrolling for mandatory army recruitment procedures between 23 January and 29 August in 2007. The measures were alcohol consumption measured in drinks of approximately 10 g of pure alcohol, number of drinking occasions with six or more drinks (RSOD) in the past 12 months and a retrospective 1 week drinking diary.

RESULTS

264 recruits were never seen by the research staff, 3536 of the remaining 3852 conscripts completed a questionnaire which showed that 7.2% abstained from alcohol and 75.5% of those drinking had an RSOD day at least monthly. The typical frequency of drinking was 1-3 days per week on weekends. The average quantity on weekends was about seven drinks, 69.3% of the total weekly consumption was in the form of RSOD days, and of all the alcohol consumed, 96.2% was by drinkers who had RSOD days at least once a month.

CONCLUSION

Among young men, RSOD constitutes the norm. Prevention consequently must address the total population and not only high-risk drinkers.

Socio-demographic correlates of alcohol consumption in the Danish general population

Aims: Little is known about specific Danish drinking patterns. This paper investigates how various socio-demographic factors are related to Danish alcohol consumption with special focus on age and sex. Methods: Data come from a national telephone survey of the Danish general population conducted in 2003 with a final sample size of 2,030 cases. Measures of beverage specific current drinking, overall drinking, daily drinking, heavy episodic drinking, mean consumption, volume per drinking occasion and frequency of drinking were analysed. Results: A little over 5% of the population are abstainers. Fourteen per cent of men and 9% of women are heavy drinkers; 38% of men and 18% of women are heavy episodic drinkers. Youth of both sexes drink heavily, and especially in a binge drinking style. Regular, more temperate drinking is associated with increasing age. Multivariate analyses suggest that other than age and sex, classical socioeconomic factors do not play a great a role in determining drinking patterns. Social integrative factors in particular influence women's drinking. Conclusions: With respect to the rest of Europe and North America, Danes consume high levels of alcohol with a large percentage of youth drinking in a binge pattern. Classical socioeconomic factors play a lesser role in determining drinking patterns compared to other Western countries. Longitudinal studies and studies of alcohol-related consequences in the Danish general population should be conducted to better formulate alcohol and public health policy.