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Correia D, Tran A, Kokole D, Neufeld M, Olsen A, Likki T, Ferreira‐Borges C, Rehm J. Designing and implementing an experimental survey on knowledge and perceptions about alcohol warning labels. Int J Methods Psychiatr Res 2024; 33:e2016. [PMID: 38760902 PMCID: PMC11101666 DOI: 10.1002/mpr.2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 01/02/2024] [Accepted: 02/28/2024] [Indexed: 05/20/2024] Open
Abstract
OBJECTIVES This paper describes the design and implementation of an online survey experiment to investigate the effects of alcohol warning labels on alcohol-related knowledge, risk perceptions and intentions. METHOD The survey collected self-reported data from 14 European countries through two waves of data collection with different recruitment strategies: dissemination via social media and public health agencies was followed by paid-for Facebook ads. The latter strategy was adopted to achieve broader population representation. Post-stratification weighting was used to match the sample to population demographics. RESULTS The survey received over 34,000 visits and resulted in a sample size of 19,601 participants with complete data on key sociodemographic characteristics. The responses in the first wave were over-representing females and higher educated people, thus the dissemination was complemented by the paid-for Facebook ads targeting more diverse populations but had higher attrition rate. CONCLUSION Experiments can be integrated into general population surveys. Pan-European results can be achieved with limited resources and a combination of sampling methods to compensate for different biases, and statistical adjustments.
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Affiliation(s)
- Daniela Correia
- WHO Regional Office for EuropeCopenhagenDenmark
- EPIUnit – Institute of Public HealthUniversity of PortoPortoPortugal
| | - Alexander Tran
- WHO Regional Office for EuropeCopenhagenDenmark
- Institute for Mental Health Policy ResearchCentre for Addiction and Mental HealthTorontoOntarioCanada
| | - Daša Kokole
- WHO Regional Office for EuropeCopenhagenDenmark
- Department of Health PromotionCAPHRI Care and Public Health Research InstituteMaastricht UniversityMaastrichtthe Netherlands
| | | | | | - Tiina Likki
- WHO Regional Office for EuropeCopenhagenDenmark
| | | | - Jürgen Rehm
- Institute for Mental Health Policy ResearchCentre for Addiction and Mental HealthTorontoOntarioCanada
- Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Center for Interdisciplinary Addiction Research (ZIS)Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
- Faculty of MedicineInstitute of Medical ScienceUniversity of TorontoTorontoOntarioCanada
- Program on Substance AbusePublic Health Agency of CataloniaProgram on Substance Abuse & WHO CCPublic Health Agency of CataloniaBarcelonaSpain
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Kerr WC, Lui CK, Ye Y, Li L, Greenfield T, Karriker-Jaffe KJ, Martinez P. Long-term trends in beverage-specific drinking in the National Alcohol Surveys: Differences by sex, age, and race and ethnicity. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024. [PMID: 38658368 DOI: 10.1111/acer.15335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Despite substantial declines in underage drinking and binge drinking, alcohol consumption has increased in the past 30 years. This study examined how beverage-specific drinking patterns varied by sex, age, and race and ethnicity from 1979 to 2020. METHODS Secondary data analysis was conducted on pooled data from the National Alcohol Survey series from 1979 to 2020 of a sample of U.S. adults ages 18 years or older. Total and beverage-specific volume were calculated from graduated frequency questions on reported beverage type, which included beer, wine, and spirits. Sex-stratified analyses focused on descriptive trends of each alcohol measure over time and by age and race and ethnicity. Time-varying effect models were also conducted to identify subgroups at higher risk for increased consumption over time. RESULTS Women's drinking increased, with alcohol volume rising substantially from 2000 to 2020; the largest increase was among women 30 and older. Men's alcohol volume also rose over this period but remained below the levels of 1979 and 1984, with older adults increasing their consumption those 18-29 decreased their drinking. Beverage-specific trends showed some similarities by gender: in 2020, wine volume was at its highest level for both women and men, while spirits volume also was at its highest level for men and in women was tied with the 1979 peak in spirits consumption. Increases were also found among Black men and women and Latina women from 2000 to 2020. CONCLUSIONS Given the increases in alcohol volume, particularly among women and older age groups, alcohol policy, interventions, and education should consider ways to reduce harms associated with alcohol use among these groups. Continued monitoring of beverage-specific drinking patterns is needed to track policy-relevant changes.
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Affiliation(s)
- William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Camillia K Lui
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Libo Li
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Thomas Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | | | - Priscilla Martinez
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
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Rehm J, Rovira P, Jiang H, Lange S, Shield KD, Tran A, Štelemėkas M. Trends of alcohol-attributable deaths in Lithuania 2001-2021: epidemiology and policy conclusions. BMC Public Health 2024; 24:774. [PMID: 38475821 DOI: 10.1186/s12889-024-18237-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Lithuania, a Baltic country in the European Union, can be characterized by high alcohol consumption and attributable burden. The aim of this contribution is to estimate the mortality burden due to alcohol use for the past two decades based on different relative risk functions, identify trends, and analyse the associations of alcohol-attributable burden with alcohol control policies and life expectancy. METHODS The standard methodology used by the World Health Organization for estimating alcohol-attributable mortality was employed to generate mortality rates for alcohol-attributable mortality, standardized for Lithuania's 2021 population distribution. Joinpoint analysis, T-tests, correlations, and regression analyses including meta-regressions were used to describe trends and associations. RESULTS Age-standardized alcohol-attributable mortality was high in Lithuania during the two decades between 2001 and 2021, irrespective of which relative risks were used for the estimates. Overall, there was a downward trend, mainly in males, which was associated with four years of intensive implementation of alcohol control policies in 2008, 2009, 2017, and 2018. For the remaining years, the rates of alcohol-attributable mortality were stagnant. Among males, the correlations between alcohol-attributable mortality and life expectancy were 0.90 and 0.76 for Russian and global relative risks respectively, and regression analyses indicated a significant association between changes in alcohol-attributable mortality and life expectancy, after controlling for gross domestic product. CONCLUSIONS Male mortality and life expectancy in Lithuania were closely linked to alcohol-attributable mortality and markedly associated with strong alcohol control policies. Further implementation of such policies is predicted to lead to further improvements in life expectancy.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St, M5T 1R8, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, M5T 1P8, Toronto, ON, Canada.
- Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, M5S 1A8, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, M5T 1R8, Toronto, ON, Canada.
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
- Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St, 08005, Barcelona, Spain.
| | - Pol Rovira
- Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St, 08005, Barcelona, Spain
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, M5T 1P8, Toronto, ON, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St, M5T 1R8, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, M5T 1R8, Toronto, ON, Canada
| | - Kevin D Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St, M5T 1R8, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, M5T 1P8, Toronto, ON, Canada
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 47181, Kaunas, Lithuania
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Garnett C, Oldham M, Brose L, Cheeseman H, Cox S. Prevalence and characteristics of co-occurrence of smoking and increasing-and-higher-risk drinking: A population survey in England. Addict Behav 2024; 150:107928. [PMID: 38091779 DOI: 10.1016/j.addbeh.2023.107928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Smoking and drinking alcohol both significantly contribute to mortality and morbidity, and there is a need to characterise the sociodemographic and health-related characteristics (e.g. mental distress) of people who do both in order to target resources. This study reports the prevalence and characteristics of adults in the general population in England who both drink alcohol at increasing-and-higher-risk levels and smoke. METHODS We used cross-sectional data from a monthly, nationally representative survey of adults in England (n = 37,258; April 2020-March 2022). Weighted data were used to report prevalence and unweighted data were used to report descriptive statistics for sociodemographic and health-related characteristics. RESULTS The prevalence of both smoking and increasing-and-higher-risk drinking was 4.6% (95% CI = 4.4-4.9; n = 1,574). They smoked a mean of 10.4 (SD = 8.86) cigarettes per day and had a mean AUDIT score of 12.8 (SD = 5.18). Nearly half (48.2%, n = 751) were trying to cut down on their smoking and 28.0% (n = 441) on their drinking. A quarter (25.3%, n = 397) had received General Practitioner advice on smoking while 8.7% (n = 76) had received advice on their drinking. Nearly half (48.6%, n = 745) reported experiencing psychological distress in the past month and 44.6% (n = 529) had a diagnosed mental health condition, both of which were higher than among all adults (28.1% and 29.1%, respectively). CONCLUSION In England, from April 2020 to March 2022, the prevalence of both smoking and increasing-and-higher-risk drinking was 4.6%. This group appears to experience high rates of mental health problems and targeted support is needed.
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Affiliation(s)
- Claire Garnett
- Department of Behavioural Science and Health, University College London, London WC1E 7HB, United Kingdom; School of Psychological Science, University of Bristol, Bristol BS8 1TU, United Kingdom.
| | - Melissa Oldham
- Department of Behavioural Science and Health, University College London, London WC1E 7HB, United Kingdom
| | - Leonie Brose
- Addictions Department, King's College London, Addiction Sciences Building, Denmark Hill Campus, 4 Windsor Walk, London SE5 8BB, United Kingdom
| | - Hazel Cheeseman
- Action on Smoking and Health, Unit 2.9, The Foundry, 17 Oval Way, London SE11 5RR, United Kingdom
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, London WC1E 7HB, United Kingdom
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Tierney HR, Ma Y, Bacchetti P, Adimora AA, Chandran A, Kempf MC, Collins LF, DeHovitz J, DiClemente RJ, French AL, Jones DL, Sharma A, Spence AB, Hahn JA, Price JC, Tien PC. Pivoting from in-person to phone survey assessment of alcohol and substance use: effects on representativeness in a United States prospective cohort of women living with and without HIV. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:54-63. [PMID: 37956200 PMCID: PMC10939835 DOI: 10.1080/00952990.2023.2267745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 09/28/2023] [Indexed: 11/15/2023]
Abstract
Background: Many clinical and population-based research studies pivoted from in-person assessments to phone-based surveys due to the COVID-19 pandemic. The impact of these transitions on survey response remains understudied, especially for people living with HIV. Given that there are gender-specific trends in alcohol and substance use, it is particularly important to capture these data for women.Objective: Identify factors associated with responding to an alcohol and substance use phone survey administered during the COVID-19 pandemic in the Women's Interagency HIV Study, a multicenter US prospective cohort of women living with and without HIV.Methods: We used multivariable logistic regression to assess for associations of pre-pandemic (April-September 2019) sociodemographic factors, HIV status, housing status, depressive symptoms, alcohol use, and substance use with response to an early-pandemic (August-September 2020) phone survey.Results: Of 1,847 women who attended an in-person visit in 2019, 78% responded to a phone survey during the pandemic. The odds of responding were lower for women of Hispanic ethnicity (aOR 0.47 95% CI 0.33-0.66, ref=Black/African American) and those who reported substance use (aOR 0.63 95% CI 0.41-0.98). By contrast, the odds were higher for White women (aOR 1.64 95% CI 1.02-2.70, ref=Black/African American) and those with stable housing (aOR 1.74 95% CI 1.24-2.43).Conclusions: Pivoting from an in-person to phone-administered alcohol and substance use survey may lead to underrepresentation of key subpopulations of women who are often neglected in substance use and HIV research. As remote survey methods become more common, investigators need to ensure that the study population is representative of the target population.
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Affiliation(s)
- Hannah R. Tierney
- School of Medicine, University of California, San Francisco, CA, USA
| | - Yifei Ma
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Peter Bacchetti
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Adaora A. Adimora
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Aruna Chandran
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Mirjam-Colette Kempf
- Schools of Nursing, Medicine and Public Health Birmingham, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lauren F. Collins
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Jack DeHovitz
- Department of Medicine, State University of New York-Downstate Medical Center, Brooklyn, NY, USA
| | - Ralph J. DiClemente
- Department of Social and Behavioral Sciences, NYU School of Global Public Health, New York, NY, USA
| | - Audrey L. French
- Department of Medicine, Division of Infectious Diseases, Stroger Hospital of Cook County, Chicago, IL, USA
| | - Deborah L. Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA
| | - Amanda B. Spence
- Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC, USA
| | - Judith A. Hahn
- Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jennifer C. Price
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Phyllis C. Tien
- Department of Medicine, Department of Veteran Affairs Medical Center, University of California San Francisco, San Francisco, CA, USA
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Holmes J, Sasso A, Hernández Alava M, Stevely AK, Warde A, Angus C, Meier PS. Change and stability in British drinking practices and culture between 2009 and 2019: A longitudinal latent class analysis of drinking occasions. SSM Popul Health 2023; 24:101548. [PMID: 38034478 PMCID: PMC10682034 DOI: 10.1016/j.ssmph.2023.101548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/23/2023] [Accepted: 10/25/2023] [Indexed: 12/02/2023] Open
Abstract
Rationale Theories of practice can support understanding of health-related behaviours, but few studies use quantitative methods to understand time-trends in practices. This paper describes changes in the prevalence and performance of alcohol drinking practices in Great Britain between 2009 and 2019. Methods Latent class analyses of annual cross-sectional data collected between 2009 and 2019. The dataset come from a one-week retrospective diary survey of adults resident in Great Britain. It contains 604,578 drinking occasions reported by 213,470 adults (18+) who consumed alcohol in the diary-week. The measures describe occasion characteristics including companions, location, motivation, timings, accompanying activities and alcohol consumed. We estimate separate latent class models for each year and for off-trade only (e.g. home), on-trade only (e.g. bar) and mixed-trade occasions. Results We identified fifteen practices; four off-trade only, eight on-trade only and three mixed-trade. The prevalence of practices was largely stable over time except for shifts away from drinking with a partner and towards drinking alone in the off-trade, and shifts away from Big nights out and towards other forms of heavy drinking in the on-trade. We identified five key trends in the performance of practices: (i) spirits increasingly replaced wine as the main beverage consumed in occasions; (ii) home-drinking moved away from routinised wine-drinking with meals on weekdays and towards spirits-drinking on weekends; (iii) the Male friends at the pub practice changed less than other pub-drinking practices; (iv) Big nights out started later, often in nightclubs, and involved less pub-drinking or heavy drinking and (v) the meal-based and Going out with partner practice formats showed few changes over time. Conclusion Key recent trends in British drinking practices include a decline in routinised wine-drinking at home, a transformation of big nights out and a mixture of stability and change in pub- and meal-based practices.
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Affiliation(s)
- John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alessandro Sasso
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- European Commission, Joint Research Center (JRC), Ispra, Italy
| | | | - Abigail K. Stevely
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alan Warde
- School of Social Sciences, University of Manchester, Manchester, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Petra S. Meier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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ZuWallack R, Jans M, Brassell T, Bailly K, Dayton J, Martinez P, Patterson D, Greenfield TK, Karriker-Jaffe KJ. Estimating Web Survey Mode and Panel Effects in a Nationwide Survey of Alcohol Use. JOURNAL OF SURVEY STATISTICS AND METHODOLOGY 2023; 11:1089-1109. [PMID: 38028817 PMCID: PMC10646698 DOI: 10.1093/jssam/smac028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Random-digit dialing (RDD) telephone surveys are challenged by declining response rates and increasing costs. Many surveys that were traditionally conducted via telephone are seeking cost-effective alternatives, such as address-based sampling (ABS) with self-administered web or mail questionnaires. At a fraction of the cost of both telephone and ABS surveys, opt-in web panels are an attractive alternative. The 2019-2020 National Alcohol Survey (NAS) employed three methods: (1) an RDD telephone survey (traditional NAS method); (2) an ABS push-to-web survey; and (3) an opt-in web panel. The study reported here evaluated differences in the three data-collection methods, which we will refer to as "mode effects," on alcohol consumption and health topics. To evaluate mode effects, multivariate regression models were developed predicting these characteristics, and the presence of a mode effect on each outcome was determined by the significance of the three-level effect (RDD-telephone, ABS-web, opt-in web panel) in each model. Those results were then used to adjust for mode effects and produce a "telephone-equivalent" estimate for the ABS and panel data sources. The study found that ABS-web and RDD were similar for most estimates but exhibited differences for sensitive questions including getting drunk and experiencing depression. The opt-in web panel exhibited more differences between it and the other two survey modes. One notable example is the reporting of drinking alcohol at least 3-4 times per week, which was 21 percent for RDD-phone, 24 percent for ABS-web, and 34 percent for opt-in web panel. The regression model adjusts for mode effects, improving comparability with past surveys conducted by telephone; however, the models result in higher variance of the estimates. This method of adjusting for mode effects has broad applications to mode and sample transitions throughout the survey research industry.
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Affiliation(s)
- Randal ZuWallack
- is a Senior Statistician with the ICF, 9300 Lee Highway, Fairfax, VA, USA
| | - Matt Jans
- is a Senior Methodologist, is a Senior Vice President with the ICF, 9300 Lee Highway, Fairfax, VA, USA
| | - Thomas Brassell
- is a Project Director, is a Senior Vice President with the ICF, 9300 Lee Highway, Fairfax, VA, USA
| | - Kisha Bailly
- is a Project Manager, with the ICF, 9300 Lee Highway, Fairfax, VA, USA
| | - James Dayton
- is a Senior Vice President with the ICF, 9300 Lee Highway, Fairfax, VA, USA
| | - Priscilla Martinez
- is a Scientist, with the Alcohol Research Group, 6001 Shellmound Street, Suite 450, Emeryville, CA, USA
| | - Deidre Patterson
- is an Associate Scientist, with the Alcohol Research Group, 6001 Shellmound Street, Suite 450, Emeryville, CA, USA
| | - Thomas K Greenfield
- is a Scientific Director with the Alcohol Research Group, 6001 Shellmound Street, Suite 450, Emeryville, CA, USA
| | - Katherine J Karriker-Jaffe
- is a Director with the Community Health & Implementation Research Program, RTI International, 2150 Shattuck Avenue, Suite 800, Berkeley, CA, USA
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Kilian C, Manthey J, Braddick F, López-Pelayo H, Rehm J. Social disparities in alcohol's harm to others: evidence from 32 European countries. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 118:104079. [PMID: 37271071 DOI: 10.1016/j.drugpo.2023.104079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Alcohol use can cause harm not only to the person who consumes it but also to others. Prior research has found that these alcohol-attributable harms to others differ across socioeconomic groups, though several findings have been contradictory. The aim of this contribution was to study the role of individual-level and population-level income inequalities in alcohol's harm to others among women and men. METHODS Logistic regression analysis of cross-sectional survey data from 2021, covering 39,629 respondents from 32 European countries. Harms from others' drinking were defined as experiences of physical harm, involvement in a serious argument, or involvement in a traffic accident, due to another person's drinking, within the past year. We examined the association of individual-level income and country-specific income inequality (Gini index) with harms from a known person's or a stranger's drinking, adjusting for the respondent's age, daily drinking levels, and at least monthly risky single-occasion drinking. RESULTS At the individual level, people with lower incomes had 21% to 47% increased odds of reporting harms from a known person's drinking (women and men) or stranger's drinking (men only) than their same-gender counterparts in the highest income quintile. At the national level, countries with higher income inequality showed increased risks of harms from a known person's drinking among women (OR = 1.09, 95% confidence interval [CI]: 1.05 - 1.14), while among men the risk of harm from strangers' drinking decreased with higher income inequality (OR = 0.86, 95% CI: 0.81 - 0.92). These associations with income inequality were observed among respondents from all but the lowest income groups. CONCLUSION Alcohol can cause harm to others, with women and people with low incomes being disproportionally exposed to these harms. Alcohol control policies targeting high consumption levels, especially among men, as well as upstream policies to reduce inequalities, are needed to lower the health burden of alcohol beyond those who consume it.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
| | - Jakob Manthey
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Fleur Braddick
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Hugo López-Pelayo
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain; Addictions Unit, Psychiatry Department, Hospital Clínic, Barcelona, Spain
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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9
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Stevely AK, Mackay D, Alava MH, Brennan A, Meier PS, Sasso A, Holmes J. Evaluating the effects of minimum unit pricing in Scotland on the prevalence of harmful drinking: a controlled interrupted time series analysis. Public Health 2023; 220:43-49. [PMID: 37263177 DOI: 10.1016/j.puhe.2023.04.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/06/2023] [Accepted: 04/21/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVES In May 2018, the Scottish Government introduced a minimum unit price (MUP) for alcohol of £0.50 (1 UK unit = 8 g ethanol) to reduce alcohol consumption, particularly among people drinking at harmful levels. This study aimed to evaluate MUP's impact on the prevalence of harmful drinking among adults in Scotland. STUDY DESIGN This was a controlled interrupted monthly time series analysis of repeat cross-sectional data collected via 1-week drinking diaries from adult drinkers in Scotland (N = 38,674) and Northern England (N = 71,687) between January 2009 and February 2020. METHODS The primary outcome was the proportion of drinkers consuming at harmful levels (>50 [men] or >35 [women] units in diary week). The secondary outcomes included the proportion of drinkers consuming at hazardous (≥14-50 [men] or ≥14-35 [women] units) and moderate (<14 units) levels and measures of beverage preferences and drinking patterns. Analyses also examined the prevalence of harmful drinking in key subgroups. RESULTS There was no significant change in the proportion of drinkers consuming at harmful levels (β = +0.6 percentage points; 95% confidence interval [CI] = -1.1, +2.3) or moderate levels (β = +1.4 percentage points; 95% confidence interval = -1.1, +3.8) after the introduction of MUP. The proportion consuming at hazardous levels fell significantly by 3.5 percentage points (95% CI = -5.4, -1.7). There were no significant changes in other secondary outcomes or in the subgroup analyses after correction for multiple testing. CONCLUSIONS Introducing MUP in Scotland was not associated with reductions in the proportion of drinkers consuming at harmful levels but did reduce the prevalence of hazardous drinking. This adds to previous evidence that MUP reduced overall alcohol consumption in Scotland and consumption among those drinking above moderate levels.
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Affiliation(s)
- A K Stevely
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK.
| | - D Mackay
- School of Health and Wellbeing, University of Glasgow, UK
| | - M H Alava
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, UK
| | - A Brennan
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, UK
| | - P S Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - A Sasso
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK; European Commission, Joint Research Center (JRC), Ispra, Italy
| | - J Holmes
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK
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10
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Booth L, McCausland T, Keric D, Kennington K, Stevens-Cutler J, Scott L, Pettigrew S. Evaluating an alcohol harm-reduction campaign advising drinkers of the alcohol-cancer link. Addict Behav 2023; 145:107760. [PMID: 37269794 DOI: 10.1016/j.addbeh.2023.107760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/27/2023] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Public awareness of the alcohol-cancer link is low. Provision of this information could reduce alcohol consumption and related harms. The Spread campaign is a multi-media education campaign implemented in Western Australia to inform people about the carcinogenic properties of alcohol and associated harms. The aims of the present study were to (i) examine attitudinal and behavioural outcomes of the Spread campaign and (ii) identify demographic and drinking status factors associated with enactment of harm-reduction behaviours resulting from exposure. METHOD A cross sectional survey of Western Australian drinkers (consumed alcohol at least a few times in the previous 12 months, n = 760) examined campaign recognition, campaign perceptions, and behaviours resulting from campaign exposure. Chi-square analyses and a generalised linear model were used to identify demographic and alcohol-related factors associated with behavioural outcomes. RESULTS Around two-thirds of respondents recognised the campaign (65%), and of these, 22% reported successfully reducing how often or how much they drank due to seeing the campaign. Three quarters (73%) of all respondents considered the campaign message about the alcohol-cancer link to be believable. Respondents drinking at levels above the Australian guideline were less likely to have positive perceptions of the campaign than those complying with the guideline, but were more likely to report enacting the assessed harm-reduction behaviours as a result of campaign exposure. DISCUSSION AND CONCLUSION The results suggest that provision of information about the alcohol-cancer link has the potential to motivate reduced alcohol consumption. Implementing such campaigns could constitute an effective alcohol harm-reduction strategy.
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Affiliation(s)
- Leon Booth
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW 2042, Australia.
| | - Tahnee McCausland
- Mental Health Commission, Western Australian Government, 1/1 Nash St, Perth, WA 6000, Australia.
| | - Danica Keric
- Cancer Council Western Australia, Level 1/420 Bagot Road, Subiaco, WA 6008, Australia.
| | - Kelly Kennington
- Mental Health Commission, Western Australian Government, 1/1 Nash St, Perth, WA 6000, Australia.
| | - James Stevens-Cutler
- Mental Health Commission, Western Australian Government, 1/1 Nash St, Perth, WA 6000, Australia.
| | - Lucy Scott
- Mental Health Commission, Western Australian Government, 1/1 Nash St, Perth, WA 6000, Australia.
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW 2042, Australia.
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11
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Manthey J, Braddick F, López-Pelayo H, Shield K, Rehm J, Kilian C. Unrecorded alcohol use in 33 European countries: Analyses of a comparative survey with 49,000 people who use alcohol. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 116:104028. [PMID: 37116403 DOI: 10.1016/j.drugpo.2023.104028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND Using data from 33 European countries (including all EU member states), this study aimed to 1) estimate the prevalence of unrecorded alcohol use among past-week alcohol users, 2) describe how unrecorded alcohol use is associated with drinking patterns, and 3) estimate the contribution of unrecorded alcohol to the total amount of alcohol consumed annually in these countries. METHODS Data from 25,728 adults who drank alcohol in the past week and self-reported their use of unrecorded alcohol in 2021 were analysed. Prevalence of unrecorded alcohol use in the last week was estimated for those with low, medium, and high risk drinking categorised using the WHO-recommended risk thresholds and definition of risky single occasion drinking. Prevalence estimates were weighted for the country-specific gender, age, and geographical population distribution. An adjusted weighted proportion of unrecorded drinking occasions in total drinking occasions was calculated and compared to 2020 recorded annual per capita consumption estimates. RESULTS Among past-week alcohol users, the average prevalence of past-week unrecorded alcohol use was 12.1% (95% CI: 11.7-12.5%), with considerable difference between countries (min: 2.0% in Malta; max: 27.0% in Greece). Unrecorded alcohol use was much more prevalent among people with high-risk alcohol use in the past week (24.2%, 95% confidence interval [CI]: 22.9-25.5%) compared to people with low- (6.5, 95% CI: 6.0-6.9%) or medium-risk alcohol intake in the past week (13.6%, 95% CI: 12.9-14.3%). Unrecorded alcohol accounted for 7% of per capita consumption in 2020. CONCLUSIONS This is the first comparable assessment of unrecorded alcohol use across EU and affiliated countries. The findings add support to the observation that availability of unrecorded alcohol may contribute to risky drinking in Europe. The observed country variations may be related to differences in country-specific pricing policies and measures to reduce the production and consumption of unrecorded alcoholic beverages.
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Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany.
| | - Fleur Braddick
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS); Rosselló, 149-153, 08036 Barcelona, Spain
| | - Hugo López-Pelayo
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS); Rosselló, 149-153, 08036 Barcelona, Spain; Addictions Unit, Psychiatry Department, Hospital Clínic; Villarroel 170, 08036 Barcelona, Spain
| | - Kevin Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 3M1, Canada; Dalla Lana School of Public Health; Institute of Health Policy, Management and Evaluation; & Department of Psychiatry, University of Toronto (UofT), Toronto, Canada; PAHO/WHO Collaborating Centre at CAMH, Toronto, Canada & WHO European Region Collaborating Centre at Public Health Institute of Catalonia, Barcelona, Spain
| | - Jürgen Rehm
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 3M1, Canada; Dalla Lana School of Public Health; Institute of Health Policy, Management and Evaluation; & Department of Psychiatry, University of Toronto (UofT), Toronto, Canada; PAHO/WHO Collaborating Centre at CAMH, Toronto, Canada & WHO European Region Collaborating Centre at Public Health Institute of Catalonia, Barcelona, Spain; Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, Germany; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Carolin Kilian
- Grup de Recerca en Addicions Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS); Rosselló, 149-153, 08036 Barcelona, Spain; Addictions Unit, Psychiatry Department, Hospital Clínic; Villarroel 170, 08036 Barcelona, Spain
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12
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Dolli I, Slade T, Teesson M, Chapman C. Longitudinal and self-attributed change in alcohol use among young adults during the COVID-19 pandemic in Australia. Drug Alcohol Rev 2023; 42:625-632. [PMID: 36682030 PMCID: PMC10947013 DOI: 10.1111/dar.13602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/23/2022] [Accepted: 12/14/2022] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The COVID-19 pandemic introduced a unique concern regarding the potential for pandemic-related increases in alcohol use. However, most studies which have measured pandemic-related changes to date utilise self-attribution measures of changes in alcohol use using cross-sectional designs, which rely on accurate self-attributions for validity. There has been minimal investigation of correspondence of self-attributed and longitudinally measured changes in alcohol use during the pandemic. The current study seeks to examine this correspondence. METHODS A total of 856 participants originally recruited from Australian secondary schools completed follow-up surveys of an ongoing study at two timepoints (2018-2019, mean age 18.6 and 2020-2021, mean age 19.9; 65.3% female). Alcohol use was measured as any drinking (1+ drinks) and binge drinking (5+ drinks) frequency in the past 6 months. The correspondence and relationship between 'longitudinal change' measured from the first to the second timepoint and 'self-attributed change' measured at the second timepoint were examined. RESULTS For both any drinking and binge drinking frequency, moderate correspondence was observed between self-attributed and longitudinal change in drinking (37.1% and 39.3%). Most participants with longitudinal increases in any drinking or binge drinking frequency failed to correctly self-attribute this increase. DISCUSSION AND CONCLUSIONS The findings suggest that self-attributed increases do not correspond well with longitudinally measured increases in pandemic-related drinking and may underestimate increases measured longitudinally. Method of measurement needs to be taken into account if data are to be used to identify sub-groups at risk of alcohol use increases and facilitate appropriate direction of public health efforts.
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Affiliation(s)
- Ishaan Dolli
- Matilda Centre for Research in Mental Health and Substance UseThe University of SydneySydneyAustralia
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance UseThe University of SydneySydneyAustralia
| | - Maree Teesson
- Matilda Centre for Research in Mental Health and Substance UseThe University of SydneySydneyAustralia
| | - Cath Chapman
- Matilda Centre for Research in Mental Health and Substance UseThe University of SydneySydneyAustralia
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Yuen WS, Peacock A, Man N, Callinan S, Slade T, Farrell M, Mattick R, Livingston M. Age, period and cohort effects on alcohol-related risky behaviours in Australia from 2001 to 2016. Addiction 2023; 118:438-448. [PMID: 36206499 PMCID: PMC10952598 DOI: 10.1111/add.16061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 09/20/2022] [Indexed: 02/07/2023]
Abstract
AIMS The aim of this study is to examine age, period and birth cohort trends in the prevalence of any alcohol-related risky behaviour and to compare these trends between men and women. DESIGN AND SETTING We used an age-period-cohort analysis of repeated cross-sectional survey data from the Australian National Drug Strategy Household Survey from 2001 to 2016. PARTICIPANTS Participants were 121 281 people aged 14-80 years who reported consuming alcohol in the past 12 months. MEASUREMENTS Any risky behaviour undertaken while under the influence of alcohol in the past 12 months (e.g. operating a motor vehicle) was measured: male or female. FINDINGS Controlling for age and cohort, cubic spline models showed that any alcohol-related risky behaviour declined with time among participants who consumed alcohol [2016 versus 2007 rate ratio (RR) = 0.80, 95% confidence interval (CI) = 0.76-0.84]. Risky behaviour peaked in the 1954 birth cohort (1954 versus 1971 RR = 1.42, 95% CI = 1.30-1.55) and then steadily declined with more recent birth cohorts (2002 versus 1971 RR = 0.32, 95% CI = 0.27-0.39). Risky behaviour peaked at age 21 years, followed by steady decline and stabilization at approximately age 70 years. Males were overall twice as likely as females to report alcohol-related risky behaviour (RR = 2.10, 95% CI = 1.84-2.39), but this effect was smaller in cohorts born after 1980 [1980 prevalence rate ratios (PRR) = 2.09, 95% CI = 1.81-2.43; 2002 PRR = 1.31, 95% CI = 1.03-1.68]. CONCLUSIONS Alcohol-related risky behaviour in Australia has declined generally since 2001, with rates for recent cohorts having the sharpest decline. Risky behaviour remains most prevalent in young adults, and the male-female gap in risky behaviour is closing for more recent birth cohorts. These trends are consistent with alcohol consumption trends observed in Australia and world-wide.
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Affiliation(s)
- Wing See Yuen
- National Drug and Alcohol Research CentreUNSW SydneyKensingtonAustralia
| | - Amy Peacock
- National Drug and Alcohol Research CentreUNSW SydneyKensingtonAustralia
- School of Psychological SciencesUniversity of TasmaniaHobartAustralia
| | - Nicola Man
- National Drug and Alcohol Research CentreUNSW SydneyKensingtonAustralia
| | - Sarah Callinan
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneAustralia
| | - Tim Slade
- The Matilda CentreThe University of SydneyCamperdownAustralia
| | - Michael Farrell
- National Drug and Alcohol Research CentreUNSW SydneyKensingtonAustralia
| | - Richard Mattick
- National Drug and Alcohol Research CentreUNSW SydneyKensingtonAustralia
| | - Michael Livingston
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneAustralia
- National Drug Research Institute and enAble Institute, Faculty of Health SciencesCurtin UniversityPerthAustralia
- Centre for Clinical NeuroscienceKarolinska InstituteSolnaSweden
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14
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Parents' drinking, childhood hangover? Parental alcohol use, subjective health complaints and perceived stress among Swedish adolescents aged 10-18 years. BMC Public Health 2023; 23:162. [PMID: 36694162 PMCID: PMC9872733 DOI: 10.1186/s12889-023-15097-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/05/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Alcohol abuse is not only harmful to the consumer but may also negatively impact individuals in the drinker's social environment. Alcohol's harm to others is vital to consider when calculating the true societal cost of alcohol use. Children of parents who have alcohol use disorder tend to have an elevated risk of negative outcomes regarding, e.g., health, education, and social relationships. Research on the general youth population has established a link between parental drinking and offspring alcohol use. However, there is a lack of knowledge regarding other outcomes, such as health. The current study aimed to investigate the associations between parental drinking and children's psychological and somatic complaints, and perceived stress. METHODS Data were derived from a nationally representative sample, obtained from the 2010 Swedish Level-of-Living survey (LNU). Parents and adolescents (ages 10-18) living in the same households were interviewed independently. The final study sample included 909 adolescents from 629 households. The three outcomes, psychological and somatic complaints and perceived stress, were derived from adolescents' self-reports. Parents' self-reports of alcohol use, both frequency and quantity, were used to categorise adolescents as having abstaining, low-consuming, moderate-drinking, or heavy-drinking parents. Control variables included adolescents' gender, age, family structure, and household socioeconomic status. Linear and binary logistic regression analyses were performed. RESULTS Parental heavy drinking was more common among adolescents living in more socioeconomically advantaged households and among adolescents living with two custodial parents or in reconstituted families. Adolescents with heavy-drinking parents reported higher levels of psychological and somatic complaints and had an increased likelihood of reporting stress, compared with those having moderate-drinking parents. These associations remained statistically significant when adjusting for all control variables. CONCLUSION The current study's results show that parental alcohol consumption is associated with poorer offspring adolescent health. Public health policies that aim to reduce parental drinking or provide support to these adolescents may be beneficial. Further studies investigating the health-related outcomes among young people living with heavy-drinking parents in the general population are needed to gain more knowledge about these individuals and to implement adequate public health measures.
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Hardie I, Sasso A, Holmes J, Meier PS. Understanding changes in the locations of drinking occasions in Great Britain: An age-period-cohort analysis of repeat cross-sectional market research data, 2001-2019. Drug Alcohol Rev 2023; 42:105-118. [PMID: 36222548 PMCID: PMC10092301 DOI: 10.1111/dar.13562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/07/2022] [Accepted: 09/15/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The 21st century has seen wide-ranging changes in drinking locations in Great Britain, with on-trade alcohol sales decreasing and off-trade sales increasing. To better understand the underlying time-trends in consumer behaviour, we examine age-period-cohort (APC) effects related to changes in the share of individuals' drinking occasions taking place in: (i) on-trade versus off-trade locations; and (ii) specific on-trade or off-trade locations, that is traditional/community pubs, modern pubs/bars/café bars, nightclubs/late-night venues, restaurants/pub restaurants, social/working men's clubs, golf/other sports clubs/venues, at home (social setting) and at home (non-social setting). METHODS Repeat cross-sectional 1-week drinking diary data, collected 2001-2019. APC analysis via negative binomial regression models for each gender (N = 162,296 men, 138,452 women). RESULTS A smaller/declining proportion of occasions took place in on-trade compared to off-trade locations. Recent cohorts tended to have a larger share of on-trade occasions than previous cohorts, driven by their larger share of occasions in modern pubs/bars/café bars and nightclubs/late-night venues. Meanwhile, occasions in social/working men's clubs, golf/other sports clubs/venues and traditional/community pubs tended to be popular among older men, but have declined. Finally, the growth of off-trade drinking appears to be driven by a growth of off-trade drinking in non-social settings, in particular by older people/cohorts. DISCUSSION AND CONCLUSION Our findings highlight the declining prominence of certain on-trade locations, and increasing prominence of home drinking in non-social settings, within British drinking practices. While rising non-social home drinking is concerning, it is positive from a public health perspective that it does not appear to be shared by recent cohorts.
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Affiliation(s)
- Iain Hardie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Alessandro Sasso
- Sheffield Alcohol Research Group, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Holmes
- Sheffield Alcohol Research Group, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Petra S Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Karjalainen K, Gunnar T, Hakkarainen P, Kankaanpää A, Rönkä S. Analysis of illicit stimulant use triangulating wastewater, general population survey and web survey data. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 40:160-175. [PMID: 37063821 PMCID: PMC10101165 DOI: 10.1177/14550725221122150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/09/2022] [Indexed: 11/06/2022] Open
Abstract
Background: We analysed illicit stimulant use in Finland by comparing three separate datasets collected at the same time. Methods: The data used were wastewater analysis (2014 and 2018), population-based drug surveys (2014 and 2018) and European Web Survey on Drugs (2018, Finnish data). Proportions, prevalence levels and trends of stimulant use as well as their consumption were measured. Factors associated with stimulant use were assessed for past-year stimulant or amphetamine use as an outcome measure in regression analyses. Results: Both population-based drug survey and wastewater data showed that stimulant use has increased in Finland between 2014 and 2018. Disadvantaged socio-demographic background and other substance use were associated with past-year stimulant use, with no geographical variation in Finland. The socio-demographics of those reporting amphetamine use differed between population-based drug survey and web survey. In the web survey, infrequent and occasional users of amphetamine were quite alike, whereas frequent users were more likely to be unemployed or use injection as the route of administration. Conclusion: Analysis of three different data revealed findings that would have been missed and conclusions that could not have been made by using only one dataset. Putting findings from different methods into dialogue raises new questions and opens new interpretations. This analysis emphasises the importance of the prevention of frequent use and associated harm, as well as the impact of versatile drug treatment and harm reduction services on it.
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Affiliation(s)
| | - Teemu Gunnar
- Finnish Institute for Health and Welfare, Finland
| | | | | | - Sanna Rönkä
- Finnish Institute for Health and Welfare, Finland
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17
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Rehm J. Patterns of drinking and disease-free living: Only a problem for alcohol abusers? Lancet Reg Health Eur 2022; 19:100432. [PMID: 35801185 PMCID: PMC9253699 DOI: 10.1016/j.lanepe.2022.100432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5T 2S1, Canada
- Department of Psychiatry and Institute of Medical Science, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada
- Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, 119992 Moscow, Russian Federation
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Rehm J, O'Donnell A, Kaner EFS, Jane LLopis E, Manthey J, Anderson P. Differential impact of minimum unit pricing on alcohol consumption between Scottish men and women: controlled interrupted time series analysis. BMJ Open 2022; 12:e054161. [PMID: 35851006 PMCID: PMC9315916 DOI: 10.1136/bmjopen-2021-054161] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the immediate impact of the introduction of minimum unit pricing (MUP) in Scotland on alcohol consumption and whether the impact differed by sex, level of alcohol consumption, age, social grade and level of residential deprivation of respondents. DESIGN Primary controlled interrupted time series analysis and secondary before-and-after analysis of the impact of introducing MUP in Scotland using alcohol consumption data for England as control. SETTING Data from Kantar Worldpanel's Alcovision survey, a continuous retrospective online timeline follow-back diary survey of the previous week's alcohol consumption. PARTICIPANTS 53 347 women and 53 143 men. INTERVENTIONS Introduction of a minimum price of 50 pence per UK unit (6.25 pence/g) for the sale of alcohol in Scotland on 1 May 2018. MAIN OUTCOME MEASURES Number of grams of alcohol consumed per week, in total, in off-trade (eg, at home) and in on-trade (eg, in pubs, restaurants). RESULTS Primary interrupted time series analyses found that the introduction of MUP was associated with a drop in reported weekly total alcohol consumption of 5.94 g (95% CI 1.29 to 10.60), a drop in off-trade consumption of 3.27 g (95% CI -0.01 to 6.56) and a drop in on-trade consumption of 2.67 g (95% CI -1.48 to 6.82). Associated reductions were larger for women than for men and were greater among heavier drinkers than for lighter drinkers, except for the 5% of heaviest drinking men for whom an associated increase in consumption was found. Secondary before-and-after analyses found that reductions in consumption were greater among older respondents and those living in less deprived areas. The introduction of MUP was not associated with a reduction in consumption among younger men and men living in more deprived areas. CONCLUSIONS Greater policy attention needs to be addressed to the heaviest drinking men, to younger men and to men who live in more deprived areas.
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Affiliation(s)
- Jürgen Rehm
- Social and Epidemiological Research, CAMH, Toronto, Ontario, Canada
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen F S Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eva Jane LLopis
- Department of Health Promotion, Maastricht University, Maastricht, Limburg, The Netherlands
- ESADE Business School, Ramon Llull University, Barcelona, Spain
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Peter Anderson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Rastogi A, Manthey J, Wiemker V, Probst C. Alcohol consumption in India: a systematic review and modelling study for sub-national estimates of drinking patterns. Addiction 2022; 117:1871-1886. [PMID: 34873774 DOI: 10.1111/add.15777] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 11/17/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS In India, alcohol per capita consumption (APC) has substantially increased over the past 2 decades. Although consumption does vary across the country, consistent state-level data are lacking. We aimed to identify all state-level alcohol exposure estimates since 2000 to (i) model consistent current drinking (CD) (12 months) prevalence estimates for all 36 states/union territories (UT) in 2019 and (ii) compare state-level CD trends with national-level APC trends. DESIGN A systematic review for studies on the Indian state-level prevalence of CD, lifetime abstinence (LA), alcohol use disorders (AUD) or the quantity of alcohol consumed among current drinkers (QU) was conducted. Subsequently, statistical modelling was applied. SETTING Data were collected and modelled for all Indian states/UTs. PARTICIPANTS Studies since 2000 referring to the general adult population (≥15 years) of at least one Indian state/UT were eligible. The total sample size covered was ~29 600 000 (males: females, 1:1.6). MEASUREMENTS Results on LA, AUD and QU were summarized descriptively. For (i) the state-, sex- and age-specific CD prevalence was estimated using random intercept fractional response models. For (ii) random intercept and slope models were performed. FINDINGS Of 2870 studies identified, 30 were retained for data extraction. LA, AUD and QU data were available for 31, 36 and 12 states/UTs, respectively. CD model estimates ranged from 6.4% (95% CI = 2.1%-18.1%; males) in Lakshadweep and 1.3% (95% CI = 0.7%-2.6%; females) in Delhi to 76.1% (95% CI = 68.1%-82.6%; males) and 63.7% (95% CI = 49.4%-75.7%; females) in Arunachal Pradesh. Over time, CD decreased in most states/UTs in the observed data, contradicting increasing national-level APC trends. CONCLUSIONS Alcohol use (measured as consistent current drinking) in India has large regional variations, with alcohol consumption being most prevalent in the North-East, Chhattisgarh, Telangana, Himachal Pradesh, Punjab and Jharkhand.
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Affiliation(s)
- Ankit Rastogi
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Veronika Wiemker
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Charlotte Probst
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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20
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Rossow I, Moan IS, Bye EK. Declining Trend in Adolescent Alcohol Use: Does It Have Any Significance for Drinking Behaviour in Young Adulthood? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137887. [PMID: 35805544 PMCID: PMC9266013 DOI: 10.3390/ijerph19137887] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/25/2022] [Accepted: 06/26/2022] [Indexed: 02/05/2023]
Abstract
Since 2000, adolescent alcohol use has declined substantially in many high-income countries, particularly in Northern Europe. This study examined whether birth cohorts in Norway who experienced different levels of alcohol consumption in mid-adolescence differed in drinking behaviour when they reached young adulthood. We analysed data from annual population surveys in Norway (2012–2021). The analytic sample comprised data from respondents aged 20–29 years (N = 5266), and we applied four birth cohorts (i.e., 1983–1987, 1988–1992, 1993–1996 and 1997–2001). We applied age categories with two- and five-year intervals and tested whether drinking frequency, heavy episodic drinking (HED) and usual number of drinks per drinking occasion during the past 12 months differed by birth cohort in age-specific strata. Possible cohort differences within age groups were tested using Pearson’s Chi square. There were no statistically significant differences between cohorts with respect to drinking frequency or HED frequency. However, the youngest cohort had fewer drinks per occasion when in their early 20s compared to older cohorts. This study showed that birth cohorts who differed substantially in levels of alcohol consumption in mid-adolescence, only to a little extent differed in drinking behaviour in young adulthood.
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21
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Garnett C, Oldham M, Shahab L, Tattan-Birch H, Cox S. Characterising smoking and smoking cessation attempts by risk of alcohol dependence: A representative, cross-sectional study of adults in England between 2014-2021. THE LANCET REGIONAL HEALTH. EUROPE 2022; 18:100418. [PMID: 35814338 PMCID: PMC9257647 DOI: 10.1016/j.lanepe.2022.100418] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background There is a strong shared association between smoking tobacco and drinking alcohol. This study aimed to compare smoking prevalence and smoking characteristics in drinkers who were versus were not at risk of alcohol dependence in England. Methods We used cross-sectional data from a monthly, nationally representative survey of adults in England (weighted n=144,583) collected between 2014-2021. Smoking and smoking cessation attempt characteristics were regressed on to alcohol dependence (drinkers at risk versus not at risk), adjusting for survey year. Findings Past-year smoking prevalence was 63·3% (95% CI=59·7-66·8) among drinkers at risk of alcohol dependence compared with 18·7% (95% CI=18·4-18·9) among those not at risk, and 19·2% (95% CI=18·8-19·7) among non-drinkers. Among past-year smokers, drinkers at risk of alcohol dependence (versus not at risk) smoked more cigarettes per day (B=3·0, 95% CI=2·3-3·8) and were more likely to smoke their first cigarette within 5 (versus >60) minutes of waking (OR=2·81, 95% CI=2·25-3·51). Interpretation In a representative sample of adults in England, a graded effect was observed where smoking prevalence increased with level of alcohol consumption. Past-year smokers at risk of alcohol dependence had higher levels of cigarette dependence than drinkers not at risk. Therefore, smokers at risk of alcohol dependence are a high priority group to target to reduce smoking prevalence as part of the NHS long-term plan. Funding Cancer Research UK and the National Institute for Health Research.
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Affiliation(s)
- Claire Garnett
- Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK,Spectrum Consortium, London, UK,Corresponding author at: University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
| | - Melissa Oldham
- Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK,Spectrum Consortium, London, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK,Spectrum Consortium, London, UK
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK,Spectrum Consortium, London, UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK,Spectrum Consortium, London, UK
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22
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Rehm J, Shield KD, Bunova A, Ferreira‐Borges C, Franklin A, Gornyi B, Rovira P, Neufeld M. Prevalence of alcohol use disorders in primary health-care facilities in Russia in 2019. Addiction 2022; 117:1640-1646. [PMID: 35072306 PMCID: PMC9305418 DOI: 10.1111/add.15816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Abstract
AIMS To estimate prevalence of alcohol use disorders (AUD) and alcohol dependence (AD) for Russia in 2019, based on clients in primary health-care facilities. DESIGN Cross-sectional assessment of AUD and AD. Prevalence estimates were cross-validated using a treatment multiplier methodology. SETTING A total of 21 primary health-care facilities, including dispanserization units (population health preventive care settings). PARTICIPANTS A total of 2022 participants (986 women and 1036 men) 18 years of age and older. MEASUREMENTS Composite International Diagnostic Interview. FINDINGS The prevalence of AD and AUD was 7.0% [95% confidence interval (CI) = 5.9-8.1%] and 12.2% (95% CI = 10.8-13.6%), respectively. Marked sex differences were observed for the prevalence of AD (women: 2.8%; 95% CI = 1.7-3.8%; men: 12.2%; 95% CI = 10.3-14.1%) and AUD (women: 6.1%; 95% CI = 4.6-7.7%; men: 19.5%; 95% CI = 17.2-21.8%). Age patterns of AD and AUD prevalence were sex-specific. Among women, the prevalence of AUD and AD was highest in the youngest age group and decreased with age. Among men, the prevalence of AUD and AD was highest among men aged 45-59 years. Sensitivity analyses indicated that the prevalence of AD as estimated using a treatment multiplier (6.5%; 95% CI = 5.0-8.9%) was similar to the estimates of the main analysis. CONCLUSIONS Even though alcohol use has declined since 2003 in Russia, the prevalence of alcohol use disorders and alcohol dependence remains high at approximately 12 and 7%, respectively.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH)TorontoOntarioCanada,Dalla Lana School of Public Health and Department of PsychiatryUniversity of TorontoTorontoOntarioCanada,Department of Psychiatry, Faculty of MedicineUniversity of TorontoTorontoOntarioCanada,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany,Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental HealthTorontoOntarioCanada,Faculty of Medicine, Institute of Medical ScienceUniversity of TorontoTorontoOntarioCanada,Program on Substance Abuse and World Health Organization (WHO) CC, Public Health Agency of CataloniaBarcelonaSpain,I. M. Sechenov First Moscow State Medical University (Sechenov University)MoscowRussia
| | - Kevin D. Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH)TorontoOntarioCanada,Dalla Lana School of Public Health and Department of PsychiatryUniversity of TorontoTorontoOntarioCanada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental HealthTorontoOntarioCanada
| | - Anna Bunova
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian FederationMoscowRussia
| | - Carina Ferreira‐Borges
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable DiseasesMoscowRussia
| | - Ari Franklin
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
| | - Boris Gornyi
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian FederationMoscowRussia
| | - Pol Rovira
- Program on Substance Abuse and World Health Organization (WHO) CC, Public Health Agency of CataloniaBarcelonaSpain
| | - Maria Neufeld
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH)TorontoOntarioCanada,Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany,World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable DiseasesMoscowRussia
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23
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Hardie I, Stevely AK, Sasso A, Meier PS, Holmes J. The impact of changes in COVID-19 lockdown restrictions on alcohol consumption and drinking occasion characteristics in Scotland and England in 2020: an interrupted time-series analysis. Addiction 2022; 117:1622-1639. [PMID: 35108758 PMCID: PMC9302640 DOI: 10.1111/add.15794] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/13/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND AIMS Early evidence suggests that COVID-19 lockdown restrictions affect alcohol consumption. However, existing studies lack data on how drinking practices changed as restrictions disrupted people's work, family life and socializing routines. We examined changes in consumption and drinking occasion characteristics during three periods of changing restrictions in Scotland/England. DESIGN Interrupted time-series analysis of repeat cross-sectional market research data (assessing step-level changes). SETTING Scotland/England, January 2009-December 2020. PARTICIPANTS Scotland: 41 507 adult drinkers; England: 253 148 adult drinkers. MEASUREMENTS Three intervention points: March 2020 lockdown, July 2020 easing of restrictions and October 2020 re-introduction of some restrictions. PRIMARY OUTCOME mean units consumed per week (total/off-trade/on-trade; 1 unit = 8 g ethanol). SECONDARY OUTCOMES drinking > 14 units per week, heavy drinking, drinking days per week, solitary drinking, drinking with family/partners, drinking with friends/colleagues, own-home drinking, drinking in someone else's home and drinking start times. FINDINGS In Scotland, March 2020's lockdown was associated with a 2.32 [95% confidence interval (CI) = 0.61, 4.02] increase in off-trade (i.e. shop-bought) units per week, a -2.84 (95% CI = -3.63, -2.06) decrease in on-trade (i.e. licensed venues) units per week, but no statistically significant change in total units per week. July 2020's easing of restrictions was associated with a 1.33 (95% CI = 0.05, 2.62) increase in on-trade units per week, but no statistically significant total/off-trade consumption changes. October 2020's re-introduction of some restrictions was not associated with statistically significant consumption changes. Results for England were broadly similar. Lockdown restrictions were also associated with later drinking start times, fewer occasions in someone else's home and with friends/colleagues, more own-home drinking and (in Scotland only) more solitary drinking. CONCLUSIONS Reductions in on-trade alcohol consumption following COVID-19 lockdown restrictions in Scotland/England in 2020 were mainly offset by increased own-home drinking. This largely persisted in periods of greater/lesser restrictions. The shift towards off-trade drinking involved significant changes in the characteristics of drinking occasions.
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Affiliation(s)
- Iain Hardie
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Abigail K. Stevely
- Sheffield Alcohol Research Group (SARG), School of Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - Alessandro Sasso
- Sheffield Alcohol Research Group (SARG), School of Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - Petra S. Meier
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - John Holmes
- Sheffield Alcohol Research Group (SARG), School of Health and Related ResearchUniversity of SheffieldSheffieldUK
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24
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Lange S, Jiang H, Bagge C, Probst C, Tran A, Rehm J. Gender-specific risk relationship between heavy alcohol use/alcohol use disorders and suicidal thoughts and behavior among adults in the United States over time. Soc Psychiatry Psychiatr Epidemiol 2022; 57:721-726. [PMID: 35032174 PMCID: PMC8969096 DOI: 10.1007/s00127-022-02225-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 01/06/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Suicidal thoughts and behaviors have been on the rise in the recent years in the US. There is a well-known link between heavy alcohol use/alcohol use disorders (AUDs) and suicidal thoughts and behaviors. An increase in the respective risk relationships is one way in which heavy alcohol use/AUDs may be driving the increase in the rate of suicidal thoughts and behaviors. The objective of the current study was to investigate whether the gender-specific risk relationships between heavy alcohol use/AUDs and past-year (1) suicidal thoughts and (2) attempted suicide have increased over time. METHODS Individual-level annual data from the National Survey on Drug Use and Health for the past 12 years (2008-2019) were utilized. Year- and gender-specific multivariate binary logistic regression analyses were first conducted. Gender-stratified random-effects meta-regressions across study years were then conducted. RESULTS Heavy alcohol use/AUDs were associated with elevated odds of past-year suicidal thoughts and attempted suicide for both men and women; however, a linear increase in the risk relationships over time was not found. CONCLUSION Although a temporal increase in the risk relationships of interest was not found, until additional research in this area is conducted, heavy alcohol use/AUDs cannot be ruled out as being a driving force behind the increasing rate of suicidal thoughts and behaviors in the US.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Courtney Bagge
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
- Heidelberg Institute for Global Health, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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25
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Sohi I, Chrystoja BR, Rehm J, Wells S, Monteiro M, Ali S, Shield KD. Changes in alcohol use during the COVID-19 pandemic and previous pandemics: A systematic review. Alcohol Clin Exp Res 2022; 46:498-513. [PMID: 35412673 PMCID: PMC9111333 DOI: 10.1111/acer.14792] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/21/2022] [Accepted: 02/04/2022] [Indexed: 12/16/2022]
Abstract
The objective of this study is to summarize the research on the relationships between exposure to the COVID-19 pandemic or previous pandemics and changes in alcohol use. A systematic search of Medline and Embase was performed to identify cohort and cross-sectional population studies that examined changes in alcohol use during or following a pandemic compared to before a pandemic occurred. Outcomes examined included differences in the volume and frequency of alcohol consumption and the frequencies of heavy episodic drinking (HED) and alcohol-related problems during a pandemic compared to before a pandemic. Quality assessment was performed using the Cochrane Risk of Bias Tool for Nonrandomized Studies. This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search yielded 672 articles; 27 were included in the narrative review, of which 6 were cohort studies (all from high-income countries). A total of 259,188 participants were included. All cohort studies examined the impact of COVID-19 and associated pandemic-related policies, including social distancing and alcohol-specific policies, on alcohol use. Cohort studies demonstrated a consistent significant decrease in total alcohol consumption (Australia) and a significant increase in the frequency of alcohol use (United States). A significant decrease in the frequency of HED was observed in Australia and Spain but not in the United States. A significant increase in the proportion of people with problematic alcohol use was observed in the United Kingdom. Initial insights into changes in alcohol use indicate substantial heterogeneity. Alcohol use may have decreased in some countries, while HED and the proportion of people with problematic alcohol use may have increased. The lack of high-quality studies from low- and middle-income countries reflects a dearth of information from countries inhabited by most of the world's population.
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Affiliation(s)
- Ivneet Sohi
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Bethany R Chrystoja
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Samantha Wells
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | | | - Shehzad Ali
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Kevin D Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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26
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Karlsson N, Skagerström J, O'Donnell A, Abidi L, Thomas K, Nilsen P, Lid TG. Public perceptions of how alcohol consumption is dealt with in Swedish and Norwegian health care. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 38:243-255. [PMID: 35310609 PMCID: PMC8899254 DOI: 10.1177/1455072520985981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 12/16/2020] [Indexed: 11/23/2022] Open
Abstract
Aims: The aims of this study were to evaluate and compare popular beliefs and attitudes regarding alcohol conversations in healthcare in Sweden and Norway; and to explore which factors were associated with different levels of support for alcohol-prevention work in the two countries. Methods: Population-based cross-sectional surveys were conducted in Sweden (n = 3000) and Norway (n = 1208). Logistic regression was used to identify the characteristics of participants who were supportive of routine alcohol screening and brief intervention delivery. Results: A higher proportion of Swedish respondents agreed to a large extent that healthcare professionals should routinely ask about alcohol consumption. In addition, a higher proportion of Swedish respondents compared to respondents from Norway agreed that healthcare providers should only ask about patient’s alcohol consumption if this was related to specific symptoms. There were similar correlates of being supportive of routine alcohol screening and brief intervention delivery in both countries. Support was lower in both countries amongst moderate and risky drinkers, and among single adults or those on parental leave, but higher amongst older individuals. Having had an alcohol conversation in healthcare increased the level of support for alcohol prevention in routine healthcare among risky drinkers. Conclusions: There is a high level of support for preventative alcohol conversations in routine healthcare in Norway and Sweden, although there was a lower proportion of respondents who were positive to alcohol prevention in routine healthcare in Norway compared to Sweden. Experiencing alcohol conversation may positively affect risky drinkers’ attitudes towards and support for alcohol prevention. Thus, more frequent alcohol conversations in routine healthcare may also result in increased level of support for alcohol prevention among risky drinkers.
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Affiliation(s)
| | - Janna Skagerström
- Linköping University, Sweden; and Research and Development Unit in Region Östergötland, Linköping, Sweden
| | | | | | | | | | - Torgeir Gilje Lid
- Stavanger University Hospital, Norway; and University of Stavanger, Norway
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27
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Gavurova B, Khouri S, Ivankova V, Kubak M. Changes in Alcohol Consumption and Determinants of Excessive Drinking During the COVID-19 Lockdown in the Slovak Republic. Front Public Health 2022; 9:791077. [PMID: 35178372 PMCID: PMC8843933 DOI: 10.3389/fpubh.2021.791077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
As a result of the coronavirus disease 2019 (COVID-19) pandemic, countries have been forced to adopt strong restrictions, such as lockdown, which can lead to serious consequences for public health, including the problematic use of addictive substances. The aim of this cross-sectional study was to examine changes in alcohol consumption and to identify determinants against the background of excessive drinking during the COVID-19 lockdown in the Slovak Republic. The research included 445 respondents (33% males and 67% females), and the data collection through the questionnaire took place from April 29, 2020 to July 1, 2020. Measures such as drinking frequency, amount of alcohol and excessive drinking were used to examine alcohol consumption. Descriptive analysis and binary logistic regression were used to meet the main aim. The findings provide a closer look at the situation in the Slovak Republic and contribute to comprehensive international knowledge. The frequency of excessive drinking did not change in about half of respondents (53% of males and 69% of females). More respondents decreased their excessive drinking than increased, both among males (31 and 16%, respectively) and females (25 and 6%, respectively). Similar results were found for drinking frequency and amount of alcohol. Amongst Slovak respondents, an increase in excessive drinking was more common among males, younger people, smokers, and smokers who increased smoking during the lockdown. Especially in the case of vulnerable populations, public policies should consider a response to impending problems. The findings of this study encourage the implementation of effective and evidence-based prevention programs, which are more than necessary in the Slovak Republic.
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Affiliation(s)
- Beata Gavurova
- Institute of Earth Resources, Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
| | - Samer Khouri
- Institute of Earth Resources, Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
| | - Viera Ivankova
- Institute of Earth Resources, Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
| | - Matus Kubak
- Department of Regional Sciences and Management, Faculty of Economics, Technical University of Košice, Košice, Slovakia
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28
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Kilian C, O'Donnell A, Potapova N, López‐Pelayo H, Schulte B, Miquel L, Paniello Castillo B, Schmidt CS, Gual A, Rehm J, Manthey J. Changes in alcohol use during the
COVID
‐19 pandemic in Europe: A meta‐analysis of observational studies. Drug Alcohol Rev 2022; 41:918-931. [PMID: 35187739 PMCID: PMC9111882 DOI: 10.1111/dar.13446] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 02/07/2023]
Abstract
Issues Numerous studies have examined the impact of the COVID‐19 pandemic on alcohol use changes in Europe, with concerns raised regarding increased use and related harms. Approach We synthesised observational studies published between 1 January 2020 and 31 September 2021 on self‐reported changes in alcohol use associated with COVID‐19. Electronic databases were searched for studies evaluating individual data from European general and clinical populations. We identified 646 reports, of which 56 general population studies were suitable for random‐effects meta‐analyses of proportional differences in alcohol use changes. Variations by time, sub‐region and study quality were assessed in subsequent meta‐regressions. Additional 16 reports identified were summarised narratively. Key Findings Compiling reports measuring changes in overall alcohol use, slightly more individuals indicated a decrease than an increase in their alcohol use during the pandemic [3.8%, 95% confidence interval (CI) 0.00–7.6%]. Decreases were also reported more often than increases in drinking frequency (8.0%, 95% CI 2.7–13.2%), quantity consumed (12.2%, 95% CI 8.3–16.2%) and heavy episodic drinking (17.7%, 95% CI 13.6–21.8%). Among people with pre‐existing high drinking levels/alcohol use disorder, high‐level drinking patterns appear to have solidified or intensified. Implications Pandemic‐related changes in alcohol use may be associated with pre‐pandemic drinking levels. Increases among high‐risk alcohol users are concerning, suggesting a need for ongoing monitoring and support from relevant health‐care services. Conclusion Our findings suggest that more people reduced their alcohol use in Europe than increased it since the onset of the pandemic. However high‐quality studies examining specific change mechanisms at the population level are lacking.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Dresden Germany
| | - Amy O'Donnell
- Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - Nina Potapova
- Grup de Recerca en Addiccions Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unitat Conductes Addictives Hospital Clínic Barcelona Spain
| | - Hugo López‐Pelayo
- Grup de Recerca en Addiccions Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unitat Conductes Addictives Hospital Clínic Barcelona Spain
| | - Bernd Schulte
- Centre for Interdisciplinary Addiction Research University Medical Center Hamburg‐Eppendorf, Department of Psychiatry Hamburg Germany
| | - Laia Miquel
- Grup de Recerca en Addiccions Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unitat Conductes Addictives Hospital Clínic Barcelona Spain
| | - Blanca Paniello Castillo
- Grup de Recerca en Addiccions Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unitat Conductes Addictives Hospital Clínic Barcelona Spain
- Department of Global Public Health (student) Karolinska Institute Stockholm Sweden
| | - Christiane Sybille Schmidt
- Centre for Interdisciplinary Addiction Research University Medical Center Hamburg‐Eppendorf, Department of Psychiatry Hamburg Germany
| | - Antoni Gual
- Grup de Recerca en Addiccions Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unitat Conductes Addictives Hospital Clínic Barcelona Spain
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Dresden Germany
- Centre for Interdisciplinary Addiction Research University Medical Center Hamburg‐Eppendorf, Department of Psychiatry Hamburg Germany
- Institute for Mental Health Policy Research Centre for Addiction and Mental Health Toronto Canada
- Dalla Lana School of Public Health University of Toronto Toronto Canada
- Faculty of Medicine, Institute of Medical Science University of Toronto, Medical Sciences Building Toronto Canada
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Dresden Germany
- Centre for Interdisciplinary Addiction Research University Medical Center Hamburg‐Eppendorf, Department of Psychiatry Hamburg Germany
- Department of Psychiatry, Medical Faculty University of Leipzig Leipzig Germany
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Jenneson V, Clarke GP, Greenwood DC, Shute B, Tempest B, Rains T, Morris MA. Exploring the Geographic Variation in Fruit and Vegetable Purchasing Behaviour Using Supermarket Transaction Data. Nutrients 2021; 14:nu14010177. [PMID: 35011053 PMCID: PMC8747042 DOI: 10.3390/nu14010177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/21/2021] [Accepted: 12/26/2021] [Indexed: 12/02/2022] Open
Abstract
The existence of dietary inequalities is well-known. Dietary behaviours are impacted by the food environment and are thus likely to follow a spatial pattern. Using 12 months of transaction records for around 50,000 ‘primary’ supermarket loyalty card holders, this study explores fruit and vegetable purchasing at the neighbourhood level across the city of Leeds, England. Determinants of small-area-level fruit and vegetable purchasing were identified using multiple linear regression. Results show that fruit and vegetable purchasing is spatially clustered. Areas purchasing fewer fruit and vegetable portions typically had younger residents, were less affluent, and spent less per month with the retailer.
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Affiliation(s)
- Victoria Jenneson
- Leeds Institute for Data Analytics, University of Leeds, Leeds LS2 9JT, UK; (D.C.G.); (M.A.M.)
- School of Geography, University of Leeds, Leeds LS2 9JT, UK;
- Correspondence:
| | | | - Darren C. Greenwood
- Leeds Institute for Data Analytics, University of Leeds, Leeds LS2 9JT, UK; (D.C.G.); (M.A.M.)
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK
| | - Becky Shute
- Sainsbury’s Supermarkets Ltd., Holborn, London EC1N 2HT, UK; (B.S.); (B.T.); (T.R.)
| | - Bethan Tempest
- Sainsbury’s Supermarkets Ltd., Holborn, London EC1N 2HT, UK; (B.S.); (B.T.); (T.R.)
| | - Tim Rains
- Sainsbury’s Supermarkets Ltd., Holborn, London EC1N 2HT, UK; (B.S.); (B.T.); (T.R.)
| | - Michelle A. Morris
- Leeds Institute for Data Analytics, University of Leeds, Leeds LS2 9JT, UK; (D.C.G.); (M.A.M.)
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK
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30
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Mäkelä P, Rossow I, Moan IS, Bye EK, Kilian C, Raitasalo K, Allebeck P. Measuring changes in alcohol use in Finland and Norway during the COVID-19 pandemic: Comparison between data sources. Int J Methods Psychiatr Res 2021; 30:e1892. [PMID: 34449127 PMCID: PMC8633923 DOI: 10.1002/mpr.1892] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/17/2021] [Accepted: 08/12/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To examine (1) how a rapid data collection using a convenience sample fares in estimating change in alcohol consumption when compared to more conventional data sources, and (2) how alcohol consumption changed in Finland and Norway during the first months of the COVID-19 pandemic. METHODS Three different types of data sources were used for the 2nd quarter of 2020 and 2019: sales statistics combined with data on unrecorded consumption; the rapid European Alcohol Use and COVID-19 (ESAC) survey (Finland: n = 3800, Norway: n = 17,092); and conventional population surveys (Finland: n = 2345, Norway: n1 = 1328, n2 = 2189, n3 = 25,708). Survey measures of change were retrospective self-reports. RESULTS The statistics indicate that alcohol consumption decreased in Finland by 9%, while little change was observed in Norway. In all surveys, reporting a decrease in alcohol use was more common than reporting an increase (ratios 2-2.6 in Finland, 1.3-2 in Norway). Compared to conventional surveys, in the ESAC survey fewer respondents reported no change and past-year alcohol consumption was higher. CONCLUSION The rapid survey using convenience sampling gave similar results on change in drinking as conventional surveys but higher past-year drinking, suggesting self-selection effects. Aspects of the pandemic driving alcohol consumption down were equally strong or stronger than those driving it up.
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Affiliation(s)
- Pia Mäkelä
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Elin K Bye
- Norwegian Institute of Public Health, Oslo, Norway
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | | | - Peter Allebeck
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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31
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Kilian C, Rehm J, Allebeck P, Braddick F, Gual A, Barták M, Bloomfield K, Gil A, Neufeld M, O'Donnell A, Petruželka B, Rogalewicz V, Schulte B, Manthey J. Alcohol consumption during the COVID-19 pandemic in Europe: a large-scale cross-sectional study in 21 countries. Addiction 2021; 116:3369-3380. [PMID: 34109685 DOI: 10.1111/add.15530] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/24/2021] [Accepted: 04/21/2021] [Indexed: 12/17/2022]
Abstract
AIMS To investigate changes in alcohol consumption during the first months of the COVID-19 pandemic in Europe as well as its associations with income and experiences of distress related to the pandemic. DESIGN Cross-sectional on-line survey conducted between 24 April and 22 July 2020. SETTING Twenty-one European countries. PARTICIPANTS A total of 31 964 adults reporting past-year drinking. MEASUREMENTS Changes in alcohol consumption were measured by asking respondents about changes over the previous month in their drinking frequency, the quantity they consumed and incidence of heavy episodic drinking events. Individual indicators were combined into an aggregated consumption-change score and scaled to a possible range of -1 to +1. Using this score as the outcome, multi-level linear regressions tested changes in overall drinking, taking into account sampling weights and baseline alcohol consumption [Alcohol Use Disorder Identification Test (AUDIT-C)] and country of residence serving as random intercept. Similar models were conducted for each single consumption-change indicator. FINDINGS The aggregated consumption-change score indicated an average decrease in alcohol consumption of -0.14 [95% confidence interval (CI) = -0.18, -0.10]. Statistically significant decreases in consumption were found in all countries, except Ireland (-0.08, 95% CI = -0.17, 0.01) and the United Kingdom (+0.10, 95% CI = 0.03, 0.17). Decreases in drinking were mainly driven by a reduced frequency of heavy episodic drinking events (-0.17, 95% CI = -0.20, -0.14). Declines in consumption were less marked among those with low- or average incomes and those experiencing distress. CONCLUSIONS On average, alcohol consumption appears to have declined during the first months of the COVID-19 pandemic in Europe. Both reduced availability of alcohol and increased distress may have affected consumption, although the former seems to have had a greater impact in terms of immediate effects.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Peter Allebeck
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Fleur Braddick
- Clínic Foundation for Biomedical Research (FCRB), Barcelona, Mallorca, Spain.,Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Mallorca, Spain
| | - Antoni Gual
- Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Mallorca, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Mallorca, Spain
| | - Miroslav Barták
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
| | - Artyom Gil
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Maria Neufeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Benjamin Petruželka
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Vladimir Rogalewicz
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Bernd Schulte
- Department of Psychiatry, Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry, Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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32
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Manthey J, Freeman TP, Kilian C, López-Pelayo H, Rehm J. Public health monitoring of cannabis use in Europe: prevalence of use, cannabis potency, and treatment rates. THE LANCET REGIONAL HEALTH. EUROPE 2021; 10:100227. [PMID: 34806072 PMCID: PMC8589728 DOI: 10.1016/j.lanepe.2021.100227] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Cannabis is one of the most widely used substances worldwide. Heavy use is associated with an increased risk of cannabis use disorders, psychotic disorders, acute cognitive impairment, traffic injuries, respiratory problems, worse pregnancy outcomes, and there are indications for genotoxic and epigenotoxic adverse effects. International regulation of medical and non-medical cannabis use is changing rapidly and substantially, highlighting the importance of robust public health monitoring. This study aimed to describe the trends of key public health indicators in European Union (27 member states + UK, Norway and Turkey) for the period 2010 to 2019, their public health implications, and to identify the steps required to improve current practice in monitoring of cannabis use and harm in Europe. Methods Data on four key cannabis indicators (prevalence of use, prevalence of cannabis use disorder [CUD], treatment rates, and potency of cannabis products) in Europe were extracted from the United Nations Office on Drugs and Crime, European Monitoring Centre for Drugs and Drug Addiction and the Global Burden of Disease study. For prevalence of use and CUD, the first and last available estimate in each country were compared. For treatment rates and cannabis potency, linear regression models were conducted. Findings Between 2010 and 2019, past-month prevalence of cannabis use increased by 27% in European adults (from 3·1 to 3·9%), with most pronounced relative increases observed among 35-64 year-olds. In 13 out of 26 countries, over 20% of all past-month users reported high-risk use patterns. The rate of treatment entry for cannabis problems per 100,000 adults increased from 27·0 (95% CI: 17·2 to 36·8) to 35·1 (95% CI: 23·6 to 46·7) and has mostly plateaued since 2015. Modest increases in potency were found in herbal cannabis (from 6·9% to 10·6% THC) while median THC values tripled in cannabis resin (from 7·6% to 24·1% THC). Interpretation In the past decade, cannabis use, treatment rates and potency levels have increased in Europe highlighting major concerns about the public health impact of cannabis use. Continued monitoring and efforts to improve data quality and reporting, including indicators of high-risk use and cannabis-attributable harm, will be necessary to evaluate the health impact of international changes in cannabis regulation. Funding This study received no specific funding.
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Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany.,Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, United Kingdom
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - Hugo López-Pelayo
- Grup Recerca Addiccions Clínic (GRAC-GRE), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain
| | - Jürgen Rehm
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany.,Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario, Canada, M5S 2S1.,Program on Substance Abuse & WHO CC in designation, Public Health Agency of Catalonia, 81-95 Roc Boronat St., 08005, Barcelona, Spain.,Dalla Lana School of Public Health & Department of Psychiatry, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario, Canada, M5T 3M7Department of Psychiatry, Faculty of Medicine, UofT, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 3M1, Canada.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8, b. 2, Moscow, 119991, Russian Federation
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33
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Reuter P, Caulkins JP, Midgette G. Heroin use cannot be measured adequately with a general population survey. Addiction 2021; 116:2600-2609. [PMID: 33651441 DOI: 10.1111/add.15458] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/23/2020] [Accepted: 02/18/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Globally, heroin and other opioids account for more than half of deaths and years-of-life-lost due to drug use and comprise one of the four major markets for illegal drugs. Having sound estimates of the number of problematic heroin users is fundamental to formulating sound health and criminal justice policies. Researchers and policymakers rely heavily upon general population surveys (GPS), such as the US National Survey on Drug Use and Health (NSDUH), to estimate heroin use, without confronting their limitations. GPS-based estimates are also ubiquitous for cocaine and methamphetamine, so insights pertaining to GPS for estimating heroin use are also relevant for those drug markets. ANALYSIS Four sources of potential errors in NSDUH are assessed: selective non-response, small sample size, sampling frame omissions and under-reporting. An alternative estimate drawing on a variety of sources including a survey of adult male arrestees is presented and explained. Other approaches to prevalence estimation are discussed. FINDINGS Under-reporting and selective non-response in NSDUH are likely to lead to substantial underestimation. Small sample size leads to imprecise estimates and erratic year-to-year fluctuations. The alternative estimate provides credible evidence that NSDUH underestimates the number of frequent heroin users by at least three-quarters and perhaps much more. IMPLICATIONS GPS, even those as strong as NSDUH, are doomed by their nature to estimate poorly a rare and stigmatized behavior concentrated in a hard-to-track population. Although many European nations avoid reliance upon these surveys, many others follow the US model. Better estimation requires models that draw upon a variety of data sources, including GPS, to provide credible estimates. Recent methodological developments in selected countries can provide guidance. Journals should require researchers to critically assess the soundness of GPS estimates for any stigmatized drug-related behaviors with low prevalence rates.
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Affiliation(s)
- Peter Reuter
- University of Maryland, Department of Criminology and Criminal Justice, College Park, MD, USA.,University of Maryland, School of Public Policy, College Park, MD, USA
| | - Jonathan P Caulkins
- Carnegie Mellon University, Heinz College of Information Systems and Public Policy, Pittsburgh, PA, USA
| | - Greg Midgette
- University of Maryland, Department of Criminology and Criminal Justice, College Park, MD, USA
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34
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van Hasselt M. Data triangulation for substance abuse research. Addiction 2021; 116:2613-2615. [PMID: 34155713 DOI: 10.1111/add.15596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/27/2021] [Indexed: 01/24/2023]
Affiliation(s)
- Martijn van Hasselt
- Department of Economics, The University of North Carolina at Greensboro, Greensboro, NC, USA
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35
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Anderson P, O'Donnell A, Kokole D, Jané Llopis E, Kaner E. Is Buying and Drinking Zero and Low Alcohol Beer a Higher Socio-Economic Phenomenon? Analysis of British Survey Data, 2015-2018 and Household Purchase Data 2015-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10347. [PMID: 34639647 PMCID: PMC8508356 DOI: 10.3390/ijerph181910347] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 11/20/2022]
Abstract
Zero and low alcohol products, particularly beer, are gaining consideration as a method to reduce consumption of ethanol. We do not know if this approach is likely to increase or decrease health inequalities. The aim of the study was to determine if the purchase and consumption of zero and low alcohol beers differs by demographic and socio-economic characteristics of consumers. Based on British household purchase data from 79,411 households and on British survey data of more than 104,635 adult (18+) respondents, we estimated the likelihood of buying and drinking zero (ABV = 0.0%) and low alcohol (ABV > 0.0% and ≤ 3.5%) beer by a range of socio-demographic characteristics. We found that buying and consuming zero alcohol beer is much more likely to occur in younger age groups, in more affluent households, and in those with higher social grades, with gaps in buying zero alcohol beer between households in higher and lower social grades widening between 2015 and 2020. Buying and drinking low alcohol beer had less consistent relationships with socio-demographic characteristics, but was strongly driven by households that normally buy and drink the most alcohol. Common to many health-related behaviours, it seems that it is the more affluent that lead the way in choosing zero or low alcohol products. Whilst the increased availability of zero and low alcohol products might be a useful tool to reduce overall ethanol consumption in the more socially advantageous part of society, it may be less beneficial for the rest of the population. Other evidence-based alcohol policy measures that lessen health inequalities, need to go hand-in-hand with those promoting the uptake of zero and low alcohol beer.
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Affiliation(s)
- Peter Anderson
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle NE2 4AX, UK
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle NE2 4AX, UK
| | - Daša Kokole
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Eva Jané Llopis
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, 6211 LK Maastricht, The Netherlands
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
- ESADE Business School, Ramon Llull University, 08034 Barcelona, Spain
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle NE2 4AX, UK
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36
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Ricard BJ, Hassanpour S. Deep Learning for Identification of Alcohol-Related Content on Social Media (Reddit and Twitter): Exploratory Analysis of Alcohol-Related Outcomes. J Med Internet Res 2021; 23:e27314. [PMID: 34524095 PMCID: PMC8482254 DOI: 10.2196/27314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/30/2021] [Accepted: 08/01/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Many social media studies have explored the ability of thematic structures, such as hashtags and subreddits, to identify information related to a wide variety of mental health disorders. However, studies and models trained on specific themed communities are often difficult to apply to different social media platforms and related outcomes. A deep learning framework using thematic structures from Reddit and Twitter can have distinct advantages for studying alcohol abuse, particularly among the youth in the United States. OBJECTIVE This study proposes a new deep learning pipeline that uses thematic structures to identify alcohol-related content across different platforms. We apply our method on Twitter to determine the association of the prevalence of alcohol-related tweets with alcohol-related outcomes reported from the National Institute of Alcoholism and Alcohol Abuse, Centers for Disease Control Behavioral Risk Factor Surveillance System, county health rankings, and the National Industry Classification System. METHODS The Bidirectional Encoder Representations From Transformers neural network learned to classify 1,302,524 Reddit posts as either alcohol-related or control subreddits. The trained model identified 24 alcohol-related hashtags from an unlabeled data set of 843,769 random tweets. Querying alcohol-related hashtags identified 25,558,846 alcohol-related tweets, including 790,544 location-specific (geotagged) tweets. We calculated the correlation between the prevalence of alcohol-related tweets and alcohol-related outcomes, controlling for confounding effects of age, sex, income, education, and self-reported race, as recorded by the 2013-2018 American Community Survey. RESULTS Significant associations were observed: between alcohol-hashtagged tweets and alcohol consumption (P=.01) and heavy drinking (P=.005) but not binge drinking (P=.37), self-reported at the metropolitan-micropolitan statistical area level; between alcohol-hashtagged tweets and self-reported excessive drinking behavior (P=.03) but not motor vehicle fatalities involving alcohol (P=.21); between alcohol-hashtagged tweets and the number of breweries (P<.001), wineries (P<.001), and beer, wine, and liquor stores (P<.001) but not drinking places (P=.23), per capita at the US county and county-equivalent level; and between alcohol-hashtagged tweets and all gallons of ethanol consumed (P<.001), as well as ethanol consumed from wine (P<.001) and liquor (P=.01) sources but not beer (P=.63), at the US state level. CONCLUSIONS Here, we present a novel natural language processing pipeline developed using Reddit's alcohol-related subreddits that identify highly specific alcohol-related Twitter hashtags. The prevalence of identified hashtags contains interpretable information about alcohol consumption at both coarse (eg, US state) and fine-grained (eg, metropolitan-micropolitan statistical area level and county) geographical designations. This approach can expand research and deep learning interventions on alcohol abuse and other behavioral health outcomes.
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Affiliation(s)
| | - Saeed Hassanpour
- Department of Biomedical Data Science, Dartmouth College, Lebanon, NH, United States
- Department of Epidemiology, Dartmouth College, Hanover, NH, United States
- Department of Computer Science, Dartmouth College, Hanover, NH, United States
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37
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Kilian C, Rehm J, Allebeck P, Barták M, Braddick F, Gual A, Matrai S, Petruželka B, Rogalewicz V, Rossow I, Schulte B, Štelemėkas M, Manthey J. Conducting a multi-country online alcohol survey in the time of the COVID-19 pandemic: Opportunities and challenges. Int J Methods Psychiatr Res 2021; 30:e1875. [PMID: 33951258 PMCID: PMC8209885 DOI: 10.1002/mpr.1875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/25/2021] [Accepted: 04/14/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This contribution provides insights into the methodology of a pan-European population-based online survey, performed without external funding during the COVID-19 pandemic. We present the impact of different dissemination strategies to collect data from a non-probabilistic convenience sample and outline post-stratification weighting schemes, to provide guidance for future multi-country survey studies. METHODS Description and comparison of dissemination strategies for five exemplary countries (Czechia, Germany, Lithuania, Norway, Spain) participating in the Alcohol Use and COVID-19 Survey. Comparison of the sample distribution with the country's actual population distribution according to sociodemographics, and development of weighting schemes. RESULTS The dissemination of online surveys through national newspapers, paid social media adverts and dissemination with the support of national health ministries turned out to be the most effective strategies. Monitoring the responses and adapting dissemination strategies to reach under-represented groups, and the application of sample weights were helpful to achieve an analytic sample matching the respective general population profiles. CONCLUSION Reaching a large pan-European convenience sample, including most European countries, in a short time was feasible, with the support of a broad scientific network.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Peter Allebeck
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Miroslav Barták
- Department of Addictology, First Faculty of Medicine and General University Hospital in Prague, Charles University, Praha, Czech Republic
| | - Fleur Braddick
- Clínic Foundation for Biomedical Research (FCRB), Barcelona, Spain.,Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Antoni Gual
- Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Silvia Matrai
- Clínic Foundation for Biomedical Research (FCRB), Barcelona, Spain.,Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Benjamin Petruželka
- Department of Addictology, First Faculty of Medicine and General University Hospital in Prague, Charles University, Praha, Czech Republic
| | - Vladimir Rogalewicz
- Department of Addictology, First Faculty of Medicine and General University Hospital in Prague, Charles University, Praha, Czech Republic
| | | | - Bernd Schulte
- Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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Rehm J, Rovira P, Llamosas-Falcón L, Shield KD. Dose-Response Relationships between Levels of Alcohol Use and Risks of Mortality or Disease, for All People, by Age, Sex, and Specific Risk Factors. Nutrients 2021; 13:2652. [PMID: 34444809 PMCID: PMC8401096 DOI: 10.3390/nu13082652] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022] Open
Abstract
Alcohol use has been causally linked to more than 200 disease and injury conditions, as defined by three-digit ICD-10 codes. The understanding of how alcohol use is related to these conditions is essential to public health and policy research. Accordingly, this study presents a narrative review of different dose-response relationships for alcohol use. Relative-risk (RR) functions were obtained from various comparative risk assessments. Two main dimensions of alcohol consumption are used to assess disease and injury risk: (1) volume of consumption, and (2) patterns of drinking, operationalized via frequency of heavy drinking occasions. Lifetime abstention was used as the reference group. Most dose-response relationships between alcohol and outcomes are monotonic, but for diabetes type 2 and ischemic diseases, there are indications of a curvilinear relationship, where light to moderate drinking is associated with lower risk compared with not drinking (i.e., RR < 1). In general, women experience a greater increase in RR per gram of alcohol consumed than men. The RR per gram of alcohol consumed was lower for people of older ages. RRs indicated that alcohol use may interact synergistically with other risk factors, in particular with socioeconomic status and other behavioural risk factors, such as smoking, obesity, or physical inactivity. The literature on the impact of genetic constitution on dose-response curves is underdeveloped, but certain genetic variants are linked to an increased RR per gram of alcohol consumed for some diseases. When developing alcohol policy measures, including low-risk drinking guidelines, dose-response relationships must be taken into consideration.
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Affiliation(s)
- Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (L.L.-F.); (K.D.S.)
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, ON M5S 1A8, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, 33 Ursula Franklin Street, Toronto, ON M5S 3M1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8, b. 2, 119991 Moscow, Russia
- Program on Substance Abuse, Public Health Agency of Catalonia, 08005 Barcelona, Spain;
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia, 08005 Barcelona, Spain;
| | - Laura Llamosas-Falcón
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (L.L.-F.); (K.D.S.)
- Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, 28041 Madrid, Spain
| | - Kevin D. Shield
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (L.L.-F.); (K.D.S.)
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, 33 Ursula Franklin Street, Toronto, ON M5S 3M1, Canada
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Jiang H, Lange S, Tran A, Imtiaz S, Rehm J. Determining the sex-specific distributions of average daily alcohol consumption using cluster analysis: is there a separate distribution for people with alcohol dependence? Popul Health Metr 2021; 19:28. [PMID: 34098997 PMCID: PMC8186209 DOI: 10.1186/s12963-021-00261-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND It remains unclear whether alcohol use disorders (AUDs) can be characterized by specific levels of average daily alcohol consumption. The aim of the current study was to model the distributions of average daily alcohol consumption among those who consume alcohol and those with alcohol dependence, the most severe AUD, using various clustering techniques. METHODS Data from Wave 1 and Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were used in the current analyses. Clustering algorithms were applied in order to group a set of data points that represent the average daily amount of alcohol consumed. Gaussian Mixture Models (GMMs) were then used to estimate the likelihood of a data point belonging to one of the mixture distributions. Individuals were assigned to the clusters which had the highest posterior probabilities from the GMMs, and their treatment utilization rate was examined for each of the clusters. RESULTS Modeling alcohol consumption via clustering techniques was feasible. The clusters identified did not point to alcohol dependence as a separate cluster characterized by a higher level of alcohol consumption. Among both females and males with alcohol dependence, daily alcohol consumption was relatively low. CONCLUSIONS Overall, we found little evidence for clusters of people with the same drinking distribution, which could be characterized as clinically relevant for people with alcohol use disorders as currently defined.
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Affiliation(s)
- Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.
- Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Sameer Imtiaz
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada
- Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, D-01187, Dresden, Germany
- Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 8th Floor, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
- Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, Moscow, Russian Federation, 119992
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
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Kilian C, Manthey J, Carr S, Hanschmidt F, Rehm J, Speerforck S, Schomerus G. Stigmatization of people with alcohol use disorders: An updated systematic review of population studies. Alcohol Clin Exp Res 2021; 45:899-911. [PMID: 33970504 DOI: 10.1111/acer.14598] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/04/2021] [Accepted: 03/10/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND We summarize research on the public stigmatization of persons with alcohol use disorder (AUD) in comparison with other mental health conditions and embed the results into a conceptual framework of the stigma process. METHODS We conducted a systematic search using Embase, MEDLINE, PubMed and PsycINFO (via Ovid), and Web of Science for population-based studies on the public stigma in AUD and at least 1 other mental health condition, published between October 1, 2010 and December 20, 2020, thus including all studies published since the last systematic review on this topic. The study is registered with PROSPERO (registration number: CRD42020173054). RESULTS We identified 20,561 records, of which 24 met the inclusion criteria, reporting results from 16 unique studies conducted in 9 different countries. Compared to substance-unrelated mental disorders, persons with AUD were generally less likely to be considered mentally ill, while they were perceived as being more dangerous and responsible for their condition. Further, the public desire for social distance was consistently higher for people with AUD. We found no consistent differences in the public stigma toward persons with AUD in comparison with other substance use disorders. CONCLUSION The stigmatization of persons with AUD remains comparatively high and is distinct from that of other substance-unrelated disorders.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Sinclair Carr
- Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Franz Hanschmidt
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany.,Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Sven Speerforck
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Georg Schomerus
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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Lange S, Rehm J. Commentary: The COVID-19 Pandemic Is Not a Good Time to Weaken Restrictions on Alcohol Availability. Healthc Policy 2021; 16:25-30. [PMID: 34129476 PMCID: PMC8200833 DOI: 10.12927/hcpol.2021.26501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Alcohol use is well established globally as one of the major risk factors for burden of disease and mortality. Although it is not yet clear how the COVID-19 pandemic has impacted the overall level of alcohol use in Canada, we do know that various levels of government have promoted its use - either by designating it essential or by increasing its availability. Such actions may have both an immediate and sustained impact on alcohol-related harm in Canada. We encourage all levels of government to support and prioritize the development and implementation of an evidence-informed framework for both alcohol policy and service delivery to reduce alcohol-related harms during the current pandemic and beyond.
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Affiliation(s)
- Shannon Lange
- Independent Scientist, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON
| | - Jürgen Rehm
- Senior Scientist, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON
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Manthey J, Kilian C, Carr S, Bartak M, Bloomfield K, Braddick F, Gual A, Neufeld M, O'Donnell A, Petruzelka B, Rogalewicz V, Rossow I, Schulte B, Rehm J. Use of alcohol, tobacco, cannabis, and other substances during the first wave of the SARS-CoV-2 pandemic in Europe: a survey on 36,000 European substance users. Subst Abuse Treat Prev Policy 2021; 16:36. [PMID: 33902668 PMCID: PMC8072737 DOI: 10.1186/s13011-021-00373-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND SARS-CoV-2 reached Europe in early 2020 and disrupted the private and public life of its citizens, with potential implications for substance use. The objective of this study was to describe possible changes in substance use in the first months of the SARS-CoV-2 pandemic in Europe. METHODS Data were obtained from a cross-sectional online survey of 36,538 adult substance users from 21 European countries conducted between April 24 and July 22 of 2020. Self-perceived changes in substance use were measured by asking respondents whether their use had decreased (slightly or substantially), increased (slightly or substantially), or not changed during the past month. The survey covered alcohol (frequency, quantity, and heavy episodic drinking occasions), tobacco, cannabis, and other illicit drug use. Sample weighted data were descriptively analysed and compared across substances. RESULTS Across all countries, use of all substances remained unchanged for around half of the respondents, while the remainder reported either a decrease or increase in their substance use. For alcohol use, overall, a larger proportion of respondents indicated a decrease than those reporting an increase. In contrast, more respondents reported increases in their tobacco and cannabis use during the previous month compared to those reporting decreased use. No distinct direction of change was reported for other substance use. CONCLUSIONS Our findings suggest changes in use of alcohol, tobacco and cannabis during the initial months of the pandemic in several European countries. This study offers initial insights into changes in substance use. Other data sources, such as sales statistics, should be used to corroborate these preliminary findings.
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Affiliation(s)
- Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Sinclair Carr
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Miroslav Bartak
- First Faculty of Medicine and General Teaching Hospital Prague, Department of Addiction, Charles University, Apolinarska 4, 128 00, Prague 2, Czech Republic
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Tuborgvej 160, 2400, Copenhagen, NV, Denmark
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Health Promotion Department of Public Health, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700, Esbjerg, Denmark
- Alcohol Research Group, Public Health Institute, 6001 Shellmound Street, Suite 450, Emeryville, CA, 94608, USA
| | - Fleur Braddick
- Clínic Foundation for Biomedical Research (FCRB), 08036, Barcelona, Spain
- Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, 08036, Barcelona, Spain
| | - Antoni Gual
- Clínic Foundation for Biomedical Research (FCRB), 08036, Barcelona, Spain
- Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, 08036, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036, Barcelona, Spain
| | - Maria Neufeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office) 9 Leontyevsky Pereulok, Moscow, Russian Federation, 125009
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle Upon Tyne, NE2 4AX, UK
| | - Benjamin Petruzelka
- First Faculty of Medicine and General Teaching Hospital Prague, Department of Addiction, Charles University, Apolinarska 4, 128 00, Prague 2, Czech Republic
| | - Vladimir Rogalewicz
- First Faculty of Medicine and General Teaching Hospital Prague, Department of Addiction, Charles University, Apolinarska 4, 128 00, Prague 2, Czech Republic
| | - Ingeborg Rossow
- Norwegian Institute of Public Health, Dept of Alcohol, Tobacco and Drugs, N-0213, Oslo, Norway
| | - Bernd Schulte
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 1P8, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario, M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 3M1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario, M5T 1R8, Canada
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8, b. 2, Moscow, Russian Federation, 119991
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Trowsdale S, Price M, Wilkins C, Tscharke B, Mueller J, Baker T. Quantifying nicotine and alcohol consumption in New Zealand using wastewater-based epidemiology timed to coincide with census. Drug Alcohol Rev 2021; 40:1178-1185. [PMID: 33715226 DOI: 10.1111/dar.13268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/19/2020] [Accepted: 01/24/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Accurate and timely information about nicotine and alcohol consumption is needed to inform effective policy. Wastewater-based epidemiology provides an opportunity to quantify consumption, which can complement traditional data collection methods. METHODS Wastewater samples were collected from seven wastewater treatment plants on seven consecutive days in three regions of New Zealand during the same week as the national census (6 March 2018). Samples were analysed for nicotine and alcohol metabolites using liquid chromatography-tandem mass spectrometry. Detailed catchment maps were developed and per capita consumption calculated. RESULTS Observed nicotine consumption (mean 1528 ± 412 cigarettes/day/1000 people) was similar to national sales data. Observed alcohol consumption (mean 1155 ± 764 standard drinks/day/1000 people) was lower than estimated using alcohol availability data. Consumption of nicotine and alcohol was generally higher in the Bay of Plenty and Canterbury compared to Auckland, mirroring trends in the New Zealand Health Survey. Intra-regional differences were observed and the patterns could not be attributed to urbanisation alone. Nicotine consumption was consistent throughout the week whereas alcohol consumption often peaked at the weekend. Nicotine consumption was correlated with neighbourhood-deprivation. There was little correlation for alcohol. DISCUSSION AND CONCLUSIONS Wastewater-based epidemiology provides a quantitative dataset that complements traditional methods of investigating nicotine and alcohol consumption. Timing data collection to coincide with the census helps to account for the influence of population mobility when normalising consumption.
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Affiliation(s)
- Sam Trowsdale
- School of Environment, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Mackay Price
- School of Environment, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Chris Wilkins
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Ben Tscharke
- Queensland Alliance for Environmental Health Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Jochen Mueller
- Queensland Alliance for Environmental Health Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Tom Baker
- School of Environment, Faculty of Science, University of Auckland, Auckland, New Zealand
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Alpers SE, Skogen JC, Mæland S, Pallesen S, Rabben ÅK, Lunde LH, Fadnes LT. Alcohol Consumption during a Pandemic Lockdown Period and Change in Alcohol Consumption Related to Worries and Pandemic Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031220. [PMID: 33572994 PMCID: PMC7908087 DOI: 10.3390/ijerph18031220] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 12/13/2022]
Abstract
Whether lockdown related to the COVID-19 pandemic influences alcohol consumption is not well known. This study assesses alcohol consumption and hazardous drinking behavior during the initial phase of pandemic measures in Norway and identifies potential risk factors. A cross-sectional study (N = 25,708) was conducted in Bergen, Norway, following the first six weeks of strict infection control measures. In a model of self-assessed increased alcohol consumption, logistic regression analysis was conducted with independent variables for COVID-19-related worries, joblessness, quarantine, self-reported drinking behavior, age, gender, and occupational situation. These are reported with odds ratios (ORs) with 95% confidence intervals. Fifty-one percent of respondents reported economic or health-related worries due to COVID-19, 16% had been in quarantine, 49% worked/studied from home, 54% reported hazardous drinking behavior, and 13% reported increased alcohol consumption. People aged 30–39 years had elevated odds of increased alcohol consumption during lockdown (OR 3.1, 2.4−3.8) compared to the oldest adults. Increased drinking was more frequent among people reporting economic worries (OR 1.6, 1.4−1.8), those quarantined (OR 1.2, 1.1−1.4), and those studying or working at home (OR 1.4, 1.3−1.6). More than half of respondents reported hazardous drinking behavior. Increased alcohol consumption during lockdown was common among people with economic worries, people in quarantine, and people studying or working at home. These data could be important when adjusting pandemic measures.
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Affiliation(s)
- Silvia Eiken Alpers
- Department of Addiction Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (L.-H.L.); (L.T.F.)
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, 5020 Bergen, Norway
- Correspondence:
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, 5015 Bergen, Norway;
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4021 Stavanger, Norway
- Alcohol & Drug Research Western Norway, Stavanger University Hospital, 4010 Stavanger, Norway
| | - Silje Mæland
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, 5020 Bergen, Norway;
- Research Unit for General Practice in Bergen, The Norwegian Research Centre, NORCE, 5008 Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, 5020 Bergen, Norway;
- Optentia Research Focus Area, North-West University, Vanderbijlpark 1900, South Africa
| | | | - Linn-Heidi Lunde
- Department of Addiction Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (L.-H.L.); (L.T.F.)
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, 5020 Bergen, Norway
| | - Lars Thore Fadnes
- Department of Addiction Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (L.-H.L.); (L.T.F.)
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, 5020 Bergen, Norway;
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López-Pelayo H, Campeny E, Oliveras C, Rehm J, Manthey J, Gual A, Balcells-Olivero MDLM. Early, Chronic, and Acute Cannabis Exposure and Their Relationship With Cognitive and Behavioral Harms. Front Psychiatry 2021; 12:643556. [PMID: 34434125 PMCID: PMC8381725 DOI: 10.3389/fpsyt.2021.643556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 07/08/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Cannabis is the third most consumed drug worldwide. Thus, healthcare providers should be able to identify users who are in need for an intervention. This study aims to explore the relationship of acute, chronic, and early exposure (AE, CE, and EE) to cannabis with cognitive and behavioral harms (CBH), as a first step toward defining risky cannabis use criteria. Methods: Adults living in Spain who used cannabis at least once during the last year answered an online survey about cannabis use and health-related harms. Cannabis use was assessed in five dimensions: quantity on use days during the last 30 days (AE), frequency of use in the last month (AE), years of regular use (YRCU) (CE), age of first use (AOf) (EE), and age of onset of regular use (AOr) (EE). CBH indicators included validated instruments and custom-made items. Pearson correlations were calculated for continuous variables, and Student's t-tests for independent samples were calculated for categorical variables. Effect sizes were calculated for each of the five dimensions of use (Cohen's d or r Pearson correlation) and harm outcome. Classification and Regression Trees (CART) analyses were performed for those dependent variables (harms) significantly associated with at least two dimensions of cannabis use patterns. Lastly, logistic binary analyses were conducted for each harm outcome. Results: The mean age of participants was 26.2 years old [standard deviation (SD) 8.5]. Out of 2,124 respondents, 1,606 (75.6%) reported at least one harm outcome (mean 1.8 and SD 1.5). In our sample, using cannabis on 3 out of 4 days was associated with an 8-fold probability of scoring 4+ on the Severity Dependence Scale (OR 8.33, 95% CI 4.91-14.16, p <0.001), which is indicative of a cannabis use disorder. Also, a start of regular cannabis use before the age of 25 combined with using cannabis at least once per month was associated with a higher probability of risky alcohol use (OR 1.33, 95% CI 1.12-1.57, p = 0.001). Besides, a start of regular cannabis use before the age of 18 combined with a period of regular use of at least 7.5 years was associated with a higher probability of reporting a motor vehicle accident (OR 1.81, 95% CI 1.41-2.32, p < 0.0001). Results were ambiguous regarding the role that age of first use and milligrams of THC per day of use might play regarding cannabis-related harms. Conclusions: The relationship among AE, CE, and EE with CBH indicators is a complex phenomenon that deserves further studies. The pattern of cannabis use should be carefully and widely evaluated-(not just including frequency but also other dimensions of pattern of use)-in research (preferably in longitudinal studies) to assess cannabis-related harms.
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Affiliation(s)
- Hugo López-Pelayo
- Grup Recerca en Addiccions Clinic (GRAC), Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Psychiatry Department, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Eugènia Campeny
- Grup Recerca en Addiccions Clinic (GRAC), Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Clara Oliveras
- Grup Recerca en Addiccions Clinic (GRAC), Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Psychiatry Department, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Jürgen Rehm
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Dalla Lana School of Public Health, University of Toronto (UofT), Toronto, ON, Canada.,Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Jakob Manthey
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research of Hamburg University (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Antoni Gual
- Grup Recerca en Addiccions Clinic (GRAC), Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Psychiatry Department, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maria de Las Mercedes Balcells-Olivero
- Grup Recerca en Addiccions Clinic (GRAC), Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Psychiatry Department, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
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Huckle T, Parker K, Romeo JS, Casswell S. Online alcohol delivery is associated with heavier drinking during the first New Zealand COVID-19 pandemic restrictions. Drug Alcohol Rev 2020; 40:826-834. [PMID: 33283442 PMCID: PMC7753625 DOI: 10.1111/dar.13222] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 01/07/2023]
Abstract
Introduction This paper aimed to assess purchasing and drinking behaviour during the first COVID‐19 pandemic restrictions in New Zealand. Method A convenience sample was collected via Facebook from 2173 New Zealanders 18+ years during pandemic restrictions April/May 2020. Measures included: the quantity typically consumed during a drinking occasion and heavier drinking (6+ drinks on a typical occasion) in the past week; place of purchase including online alcohol delivery. Descriptive statistics were generated, logistic and linear regression models predicted heavier drinking and typical occasion quantity, respectively. Weighting was not applied. Results During pandemic restrictions, around 75% of respondents purchased from supermarkets, 40% used online alcohol delivery services (18% for the first time during COVID‐19). Purchasing online alcohol delivery during pandemic restrictions was associated with heavier drinking (75% higher odds) in the past week, while purchasing from supermarkets was not. About 58% of online purchasers under 25 reported no age checks. Sixteen percent of those purchasing online repeat ordered online to keep drinking after running out. Of respondents who had tried to buy alcohol and food online, 56% reported that alcohol was easier to get delivered than fresh food. Advertising for online alcohol delivery was seen by around 75% of the sample. Half of the sample reported drinking more alcohol during the restrictions. Discussion and Conclusions Online alcohol delivery during the COVID‐19 pandemic restrictions was associated with heavier drinking in the past week. The rapid expansion of online alcohol delivery coupled with a lack of regulatory control requires public health policy attention.
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Affiliation(s)
- Taisia Huckle
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Karl Parker
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Jose S Romeo
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Sally Casswell
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
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Manthey J, Kilian C, Schomerus G, Kraus L, Rehm J, Schulte B. Alkoholkonsum in Deutschland und Europa während der SARS-CoV-2 Pandemie. SUCHT-ZEITSCHRIFT FUR WISSENSCHAFT UND PRAXIS 2020. [DOI: 10.1024/0939-5911/a000686] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Zusammenfassung. Zielsetzung: Ziel der vorliegenden Studie war, die Veränderung des Alkoholkonsums während der SARS-CoV-2 Pandemie in Deutschland zu untersuchen und mit derer anderer europäischer Länder zu vergleichen. Methodik: Analyse von soziodemographischen und sozioökonomischen Daten sowie Angaben zur Veränderung des Alkoholkonsums seit der Pandemie in einer europaweiten Onlinebefragung (n=40.064) aus 21 Ländern. Zur Anpassung an die Bevölkerungsverteilung in den Ländern erfolgte eine Gewichtung anhand von Geschlecht, Alter und Bildungsabschluss. Ergebnisse: Seit Beginn der Pandemie wurde im Mittel weniger Alkohol getrunken. Der Rückgang des Konsums ist vor allem auf eine Reduktion der Gelegenheiten zum Rauschtrinken zurückzuführen. Der Alkoholkonsum ist in Deutschland weniger stark als in anderen Europäischen Ländern zurückgegangen. Gründe dafür sind Zunahmen im Alkoholkonsum bei Frauen sowie bei Personen, die negative Auswirkungen in Beruf und Finanzen erlebt haben und bei Personen mit riskanten Konsummustern. Schlussfolgerungen: Um den negativen Folgen des in Teilgruppen verstärkten Alkoholkonsums während der Pandemie entgegenzuwirken, sollte die Verfügbarkeit von Alkohol durch eine sinnvolle Besteuerung reduziert sowie eine Ausweitung routinemäßiger Alkoholscreenings in der allgemeinärztlichen Versorgung umgesetzt werden.
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Affiliation(s)
- Jakob Manthey
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
- Zentrum für Interdisziplinäre Suchtforschung (ZIS), Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf (UKE)
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig
| | - Carolin Kilian
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
| | - Georg Schomerus
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, München
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Schweden
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Ungarn
| | - Jürgen Rehm
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Kanada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Kanada
- Department of Psychiatry, University of Toronto, Toronto, Kanada
- Department of International Health Projects, Institute for Leadership and Health Management, I. M. Sechenov First Moscow State Medical University, Moskau, Russland
| | - Bernd Schulte
- Zentrum für Interdisziplinäre Suchtforschung (ZIS), Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf (UKE)
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Greenfield TK. The elusiveness of representativeness in general population surveys for alcohol: Commentary on Rehm et al. Drug Alcohol Rev 2020; 40:169-170. [PMID: 32959395 DOI: 10.1111/dar.13168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 11/28/2022]
Abstract
Concurring with the authors of Rehm et al., this comment endorses their recommendations, but points out that adult household population surveys will still be valuable in cross-sectional and panel series long based on this frame, recognising too that to fully account for heavy drinkers beyond this frame, though valuable, is onerous (by providing one rigorous example from a county study). Last, the importance of attending to improved alcohol pattern measurement to partly close the gap in population survey coverage is essential as well.
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Rehm J, Kilian C, Manthey J. Future of surveys in the alcohol field. Drug Alcohol Rev 2020; 40:176-178. [PMID: 32959438 DOI: 10.1111/dar.13180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/04/2020] [Accepted: 09/04/2020] [Indexed: 11/27/2022]
Abstract
Responding to the commentaries on a recent paper on the elusiveness of representativeness in general population alcohol surveys, we can summarise that there is agreement that the status quo of current alcohol surveys is scientifically no longer defensible. Current surveys cannot per se be assumed to yield representative results for the general populations of countries based on a probabilistic sampling alone. Alternatives are discussed and-as for any survey-creative ideas on validating key results on indicators or hypotheses need to be developed and used. This will inevitably lead away from omnibus surveys to more focused studies requiring more complex methodological tools. While there may not be obvious solutions for every problem related to alcohol use prevention and policy or treatment use disorders, and it may take years to find solutions for some of the issues, continued use of the methodology of the status quo will surely fail to answer the questions posed by modern societies concerning these issues.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.,Institute of Clinical Psychology and Psychotherapy and Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.,WHO Collaborating Centre-Barcelona (Currently in Development), Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy and Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy and Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.,Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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Robinson M, Kibuchi E, Gray L, McCartney G. Approaches to triangulation of alcohol data in Scotland: Commentary on Rehm
et al
. Drug Alcohol Rev 2020; 40:173-175. [DOI: 10.1111/dar.13164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 08/18/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Mark Robinson
- Institute for Social Science Research University of Queensland Brisbane Australia
- Institute of Health and Wellbeing University of Glasgow Glasgow United Kingdom
| | - Eliud Kibuchi
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit University of Glasgow Glasgow United Kingdom
| | - Linsay Gray
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit University of Glasgow Glasgow United Kingdom
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