The joint association of average volume of alcohol and binge drinking with hazardous driving behaviour and traffic crashes

Primary graft dysfunction following lung transplantation: From pathogenesis to future frontiers

Lung transplantation is the treatment of choice for patients with end-stage lung disease. Currently, just under 5000 lung transplants are performed worldwide annually. However, a major scourge leading to 90-d and 1-year mortality remains primary graft dysfunction. It is a spectrum of lung injury ranging from mild to severe depending on the level of hypoxaemia and lung injury post-transplant. This review aims to provide an in-depth analysis of the epidemiology, pathophysiology, risk factors, outcomes, and future frontiers involved in mitigating primary graft dysfunction. The current diagnostic criteria are examined alongside changes from the previous definition. We also highlight the issues surrounding chronic lung allograft dysfunction and identify the novel therapies available for ex-vivo lung perfusion. Although primary graft dysfunction remains a significant contributor to 90-d and 1-year mortality, ongoing research and development abreast with current technological advancements have shed some light on the issue in pursuit of future diagnostic and therapeutic tools.

Cognitive Biases, Risk Perception, and Risky Driving Behaviour

This study evaluated the relationship between drivers’ cognitive biases (i.e., optimism bias, illusion of control) and risky driving behaviour. It also investigated the mediational role of risk perception in the relationship between cognitive biases and self-reported risky driving. The sample included 366 drivers (Mage = 39.13, SD = 13.63 years) who completed scales measuring optimism bias, illusion of control, risk perception, and risky driving behaviour, as well as demographic information. The results showed that risky driving behaviour was negatively predicted by optimism bias and positively predicted by the illusion of control. Further, risk perception negatively correlated with risky behaviour and also mediated the relation between both optimism bias and illusion of control with risky driving. The practical implications of these results for traffic safety and future research are discussed.

The limits of measuring binge drinking prevalence for epidemiological surveillance: An example from Spain

BACKGROUND

The public health impact of binge drinking depends on its population prevalence and its frequency and intensity among binge drinkers. The objective is to assess the consistency of time trends and age-sex disparities between binge-drinking prevalence and binge-drinking exposure indicators that combine such prevalence with the number of binge-drinking days among binge drinkers.

METHODS

Data come from 11 biennial national household surveys from 1997 to 2017 in young (15-34 years) and middle-aged adults (35-64 years) in Spain (n = 211,961). Binge-drinking was the intake of 5+ standard drinks (4+ in women from 2009 onwards) in approximately two hours. Three monthly indicators were analyzed: binge-drinking prevalence, population rate of binge-drinking days, and proportion of drinking days with binge drinking. Results were stratified for sex and two age groups. Annual percent changes (APCs), ratios of young to middle-aged people (age ratios) and men-to-women ratios were obtained from negative binomial regression.

RESULTS

Although the three indicators showed considerable consistency as an intense increase in binge drinking from 2009 to 2017 among middle-aged people, especially women, there were relevant inconsistencies. In 2009-2017 the APCs for prevalence and rate were +1.3 % and -1.6 %, respectively, in young women, and -0.6 % and -3.0 % in young men. Age ratios were significantly higher for prevalence and proportional ratio than rates, while men-to-women ratios were lower, especially in middle-aged people.

CONCLUSIONS

Adequate monitoring of binge drinking should incorporate indicators of absolute exposure, which better reflect its impact on public health, such as the population rate of binge-drinking days.

The Use of Alcohol, Tobacco, Illegal Drugs and Medicines: An Estimate of Consumption and Substance-Related Disorders in Germany

BACKGROUND

Prevalence estimates of the use of tobacco, alcohol, illegal drugs, and psychoactive medications and of substance-related disorders enable an assessment of the effects of substance use on health and society.

METHODS

The data used for this study were derived from the 2018 Epidemiological Survey of Substance Abuse (Epidemiologischer Suchtsurvey, ESA). The sample of the German adult population comprised 9267 persons aged 18 to 64 (response rate, 42%). Population estimates were obtained by extrapolation to a total resident population of 51 544 494 people.

RESULTS

In the 30 days prior to the survey, 71.6% of the respondents (correspond- ing to 36.9 million persons in the population) had consumed alcohol, and 28.0% (14.4 million) had consumed tobacco. 4.0% reported having used e-cigarettes, and 0.8% reported having used heat-not-burn products. Among illegal drugs, cannabis was the most commonly used, with a 12-month prevalence of 7.1% (3.7 million), followed by amphetamines (1.2%; 619 000). The prevalence of the use of anal- gesics without a prescription (31.4%) was markedly higher than that of the use of prescribed analgesics (17.5%, 26.0 million); however, analgesics were taken daily less commonly than other types of medication. 13.5% of the sample (7.0 million) had at least one dependence diagnosis (12-month prevalence).

CONCLUSION

Substance use and the consumption of psychoactive medications are widespread in the German population. Substance-related disorders are a major burden to society, with legal substances causing greater burden than illegal substances.

Cross-country comparison of proportion of alcohol consumed in harmful drinking occasions using the International Alcohol Control Study

INTRODUCTION AND AIMS

This study examines the proportion of alcohol markets consumed in harmful drinking occasions in a range of high-, middle-income countries and assesses the implications of these findings for conflict of interest between alcohol producers and public health and the appropriate role of the alcohol industry in alcohol policy space.

DESIGN AND METHODS

Cross-sectional surveys were conducted in 10 countries as part of the International Alcohol Control study. Alcohol consumption was measured using location- and beverage-specific measures. A level of consumption defined as harmful use of alcohol was chosen and the proportion of the total market consumed in these drinking occasions was calculated for both commercial and informal alcohol.

RESULTS

In all countries, sizeable proportions of the alcohol market were consumed during harmful drinking occasions. In general, a higher proportion of alcohol was consumed in harmful drinking occasions by respondents in the middle-income countries than respondents in the high-income countries. The proportion of informal alcohol consumed in harmful drinking occasions was lower than commercial alcohol.

DISCUSSION AND CONCLUSIONS

Informal alcohol is less likely to be consumed in harmful drinking occasions compared with commercial alcohol. The proportion of commercial alcohol consumed in harmful drinking occasions in a range of alcohol markets shows the reliance of the transnational alcohol corporations on harmful alcohol use. This reliance underpins industry lobbying against effective policy and support for ineffective approaches. The conflict of interest between the alcohol industry and public health requires their exclusion from the alcohol policy space.

Binge drinking affects brain oscillations linked to motor inhibition and execution

INTRODUCTION

Neurofunctional studies have shown that binge drinking patterns of alcohol consumption during adolescence and youth are associated with anomalies in brain functioning. Recent evidence suggests that event-related oscillations may be an appropriate index of neurofunctional damage associated with alcoholism. However, there is no study to date that has evaluated the effects of binge drinking on oscillatory brain responses related to task performance. The purpose of the present study was to examine brain oscillations linked to motor inhibition and execution in young binge drinkers (BDs) compared with age-matched controls.

METHODS

Electroencephalographic activity was recorded from 64 electrodes while 72 university students (36 controls and 36 BDs) performed a visual Go/NoGo task. Event-related oscillations along with the Go-P3 and NoGo-P3 event-related potential components were analysed.

RESULTS

While no significant differences between groups were observed regarding event-related potentials, event-related oscillation analysis showed that BDs displayed a lower oscillatory response than controls in delta and theta frequency ranges during Go and NoGo conditions.

CONCLUSIONS

Findings are congruent with event-related oscillation studies showing reduced delta and/or theta oscillations in alcoholics during Go/NoGo tasks. Thus, BDs appear to show disruptions in neural oscillations linked to motor inhibition and execution similar to those observed in alcohol-dependent subjects. Finally, these results are the first to evidence that oscillatory brain activity may be a sensitive indicator of underlying brain anomalies in young BDs, which could complement standard event-related potential measures.

Heavy episodic drinking and alcohol-related injuries: An open cohort study among college students

AIM

The objective of this study is to assess the effects of Heavy Episodic Drinking (HED) on the incidence of alcohol-related injuries among university students in Spain, taking sex into consideration.

METHODS

We carried out an open cohort study among college students in Spain (992 women and 371 men). HED and alcohol-related injuries were measured by question 3rd and 9th of Alcohol Use Disorders Identification Test to every participant at the ages of 18, 20, 22, 24 and 27. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for alcohol and cannabis use.

RESULTS

The incidence rate of alcohol-related injuries was 0.028year^-1 for females and 0.036year^-1 for males. The multivariate analysis showed that among females a high frequency of HED and use of cannabis are risk factors for alcohol-related injuries (Odds Ratio [OR]=2.64 and OR=3.68), while being more than 23 is a protective factor (OR=0.34). For males, bivariate analysis also showed HED like risk factor (OR=4.69 and OR=2.51). Finally, the population attributable fraction for HED among females was 37.12%.

CONCLUSIONS

HED leads to an increase of alcohol-related injuries in both sexes and being over 23 years old acts as a protective factor among women. Our results suggest that about one third of alcohol-related injuries among women could be avoided by removing HED.

Risky consumption, reasons for use, migratory status and normalization: the results of an Italian study on minors aged between 13 and 16

Purpose

The purpose of this paper is to describe the relationship between migratory status, the use of legal and illegal psychoactive substances and psychological disorders perceived in a sample of minors.

Design/methodology/approach

A transversal multicentre study was carried out with interviews with young people aged 13-16 years recruited from middle and high schools in Italy.

Findings

The results show the implementation of a process of normalization in terms of the presence of legal and illegal psychoactive substances in the living contexts of the minors, of their widespread early use and of a substantial indifferentiation in the reasons for use (e.g. pleasure, curiosity, fun). Youths born in Italy with at least one non-native parent are noteworthy for an elevated prevalence of perceived psychological disorders and for particular lifestyles linked to the use of marijuana, alcohol abuse and the intensive consumption of tobacco. Second-generation minors show symptoms of psychological malaise, anxiety and depression before which the use of substances appears to realize a particular form of self-cure.

Research limitations/implications

This study presents some objective limits that indicate prudence in generalizing the results: only those who obtained consent from their parents were interviewed and the information communicated in the interviews could have been influenced by various factors, including the situation and the location. The authors used a standard definition of binge-drinking (Valencia-Martín et al., 2008). Actually, different criteria (i.e. number of drinks, time of consumption, etc.) and formulations of the question are used in different surveys, showing that there is as yet no consensus definition of binge-drinking. Nevertheless, the term has become somewhat confusing as it is often used as a synonym of drunkenness, making cross-cultural comparisons difficult (Beccaria et al., 2014). These are aspects that limit the generalizability of the results to the interviews alone and do not allow for prevalence estimates. Nevertheless, the results offer useful indications for future prevention projects specifically oriented to early adolescence.

Practical implications

The results of the study, on the one hand, document the growing use of legal and illegal proactive substances among minors and the relative cultural trend in this particular age band, testified to by the high number of those who have been present in situations of consumption to whom the substances were offered; on the other, they evidence a subpopulation of youths born in Italy with at least one non-native parent (i.e. second generation of immigrants). These youths stand out for an elevated prevalence of perceived psychological disorders and for their particular lifestyles connected to the use of marijuana, alcohol abuse and the intensive consumption of alcohol. This is also the group with the highest percentage of mothers alone in the family.

Social implications

A group of adolescents living in a monoparental family, that is, with the mother alone emerges, and as the literature has shown, family structure and poverty are linked (Landale et al., 2011; Svensson and Hagquist, 2009). In fact, such mothers, even those with a high level of education, are mostly unemployed. Adolescents with a single parent often not only face resource deficits but also other risk factors, such as high family stress, inadequate supervision, multiple family transitions and frequent residential moves. Specifically, these second-generation adolescents are female and they manifest sensation-seeking behaviours, but without drug abuse.

Originality/value

The results of the study show new and little-known aspects of the multicultural Italian society that is changing profoundly that should be explored in more detail by targeted research that also focussed on structural factors relatable to specific social positions. In this framework, a particular subgroup, i.e. the second-generation minors, shows symptoms of psychic malaise, anxiety and depression in terms of which substance use seems to realize a form of self-cure.

Students worry about the impact of alcohol on quality of life: Roles of frequency of binge drinking and drinker self-concept

INTRODUCTION

The aim of this study was to clarify the impact of binge drinking, its intensity and frequency, and drinker self-concept on health-related quality-of-life (HRQOL) in students.

METHODS

This cross-sectional online survey included 16,930 students. We collected sociodemographics, environmental data, and drinking behaviors. We assessed HRQOL using the Alcohol Quality-of-Life scale, which explicitly explores the subjective negative impact on quality of life one attributes to his relationship with alcohol and the degree to which drinking is a part of an individual's self-concept. Data analyses were performed in 2015 and 2016. We described and compared binge drinkers and non-binge drinkers. Using a regression model we identified the independent factors associated with HRQOL.

RESULTS

The impact on HRQOL attributed to alcohol was significantly greater among binge drinkers. Factors of impact on HRQOL subjectively attributed to alcohol by students were: AUDIT-C score, interaction between gender and AUDIT-C score, strong individual identity as a drinker, binge-drinking frequency, financial difficulties, being a foreigner, fewer years since diploma, chronic condition, recent use of cannabis, psychostimulant, poppers or gambling. Sleep quality, ability to work, expenditure on alcohol, shame, and health-related concerns were the most strongly impacted quality of life areas.

CONCLUSIONS

Binge-drinking frequency should be considered as an important target in prevention programs. In addition, integrating findings on students' subjective perceptions of impairment of HRQOL by alcohol could enable the development of more acceptable and more relevant prevention messages.

Prevalence of at-risk drinking among Brazilian truck drivers and its interference on the performance of executive cognitive tasks

BACKGROUND

Binge drinking (BD) has been associated with an increase in the risk of alcohol-related injuries. Alcohol continues to be the main substance consumed by truck drivers, a population of special concern, since they are often involved in traffic accidents. The aim of this study was to estimate the prevalence of BD and its interference in the executive functioning among truck drivers in Sao Paulo, Brazil.

METHODS

A non-probabilistic sample of 684 truck drivers was requested to answer a structured research instrument on their demographic data and alcohol use. They performed cognitive tests to assess their executive functioning and inventories about confounding variables. The participants were then divided according to their involvement in BD.

RESULTS

17.5% of the interviewees have reported being engaged in BD. Binge drinkers showed a better performance on one test, despite having done so at the expense of more mistakes and lower accuracy. More interestingly, binge drinkers took three seconds longer than non-binge drinkers to inhibit an inadequate response, which is worrisome in the context of traffic. Overall, the deleterious effect of BD on performance remained after controlling for the effects of confounding variables in regression logistic models.

CONCLUSIONS

As the use of alcohol among truck drivers may be as a way to get by with their work conditions, we believe that a negotiation between their work organization and public authorities would reduce such use, preventing negative interferences on truck drivers' cognitive functioning, which by its turn may also prevent traffic accidents.

First Consumers, Then Socially Integrated: Results of a Study on 100 Italian Drug Users Who Had Never Turned to Public or Private Addiction Services

This study, which addressed a per quota sample of 100 socially integrated drug users (SID) residing in Emilia Romagna (Italy) who have never referred to a public/private Addiction Service, has four main aims: (1) to describe the phenomenology of substance use in all its different facets; (2) to identify feared unwanted consequences due to the use of illegal substances and possible behaviors finalized to preventing them; (3) to identify possible common consumption rules; (4) to identify any differences among the SID. Two types of consumers have been compared: the "law-breakers" (i.e. those who have committed an illegal activity to procure money) and the "law-abiders" (no such action).From the interviewees some discontinuous consumption trajectories over time are reported in relation to the different levels of disposable income and the change in the relationship with the substances. Most of these consumers fear being stigmatized or labeled as drug-addicts, and cause themselves physical, psychological or economic harm; instead only a minority fear developing addiction. The most widespread protective behavior is to purchase through trusted direct channels, followed by the attempt to limit the doses and to consume only in positive emotional states. Rules of conduct implemented at a general level by all the consumers were evidenced, which the law-breakers finalize towards a greater attention to their own psycho-physical health and to better handling the effects produced by the substances, while the law-abiders seek to keep their status as consumers secret.

Independent and combined associations of risky single-occasion drinking and drinking volume with alcohol use disorder: Evidence from a sample of young Swiss men

BACKGROUND

Risky single-occasion drinking (RSOD) is a prevalent and potentially harmful alcohol use pattern associated with increased alcohol use disorder (AUD). However, RSOD is commonly associated with a higher level of alcohol intake, and most studies have not controlled for drinking volume (DV). Thus, it is unclear whether the findings provide information about RSOD or DV. This study sought to investigate the independent and combined effects of RSOD and DV on AUD.

METHODS

Data were collected in the longitudinal Cohort Study on Substance Use Risk Factors (C-SURF) among 5598 young Swiss male alcohol users in their early twenties. Assessment included DV, RSOD, and AUD at two time points. Generalized linear models for binomial distributions provided evidence regarding associations of DV, RSOD, and their interaction.

RESULTS

DV, RSOD, and their interaction were significantly related to the number of AUD criteria. The slope of the interaction was steeper for non/rare RSOD than for frequent RSOD.

CONCLUSIONS

RSOD appears to be a harmful pattern of drinking, associated with increased AUD and it moderated the relationship between DV and AUD. This study highlighted the importance of taking drinking patterns into account, for both research and public health planning, since RSO drinkers constitute a vulnerable subgroup for AUD.

Evolution of the binge drinking pattern in college students: neurophysiological correlates

It is well known that alcohol impairs response inhibition and that adolescence is a critical period of neuromaturation where cognitive processes such as inhibitory control are still developing. In recent years, growing evidence has shown the negative consequences of alcohol binge drinking on the adolescent and young human brain. However, the effects of cessation of binge drinking on brain function remain unexplored. The objective of the present study was to examine brain activity during response execution and inhibition in young binge drinkers in relation to the progression of their drinking habits over time. Event-related potentials (ERPs) elicited by a Go/NoGo task were recorded twice within a 2-year interval in 57 undergraduate students (25 controls, 22 binge drinkers, and 10 ex-binge drinkers) with no personal or family history of alcoholism or psychopathological disorders. The results showed that the amplitude of NoGo-P3 over the frontal region correlated with an earlier age of onset of regular drinking as well as with greater quantity and speed of alcohol consumption. Regression analysis showed that NoGo-P3 amplitude was significantly predicted by the speed of alcohol intake and the age of onset of regular drinking. The group comparisons showed that, after maintaining a binge drinking pattern for at least 2 years, binge drinkers displayed significantly larger NoGo-P3 amplitudes than controls, whereas ex-binge drinkers were in an intermediate position between the two other groups (with no significant differences with respect to controls or binge drinkers). These findings suggest that binge drinking in young people may impair the neural functioning related to inhibitory processes, and that the cessation of binge drinking may act as a brake on the neurophysiological impairments related to response inhibition.

Three-year changes in drinking patterns in Spain: a prospective population-based cohort study

BACKGROUND

This study examined changes in alcohol drinking patterns (DP) and associated variables in a Mediterranean country.

METHODS

Changes in DP between baseline (2008-2010) and follow-up (2012-2013) were examined on a Spanish population-based cohort of 2254 adults (18-59 years) using multinomial logistic regression. Heavy consumption was defined as ≥40 g/day of alcohol in men (≥24 g/day in women) and binge drinking (BD) as the intake of ≥80 g of alcohol in men (≥60 g in women) on one occasion in the previous month. Six patterns were defined: (1) non-drinkers; (2) ex-drinkers; (3) moderate drinkers without BD (MNB); (4) moderate drinkers with BD (MB); (5) heavy drinkers without BD (HNB); and (6) heavy drinkers with BD (HB).

RESULTS

Overall, 45.2% of participants changed DP during follow-up. Over 24% of non-drinkers and 19.4% of ex-drinkers at baseline qualified as MNB at follow-up. The largest flow was from HNB to MNB (57.1%). Light-drinking patterns experienced the largest gains (ex-drinkers: 37.5% and MNB: 66.7%) by absorbing individuals lost by heavy-drinking patterns (MB: 50.8% and HNB: 48.4%). Men, younger individuals, and current smokers were more likely to report heavy-drinking patterns at one or both assessments. Being married or employed increased the likelihood of reporting light-drinking patterns at both surveys (p<0.05). Improving physical quality of life and exercise were associated with a shift from light- to heavy-drinking pattern during follow-up (p<0.05).

CONCLUSIONS

DP in Spain changed over 3 years with a tendency to "regress" toward moderate patterns. Repeated measures of alcohol intake may reduce classification errors and biased results when examining the impact of alcohol on health.

The link between early onset drinking and early onset alcohol-impaired driving in young males

BACKGROUND

Young drivers represent a disproportionate number of the individuals involved in alcohol-impaired driving. Although there is a known association between drinking and alcohol-impaired driving in young drivers, the link between early onset drinking and early onset alcohol-impaired driving has not been explored.

OBJECTIVES

The present study aimed to assess this link along with potentially confounding factors.

METHODS

The assessment used a proportional hazards model with data collected from the Buffalo Longitudinal Study of Young Men, a population-based sample of 625 males at aged 16-19.

RESULTS

Controlling for the effects of potentially relevant confounds, the early onset of drinking was the most influential factor in predicting the early onset of alcohol-impaired driving. Race and the early onset of other forms of delinquency also played a significant role in the early onset of alcohol-impaired driving.

CONCLUSION

Preventing an early start of drinking among adolescents may be the most critical factor to address in preventing an early start of alcohol-impaired driving.

Self-control and the effects of movie alcohol portrayals on immediate alcohol consumption in male college students

BACKGROUND

In movies, alcohol-related cues are frequently depicted and there is evidence for a link between movie alcohol cues and immediate alcohol consumption. Less is known about factors influencing immediate effects movie alcohol exposure on drinking. The exertion of self-control is thought to be important in avoiding or resisting certain temptations.

AIMS

The aim of the present study was to assess the immediate effects of movie alcohol portrayals on drinking of male social drinkers and to assess the moderating role of self-control in this relation. It was hypothesized that participants would drink more when exposed to movie alcohol portrayals and that especially participants with low self-control would be affected by these portrayals.

METHODS

A between-subjects design comparing two movie conditions (alcohol or no portrayal of alcohol) was used, in which 154 pairs of male friends (ages 18-30) watched a 1-h movie in a semi-naturalistic living room setting. Their alcohol consumption while watching was examined. Participants completed a questionnaire assessing self-control as well as their self-reported weekly alcohol use. A multivariate regression analysis was conducted to test the effects of movie condition on alcohol comsumption.

RESULTS

Self-control moderated the relation between movie condition and alcohol consumption. Assignment to the alcohol movie condition increased alcohol consumption during the movie for males with high self-control but not for males with low self-control.

CONCLUSION

Viewing a movie with alcohol portrayals can lead to higher alcohol consumption in a specific sample of young men while watching a movie.

Binge drinking in Spain, 2008-2010

BACKGROUND

Most alcohol-related research has focused on northern and eastern Europe and the United States. Data on Mediterranean countries point to drinking patterns approaching the sporadic and excessive patterns found in northern and eastern Europe. This is the first study to estimate the prevalence of binge drinking (BD) and the joint distribution of BD, regular heavy alcohol consumption, and alcohol abuse or dependence (AAD) in a nationally representative sample of the adult population of Spain.

METHODS

Cross-sectional study conducted in 2008 to 2010 with 9,130 persons aged 18 to 64 years. BD was defined as intake of ≥80 g of alcohol in men (≥60 g in women) during any drinking occasion in the previous month, with ≥3 BD episodes discriminating between frequent and sporadic BD. Regular alcohol consumption was measured with a validated diet history, and the threshold between moderate and heavy drinking was ≥40 g of alcohol/d in men (≥24 g in women). AAD was defined by a CAGE score ≥2.

RESULTS

BD prevalence was 10% (95% confidence interval [CI]: 8.8 to 11.2) in men and 4.2% (95% CI: 3.5 to 4.8) in women, and proved highest among 18- to 24-year-olds (19.5% in men and 10.3% in women). During the latest BD episode, men consumed a mean of 114 g of alcohol versus 85.3 g in women; spirits accounted for 65.2 and 66.2% of total intake, respectively. The mean number of monthly BD episodes was 2.3 in men and 2 in women. Among binge drinkers, 61% were 18- to 34-year-olds, over 80% had regular moderate drinking, 25% reported frequent BD, and 22.8% reported AAD. In multivariate analyses, sporadic BD and frequent BD were associated with AAD independently of regular alcohol intake.

CONCLUSIONS

Prevalence of BD in Spain is moderately high. Prevention interventions should consider that the majority of binge drinkers are young men with regular moderate consumption and no AAD traits.

Lifetime and twelve-month prevalence of heavy-drinking in Singapore: results from a representative cross-sectional study

Background

The study aimed to establish the prevalence of heavy drinking, evaluate correlations between heavy drinking and socio-demographic factors, physical and psychiatric conditions, and assess the impact of heavy drinking on quality of life and days of work-loss.

Methods

Data from a nationally-representative cross-sectional sample were used. The sample comprised 6616 community-dwelling Singaporeans & Singapore Permanent Residents. The main instruments used were the World Mental Health Composite International Diagnostic Interview and EuroQol 5D. Heavy drinking was defined as consumption of 4 or more drinks, or 5 or more drinks in a day in women and men respectively.

Results

12.6% of all adult Singapore residents reported heavy drinking in the last 12 months, and 15.9% reported lifetime heavy-drinking. Strong gender, ethnic, age and income differences were seen. Heavy drinking was positively associated with major depression, the presence of any mood disorder, and with chronic pain. It was also strongly associated with alcohol dependence, alcohol abuse, and nicotine dependence. Heavy-drinkers reported lower quality of life compared to non-heavy drinkers, measured using the EuroQol 5D Visual Analogue Scale.

Conclusions

Singapore has a relatively high prevalence of 12-month heavy drinking of 12.6%, and lifetime heavy drinking of 15.9%. Heavy drinking was positively associated with both physical and mental health conditions, and with declines in quality of life. Continued monitoring of heavy drinking behavior and sustained efforts to mitigate the risks associated with heavy drinking is needed.

Regional differences associated with drinking and driving in Brazil

OBJECTIVE

To evaluate regional differences and similarities associated with drinking and driving (DUI) in the five Brazilian macro-regions.

METHOD

A roadside survey was conducted in the 27 Brazilian state capitals. A total of 3,398 drivers were randomly selected and given a structured interview and a breathalyzer test. To determine the predictors of positive blood alcohol concentration (BAC) in each region, a MANOVA was performed, and 3 groups were used as follows: 1) North and Northeast, 2) South and Midwest, and 3) Southeast. A Poisson robust regression model was performed to assess the variables associated with positive BAC in each group.

RESULTS

Of all surveyed drivers, 2,410 had consumed alcohol in the previous 12 months. Most were male, with a median age of 36. Leisure as the reason for travel was associated with positive BAC in all 3 groups. Low schooling, being older than 30, driving cars or motorcycles and having been given a breathalyzer test at least once in their lives predicted DUI in at least two different groups.

CONCLUSIONS

Factors , especially low schooling and leisure as a reason for travel, associated with drinking and driving were similar among regions, although certain region-specific features were observed. This information is important for aiming to reduce DUI in the country.

Household social characteristics of the demand for alcoholic beverages among Spanish students

This paper studies how household social capital affects adolescents' demand for alcoholic drinks. To that end, we focus on a theoretical framework that combines elements from the Model of Rational Addiction and the Model of Social Economics. For the empirical framework, we use a simultaneous Type II Tobit model, with data drawn from the Spanish National Survey on Drug Use in the School Population (2000, 2002, and 2004). The sample is comprised of 12,627 students aged 17 years old. Our results confirm that parents' decisions about drinking are even more decisive in their children's behavior than socioeconomic variables, such as parents' educative levels or working status. Parental responsibilities go beyond the endowment of health and educational goods and services; so, these results suggest the importance of designing family-drug use prevention programs. The study's limitations are noted.

Traffic crashes and alcohol outlets in a Brazilian state capital

OBJECTIVE

Restricting alcohol outlets is being considered as a measure for preventing alcohol-related crashes. However, in many developing countries, alcohol availability is not regulated and its influence on motor vehicle traffic crashes is unknown. This study explores the association between traffic crashes and alcohol outlets in a Brazilian city.

METHOD

Data were geocoded and exploratory analysis was conducted using the kernel density estimator. Two generalized additive models (GAMs) were implemented to predict the factors associated with alcohol-related crashes.

RESULTS

For 78 percent of the 3840 traffic crashes where the driver was a victim, there was at least one bar located within a 300-m radius. The median distances between an outlet were 124.4 and 130.7 m for a non-alcohol- and alcohol-related crashes, respectively (P =.13). The GAMs did not make evident any significant association between the outlet locations and alcohol-related crashes: the presence of at least one outlet was associated with alcohol-related crashes with an odds ratio (OR) of 0.94 (95% confidence interval [CI] = 0.75-1.17). Alcohol crashes are more likely to be observed among males (OR = 1.58; 95% CI = 1.21-2.06), young drivers vs. those aged 50 years+ (OR = 3.4; 95% CI = 1.79-6.43), and crashes with fatalities (OR = 1.73; 95% CI = 0.98-3.04).

CONCLUSIONS

Density of alcohol outlets was high all over the city and both alcohol- and non-alcohol-related crashes occurred near an outlet. The study helps to better understand the relationship between alcohol availability and traffic crashes in a middle-income country where licensing/zoning is absent and suggests that measures for restricting the physical availability of alcohol are necessary, even though further studies are still needed.

Indikatoren für das Ausmaß jugendlichen Rauschtrinkens in Bayern

Fragestellung: Ist der Anstieg der Krankenhausbehandlungen Jugendlicher wegen einer Alkoholintoxikation ein Indikator für eine Zunahme riskanten Trinkverhaltens? Methodik: Durchgeführt wurden zwei Sekundäranalysen (Untersuchung der Straftaten und Unfälle unter Alkoholeinfluss von 10 – 20-jährigen Jugendlichen sowie der Blutalkoholkonzentrationen (BAK) von stationär behandelten Jugendlichen, n = 1 020) und eine Feldstudie (Bevölkerungsbefragung, n = 285). Ergebnisse: Die Zahl der Krankenhausbehandlungen korrelierte positiv mit den Straftaten, jedoch nicht mit den Unfällen unter Alkoholeinfluss. In einer Stadt mit hohen Behandlungszahlen würden mehr Studienteilnehmer in Notfallsituationen als Erstes den Rettungsdienst verständigen als in einer vergleichbaren Stadt mit geringen Behandlungszahlen. Die durchschnittlichen BAK sanken innerhalb eines Zweijahreszeitraums (2008 – 2009) kontinuierlich. Schlussfolgerungen: Die Entwicklung von Krankenhausbehandlungen und Straftaten unter Alkoholeinfluss sprechen für einen gestiegenen Risikokonsum. Die Zunahme der Behandlungen wegen Alkoholintoxikation ist jedoch mit einer erhöhten Sensibilisierung der Bevölkerung assoziiert und wird durch alkoholbezogene Unfallzahlen nicht unterstützt.

The association between low alcohol use and traffic risk behaviors among Brazilian college students

Although there are a large number of studies focused on binge drinking and traffic risk behaviors (TRB), little is known regarding low levels of alcohol consumption and its association to TRB. The aim of this cross-sectional study is to examine the association of low to moderate alcohol intake pattern and TRB in college students in Brazil. 7037 students from a National representative sample were selected under rigorous inclusion criteria. All study participants voluntarily fulfilled a structured, anonymous, and self-questionnaire regarding alcohol and drug use, social-demographic data, and TRB. Alcohol was assessed according to the average number of alcoholic units consumed on standard occasions over the past 12 months. The associations between alcohol intake and TRB were summarized with odds ratio and their confidence interval obtained from logistic regression. Compared with abstainers students who consumed only one alcohol unit had the risk of being a passenger in a car driven by a drunk driver increased by almost four times, students who reported using five or more units were increased by almost five times the risk of being involved in a car crash. Compared with students who consumed one alcohol unit, the risk of driving under the influence of alcohol increased four times in students using three alcohol units. Age group, use of illicit drugs, employment status, gender, and marital status significantly influenced occurrence of TRB among college students. Our study highlights the potential detrimental effects of low and moderate pattern of alcohol consumption and its relation to riding with an intoxicated driver and other TRB. These data suggest that targeted interventions should be implemented in order to prevent negative consequences due to alcohol use in this population.

High-risk driving behaviors among adolescent binge drinkers

BACKGROUND

Binge drinking is common among adolescents. Alcohol use, particularly binge drinking, has been associated with neurocognitive deficits and increased risk-taking behaviors, which may contribute to negative driving outcomes among adolescents even while sober.

OBJECTIVES

To examine potential differences in self-reported risky driving behaviors between adolescent binge drinkers and a matched sample of controls on measures of (1) compliance with graduated licensing laws, (2) high-risk driving behaviors, and (3) driving outcomes (i.e., crashes, traffic tickets).

METHODS

This study examined driving behaviors and outcomes in adolescent recent binge drinkers (n = 21) and demographically and driving history matched controls (n = 17) between the ages of 16-18 years.

RESULTS

Binge drinkers more frequently violated graduated licensing laws (e.g., driving late at night) and engaged in more "high-risk" driving behaviors, such as speeding and using a cell phone while driving. Binge drinkers had more traffic tickets, crashes, and "near crashes" than the control group. Speeding was the behavior most associated with crashes within the binge drinkers.

CONCLUSION

In this study, binge-drinking teens consistently engage in more dangerous driving behaviors and experience more frequent crashes and traffic tickets. They are also less compliant with preventative restrictions placed on youth while they are learning critical safe driving skills.

SCIENTIFIC SIGNIFICANCE

These findings highlight a need to examine the contribution of underlying traits (such as sensation seeking) and binge-related cognitive changes to these high-risk driving behaviors, which may assist researchers in establishing alternative prevention and policy efforts targeting this population.

Alcohol-impaired driving: average quantity consumed and frequency of drinking do matter

OBJECTIVE

The objective of this article is to estimate and validate a logistic model of alcohol-impaired driving using previously ignored alcohol consumption behaviors, other risky behaviors, and demographic characteristics as independent variables.

METHODS

The determinants of impaired driving are estimated using the US Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) surveys. Variables used in a logistic model to explain alcohol-impaired driving are not only standard sociodemographic variables and bingeing but also frequency of drinking and average quantity consumed, as well as other risky behaviors. We use interactions to understand how being female and being young affect impaired driving. Having estimated our model using the 1997 survey, we validated our model using the BRFSS data for 1999.

RESULTS

Drinking 9 or more times in the past month doubled the odds of impaired driving. The greater average consumption of alcohol per session, the greater the odds of driving impaired, especially for persons in the highest quartile of alcohol consumed. Bingeing has the greatest effect on impaired driving. Seat belt use is the one risky behavior found to be related to such driving. Sociodemographic effects are consistent with earlier research. Being young (18-30) interacts with two of the alcohol consumption variables and being a woman interacts with always wearing a seat belt. Our model was robust in the validation analysis.

CONCLUSIONS

All 3 dimensions of drinking behavior are important determinants of alcohol-impaired driving, including frequency and average quantity consumed. Including these factors in regressions improves the estimates of the effects of all variables.

Early onset of delinquency and the trajectory of alcohol-impaired driving among young males

Building upon the literature in developmental and life-course criminology, the present study assesses the possible association of age onset of delinquency with the trajectory of alcohol-impaired driving using data collected from the three waves of the Buffalo Longitudinal Survey of Young Men (BLSYM). It is argued that as a unique form of delinquency, alcohol-impaired driving among adolescents may be better understood in a broad context of adolescent delinquency involvement. The study adopts the general approach for the analysis of early onset of delinquency and criminal careers in developmental and life-course criminology and hypothesizes that early onset of delinquency is associated with a higher growth of alcohol-impaired driving over time among adolescents when age onsets of alcohol-impaired driving, drinking, and drug use are controlled. Our analysis with the HLM growth modeling method provides support for the hypothesis. Respondents who had an early start in delinquency were likely to have a faster growth of alcohol-impaired driving over the three waves of BLSYM, which implies that these respondents were likely to have a longer path of alcohol-impaired driving in their transition to adulthood. The implication of this finding is discussed.

The association between alcohol consumption patterns and adherence to food consumption guidelines

OBJECTIVE

To examine the association between alcohol consumption patterns and adherence to major food consumption guidelines in adults in Spain.

METHODS

Telephone survey of 12,037 persons, representative of the population age 18 to 64 years in the region of Madrid, conducted from 2000 to 2005. The threshold between average moderate and excessive drinking was 40 g alcohol/d in men and 24 g/d in women. Binge drinking was defined as intake of ≥80 g alcohol in men and ≥60 g in women during 1 drinking session in the last 30 days. Food consumption was measured with a 24-hour recall. Statistical analyses were performed using logistic regression and adjusted for the main confounders.

RESULTS

In total, 4.3% of study participants were excessive drinkers and 10.3% binge drinkers; 6.5% preferred spirits and 24.2% drank with meals. In comparison with never drinking, average moderate drinking with binge drinking was associated with excessive meat consumption (>1 serving/d). Excessive alcohol consumption without binge drinking was associated with insufficient intake of milk products (<2 servings/d) and excessive consumption of meat, fish, and eggs (>2 servings/d). Excessive drinkers with binge drinking more often did not meet the guidelines on consumption of fruit and vegetables (<3 servings/d), milk products, and meat. Excessive drinkers, with and without binge drinking, were more likely to skip a meal, especially breakfast. Consumption mainly of spirits was associated with insufficient fruit and vegetable consumption, and with skipping a meal. Finally, drinking at mealtimes was associated with poor adherence to most of the food consumption guidelines. No dietary differences between men and women were found in relation to alcohol consumption.

CONCLUSIONS

Average excessive alcohol consumption, binge drinking, preference for spirits, and drinking alcohol at mealtimes are associated with poor adherence to major food consumption guidelines.

Factors associated with alcohol and drug use among traffic crash victims in southern Brazil

OBJECTIVE

To investigate the prevalence of and factors associated with alcohol- or drug-related traffic crashes (TC) in a sample of TC victims who were admitted to the two emergency rooms of Porto Alegre in southern Brazil.

METHODS

A cross-sectional study with consecutive samples was used. Victims of non-fatal TCs (as drivers, passengers or pedestrians) who had presented at emergency rooms during the 45 days of data collection were selected. Subjects participated in a structured interview, were breathalyzed and underwent salivary drug testing. A multinomial logistic regression model was used to verify factors associated with alcohol or drug use.

RESULTS

Of the 609 victims who participated in the interview, 72% were male, and the median age was 29 years (interquartile range 23.0-40.0 years). The drivers were mostly men (p<0.001), with a higher binge drinking rate (p=0.003) and marijuana use (p=0.005) than seen in pedestrian and passengers. The prevalence of a positive blood alcohol concentration (BAC) ranged from 7.8% among the drivers to 9.2% among the pedestrians (p=0.861), and the cannabis prevalence was 13.3% among the drivers. The variables associated with an alcohol-related accident were binge drinking in the prior 12 months (OR 2.4; CI 95% 1.1-5.1) and coming from a party/bar (OR 8.7; CI 95% 2.8-26.7). Alcohol abuse or dependence increased by 5.2-fold the chance of another substance-related TC.

CONCLUSION

The large number of individuals found in TC-related emergency room visits in a short time frame is evidence of the Brazilian epidemic of TC. The data showed that alcohol abuse or dependence also increases the risk of intoxication by other drugs, and they point to alcohol and drug use as a major problem requiring specific TC-related public policies and law enforcement.

Do we act upon what we see? Direct effects of alcohol cues in movies on young adults' alcohol drinking

AIMS

Ample survey research has shown that alcohol portrayals in movies affect the development of alcohol consumption in youth. Hence, there is preliminary evidence that alcohol portrayals in movies also directly influence viewers' drinking of alcohol while watching movies. One process that might account for these direct effects is imitation. The present study therefore examined whether young people imitate actors sipping alcohol on screen.

METHODS

We observed sipping behaviours of 79 young adults (ages 18-25) watching a 60-min movie clip, 'What Happens in Vegas', in a semi-naturalistic home setting. Each of the 79 participants was exposed to 25 alcohol cues. Two-level logistic regression analyses were used to analyse whether participants in general imitated actors' sipping during this clip. In addition, we applied proportional hazard models in a survival analysis framework (Cox regression) to test whether there was a difference in imitation of the cues between male and female participants, and to test whether the timing of the actors' sipping throughout the movie played a role.

RESULTS

The findings showed that participants were more likely to sip in accordance with the actors' sipping than without such a cue. Further, we found that men were more likely to imitate actors' sipping than females and that participants tended to respond to actors' sipping at the beginning of the movie rather than at the end.

CONCLUSION

Exposure to actors sipping alcohol in a movie seems to have an immediate impact on the drinking behaviour of viewers, via the mechanism of imitation.

Effects of alcohol portrayals in movies on actual alcohol consumption: an observational experimental study

AIMS

This study uses an experimental design to assess the effects of movie alcohol portrayal on alcohol consumption of young adults while watching a movie. Gender, weekly alcohol use and identification with the movie actor/character were assessed as moderators.

DESIGN

A two (sex) × two (movie: alcohol or no portrayal of alcohol) between-subject design was used.

SETTING

Participants watched a contemporary movie in a semi-naturalistic living room setting.

PARTICIPANTS

A total of 122 same-sex, young adult dyads (ages 18-29 years) participated in the experiment.

MEASUREMENTS

Their actual alcohol consumption while watching was examined. A multivariate regression analysis was used to examine the effects of the movie condition on alcohol consumption.

FINDINGS

Assignment to movie alcohol increased alcohol consumption during the movie for men but not women. Identification and weekly alcohol consumption did not moderate the relation between movie condition and alcohol consumption.

CONCLUSIONS

Viewing a movie with alcohol portrayal can lead to higher alcohol consumption in young men while watching the movie.

The effects of binge drinking and socio-economic status on sober driving behavior

OBJECTIVE

Drinking and driving is a primary cause of traffic fatalities and it has been suggested that binge drinkers comprise a major portion of those drivers involved in drinking and driving accidents. Although several experimental studies have investigated the driving behavior of binge drinkers (particularly college students and/or young adults) under the influence of alcohol, few studies have focused on a comparison of sober driving behavior of the general population between binge and non-binge drinkers with a consideration of drivers' income levels. In addition, these studies have not taken other potentially influential factors into account such as socio economic status.

METHODS

A driving simulator study was conducted with a 2 x 2 factorial design (binge vs. non-binge drinker; low vs. high income). Sixty-two participants who were not under the influence of alcohol or drugs were asked to operate a driving simulator following traffic rules. Multiple aspects of participants' driving behaviors were measured in a sober driving situation. To control the potential effects of confounding factors, factors (e.g., age, gender, etc.) that were significantly correlated to the driving behavior were all entered into the multivariate analysis of variance (MANOVA) as covariates.

RESULTS

Significant interaction effects were found between effects of binge drinking and income levels. Analyses indicated that binge drinkers-independent of their income levels-exhibited more speeding exceedances and longer speeding duration than those of non-binge drinkers with a high income. Individuals characterized as non-binge drinkers with a low income also exhibited more speeding behaviors.

CONCLUSION

Cognitive deficits and problems in vehicle control resulting from chronic alcohol consumption may impact binge drinkers' abilities to perform adequately, even in a sober driving situation. In addition, non-binge drinkers with a low income were more prone to make unsafe choices compared to non-binge drinkers with a high income. Further implications of the results in transportation safety and alcohol addiction were also discussed.

Delinquency and alcohol-impaired driving among young males: A longitudinal study

The present study assessed how the trajectory of delinquency affects the growth curve of alcohol-impaired driving using three-waves of data collected from the Buffalo Longitudinal Survey of Young Men (BLSYM). Using the structural equation modeling method, latent growth modeling was utilized to assess four age cohorts of sixteen, seventeen, eighteen, and nineteen years of age at the first wave. The data indicated that the growth rate of delinquency significantly and positively affects the growth rate of alcohol-impaired driving for the respondents who were sixteen at the first wave. The growth rate of drinking was also significantly and positively associated with the growth rate of alcohol-impaired driving for this age cohort. Although the growth rate of delinquency had no significant effect on the growth rate of alcohol-impaired driving for the age cohort which was seventeen at Wave 1, the growth rates of both drinking and drug use did affect for this age cohort. The data, however, showed that alcohol-impaired driving had a significant increase across the waves for the eighteen year old cohort, but there was no significant variation in the rate across respondents. Finally, for the nineteen year old cohort there was no significant increase in alcohol-impaired driving across the waves, and also no significant variation of the growth rate of alcohol-impaired driving across the respondents. These findings indicated that interventions focused on reducing delinquency, alcohol and drug use by sixteen and seventeen year old male adolescents will also reduce their alcohol-impaired driving.

Driver seat belt use indicates decreased risk for child passengers in a motor vehicle crash

STUDY OBJECTIVE

We examined the association between driver restraint use and child emergency department (ED) evaluation following a motor vehicle crash (MVC).

METHODS

This cohort study included child passengers aged 0-12 years riding with an adult driver aged 21 years or older involved in a MVC in Utah from 1999 to 2004. The 6 years of Utah MVC records were probabilistically linked to statewide Utah ED records. We estimated the relative risk of ED evaluation following a MVC for children riding with restrained versus unrestrained drivers. Generalized estimating equations were used to calculate relative risks adjusted for child, driver, and crash characteristics.

RESULTS

Six percent (6%) of children riding with restrained adult drivers were evaluated in the ED compared to twenty-two percent (22%) of children riding with unrestrained adult drivers following a MVC (relative risk 0.29, 95% confidence interval 0.26-0.32). After adjusting for child, vehicle, and crash characteristics, the relative risk of child ED evaluation associated with driver restraint remained significant (relative risk 0.82, 95% confidence interval 0.72-0.94). Driver restraint use was associated with child restraint use, less alcohol/drug involvement, and lower relative risk of severe collision types (head-on, rollover).

CONCLUSIONS

Driver seat belt use is associated with decreased risk of ED evaluation for child passengers in the event of a MVC.

Categories of Alcohol Consumers

Common patterns of alcohol consumption are described with their main criteria, blood alcohol levels, and diagnostic criteria. Binge drinking, an acute alcohol intoxication pattern of particularly concern, is also described, as it appears to be the most common pattern among teenagers when the brain is not yet mature. A number of classification schemes have been proposed specially for social drinking and alcohol dependence, and discussions still surround about them. The article summarize a consensus in classification.

Web-based screening and advice for hazardous drinkers: use of a Spanish site

INTRODUCTION AND AIMS

A website for implementing screening and brief intervention on alcohol was launched in Barcelona, Spain, in October 2006. Its aim was to reach hazardous drinkers who probably would not ask for advice. This article describes use of the site, profiles users and discusses limitations concerning screening.

DESIGN AND METHODS

The website included screening, advice and information. Demographic and self-screening data (typical weekly consumption and the Alcohol Use Disorders Identification Test, AUDIT) were examined.

RESULTS

In a 12 month period, 12,138 visitors entered the website, 2574 started self-assessment, 1342 completed the table and 724 of these participants completed the AUDIT. These users had a mean age of 27.6 years, one-third of them drank above recommended weekly limits and 84.1% of those who completed the AUDIT (n = 724) scored positive (> or =5); a total of 70.3% of identified at-risk drinkers entered the advice section. Among visitors to the site, risk factors for hazardous drinking were: being male, > or =35 years of age, and drinking heavily at weekends.

DISCUSSION AND CONCLUSIONS

The percentage of hazardous drinkers accessing the site was high, and visitors reported that they liked the design, that it was easy to use and that it provided relevant information. Most of those who had sought advice considered it to be helpful. The website seems to be an accessible and useful tool for young people and might be used in youth centres as well as in health-care settings, such as primary care and emergency centres, where it could contribute to health promotion and constitute an easier alternative to screening and brief intervention given by the staff.

The language of intoxication: preliminary investigations

BACKGROUND

The extensive vocabulary individuals use to describe alcohol's subjective effects has largely gone unexamined in contemporary alcohol research. The present study examined the language drinkers use to describe their own intoxication. It is argued that this language can provide a more complete characterization of alcohol's subjective effects than is available from existing objective and subjective measures of alcohol use and can inform future self-report research.

METHOD

Toward this goal, a preliminary, cross-sectional, web-based study of the familiarity and usage of current intoxication-related words was conducted in 2 different samples (n = 290 and 146, respectively) of university undergraduates.

RESULTS

Exploratory factor analyses using data from the first sample and confirmatory factor analyses using data from the second sample similarly showed that commonly used terms loaded onto 2 factors, which directly reflected the number of drinks required to be considered moderately or heavily intoxicated, respectively. Gender differences were also found in the familiarity and self-use of some terms across both samples.

CONCLUSIONS

The findings suggest that alcohol researchers include multiple intoxication-related terms in future self-report research, and to periodically assess current intoxication-related vocabulary considering demographic, generational, and socio-cultural differences.