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Greenfield TK. Debating Shield et al.'s perspectives on how to formulate alcohol drinking guidelines. Addiction 2024; 119:22-23. [PMID: 37920911 DOI: 10.1111/add.16375] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023]
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2
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Grummon AH, Ruggles PR, Greenfield TK, Hall MG. Designing Effective Alcohol Warnings: Consumer Reactions to Icons and Health Topics. Am J Prev Med 2023; 64:157-166. [PMID: 37575887 PMCID: PMC10421534 DOI: 10.1016/j.amepre.2022.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Introduction New warning labels for alcohol could reduce alcohol-related health harms. This study examined consumer responses to alcohol warnings with different designs. Methods A national sample of 3,051 U.S. adults completed an online survey in August 2021. Participants were randomized to 1 of 4 warning topics (addiction, liver damage, early death, or colon cancer). Participants viewed 3 labels, presented in random order: 2 types of warning labels (text-only and icon) showing a newly developed warning message about their assigned topic and a text-only control label showing a neutral message. Participants rated each label on effectiveness at discouraging alcohol consumption (primary outcome) and attention (secondary outcome) using 1 to 5 Likert-type scales. Participants also rated warnings with different causal language variants (e.g., "increases risk of," "contributes to") and marker words (e.g., "WARNING," "SURGEON GENERAL WARNING"). Results Both the text-only and icon warnings were perceived as more effective (Average Differential Effects [ADEs]=0.79 and 0.86, respectively) and more attention-grabbing (ADEs=0.43 and 0.69, respectively) than control labels (all ps<0.001). The icon warnings were rated as more effective and attention-grabbing than the text-only warnings (ADEs=0.07 and 0.27, respectively, both ps<0.001). Although all warning topics outperformed the control messages, warnings about addiction were rated as less effective and attention-grabbing than the other topics. A majority (60%) of participants selected "increases risk of" as the most discouraging causal variant and a plurality (47%) selected "SURGEON GENERAL WARNING" as the most discouraging marker word. Conclusions New alcohol warnings could discourage alcohol consumption, especially if warnings include icons.
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Affiliation(s)
- Anna H. Grummon
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Phoebe R. Ruggles
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | | | - Marissa G. Hall
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
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Llamosas-Falcón L, Tran A, Jiang H, Rehm J. Liver holidays? A meta-analysis of drinking the same amount of alcohol daily or non-daily and the risk for cirrhosis. Drug Alcohol Rev 2023; 42:119-124. [PMID: 36274528 PMCID: PMC10749115 DOI: 10.1111/dar.13563] [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: 05/16/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Several alcohol drinking guidelines indicate that daily alcohol consumption should be avoided because of its negative impact on the liver and to avoid the development of alcohol use disorders. Evidence that supports this recommendation is scarce. Our aim was to compare daily versus non-daily drinking and its association with liver cirrhosis. METHODS We conducted a review using PubMed/Medline and Embase as databases, selecting longitudinal or case control studies. A random effects meta-analysis was conducted. RESULTS Five mainly large-scale studies were retrieved. Daily drinking was associated with a significant increase in risk of liver cirrhosis compared to non-daily drinking, with a pooled relative risks of 1.71 (95% confidence interval 1.23-2.23) for men and 1.56 (95% confidence interval 1.39-1.74) for women. DISCUSSION AND CONCLUSIONS The consistent exposure to acetaldehyde and other toxins for daily drinkers may explain our findings. There should be days of abstinence to allow the liver to recover, especially for heavier drinkers.
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Affiliation(s)
- Laura Llamosas-Falcón
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Huan Jiang
- 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
| | - Jürgen Rehm
- 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
- Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, 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
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4
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Calvo E, Allel K, Staudinger UM, Castillo-Carniglia A, Medina JT, Keyes KM. Cross-country differences in age trends in alcohol consumption among older adults: a cross-sectional study of individuals aged 50 years and older in 22 countries. Addiction 2021; 116:1399-1412. [PMID: 33241648 PMCID: PMC8131222 DOI: 10.1111/add.15292] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/01/2020] [Accepted: 10/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Age-related changes in physiological, metabolic and medication profiles make alcohol consumption likely to be more harmful among older than younger adults. This study aimed to estimate cross-national variation in the quantity and patterns of drinking throughout older age, and to investigate country-level variables explaining cross-national variation in consumption for individuals aged 50 years and older. DESIGN Cross-sectional observational study using previously harmonized survey data. SETTING Twenty-two countries surveyed in 2010 or the closest available year. PARTICIPANTS A total of 106 180 adults aged 50 years and over. MEASUREMENTS Cross-national variation in age trends were estimated for two outcomes: weekly number of standard drink units (SDUs) and patterns of alcohol consumption (never, ever, occasional, moderate and heavy drinking). Human Development Index and average prices of vodka were used as country-level variables moderating age-related declines in drinking. FINDINGS Alcohol consumption was negatively associated with age (risk ratio = 0.98; 95% confidence interval = 0.97, 0.99; P-value < 0.001), but there was substantial cross-country variation in the age-related differences in alcohol consumption [likelihood ratio (LR) test P-value < 0.001], even after adjusting for the composition of populations. Countries' development level and alcohol prices explained 31% of cross-country variability in SDUs (LR test P-value < 0.001) but did not explain cross-country variability in the prevalence of heavy drinkers. CONCLUSIONS Use and harmful use of alcohol among older adults appears to vary widely across age and countries. This variation can be partly explained both by the country-specific composition of populations and country-level contextual factors such as development level and alcohol prices.
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Affiliation(s)
- Esteban Calvo
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, USA
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, NY, USA
| | - Kasim Allel
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
- Institute for Global Health, University College London, London, UK
| | - Ursula M. Staudinger
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, NY, USA
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, NY, USA
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
- Department of Population Health, New York University School of Medicine, NY, USA
| | - José T. Medina
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Katherine M. Keyes
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, USA
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5
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Rehm J, Patra J, Brennan A, Buckley C, Greenfield TK, Kerr WC, Manthey J, Purshouse RC, Rovira P, Shuper PA, Shield KD. The role of alcohol use in the aetiology and progression of liver disease: A narrative review and a quantification. Drug Alcohol Rev 2021; 40:1377-1386. [PMID: 33783063 PMCID: PMC9389623 DOI: 10.1111/dar.13286] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/16/2020] [Accepted: 03/10/2021] [Indexed: 12/16/2022]
Abstract
Issues. Alcohol use has been shown to impact on various forms of liver disease, not restricted to alcoholic liver disease. Approach. We developed a conceptual framework based on a narrative review of the literature to identify causal associations between alcohol use and various forms of liver disease including the complex interactions of alcohol with other major risk factors. Based on this framework, we estimate the identified relations for 2017 for the USA. Key Findings. The following pathways were identified and modelled for the USA for the year 2017. Alcohol use caused 35 200 (95% uncertainty interval 32 800–37 800) incident cases of alcoholic liver cirrhosis. There were 1700 (uncertainty interval 1100–2500) acute hepatitis B and C virus (HBV and HCV) infections attributable to heavy-drinking occasions, and 14 000 (uncertainty interval 5900–19 500) chronic HBV and 1700 (uncertainty interval 700–2400) chronic HCV infections due to heavy alcohol use interfering with spontaneous clearance. Alcohol use and its interactions with other risk factors (HBV, HCV, obesity) led to 54 500 (uncertainty interval 50 900–58 400) new cases of liver cirrhosis. In addition, alcohol use caused 6600 (uncertainty interval 4200–9300) liver cancer deaths and 40 700 (uncertainty interval 36 600–44 600) liver cirrhosis deaths. Implications. Alcohol use causes a substantial number of incident cases and deaths from chronic liver disease, often in interaction with other risk factors. Conclusion. This additional disease burden is not reflected in the current alcoholic liver disease categories. Clinical work and prevention policies need to take this into consideration.
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Affiliation(s)
- Jürgen Rehm
- 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.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Institute of Clinical Psychology and Psychotherapy, Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry, 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, Russia.,Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain.,Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jayadeep Patra
- 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
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Charlotte Buckley
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | | | - William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, USA
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Robin C Purshouse
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
| | - Paul A Shuper
- 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.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Kevin D Shield
- 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.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
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6
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Cunradi CB, Caetano R, Alter HJ, Ponicki WR. Adverse childhood experiences are associated with at-risk drinking, cannabis and illicit drug use in females but not males: an Emergency Department study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:739-748. [PMID: 33186088 PMCID: PMC8432740 DOI: 10.1080/00952990.2020.1823989] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/06/2020] [Accepted: 09/10/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with adult substance use in the general population. Given pervasive health disparities among underserved populations, understanding how ACEs are associated with substance use among urban Emergency Department (ED) patients could help inform design of effective screening, brief interventions, and referral to treatment. OBJECTIVES To estimate gender differences in prevalence of separate and cumulative ACEs among a sample of urban ED patients, and assess its association with at-risk drinking (4+/5+ drinks for females/males), cannabis, and illicit drug use. We hypothesized that the association between ACEs and each outcome would be stronger among females than males. METHODS Cross-sectional survey data were obtained from 1,037 married/partnered ED patients (53% female) at a public safety-net hospital. Gender-stratified logistic regression models were estimated for each substance use outcome. RESULTS One+ ACEs were reported by 53% of males and 60% of females. Females whose mother was a victim of domestic violence had greater odds of at-risk drinking compared to females who did not report this ACE (AOR = 1.72; 95% CI 1.03, 2.88). Females' cumulative ACEs were associated with cannabis use (OR = 2.26, 95% CI 1.06, 4.83) and illicit drug use (OR = 3.35; 95% CI 1.21, 9.30). Males' separate and cumulative ACEs were not associated with increased likelihood for any of the outcomes. CONCLUSION ACEs are associated with greater odds of substance use among female than male ED patients. The prevalence of ACE exposure in this urban ED sample underscores the importance of ED staff providing trauma-informed care.
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Affiliation(s)
- Carol B Cunradi
- Prevention Research Center, Pacific Institute for Research & Evaluation , Berkeley, CA, USA
| | - Raul Caetano
- Prevention Research Center, Pacific Institute for Research & Evaluation , Berkeley, CA, USA
| | - Harrison J Alter
- Alameda Health System, Andrew Levitt Center for Social Emergency Medicine , Oakland, CA, USA
| | - William R Ponicki
- Prevention Research Center, Pacific Institute for Research & Evaluation , Berkeley, CA, USA
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7
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Bohnsack JP, Pandey SC. Histone modifications, DNA methylation, and the epigenetic code of alcohol use disorder. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 156:1-62. [PMID: 33461661 DOI: 10.1016/bs.irn.2020.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Alcohol use disorder (AUD) is a leading cause of morbidity and mortality. Despite AUD's substantial contributions to lost economic productivity and quality of life, there are only a limited number of approved drugs for treatment of AUD in the United States. This chapter will update progress made on the epigenetic basis of AUD, with particular focus on histone post-translational modifications and DNA methylation and how these two epigenetic mechanisms interact to contribute to neuroadaptive processes leading to initiation, maintenance and progression of AUD pathophysiology. We will also evaluate epigenetic therapeutic strategies that have arisen from preclinical models of AUD and epigenetic biomarkers that have been discovered in human populations with AUD.
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Affiliation(s)
- John Peyton Bohnsack
- Center for Alcohol Research in Epigenetics, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Subhash C Pandey
- Center for Alcohol Research in Epigenetics, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States; Jesse Brown VA Medical Center, Chicago, IL, United States; Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL, United States.
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8
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Calvo E, Medina JT, Ornstein KA, Staudinger UM, Fried LP, Keyes KM. Cross-country and historical variation in alcohol consumption among older men and women: Leveraging recently harmonized survey data in 21 countries. Drug Alcohol Depend 2020; 215:108219. [PMID: 32795884 PMCID: PMC7585691 DOI: 10.1016/j.drugalcdep.2020.108219] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Alcohol consumption causes greater harm in older than younger adults. As the population ages, understanding cross-country and time-varying drinking patterns of older adults is of critical importance. Available evidence relies primarily on ecological data. METHODS We harmonized survey data for 179,881 adults age 50+ observed repeatedly between 1998 and 2016 in 21 countries. Next, we estimated historical variation in consumption across countries (overall and stratified by gender and age group 50-64/65+). RESULTS On average, 51.95 % of older adults consumed any alcohol over the observed period. For 13 countries, the proportion of older adults who drink increased (mean annual increase: 0.76 percent points). Heavy drinking (men drinks/day>3 or binge>5, women drinks/day>2 or binge>4) peaked at 23.54 % for England in 2010 and lifetime abstainers at 69.65 % for China in 2011. Across countries and among drinkers, consumption frequency was 2.57 days/week, the number of standard drink units when drinking was 2.57, and the average number of drinks/day over a week was 1.12. Consumption patterns varied substantially across countries and historical time. Overall probability and frequency of consumption were higher in men than women, with the largest gaps observed in 2011 for China, but gender gaps decreased (even reversed) in the young old and varied across country and time. CONCLUSIONS Wide variation in older adults' alcohol consumption across countries and time suggests that broad scale prevention and intervention efforts can be harnessed for potential population-level health benefits. Further variation by gender and age reflect physiological and social factors simultaneously shaping alcohol consumption.
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Affiliation(s)
- Esteban Calvo
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, United States; Society and Health Research Center and Laboratory on Aging and Social Epidemiology, School of Public Health and Facultad de Humanidades, Universidad Mayor, Santiago, Chile.
| | - José T Medina
- Laboratory on Aging and Social Epidemiology, Universidad Mayor, Santiago, Chile
| | - Katherine A Ornstein
- Geriatrics and Palliative Medicine and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Ursula M Staudinger
- Robert N. Butler Columbia Aging Center and Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Linda P Fried
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America. Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
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9
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Roche AM, Chapman J, Duraisingam V, Phillips B, Finnane J, Pidd K. Construction workers' alcohol use, knowledge, perceptions of risk and workplace norms. Drug Alcohol Rev 2020; 39:941-949. [PMID: 32350917 DOI: 10.1111/dar.13075] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/26/2020] [Accepted: 03/29/2020] [Indexed: 01/28/2023]
Abstract
INTRODUCTION AND AIMS Globally, there is growing concern regarding workers' alcohol use and its implications for health, wellbeing and workplace safety. Male-dominated industries are more susceptible to risky alcohol consumption and its associated harms. This paper investigated the patterns, prevalence and predictors of risky drinking among construction workers. DESIGN AND METHODS Male construction workers (n = 511) completed a survey measuring alcohol-related measures including Alcohol Use Disorders Identification Test - Concise (AUDIT-C), which was compared with population data. Hierarchical multiple regression examined alcohol-related knowledge, perception of risk to workplace safety, psychological distress, job stress, general health, quality of life and workplace alcohol culture variables as predictors of risky drinking. RESULTS Prevalence of risky drinking was higher than the national average, particularly for younger (<25 years) and mid-aged (45-54 years) workers. One in six construction workers reported workmates being visibly affected by alcohol in the workplace. Key predictors of risky drinking were perception of alcohol-related risks to workplace safety, general health, alcohol knowledge and descriptive norms regarding workmates' alcohol use. DISCUSSION AND CONCLUSIONS These findings provide useful insights into the patterns and predictors of risky drinking in construction and can inform future preventive programs and interventions in high-risk workplaces. In addition to tailoring programs to both young and mid-aged workers, this work highlights the importance of implementing strategies to increase awareness of risks to workplace safety; and the adoption of norms that inhibit the social acceptability of risky drinking behaviour in the wider workplace.
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Affiliation(s)
- Ann M Roche
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Janine Chapman
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Vinita Duraisingam
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Brooke Phillips
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia.,Building Trades Group Drug and Alcohol Program, Sydney, Australia
| | - Jim Finnane
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Ken Pidd
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
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10
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Keyes KM, Calvo E, Ornstein KA, Rutherford C, Fox MP, Staudinger UM, Fried LP. Alcohol Consumption in Later Life and Mortality in the United States: Results from 9 Waves of the Health and Retirement Study. Alcohol Clin Exp Res 2019; 43:1734-1746. [PMID: 31276233 PMCID: PMC6677628 DOI: 10.1111/acer.14125] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/04/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Alcohol consumption in later life has increased in the past decade, and the relationship between alcohol consumption and mortality is controversial. Recent studies suggest little, if any, health benefit to alcohol. Yet most rely on single-time point consumption assessments and minimal confounder adjustments. METHODS We report on 16 years of follow-up from the Health and Retirement Study (HRS) cohorts born 1931 to 1941 (N = 7,904, baseline mean age = 61, SD = 3.18). Respondents were queried about drinking frequency/quantity. Mortality was established via exit interviews and confirmed with the national death index. Time-varying confounders included but were not limited to household assets, smoking, body mass index, health/functioning, depression, chronic disease; time-invariant confounders included baseline age, education, sex, and race. RESULTS After adjustment, current abstainers had the highest risk of subsequent mortality, consistent with sick quitters, and moderate (men: HR = 0.74, 95% CI: 0.60 to 0.91; women: HR = 0.82, 95% CI: 0.63 to 1.07) drinking was associated with a lower mortality rate compared with occasional drinking, though smokers and men evidenced less of an inverse association. Quantitative bias analyses indicated that omitted confounders would need to be associated with ~4-fold increases in mortality rates for men and ~9-fold increases for women to change the results. CONCLUSIONS There are consistent associations between moderate/occasional drinking and lower mortality, though residual confounding remains a threat to validity. Continued efforts to conduct large-scale observational studies of alcohol consumption and mortality are needed to characterize the changing patterns of consumption in older age.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Columbia University, New York, New York
- Robert N. Butler Columbia Aging Center, Columbia University, New York, New York
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Esteban Calvo
- Department of Epidemiology, Columbia University, New York, New York
- Robert N. Butler Columbia Aging Center, Columbia University, New York, New York
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Katherine A Ornstein
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine, New York, New York
| | | | - Matthew P Fox
- Departments of Epidemiology and Global Health, Boston University, Boston, Massachusetts
| | - Ursula M Staudinger
- Robert N. Butler Columbia Aging Center, Columbia University, New York, New York
- Department of Sociomedical Sciences, Columbia University, New York, New York
| | - Linda P Fried
- Department of Epidemiology, Columbia University, New York, New York
- Robert N. Butler Columbia Aging Center, Columbia University, New York, New York
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11
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Probst C, Fleischmann A, Gmel G, Poznyak V, Rekve D, Riley L, Rylett M, Shield KD, Rehm J. The global proportion and volume of unrecorded alcohol in 2015. J Glob Health 2019; 9:010421. [PMID: 31131099 PMCID: PMC6513411 DOI: 10.7189/jogh.09.010421] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Alcohol consumption is associated with elevated risks of disease and injury, and the best indicator of the level of consumption in a country is total alcohol per capita (APC) consumption among adults which comprises recorded consumption and unrecorded consumption. While recorded consumption can be assessed with small measurement bias via taxation or other governmental records, unrecorded consumption is more difficult to assess. The objectives of this study were to estimate the country-specific proportion and volume of unrecorded APC in 2015, to identify main sources of unrecorded alcohol and to assess to what extent experts perceive unrecorded alcohol as a public health, social, and financial problem. Methods Estimates of unrecorded APC were based on a multilevel fractional response regression model using data from World Health Organization’s (WHO) STEPwise approach to surveillance surveys (16 countries, 66 188 participants), estimates from the routine WHO reporting on key indicators of alcohol use (189 countries), and a nominal group expert assessment (42 countries, 129 experts). Expert assessments also included data on the sources of unrecorded alcohol and the perception of unrecorded alcohol as a public health, social, and financial problem. Results The volume of global unrecorded APC was 1.6 L pure alcohol, representing 25% of the total APC. The volume of unrecorded APC was highest in Europe (2.1 L per capita), while the proportion of unrecorded APC was highest in the WHO Eastern Mediterranean region (57% of the total alcohol). In countries with available data, homemade alcohol was identified as a major source of unrecorded alcohol. The majority of experts considered unrecorded alcohol to be a public health (62%), social (60%), and financial problem (54%). Conclusions High volumes of unrecorded alcohol are consumed globally; however, the volumes consumed and the sources of the unrecorded alcohol exhibit large geographical variation.
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Affiliation(s)
- Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,World Health Organization/Pan-American Health Organization Collaborating Centre in Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Gerhard Gmel
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Addiction Switzerland, Lausanne, Switzerland.,Alcohol Treatment Centre, Lausanne University Hospital, Lausanne, Switzerland.,University of the West of England, Bristol, United Kingdom
| | - Vladimir Poznyak
- Management of Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Dag Rekve
- Management of Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Leanne Riley
- Prevention of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Margaret Rylett
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,World Health Organization/Pan-American Health Organization Collaborating Centre in Addiction and Mental Health, Toronto, Ontario, Canada
| | - Kevin D Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,World Health Organization/Pan-American Health Organization Collaborating Centre in Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,World Health Organization/Pan-American Health Organization Collaborating Centre in Addiction and Mental Health, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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12
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Greenfield TK, Cook WK, Karriker-Jaffe KJ, Patterson D, Kerr WC, Xuan Z, Naimi TS. The Relationship Between the U.S. State Alcohol Policy Environment and Individuals' Experience of Secondhand Effects: Alcohol Harms Due to Others' Drinking. Alcohol Clin Exp Res 2019; 43:1234-1243. [PMID: 31166048 PMCID: PMC6553486 DOI: 10.1111/acer.14054] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 04/05/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although restrictive state alcohol policy environments are protective for individuals' binge drinking, research is sparse on the effect of alcohol policies on alcohol's harms to others (AHTO). We examined the lagged associations between efficacy of U.S. state alcohol policies and number of harms from others' drinking 1 year later. METHODS Individuals with AHTO data in a nationally representative sample of U.S. adults (analytic sample n = 26,744) that pooled the 2000, 2005, 2010, and 2015 National Alcohol Surveys and a 2015 National Alcohol's Harm to Others Survey were linked with prior-year state policy measures. We used 2 measures from the Alcohol Policy Scale (APS)-effectiveness in reducing (i) binge drinking and (ii) impaired driving, based on experts' efficacy judgments regarding 29 state alcohol policies. Three 12-month AHTO measures (due to another drinker) were experiencing: (i) either family/marriage difficulties or financial troubles; (ii) being assaulted or vandalized; and (iii) passenger with drunk driver or traffic accident. Multilevel models accounting for clustering within states and stratified by age-groups (<40 vs. ≥40) examined associations between the APS and AHTO measures, controlling for individual covariates (gender, race, education, employment and marital status, family problem-drinking history) of the victim. RESULTS Only for those aged <40, the lagged APS-Binge drinking and APS-Impaired driving scores were each inversely associated with aggression-related harms and, separately, with drunk driving-related harm from someone else's drinking (ps < 0.05 to < 0.01). Family/financial harms were not associated with APS scores for either age-group. Composite AHTO measures (any of 3 harm-types) also were inversely associated with stronger state alcohol policy environments (ps < 0.05 to <0.01). CONCLUSIONS State alcohol policies may be effective in reducing, to a meaningful degree, aggression-related harms and vehicular hazards due to other drinkers, but mainly in those under 40.
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Affiliation(s)
| | - Won K. Cook
- Public Health Institute, Alcohol Research Group, Emeryville California USA
| | | | - Deidre Patterson
- Public Health Institute, Alcohol Research Group, Emeryville California USA
| | - William C. Kerr
- Public Health Institute, Alcohol Research Group, Emeryville California USA
| | - Ziming Xuan
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Timothy S. Naimi
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
- Clinical Addiction Research & Education Unit, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts, USA
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13
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Šefránek M, Miovský M. Treatment Outcome Evaluation in Therapeutic Communities in the Czech Republic: Alcohol Consumption and Other Results One Year After Discharge. ALCOHOLISM TREATMENT QUARTERLY 2017. [DOI: 10.1080/07347324.2017.1387036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Martin Šefránek
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Michal Miovský
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
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14
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Greenfield TK, Ye Y, Lown EA, Cherpitel CJ, Zemore S, Borges G. Alcohol Use Patterns and DSM-5 Alcohol Use Disorder on Both Sides of the U.S.-Mexico Border. Alcohol Clin Exp Res 2017; 41:769-778. [PMID: 28207949 DOI: 10.1111/acer.13356] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 02/09/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alcohol consumption patterns on the U.S.-Mexico border and their relationships with DSM-5 alcohol use disorders (AUD) have been understudied. Yet, the effects of drinking by Mexican-origin individuals may differ between cities on versus off the border both in the United States and in Mexico. We characterize prior 12-month drinking patterns and examine their relationships with AUD, in border and off-border cities of Texas and adjacent Mexican states. METHODS Data come from the U.S.-Mexico Study of Alcohol and Related Conditions involving 2,336 Mexican Americans in Texas and 2,460 Mexicans in bordering states of Nuevo Leon and Tamaulipas in Mexico. Drinking pattern was defined as an interaction between volume and maximum amount, or intensity (never vs. ever 5+/4+ [men/women], 8+, and 12+ drinks in a day). DSM-5 AUD was assessed using an adaptation of the Alcohol Section of the World Health Organization Composite International Diagnostic Interview core. Separately by gender, 5 logistic regressions models controlling for age were estimated predicting symptoms in 2 or more AUD criteria domains from volume, heavy pattern and, successively, effects of country, and (by country) residing on vs. off the border, or in each of 3 cities/country. RESULTS A segmentation analysis for Texas males based on rate of experiencing AUD generated several distinct volume groups, each partitioned by an empirically selected maximum, and helped identify a drinking-pattern typology. In gender-stratified models of AUD rates using this typology, adjusting for age, significant volume and intensity effects were seen, more strongly in the United States. Border versus interior differences implied more AUD for given patterns at the border in the United States and the reverse in Mexico, with some city differences also evident. CONCLUSIONS Drinking-pattern analyses confirm that border proximity may affect drinking problems but in opposite directions in the United States and Mexico, possibly related to economic and psychological stresses specific to respective communities.
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Affiliation(s)
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - E Anne Lown
- Alcohol Research Group, Public Health Institute, Emeryville, California.,Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, San Francisco, California
| | | | - Sarah Zemore
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - Guilherme Borges
- Instituto Nacional de Psiquiatria, Autonomous Metropolitan University of Mexico, Mexico City, Mexico
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15
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Karriker-Jaffe KJ, Greenfield TK, Kaplan LM. Distress and alcohol-related harms from intimates, friends, and strangers. JOURNAL OF SUBSTANCE USE 2016; 22:434-441. [PMID: 28757806 DOI: 10.1080/14659891.2016.1232761] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Alcohol's harms to others (AHTO) has gained increased research and policy attention, yet little information is available on different social relationships involved in such harms or consequences of harms perpetrated by various types of drinkers. Using data from the 2014-15 U.S. National Alcohol Survey (N=5,922), we present analyses comparing frequency and impacts of eight past-year harms from other drinkers. In this sample (53% female; 66% White/Caucasian, 13% Black/African American, and 15% other race; 15% Hispanic/Latino of any race; mean age=47 years), 19% reported at least one harm in the prior 12 months, 8% reported more than one harm, 4.9% reported a family perpetrator, 3.5% a spouse perpetrator, 6.1% a friend perpetrator, and 8.1% a stranger perpetrator. Controlling for basic demographics, the number of harms in the past year and harms perpetrated by known others (but not strangers) were significantly associated with recent distress. When comparing specific harms, financial problems due to a family member's or a spouse/partner's drinking each were associated with significantly greater distress, as were feeling threatened or afraid of family members, spouses/partners or friends who had been drinking. These new data shed light on possible intervention points to reduce negative impacts of AHTO in the U.S.
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Affiliation(s)
| | | | - Lauren M Kaplan
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
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16
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Greenfield TK, Ye Y, Giesbrecht N. Alcohol Policy Opinions in the United States over a 15-Year Period of Dynamic per Capita Consumption Changes: Implications for Today's Public Health Practice. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/009145090703400408] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We examine 1989–2005 trends in United States (US) public opinion using 11 alcohol policy items (seven national telephone surveys) during a dynamic drop in per capita intake until the mid-1990s, followed by the first sustained upturn seen since 1980. In the 2000 U.S. National Alcohol Survey (NAS) survey 14 available policy items were factor analyzed, forming four factor-based scales replicated in 2005. Linear regression examined changing demographic correlates of support for the four policy areas between 2000 and 2005. Several empirically effective policy levers have weak support, which continues to erode. Between 2000 and 2005 support weakened by an average of 1% for all except two policies, both of which declined since 1989. Even support for alcohol warning labels has turned down for the first time since 1989. Implications of the declining endorsement of alcohol policies are discussed, given the upturn in consumption. Community-based strategies are needed to inform the public of benefits of alcohol policies.
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17
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Greenfield TK, Nayak MB, Bond J, Kerr WC, Ye Y. Test-retest reliability and validity of life-course alcohol consumption measures: the 2005 National Alcohol Survey follow-up. Alcohol Clin Exp Res 2014; 38:2479-87. [PMID: 25070623 PMCID: PMC4177326 DOI: 10.1111/acer.12480] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 05/09/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Few studies assess reliability and validity of lifetime alcohol measures. We undertook extended test-retest analyses of retrospective lifetime drinking measures and of incremental predictive ability of lifetime heavy drinking (days 5+ drinks) in teens, 20s, and 30s for current (12-month) alcohol use disorders (AUDs). METHODS A subset (31.4%; 962 men, 1,220 women) of the 2005 U.S. National Alcohol Survey (NAS; N11) completed a follow-up survey (N11T) by phone or mail (mean delay of 2.7 years). Both surveys assessed lifetime drinking. RESULTS In N11T, drinking status was reported consistently by 94.7% of N11 current drinkers, 85.5% of ex-drinkers, and 74.4% of lifetime abstainers (93.5% overall). Cumulative number of prior heavy drinking days (teens through 30s) were moderately consistent (Pearson's ρ = 0.6, p < 0.001, n = 1,636). Reliability was lower for younger respondents under 30 and higher for Whites versus Blacks and Hispanics (ρ = 0.68 vs. ρ = 0.56 vs. ρ = 0.56, both p = 0.01), but did not differ by gender. Heavy drinking days in teens correlated 0.63 (p < 0.001) for those aged 20 or older, higher for women than men and for Whites versus ethnic minorities. Heavy drinking days in the 20s and 30s reported by those 30 and older and 40 and older correlated at 0.63 and 0.67, respectively, being higher for Whites. Age of drinking onset and of lifetime maximum quantity reports were also consistent (0.65, 0.73), higher for women versus men, for those older than 29 versus younger, and for Whites versus Blacks and Hispanics. In N11, controlling for gender, age, ethnicity, and current 5+ frequency, cumulative prior 5+ days (teens to age 39) predicted current alcohol-related consequences and dependence (both p = 0.003). CONCLUSIONS Measurements of earlier heavy drinking are feasible, efficient, and reasonably reliable, albeit with some individual imprecision. Prior drinking data improve prediction of current AUDs, adjusting for demographics and current drinking.
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18
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Schrad ML. Can Policy Overcome Tradition? Assessing Russia's Ongoing Anti-Alcohol Campaign. WORLD MEDICAL & HEALTH POLICY 2014. [DOI: 10.1002/wmh3.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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19
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Rehm J, Kailasapillai S, Larsen E, Rehm MX, Samokhvalov AV, Shield KD, Roerecke M, Lachenmeier DW. A systematic review of the epidemiology of unrecorded alcohol consumption and the chemical composition of unrecorded alcohol. Addiction 2014; 109:880-93. [PMID: 24467748 DOI: 10.1111/add.12498] [Citation(s) in RCA: 134] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 09/27/2013] [Accepted: 01/22/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Unrecorded alcohol constitutes about 30% of all alcohol consumed globally. The aims of this systematic review were to determine the epidemiology (occurrence, types, prevalence) of unrecorded alcohol consumption in different countries/regions, analyse the chemical composition of unrecorded alcohol and examine health outcomes caused by the consumption of unrecorded alcohol, based on either epidemiology or toxicology. METHODS A systematic search for, and qualitative analysis of, papers with empirical results on the different categories of unrecorded alcohol, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Unrecorded alcohol was widespread in all regions of the world. Artisanal fermented beverages and spirits were the most common categories of unrecorded alcohol globally, and were available on all continents. In India, industrially produced spirits (country spirits) were most prevalent. In Russia and countries of the former Soviet Union, surrogate alcohols complemented artisanal spirits. Cross-border shopping was the most prevalent method of obtaining unrecorded alcohol in parts of Europe. Ethanol was the most harmful ingredient of unrecorded alcohol, and health consequences due to other ingredients found in unrecorded alcohol were scarce. However, as unrecorded alcohol is usually the least expensive form of alcohol available in many countries, it may contribute to higher rates of chronic and irregular heavy drinking. CONCLUSIONS Very large amounts of alcohol are produced globally that go unrecorded. The primary harm from this kind of alcohol arises from the fact that it is typically much cheaper than licit alcohol.
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Affiliation(s)
- Jürgen Rehm
- Social and Epidemiological Research (SER) Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Institute of Medical Sciences, University of Toronto (UofT), Toronto, Canada; Dalla Lana School of Public Health, UofT, Toronto, Canada; Dept. of Psychiatry, Faculty of Medicine, UofT, Toronto, Canada; PAHO/WHO Collaborating Centre for Mental Health & Addiction, Toronto, Canada; Epidemiological Research Unit, Technische Universität Dresden, Klinische Psychologie & Psychotherapie, Dresden, Germany
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20
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Rehm J, Marmet S, Anderson P, Gual A, Kraus L, Nutt DJ, Room R, Samokhvalov AV, Scafato E, Trapencieris M, Wiers RW, Gmel G. Defining Substance Use Disorders: Do We Really Need More Than Heavy Use? Alcohol Alcohol 2013; 48:633-40. [DOI: 10.1093/alcalc/agt127] [Citation(s) in RCA: 161] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Pillai A, Nayak MB, Greenfield TK, Bond JC, Nadkarni A, Patel V. Patterns of alcohol use, their correlates, and impact in male drinkers: a population-based survey from Goa, India. Soc Psychiatry Psychiatr Epidemiol 2013; 48:275-82. [PMID: 22752108 PMCID: PMC3529206 DOI: 10.1007/s00127-012-0538-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Accepted: 06/09/2012] [Indexed: 12/01/2022]
Abstract
PURPOSE Associations between low socio-economic class and alcohol use disorders are relatively well established in developed countries; however, there is comparably little research in India and other developing countries on the associations between socio-economic class, drinking patterns, and alcohol-related problems. We sought to assess drinking patterns and adverse outcomes among male drinkers and examine whether the association between drinking patterns and adverse outcomes differ by socioeconomic class. METHODS Population survey of 732 male drinkers screened from 1,899 men, aged 18 to 49 years, randomly selected from rural and urban communities in northern Goa, India. RESULTS Usual quantity of alcohol consumed by 14.8% (rural 16.8%; urban 13.6%) current drinkers is at high-risk level. About 28.6% (rural 31%; urban 27.2%) and 33.7% (rural 30.5%; urban 35.5%) of current drinkers reported monthly or more frequent heavy episodic drinking and drunkenness, respectively. Lower education and lower standard of living (SLI) were associated with higher usual quantity of alcohol consumption. More frequent heavy episodic drinking was associated with older age, being separated, lower education, and lower standard of living; weekly or more frequent drunkenness was associated only with rural residence. All three risky drinking patterns were associated with common mental disorders, sexual risk, intimate partner violence, acute alcohol-related consequences, and alcohol dependence. Significant interactions between SLI and risky alcohol use patterns suggested an increased risk of intimate partner violence among men with risky drinking and lower SLI. CONCLUSIONS Risky drinking patterns are common among male drinkers in Goa and associated with lower socio-economic class. A range of adverse health and social outcomes were associated with risky drinking across all socio-economic classes. Alcohol policy should target risky drinking patterns, particularly among poorer men, to reduce the health and social burden of alcohol use in India.
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Midanik LT, Ye Y, Greenfield TK, Kerr W. Missed and inconsistent classification of current drinkers: results from the 2005 US National Alcohol Survey. Addiction 2013; 108:348-55. [PMID: 22974256 PMCID: PMC3810534 DOI: 10.1111/j.1360-0443.2012.04079.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 04/13/2012] [Accepted: 09/05/2012] [Indexed: 11/28/2022]
Abstract
AIMS This study compares current 12-month drinkers who do not report drinking in the last 30 days with current drinkers who drank in the last 30 days and assesses possible misclassification errors from use of a 30-day consumption measure. DESIGN Data are from the 2005 US National Alcohol Survey (n = 6919), a national household probability survey. SETTING Telephone interviews were used to measure alcohol use and alcohol-related problems. PARTICIPANTS This study compared 1300 current drinkers who did not drink in the last 30 days with 2956 current drinkers who drank in the last 30 days. MEASUREMENTS Volume was measured by quantity/frequency scales (12-month and 30-day) and a graduated frequency scale (12-month). Both groups were compared by demographic, alcohol volume, days of five or more drinks, social consequences and dependence measures. FINDINGS Results indicate a significantly lower prevalence rate of current drinking for 30-day measures-47.3% (45.8%, 48.8%) versus 67.3% (66.0%, 68.7%) with 12-month measures. Further, 385 non-30-day drinkers reported 12-month drinking frequencies of once a month or more often, suggesting possible inconsistent reporting of their alcohol use. When this group of 'inconsistent' respondents is compared with the 915 non-30-day current drinkers who reported less than monthly drinking, they reported significantly higher yearly volume, days of five or more drinks, mean social consequences and proportion reporting alcohol dependence. CONCLUSIONS In population surveys assessing alcohol use, asking about the previous 12 months rather than the past 30 days provides higher estimates of current use, including more days of heavy episodic use.
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Affiliation(s)
- Lorraine T. Midanik
- Alcohol Research Group, Public Health Institute, Emeryville, California,School of Social Welfare, University of California at Berkeley
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - Thomas K. Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, California,Department of Psychiatry, University of California, San Francisco
| | - William Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California
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Neufeld M, Rehm J. Alcohol consumption and mortality in Russia since 2000: are there any changes following the alcohol policy changes starting in 2006? Alcohol Alcohol 2013; 48:222-30. [PMID: 23299570 DOI: 10.1093/alcalc/ags134] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS To elucidate the possible effects of Russian alcohol control policy on alcohol consumption and alcohol-related mortality for the period 2000-2010. METHODS Narrative review including statistical analysis. Trends before and after 2006 are compared, 2006 being the date of implementation of the Russian government's long-term strategy to reduce alcohol-related harms. Mortality data were taken from the World Health Organization (WHO) database 'Health for All'. Data on recorded alcohol consumption were taken from the WHO, based on the Russian Statistical Service (Rosstat). For unrecorded consumption, the calculations of Alexandr Nemtsov were used. Russian public opinion surveys on drinking habits were utilized. Treatment data on alcohol dependence were obtained from the Moscow National Research Centre on Addictions. Information on alcohol policy was obtained from official reports. RESULTS Marked fluctuations in all-cause and alcohol-associated mortality in the working-age population were observed during the reviewed period. A decrease in total consumption and mortality was noted since the end of 2005, when the Russian government initially adopted the regulation of alcohol production and sale. The consumption changes were driven by decreases in recorded and unrecorded spirit consumption, only partly compensated for by increases in beer and wine consumption. CONCLUSIONS Alcohol is a strong contributor to premature deaths in Russia, with both the volume and the pattern of consumption being detrimental to health. The regulations introduced since 2006 seem to have positive effects on both drinking behavior and health outcomes. However, there is an urgent need for further alcohol-control strategies to reduce alcohol-related harm.
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Affiliation(s)
- Maria Neufeld
- Centre for Addiction and Mental Health, Toronto, ON, Canada
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24
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Härkönen JT, Mäkelä P. Age, period and cohort analysis of light and binge drinking in Finland, 1968-2008. Alcohol Alcohol 2012; 46:349-56. [PMID: 21508197 DOI: 10.1093/alcalc/agr025] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS To analyse the effects of age, period and cohort (APC) on light and binge drinking in the general population of Finland over the past 40 years. METHODS All analyses were based on six Drinking Habits Surveys between 1968 and 2008 of representative samples of the Finnish population aged between 15 and 69 (n = 16,400). The number of drinking occasions per year involving 1-2 drinks (light) and 4+ or 6+ drinks (binges) was used as a dependent variable in APC modelling. Descriptive cohort profiles and negative binomial models were used to assess the effects of APC. RESULTS Descriptive cohort profiles differed for light and binge drinking. No substantial differences were found across cohort profiles for light drinking, while APC modelling predicted declining cohort and increasing period effects. Differences between cohorts were found for binge drinking, with predictions of slightly declining or increasing period and increasing cohort effects. CONCLUSIONS Light drinking has increased over time for each cohort, with no substantial differences between cohort profiles. Binge drinking has increased with more recent cohorts and there are distinct differences between cohort profiles, especially among women.
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Affiliation(s)
- Janne T Härkönen
- The Finnish Foundation for Alcohol Studies, PO Box 30, FI-00271 Helsinki, Finland.
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25
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Kerr WC, Greenfield TK, Bond J, Ye Y, Rehm J. Racial and ethnic differences in all-cause mortality risk according to alcohol consumption patterns in the national alcohol surveys. Am J Epidemiol 2011; 174:769-78. [PMID: 21856649 PMCID: PMC3203376 DOI: 10.1093/aje/kwr147] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Accepted: 04/10/2011] [Indexed: 11/12/2022] Open
Abstract
Previous studies have found J-shaped relations between volume of alcohol consumed and mortality risk in white Americans but not in African Americans, suggesting the need for studies in which race/ethnicity-defined subgroups are analyzed in separate comparable models. In the present study, the authors utilized mortality follow-up data (through 2006) on respondents from the 1984 and 1995 National Alcohol Surveys, including similar numbers of black, white, and Hispanic respondents by oversampling the minority groups. Cox proportional hazards models controlling for demographic, socioeconomic, mental health, and drug- and tobacco-use measures were used to estimate mortality risk from all causes. Findings indicated a protective effect of moderate alcohol drinking (2-30 drinks/month for women and 2-60 drinks/month for men) with no monthly ≥5-drink days) relative to lifetime abstention for whites only. Elevated mortality risk relative to moderate drinking was found in former drinkers with lifetime alcohol problems. Moderate drinkers who consumed ≥5 drinks in 1 day at least monthly were also found to have increased risk, suggesting the importance of identifying heavy-occasion drinking for mortality analyses. These differential results regarding lifetime abstainers may suggest bias from differential unmeasured confounding or unmeasured aspects of alcohol consumption pattern or may be due to genetic differences in the health impact of alcohol metabolism.
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Affiliation(s)
- William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA.
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Stockwell T, Butt P, Beirness D, Gliksman L, Paradis C. The basis for Canada's new low-risk drinking guidelines: a relative risk approach to estimating hazardous levels and patterns of alcohol use. Drug Alcohol Rev 2011; 31:126-34. [PMID: 21954872 DOI: 10.1111/j.1465-3362.2011.00342.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
ISSUE Low-risk drinking guidelines have been developed independently in a number of jurisdictions resulting in different sets of advice with different definitions of 'low risk'. This paper discusses some of the fundamental issues addressed by an expert advisory panel during the course of developing national guidelines for Canadians and summarises key sets of evidence that were influential. APPROACH The underlying reasoning and connection between the evidence and the guidelines is discussed in relation to: (i) how to minimise risk of long-term illnesses; (ii) how to minimise risk of short-term harms, for example injury; and (iii) alcohol use during pregnancy. Both absolute and relative risks were considered in the development of the guidelines. FINDINGS Meta-analyses of all-cause mortality were used to identify upper limits for usual drinking levels where potential benefits and risks were balanced for the average person in comparison with lifetime abstainers (10 standard drinks per week for women, 15 for men). Emergency room studies and situational risk factors were considered for advice on reducing short-term: (i) when not to drink at all; (ii) how to reduce intoxication; and (iii) upper limits for occasional daily consumption by adults aged 25 to 64 years (3 standard drinks for women, 4 for men). Shortcomings in the research data were highlighted. IMPLICATIONS It was estimated that total compliance with these guidelines at a national level would result in substantially reduced per capita alcohol consumption and approximately 4600 fewer deaths per year.
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Affiliation(s)
- Tim Stockwell
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, BC, Canada.
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27
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Fichter MM, Quadflieg N, Fischer UC. Severity of alcohol-related problems and mortality: results from a 20-year prospective epidemiological community study. Eur Arch Psychiatry Clin Neurosci 2011; 261:293-302. [PMID: 20839004 DOI: 10.1007/s00406-010-0141-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 08/17/2010] [Indexed: 01/16/2023]
Abstract
There is evidence that high alcohol use is associated with an increase in mortality. Little is known about long-term effects of problematic alcohol consumption in non-clinical (community) populations. The aim of our study was to obtain data on this and related issues in a representative rural community sample assessed longitudinally over a period of 20 years. Assessments focused on a baseline survey from 1980 to 1984 and 20-year follow-up from 2001 to 2004. Based on expert interviews and standardized self-rating scales (e.g. MALT; Munich Alcoholism Test), the following three groups were defined (a) severe alcohol problems, (b) moderate alcohol problems, and (c) no alcohol problems. Mortality and hazard rates were analyzed with logistic and Cox regression adjusted for several health risk factors. From an original community sample of 1,465 individuals, 448 were deceased at 20-year follow-up. Participation rates were high. Baseline prevalence according to the MALT was 1.6% for severe alcohol problems and 4.0% for moderate alcohol problems. Over the 20-year time span, individuals with severe alcohol problems had a significantly elevated risk for dying earlier than the group with no alcohol problems (2.4 times higher). Mortality for those with moderate alcohol problems at baseline had a non-significantly elevated 20-year mortality risk (1.5 times higher) compared to those with no alcohol problems. Cox survival analyses corroborate these findings from multiple sequential logistic regression analyses. In discussing the mortality risk of persons with alcohol problems, the severity of the alcohol problems must be taken into account.
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Budescu M, Taylor RD, McGill RK. Stress and African American Women’s Smoking/Drinking to Cope. JOURNAL OF BLACK PSYCHOLOGY 2011. [DOI: 10.1177/0095798410396087] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Associations of urban poverty-related stress with smoking and drinking to cope and the moderating role of kin social support were assessed in African American women. Findings revealed that among a sample of 101 poor African American women residing in economically and socially disadvantaged neighborhoods, depressive symptoms and relationship stress were significantly associated with smoking. Similarly, perceptions of neighborhood crime were marginally associated with alcohol use. Kinship support was hypothesized to buffer women from the deleterious impacts of stress. The results revealed that kin social support moderated the association of poverty-related stress with smoking and drinking. For women with higher levels of kin support, the positive association of neighborhood crime and drinking was less apparent compared with women with low support. Also, the links between relationship stress, depressive symptoms, and smoking were less apparent for women with higher kin support compared with those with lower support. Findings are discussed in terms of the need for additional research on the social networks available to economically disadvantaged African American families and the manner in which networks operate.
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Greenfield TK, Kerr WC. Commentary on Liang & Chikritzhs (2011): Quantifying the impacts of health problems on drinking and subsequent morbidity and mortality – life-course measures are essential. Addiction 2011; 106:82-3. [PMID: 21618726 DOI: 10.1111/j.1360-0443.2010.03298.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Thomas K Greenfield
- Public Health Institute—Alcohol Research Group, 6475Christie Ave., Suite 400 Emeryville, CA 94608, USA.E-mail:
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Greenfield TK, Nayak MB, Bond J, Patel V, Trocki K, Pillai A. Validating alcohol use measures among male drinkers in Goa: implications for research on alcohol, sexual risk, and HIV in India. AIDS Behav 2010; 14 Suppl 1:S84-93. [PMID: 20567894 PMCID: PMC2919569 DOI: 10.1007/s10461-010-9734-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Assessment of heavy drinking patterns is vital for HIV/AIDs studies in India and developing countries. A population survey in northern Goa included urban and rural male drinkers (n = 743) who completed a new Fractional Graduated Frequencies (F-GF) alcohol patterns measure assessing seven beverage types and drink sizes for the largest daily amount, then drinking frequencies at fractional amounts. The new measure was compared to a simpler quantity-frequency (QF) summary and, in a validity subsample of hazardous drinkers (n = 56), 28-day diaries of drinking events. Approximately 56% of total volume came from peak drinking (averaging 60 g ethanol/day). For AUDIT-based Hazardous Drinkers, QF and F-GF volumes (drinks/day) were not significantly different from diary volume (correlations 0.65 and 0.57, respectively). F-GF well captured the profile of daily amounts in drinking event data. In addition, the F-GF showed evidence of better predicting any sexual risk behavior or partner violence perpetration than the QF measure. Summary drinking pattern measures, especially the new F-GF, are more cost efficient than intensive event records, and appear valid when carefully assessing quantities with local beverage types and drink ethanol content.
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Affiliation(s)
- Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, 6475 Christie Ave, Suite 400, Emeryville, CA 94608, USA.
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Abstract
Data are from the 2000 National Alcohol Survey Methodological Follow-up, which includes 323 individuals from across the United States. Directly measured estimates of drink volume and amount left unfinished along with self-report of the frequency and reasons for which drinks are not finished and are compared across groups. Overall, 12% of drinks reported in the sample were not finished. Smaller amounts of beer and wine volume were left by men, "heavier drinkers" and older persons. This research was supported by grant P-30-A05595 to the Alcohol Research Group, Public Health Institute from the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
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Affiliation(s)
- William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California 94608, USA
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McCauley JL, Ruggiero KJ, Resnick HS, Kilpatrick DG. Incapacitated, forcible, and drug/alcohol-facilitated rape in relation to binge drinking, marijuana use, and illicit drug use: a national survey. J Trauma Stress 2010; 23:132-40. [PMID: 20135676 DOI: 10.1002/jts.20489] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined the relation between rape and substance use problems as a function of three legally recognized forms of rape: forcible, incapacitated, and drug/alcohol facilitated rape. Data were collected via structured telephone interview within a national household sample of U.S. women aged 18-34 years (n = 1,998). Lifetime experience of incapacitated rape was associated with increased odds of past-year binge drinking, marijuana use, and illicit drug use. Lifetime history of forcible rape and drug/alcohol facilitated rape were associated with increased odds of marijuana and illicit drug use. Findings highlight the importance of including incapacitated and drug/alcohol facilitated rape in trauma history assessments, particularly among substance abusing populations, and have implications for secondary prevention and treatment of women with victimization histories.
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Affiliation(s)
- Jenna L McCauley
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
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Mulia N, Ye Y, Greenfield TK, Zemore SE. Disparities in alcohol-related problems among white, black, and Hispanic Americans. Alcohol Clin Exp Res 2009; 33:654-62. [PMID: 19183131 PMCID: PMC2771773 DOI: 10.1111/j.1530-0277.2008.00880.x] [Citation(s) in RCA: 268] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND This study assesses racial/ethnic disparities in negative social consequences of drinking and alcohol dependence symptoms among white, black, and Hispanic Americans. We examine whether and how disparities relate to heavy alcohol consumption and pattern, and the extent to which social disadvantage (poverty, unfair treatment, and racial/ethnic stigma) accounts for observed disparities. METHODS We analyzed data from the 2005 U.S. National Alcohol Survey, a nationally representative telephone-based survey of adults ages 18 and older (N = 6,919). Given large racial/ethnic differences in abstinence rates, core analyses were restricted to current drinkers (N = 4,080). Logistic regression was used to assess disparities in alcohol-related problems at 3 levels of heavy drinking, measured using a composite variable incorporating frequency of heavy episodic drinking, frequency of drunkenness, and maximum amount consumed in a single day. A mediational approach was used to assess the role of social disadvantage. RESULTS African American and Hispanic drinkers were significantly more likely than white drinkers to report social consequences of drinking and alcohol dependence symptoms. Even after adjusting for differences in heavy drinking and demographic characteristics, disparities in problems remained. The racial/ethnic gap in alcohol problems was greatest among those reporting little or no heavy drinking, and gradually diminished to nonsignificance at the highest level of heavy drinking. Social disadvantage, particularly in the form of racial/ethnic stigma, appeared to contribute to racial/ethnic differences in problems. CONCLUSIONS These findings suggest that to eliminate racial/ethnic disparities in alcohol-related problems, public health efforts must do more than reduce heavy drinking. Future research should address the possibility of drink size underestimation, identify the particular types of problems that disproportionately affect racial/ethnic minorities, and investigate social and cultural determinants of such problems.
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Affiliation(s)
- Nina Mulia
- Alcohol Research Group, Public Health Institute, Emeryville, California 94608-1010, USA.
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RAMSTEDT MATS. Fluctuations in male ischaemic heart disease mortality in Russia 1959-1998: Assessing the importance of alcohol. Drug Alcohol Rev 2009; 28:390-5. [DOI: 10.1111/j.1465-3362.2009.00059.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kerr WC, Greenfield TK, Bond J, Ye Y, Rehm J. Age-period-cohort modelling of alcohol volume and heavy drinking days in the US National Alcohol Surveys: divergence in younger and older adult trends. Addiction 2009; 104:27-37. [PMID: 19133886 PMCID: PMC2728753 DOI: 10.1111/j.1360-0443.2008.02391.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS The decomposition of trends in alcohol volume and heavy drinking days into age, period, cohort and demographic effects offers an important perspective on the dynamics of change in alcohol use patterns in the United States. DESIGN The present study utilizes data from six National Alcohol Surveys conducted over the 26-year period between 1979 and 2005. Setting United States. MEASUREMENTS Alcohol volume and the number of days when five or more and eight or more drinks were consumed were derived from overall and beverage-specific graduated frequency questions. RESULTS Trend analyses show that while mean values of drinking measures have continued to decline for those aged 26 and older, there has been a substantial increase in both alcohol volume and 5+ days among those aged 18-25 years. Age-period-cohort models indicate a potential positive cohort effect among those born after 1975. However, an alternative interpretation of an age-cohort interaction where drinking falls off more steeply in the late 20s than was the case in the oldest surveys cannot be ruled out. For women only, the 1956-60 birth cohort appears to drink more heavily than those born just before or after. Models also indicate the importance of income, ethnicity, education and marital status in determining these alcohol measures. CONCLUSIONS Increased heavy drinking among young adults in recent surveys presents a significant challenge for alcohol policy and may indicate a sustained increase in future US alcohol consumption.
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Affiliation(s)
- William C. Kerr
- Alcohol Research Group, Public Health Institute, Toronto, Canada
| | | | - Jason Bond
- Alcohol Research Group, Public Health Institute, Toronto, Canada
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Toronto, Canada
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Toronto, Canada
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Nayak MB, Kerr W, Greenfield TK, Pillai A. Not all drinks are created equal: implications for alcohol assessment in India. Alcohol Alcohol 2008; 43:713-8. [PMID: 18832137 DOI: 10.1093/alcalc/agn074] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS There is sparse literature on drink alcohol content in developing countries. This study documented detailed information on drink sizes and ethanol content of alcoholic beverages consumed in three different parts of India. METHODS Data primarily from formative phases of studies on alcohol use patterns in the states of Delhi, Rajasthan and Goa are reported. Participant observation and semi-structured interviews with key informants and drinking respondents were used to assess different beverage types and to empirically measure actual drink sizes as poured. Investigation of ethanol content included the use of biochemical analyses, the alcoholmeter and the Analox Analyser AM3. Respondents interviewed in the post-formative phase in one study were also asked to define the volume of their drinks by indicating pour levels in select drinking vessels. RESULTS A wide range of alcoholic drinks were documented that varied in ethanol concentration across and within sites. Drink sizes, particularly for high-strength beverages, varied both by study site and respondent, with pours of distilled spirits on average being larger than standard measures. CONCLUSION Estimates of both mean volume of alcohol consumption and heavy drinking amounts are influenced by variability in alcohol concentration and respondent-defined pour sizes. The variation in drink alcohol content found across Indian states indicates that prior to conducting quantitative surveys, preliminary work on sources of drink alcohol content variation should be undertaken to tailor measurement tools to specific beverages and drinking practices observed. Recommendations for alcohol research in developing countries are provided.
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Affiliation(s)
- Madhabika B Nayak
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, USA.
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Abstract
AIM To review and discuss measurement issues in survey assessment of alcohol consumption for epidemiological studies. METHODS The following areas are considered: implications of cognitive studies of question answering such as self-referenced schemata of drinking, reference period and retrospective recall, as well as the assets and liabilities of types of current (e.g. food frequency, quantity-frequency, graduated frequencies and heavy drinking indicators) and life-time drinking measures. Finally we consider units of measurement and improving measurement by detailing the ethanol content of drinks in natural settings. RESULTS AND CONCLUSIONS Cognitive studies suggest inherent limitations in the measurement enterprise, yet diary studies show promise of broadly validating methods that assess a range of drinking amounts per occasion; improvements in survey measures of drinking in the life course are indicated; attending in detail to on- and off-premise drink pour sizes and ethanol concentrations of various beverages shows promise of narrowing the coverage gap plaguing survey alcohol measurement.
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Affiliation(s)
- Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, USA.
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Witbrodt J, Kaskutas LA, Korcha R, Armstrong MA. Under-estimation of Alcohol Consumption among Women At-risk for Drinking during Pregnancy. CONTEMPORARY DRUG PROBLEMS 2008; 35:37-58. [PMID: 20589228 PMCID: PMC2892911 DOI: 10.1177/009145090803500103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
This study adds to a growing literature showing that definitions for "standard drinks" are often difficult to conceptualize and that people often underestimate their actual drink sizes. As part of an intervention aimed at reducing negative neonatal and maternal outcomes, insured at-risk women were asked to identify the vessels from which they drank each of 6 beverages (n=266). We calculated differences between their actual and standard drink sizes. Additionally, differences were compared to those reported in an earlier study of uninsured inner city minority women that used identical vessels methodology. Over half of the spirits, fortified wine and malt liquor drinkers underestimated the actual number of ounces their drinks contained. Most spirits drinkers (90%) and approximately three-quarters of the wine and malt liquor drinkers drank larger-than-standard drink sizes, with the median drink size 1.5 to 2.0 times larger than the standard size for those beverages. Heavier drinkers (>/=3 drinks per sitting) were more likely than lighter drinkers to underestimate their drink sizes. Findings were similar to those in the previous study using identical drink size measurements. Accurately assessing true drink sizes is underscored when the social, health and epidemiologic consequences associated with miscalculation are considered.
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Affiliation(s)
- Jane Witbrodt
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608
| | - Lee Ann Kaskutas
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608
| | - Rachael Korcha
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608
| | - Mary Anne Armstrong
- Kaiser Permanente Medical Care Program, Division of Research, 2000 Broadway, Oakland, CA 94612
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Heeb JL, Gmel G, Rehm J, Mohler-Kuo M. Exploring daily variations of drinking in the Swiss general population. A growth curve analysis. Int J Methods Psychiatr Res 2008; 17:1-11. [PMID: 18286462 PMCID: PMC6878556 DOI: 10.1002/mpr.238] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This study aims to address the underlying trajectories of weekly individual drinking patterns by growth models and to relate differences in drinking patterns to socio-demographic and drinking characteristics of respondents. Data came from a two-stage stratified random subsample of 747 persons aged 15 years or more from a Swiss study on alcohol consumption using a within-subject design conducted between March 1999 and July 1999. Beverage specific assessment of daily alcohol consumption was obtained by a weekly drinking diary and other characteristics via telephone interviews. The diary had to be filled out on seven consecutive days. The growth models accounted for up to 37.6% of the initial error variance and provided evidence for two distinct, negatively correlated underlying trajectories of drinking patterns. The first trajectory described an increase in consumption from Monday to Sunday. The second trajectory was about a specific weekend consumption culminating on Saturday with a significantly higher growth rate among young people and heavy episodic drinkers than in other subgroups. Therefore, young and heavy episodic drinkers may be exposed to sudden adverse consequences of alcohol consumption during the weekend. Prevention efforts which are targeted to this subgroup should take its specific drinking pattern into account.
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Affiliation(s)
- Jean-Luc Heeb
- Swiss Institute for the Prevention of Alcohol and other Drug Problems, Lausanne, Switzerland.
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Kerr WC, Ye Y. Population-Level Relationships Between Alcohol Consumption Measures and Ischemic Heart Disease Mortality in U.S. Time-Series. Alcohol Clin Exp Res 2007; 31:1913-9. [PMID: 17877780 DOI: 10.1111/j.1530-0277.2007.00486.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Individual-level studies indicate the possibility of both protective and harmful effects of alcohol consumption on Ischemic Heart Disease (IHD) mortality depending on the pattern of consumption. Population-level relationships could be in either direction and previous studies have found mixed results. METHODS Population-level relationships between IHD mortality rates and per capita consumption of alcoholic beverages, cirrhosis mortality rates, cigarettes, and sugar sweetened soda for the period from 1950 to 2002 are modeled using autoregressive integrated moving average (ARIMA) and vector error correction methods. RESULTS In multivariate ARIMA models controlling for accumulated heavy drinking as represented by cirrhosis mortality, a protective effect of 4%/l was found for total alcohol consumption while cirrhosis mortality rates had significant positive effects on IHD rates. Beverage-specific models found no effect for wine, positive risks for spirits, and significant protective effects for beer. The protective effects for both total alcohol and beer were also found in vector error correction models. Significant positive effects of cigarette sales on IHD rates were also found in both types of models. CONCLUSIONS The complexity of alcohol's relationship with IHD is highlighted. Aspects of pattern represented by beverage-specific consumption and cirrhosis mortality indicate potential protective effects from moderate drinking and harmful effects from heavy drinking in accord with individual-level findings.
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Affiliation(s)
- William C Kerr
- Alcohol Research Group, Emeryville, California 94608, USA.
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Rehm J, Taylor B, Patra J. Volume of alcohol consumption, patterns of drinking and burden of disease in the European region 2002. Addiction 2006; 101:1086-95. [PMID: 16869838 DOI: 10.1111/j.1360-0443.2006.01491.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To describe the volume of alcohol consumption and patterns of drinking in the World Health Organization (WHO) European regions in 2002 and to estimate quantitatively the burden of disease attributable to alcohol in that year. METHODS Secondary data analysis. Exposure data were taken from the WHO Comparative Risk Assessment, outcome data from the WHO Measurement and Health Information department, and used to derive three outcome measures: deaths, years of life lost (YLL) and disability adjusted life years (DALY) for 2002. All calculations were conducted according to age, sex and region. RESULTS Alcohol consumption in the WHO regions for Europe was high, with 12.1 litres pure alcohol per capita, on average more than 100% above the global consumption. Alcohol consumption caused a considerable disease burden: 6.1% of all the deaths, 12.3% of all YLL and 10.7% of all DALY in all European regions in 2002 could be attributed to this exposure. Intentional and unintentional injuries accounted for almost 50% of all alcohol-attributable deaths and almost 44% of alcohol-attributable disease burden. Young people and men were affected the most. Geographically, the most eastern region around Russia had the highest alcohol-attributable disease burden. CONCLUSIONS Interventions should be implemented to reduce the high burden of alcohol-attributable disease in the European regions. Given the epidemiological structure of the burden, injury prevention, including but not restricted to the prevention of traffic injuries, and specific prevention for young people should play the most important role in a comprehensive plan to reduce alcohol-attributable burden.
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Affiliation(s)
- Jürgen Rehm
- Institut für Sucht- und Gesundheitsforschung (ISGF-Research Institute for Public Health and Addictions), Zurich, Switzerland.
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