Predictors of beverage-specific, alcohol consumption trajectories: A Swedish population-based cohort study

Alcohol consumption trajectories and associated factors in adult women: the Norwegian Women and Cancer study

AIMS

We described the age-specific trajectories of total alcohol consumption and the consumption of different types of beverages among adult Norwegian women as they age, and how these relate to education, lifestyle, and health-related factors.

METHODS

This study included 76 382 women aged 31-70 years who participated in at least two of the three Norwegian Women and Cancer (NOWAC) study surveys conducted in 1991-97, 1998-2003, and 2004-11. Group-based trajectory modeling was used to identify the trajectories of self-reported alcohol consumption. Multinomial regression models were used to fit the adjusted odds ratios (ORs) of the associations between education, lifestyle, health-related factors, and the trajectory membership. Analysis was stratified into two subcohorts: women aged 31-49 years and women aged 50-70 years at enrolment.

RESULTS

Five different trajectories of total alcohol consumption were identified among the two subcohorts: non-drinker stable (12.5%-23.6%), low stable (66.3%-60.1%), light increasing or light unstable (17.8%-12.1%), moderate to high or light to high (2.8%-2.7%), and high to moderate or moderate decreasing (.6%-1.4%). Trajectories were resembled by those of wine consumption. Compared to low stable drinkers, women who sustained or increased their total alcohol consumption showed higher ORs for higher education level, excellent self-rated health, former or current smoking status, and a body mass index (BMI) below 25 kg/m2.

CONCLUSION

While most women in this study maintained stable low-light levels of alcohol consumption, certain groups-such as women with higher education and better health-were more likely to increase their drinking with age. Women can particularly increase their drinking around the retirement age. The increasing trends of total alcohol consumption were reflected by those of wine. These findings provide information into groups and beverages that could be targeted in alcohol-reducing interventions.

The alcohol harm paradox: is it valid for self-reported alcohol harms and does hazardous drinking pattern matter?

BACKGROUND

The alcohol harm paradox (APH) posits that alcohol harms are more prevalent in low socioeconomic position (SEP) groups compared to high SEP groups, when adjusted for alcohol consumption volume.

AIM

We explored whether APH is valid for self-reported alcohol harms and whether SEP differences in hazardous drinking patterns may explain SEP differences in alcohol harms, accounting for consumption volume.

DATA AND METHODS

We applied cross-sectional data from national population surveys in Norway, restricted to a subsample of past month drinkers aged 25-79 years (n = 8 171). Two binary outcome measures of self-reported alcohol-related harms were constructed from the AUDIT-10 items 4 through 10; alcohol dependence symptoms and alcohol related consequences. We separated two SEP groups based on education level: low versus high. Employing logistic regression models, we examined the extent to which SEP differences in alcohol-related harms were attributable to a more hazardous drinking pattern in terms of: (i) heavy episodic drinking and (ii) proportion of consumption volume by spirits, adjusting for consumption volume and demographic characteristics.

RESULTS

In the low SEP group, alcohol-related harms were significantly more prevalent as compared to the high SEP group when adjusted for gender and age, and more so after adjustment for consumption volume. Measures of hazardous drinking pattern and having a spouse could only to a minor extent account for the elevated risk of alcohol-related harm in the low SEP group. The findings were robust across various sensitivity analyses.

CONCLUSION

Low SEP was associated with alcohol-related harm and a more hazardous drinking pattern but also with lower consumption volume. The findings support the validity of the alcohol harm paradox for self-reported alcohol harms.