Predictors of aging out of heavy episodic drinking in emerging adults: a systematic review protocol

Is alcohol outlet availability associated with binge drinking in Canadian young adults? Findings from British Columbia and Quebec

OBJECTIVES

Alcohol availability is associated with alcohol consumption and related harms, but there is less evidence on associations with heavy episodic drinking (HED), a drinking pattern prevalent among young adults. This study aimed to assess the associations between alcohol availability and HED among young Canadians.

METHODS

We used a population-based sample of Canadian urban-dwelling young adult drinkers (18‒29 years) from the cross-sectional Canadian Community Health Survey (CCHS; cycles 2015‒2019). We linked data from CCHS respondents in British Columbia and Quebec with two measures of alcohol availability for both offsite and onsite outlets: density (AOD) and accessibility (SAI) within dissemination areas (N = 1,067,747). We used logistic regression to estimate the associations between alcohol availability and monthly HED, adjusting for covariates.

RESULTS

The associations between availability and HED differed by province, and availability measure. In British Columbia, offsite and onsite accessibility using SAI was inversely associated with HED. For example, living in neighbourhoods with medium alcohol accessibility (as compared to low) was significantly associated with reduced odds of HED (offsite OR = 0.33, 95% CI 0.17‒0.64; onsite OR = 0.49, 95% CI 0.27‒0.89). In Quebec, offsite availability was positively associated with HED using SAI (although not statistically significant) while no clear trend was seen for onsite availability.

CONCLUSION

Results were consistent with previous evidence. Restricting spatial availability of alcohol remains an important public health strategy for decreasing the ease/convenience of access. Understanding why patterns of availability and drinking differ across regions could inform regionally tailored policies.

High peak drinking levels mediate the relation between impulsive personality and injury risk in emerging adults

BACKGROUND

Alcohol-induced injury is one of the leading causes of preventable morbidity and mortality. We investigated the relationship between impulsive personality and physical injury (e.g. falls, sports), and whether peak drinking quantity specifically, and/or risky behaviour more generally, mediates the relationship between impulsivity and injury in undergraduates.

METHOD

We used data from the winter 2021 UniVenture survey with 1316 first- and second-year undergraduate students aged 18-25 years (79.5% female) from five Canadian Universities. Students completed an online survey regarding their demographics, personality, alcohol use, risky behaviours, and injury experiences. Impulsivity was measured with the substance use risk profile scale, past 30-day peak alcohol use with the quantity-frequency-peak Alcohol Use Index, general risky behaviour with the risky behaviour questionnaire, and past 6-month injury experience with the World Health Organization's (2017) injury measurement questionnaire.

RESULTS

Of 1316 total participants, 12.9% (n = 170) reported having sustained a physical injury in the past 6 months. Mean impulsivity, peak drinking quantity, and risky behaviour scores were significantly higher among those who reported vs. did not report injury. Impulsivity and peak drinking quantity, but not general risky behaviour, predicted injury in a multi-level generalized mixed model. Mediation analyses supported impulsivity as both a direct predictor of physical injury and an indirect predictor through increased peak drinking (both p < .05), but not through general risky behaviour.

CONCLUSION

Results imply emerging adults with impulsive tendencies should be identified for selective injury prevention programs and suggest targeting their heavy drinking to decrease their risk for physical injury.

Social disparities in alcohol consumption among Canadian emerging adults

INTRODUCTION

Young adult drinking is a public health priority, but knowledge of socioeconomic status (SES) indicators and alcohol use among emerging adults (EAs; aged 18-29 years) is primarily informed by college samples, populations in their late teens and early twenties and non-Canadian data. We compared the association of three different SES indicators with monthly heavy episodic drinking (HED), less-than-monthly HED, no HED, and no drinking among Canadian EAs.

METHODS

We pooled the 2015 to 2019 waves of the Canadian Community Health Survey to include participants aged 18 to 29 years (n = 29 598). Using multinomial regression, we calculated weighted estimates of alcohol use by education, household income and area-level disadvantage, adjusting for adult roles and sociodemographic characteristics.

RESULTS

Approximately 30% of EAs engaged in monthly HED, whereas 16% did not drink at all in the past year. Compared to those in the lowest household incomes, being in the top income quintile was significantly associated with increased relative odds of monthly HED (e.g. in combined SES model, RRR = 1.21, 95% CI: 1.04-1.39). Higher levels of education, being in higher income quintiles and living in less disadvantaged areas were significantly associated with reduced relative odds of no HED and not drinking. Adjusting for adult roles did not substantially change the associations between SES and alcohol use.

CONCLUSION

Higher SES was associated with HED among EAs, although the magnitude of association was small. Universal prevention measures addressing the affordability, availability and marketing of alcohol could be complemented by interventions targeting EA populations at higher risk of HED.