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Jirwe M, Andreasson S, Wallhed Finn S. Alcohol Dependence, Treatment Seeking, and Treatment Preferences Among Elderly: A Qualitative Study. J Addict Nurs 2024; 35:28-35. [PMID: 38373173 DOI: 10.1097/jan.0000000000000564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
INTRODUCTION In Sweden, alcohol consumption has increased among people aged 65 years and older. Among older adults, 2.7% of men and 1.6% of women fulfill criteria for alcohol dependence. The large majority do not seek treatment. Little is known about treatment seeking among older adults with alcohol dependence. AIM The aim of this study was to describe elderly's views on alcohol dependence, treatment seeking, and treatment preferences. Possible gender differences will also be explored. METHODS Between December 2017 and March 2018, two focus group interviews and 10 individual interviews were conducted, using semistructured interviews. In total, 13 elderly participated. Data were analyzed using the framework approach. RESULTS Two themes and five subthemes were identified: (a) "regret and feelings of shame when losing control" consisting of two subthemes, namely, (1) loss of control over your alcohol consumption and (2) regret and feelings of shame, and (b) "taking back control over your life" consisting of three subthemes, namely, (1) becoming aware that you have problematic alcohol use, (2) to seek help for alcohol dependence, and (3) views on treatment options and treatment settings. CONCLUSIONS Increased alcohol use was attributed to a decrease in responsibility and belonging. Alcohol dependence was associated with shame and stigma, which was especially strong for women. Preferred treatments were tailored for the individual, rather than to general factors such as age or gender. Moreover, important components of treatment were to be met with respect, continuity, and controlled drinking as a treatment goal. Future research should focus on interventions to reduce stigma and the development of patient-centered treatments.
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Wallhed Finn S, Mejldal A, Baskaran R, Nielsen AS. Effects of media campaign videos on stigma and attitudes towards treatment seeking for alcohol use disorder: a randomized controlled study. BMC Public Health 2023; 23:1919. [PMID: 37794390 PMCID: PMC10552234 DOI: 10.1186/s12889-023-16811-4] [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: 08/25/2022] [Accepted: 09/21/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Alcohol Use Disorder (AUD) is one of the most stigmatized diagnosis, and stigma imposes a major barrier to treatment seeking. There is a need to develop interventions that can reduce stigma and increase treatment seeking. Little is known about the effects of video materials. The aim of this study was to investigate effects of different videos. The primary outcome was public stigma, and secondary outcomes were: self-stigma, and motivation to change own alcohol use; talking to someone else about their alcohol use; seeking information about AUD treatment or seeking AUD treatment. METHODS This is a three-armed double blind randomized controlled study. The study included 655 Danish adults. Data was collected at a study webpage, and the survey could be completed anywhere with Internet access. After informed consent and completing baseline measures, participants were randomized, 1:1:1 ratio, to a video (video 1 n = 228; video 2 n = 198; video 3 n = 229). Video 1 and 2 have been used in a national mass media campaign and video 3 was recorded for use in the present study. Immediately after exposure, follow-up measures were completed. Outcomes were analyzed with mixed effects linear regression. RESULTS In total n = 616 completed follow-up (video 1 n = 215; video 2 n = 192; video 3 n = 209). Randomization to video 1 and 3 decreased public stigma measured with "Difference, Disdain & Blame Scales", while video 2 increased stigma. Video 2 compared to 1: 2.262 (95% CI 1.155; 3.369) p < 0.001. Video 3 compared to 1: -0.082 (95% CI -1.170; 1.006) p = 0.882. Video 3 compared to 2: -2.344 (95% CI -3.455; -1.233) p = 0.882. All videos reduced motivation to change own alcohol use. Participants with hazardous alcohol use, were more sensitive to the different videos, compared to low-risk alcohol use. Video 2 decreased motivation to seek information about treatment. No effects were seen on motivation to seek treatment, motivation to talk to someone else or self-stigma. CONCLUSIONS Videos can have an immediate effect on level of public stigma. Other types of interventions are needed to increase motivation and reduce self-stigma. To avoid adverse effects in future interventions, the use of theoretical frameworks and stakeholder involvement is emphasized.
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Affiliation(s)
- Sara Wallhed Finn
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, Odense, 5000, Denmark.
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Anna Mejldal
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, Odense, 5000, Denmark
| | - Ruben Baskaran
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, Odense, 5000, Denmark
- SDU Health informatics and technology, Faculty of engineering, The Maersk Mc-Kinney Moller institute, University of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, Odense, 5000, Denmark
- Psychiatric Hospital, University Function, Region of Southern, Odense, Denmark
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Jackson SE, Cox S, Shahab L, Brown J. Impact of the cost-of-living crisis on the nature of attempts to stop smoking and to reduce alcohol consumption in Great Britain: A representative population survey, 2021-2022. PLoS One 2023; 18:e0286183. [PMID: 37220140 PMCID: PMC10204963 DOI: 10.1371/journal.pone.0286183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/11/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Smoking and excessive drinking place a strain on household budgets. We aimed to examine the impact of the cost-of-living crisis in Great Britain on the nature of smoking cessation and alcohol reduction attempts, and explore changes in health professionals offering support. METHODS Data were from 14,567 past-year smokers and high-risk drinkers (AUDIT-C ≥5) participating in monthly representative surveys, January-2021 through December-2022. We estimated time trends in cost as a motive driving the most recent (smoking cessation/alcohol reduction) attempt, use of paid or evidence-based support, and receipt of GP offer of support for smoking cessation or alcohol reduction, and tested for moderation by occupational social grade. RESULTS The proportion of attempts motivated by cost did not change significantly over time among smokers (25.4% [95%CI = 23.8-26.9%]), but increased between December-2021 and December-2022 among high-risk drinkers from less advantaged social grades (from 15.3% [95%CI 12.1-19.3] to 29.7% [20.1-44.1]). The only change in support use was an increase in smokers using paid support, specifically e-cigarettes (from 28.1% [23.7-33.3] to 38.2% [33.0-44.4]). Among those visiting their GP, the proportion who received an offer of support was similar over time among smokers (27.0% [25.7-28.2]) and high-risk drinkers (1.4% [1.1-1.6%]). CONCLUSIONS There is limited evidence that the 2021/22 cost-of-living crisis affected the nature of attempts to stop smoking and reduce alcohol consumption, or receipt of GP offer of support. It is encouraging that use of evidence-based support has not declined and that use of e-cigarettes in quit attempts has increased. However, cost is increasingly motivating alcohol reduction attempts among less advantaged drinkers, and rates of GPs offering support, especially for alcohol reduction, remain very low.
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Affiliation(s)
- Sarah E. Jackson
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, London, United Kingdom
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, London, United Kingdom
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, London, United Kingdom
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, London, United Kingdom
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Bowden J, Harrison NJ, Caruso J, Room R, Pettigrew S, Olver I, Miller C. Which drinkers have changed their alcohol consumption due to energy content concerns? An Australian survey. BMC Public Health 2022; 22:1775. [PMID: 36123667 PMCID: PMC9484340 DOI: 10.1186/s12889-022-14159-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Alcohol is a discretionary, energy dense, dietary component. Compared to non-drinkers, people who consume alcohol report higher total energy intake and may be at increased risk of weight gain, overweight, and obesity, which are key preventable risk factors for illness. However, accurate consumer knowledge of the energy content in alcohol is low. To inform future behaviour change interventions among drinkers, this study investigated individual characteristics associated with changing alcohol consumption due to energy-related concerns. Methods An online survey was undertaken with 801 Australian adult drinkers (18–59 years, 50.2% female), i.e. who consumed alcohol at least monthly. In addition to demographic and health-related characteristics, participants reported past-year alcohol consumption, past-year reductions in alcohol consumption, frequency of harm minimisation strategy use (when consuming alcohol), and frequency of changing alcohol consumption behaviours because of energy-related concerns. Results When prompted, 62.5% of participants reported changing alcohol consumption for energy-related reasons at least ‘sometimes’. Women, those aged 30–44 years, metropolitan residents, those with household income $80,001–120,000, and risky/more frequent drinkers had increased odds of changing consumption because of energy-related concerns, and unemployed respondents had reduced odds. Conclusions Results indicate that some sociodemographic groups are changing alcohol consumption for energy-related reasons, but others are not, representing an underutilised opportunity for health promotion communication. Further research should investigate whether messaging to increase awareness of alcohol energy content, including through systems-based policy actions such as nutritional/energy product labelling, would motivate reduced consumption across a broader range of drinkers.
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Affiliation(s)
- Jacqueline Bowden
- National Centre for Education and Training on Addiction (NCETA), Flinders Health and Medical Research Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.,Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Nathan J Harrison
- National Centre for Education and Training on Addiction (NCETA), Flinders Health and Medical Research Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia. .,Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
| | - Joanna Caruso
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, School of Psychology & Public Health, La Trobe University, Bundoora, VIC, Australia.,Department of Public Health Sciences, Centre for Social Research On Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,The National Drug Research Institute, Curtin University, Bentley, WA, Australia
| | - Ian Olver
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Caroline Miller
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Public Health, The University of Adelaide, Adelaide, SA, Australia
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Sasso A, Hernández-Alava M, Holmes J, Field M, Angus C, Meier P. Strategies to cut down drinking, alcohol consumption, and usual drinking frequency: Evidence from a British online market research survey. Soc Sci Med 2022; 310:115280. [PMID: 35994876 DOI: 10.1016/j.socscimed.2022.115280] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/30/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Relatively little is known about how risky drinkers attempt to moderate their drinking in the absence of specialist support. The broader literature has identified multiple potential strategies that people use to cope with temptation when trying to control health-risk behaviours. This study aims to identify types of alcohol moderation strategies used by British adults, and to explore how concurrent alcohol consumption differs across moderation strategies, focusing on the important role of usual drinking frequency. METHODS We use a continuous repeat cross-sectional survey and one-week drinking diary collected by the market research company Kantar; these provide detailed information on alcohol consumption during a diary week and on how individuals try to moderate alcohol use for 49,204 British adults trying to reduce their drinking from 2013 to 2019. We use Latent Class Analysis (LCA) to identify predominant types of moderation strategies. With a three-step method, we also analyse the associations between adopting different moderation strategies, measures of frequency and intensity of drinking events, and usual drinking frequency. RESULTS We found evidence of four alcohol moderation strategies: 29% of individuals use a pre-commitment-focused strategy (having fewer drinking occasions), two set of individuals adopt self-control strategies within drinking occasions (specifically 28% select smaller drinks and 5% have fewer drinks), while 38% adopt a mixed strategy that involves all three. Those using commitment tend to have a higher average consumption per drinking occasion but lower overall weekly consumption compared to those using self-control. Weekly alcohol consumption is particularly high among individuals who are usual everyday drinkers and use self-control to cut down drinking. CONCLUSION This analysis provides a useful platform for further work, using prospective or intervention designs, to test the relative effectiveness of different moderation strategies for alcohol consumers who want to reduce their alcohol consumption.
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Affiliation(s)
- Alessandro Sasso
- Sheffield Alcohol Research Group (SARG), School of Health and Related Research, University of Sheffield, UK; Health Economics and Decision Science (HEDS), School of Health and Related Research, University of Sheffield, UK.
| | - Mónica Hernández-Alava
- Health Economics and Decision Science (HEDS), School of Health and Related Research, University of Sheffield, UK
| | - John Holmes
- Sheffield Alcohol Research Group (SARG), School of Health and Related Research, University of Sheffield, UK
| | - Matt Field
- Department of Psychology, University of Sheffield, UK
| | - Colin Angus
- Sheffield Alcohol Research Group (SARG), School of Health and Related Research, University of Sheffield, UK
| | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, UK
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Lee B, Seo DC. A 114% Cigarette Tax Hike and Drinking Behavior: Results From Nationally Representative Longitudinal Panel Data in Korea. Asia Pac J Public Health 2022; 34:627-633. [DOI: 10.1177/10105395221096545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated whether or not drinking behavior changed among Korean adult smokers after a 114% cigarette tax hike in 2015. Data were drawn from waves 9 to 12 (collected yearly from 2014 to 2017) of the nationally representative longitudinal study, the Korean Welfare Panel Study. Korean adults who were ≥19 years comprised the analysis sample (N = 10 875). We applied a difference-in-differences approach to compare drinking behavior before and after the tax increase among three groups (ie, quitters, continued smokers, and nonsmokers). We found that alcohol drinking significantly decreased among those who quit smoking after the tax increase, compared with nonsmokers ( P = .022). Our findings support that a cigarette tax increase may have the beneficial spillover influence of reduction in drinking as well as smoking if the tax increase can induce smokers to quit, but such positive spillover influence may be short-term or null for continued smokers.
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Affiliation(s)
- Boram Lee
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
- Tobacco Treatment and Research Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Dong-Chul Seo
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
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Irizar P, Puddephatt JA, Warren JG, Field M, Jones A, Rose AK, Gage SH, Goodwin L. "Drinkers Like Me": A Thematic Analysis of Comments Responding to an Online Article About Moderating Alcohol Consumption. Front Psychol 2022; 13:780677. [PMID: 35360610 PMCID: PMC8963980 DOI: 10.3389/fpsyg.2022.780677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/17/2022] [Indexed: 11/28/2022] Open
Abstract
Background There has been media coverage surrounding the dangers of heavy drinking and benefits of moderation, with TV and radio presenter, Adrian Chiles, documenting his experience of moderating alcohol consumption in an online article for the Guardian. By analysing the comments in response to Chiles' article, this study aimed to explore (i) posters' (someone who has posted a comment in response to the article) attitudes or beliefs toward moderating alcohol and (ii) posters' experiences of moderating or abstaining from alcohol. Method A secondary qualitative analysis of online comments in response to an article about moderating alcohol consumption. Main outcome measures: Comments (n = 784) in response to a United Kingdom online news article about moderating alcohol consumption were extracted and inductive thematic analysis was used. Results For aim one, two themes were developed; "general attitudes toward drinking" and "general attitudes toward reducing consumption". These themes reflect negative perceptions of alcohol and issues around changing attitudes. For aim two, three themes were developed: "moderation vs. abstention", "reflection on past drinking behaviours", and "current drinking behaviours". These themes represent posters' experiences and implications changing their drinking habits. Conclusion Our analysis provides a novel insight into perceptions and experiences of moderating or abstaining from alcohol. Alcohol is embedded within United Kingdom culture, creating difficulties for those who choose to moderate or abstain from alcohol. Our analysis highlights the need for public health to focus on shifting the current drinking culture, through clearer drinking guidelines and a wider availability of alcohol-free alternatives.
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Affiliation(s)
- Patricia Irizar
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, Liverpool Health Partners, Liverpool, United Kingdom
| | - Jo-Anne Puddephatt
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, Liverpool Health Partners, Liverpool, United Kingdom
| | - Jasmine G. Warren
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, Liverpool Health Partners, Liverpool, United Kingdom
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Andrew Jones
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, Liverpool Health Partners, Liverpool, United Kingdom
| | - Abigail K. Rose
- Liverpool Centre for Alcohol Research, Liverpool Health Partners, Liverpool, United Kingdom
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Suzanne H. Gage
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, Liverpool Health Partners, Liverpool, United Kingdom
| | - Laura Goodwin
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, Liverpool Health Partners, Liverpool, United Kingdom
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Skourlis N, Massara P, Patsis I, Peppa E, Katsouyanni K, Trichopoulou A. Long-Term Trends (1994-2011) and Predictors of Total Alcohol and Alcoholic Beverages Consumption: The EPIC Greece Cohort. Nutrients 2021; 13:3077. [PMID: 34578956 PMCID: PMC8469614 DOI: 10.3390/nu13093077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/21/2021] [Accepted: 08/25/2021] [Indexed: 01/21/2023] Open
Abstract
The aim of this study was to evaluate the longitudinal changes in alcohol consumption (total alcohol and types of alcoholic beverages) of the Greek EPIC cohort participants (28,572) during a 17-year period (1994-2011), with alcohol information being recorded repeatedly over time. Descriptive statistics were used to show crude trends in drinking behavior. Mixed-effects models were used to study the consumption of total alcohol, wine, beer and spirits/other alcoholic beverages in relation to birth cohort, socio-demographic, lifestyle and health factors. We observed a decreasing trend of alcohol intake as age increased, consistent for total alcohol consumption and the three types of beverages. Older birth cohorts had lower initial total alcohol consumption (8 vs. 10 g/day) and steeper decline in wine, spirits/other alcoholic beverages and total alcohol consumption compared to younger cohorts. Higher education and smoking at baseline had a positive association with longitudinal total alcohol consumption, up to +30% (vs. low education) and more than +25% (vs. non-smoking) respectively, whereas female gender, obesity, history of heart attack, diabetes, peptic ulcer and high blood pressure at baseline had a negative association of -85%, -25%, -16%, -37%, -22% and -24% respectively. Alcohol consumption changed over age with different trends among the studied subgroups and types of alcohol, suggesting targeted monitoring of alcohol consumption.
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Affiliation(s)
- Nikolaos Skourlis
- Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos, 11527 Athens, Greece; (P.M.); (I.P.); (E.P.); (K.K.); (A.T.)
| | - Paraskevi Massara
- Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos, 11527 Athens, Greece; (P.M.); (I.P.); (E.P.); (K.K.); (A.T.)
| | - Ioannis Patsis
- Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos, 11527 Athens, Greece; (P.M.); (I.P.); (E.P.); (K.K.); (A.T.)
| | - Eleni Peppa
- Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos, 11527 Athens, Greece; (P.M.); (I.P.); (E.P.); (K.K.); (A.T.)
| | - Klea Katsouyanni
- Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos, 11527 Athens, Greece; (P.M.); (I.P.); (E.P.); (K.K.); (A.T.)
- Department of Hygiene Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos, 11527 Athens, Greece; (P.M.); (I.P.); (E.P.); (K.K.); (A.T.)
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Jackson SE, Garnett C, Shahab L, Oldham M, Brown J. Association of the COVID-19 lockdown with smoking, drinking and attempts to quit in England: an analysis of 2019-20 data. Addiction 2021; 116:1233-1244. [PMID: 33089562 PMCID: PMC8436745 DOI: 10.1111/add.15295] [Citation(s) in RCA: 164] [Impact Index Per Article: 54.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/09/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022]
Abstract
AIM To examine changes in smoking, drinking and quitting/reduction behaviour following the COVID-19 lockdown in England. DESIGN/SETTING Monthly cross-sectional surveys representative of the adult population in England, aggregated before (April 2019-February 2020) versus after (April 2020) lockdown. PARTICIPANTS A total of 20 558 adults (≥ 16 years). MEASUREMENTS The independent variable was the timing of the COVID-19 lockdown (before versus after March 2020). Dependent variables were: prevalence of smoking and high-risk drinking, past-year cessation and quit attempts (among past-year smokers), past-year attempts to reduce alcohol consumption (among high-risk drinkers) and use of evidence-based (e.g. prescription medication/face-to-face behavioural support) and remote support [telephone support/websites/applications (apps)] for smoking cessation and alcohol reduction (among smokers/high-risk drinkers who made a quit/reduction attempt). Covariates included age, sex, social grade, region and level of nicotine and alcohol dependence (as relevant). FINDINGS The COVID-19 lockdown was not associated with a significant change in smoking prevalence [17.0% (after) versus 15.9% (before), odds ratio (OR) = 1.09, 95% CI = 0.95-1.24], but was associated with increases in quit attempts [39.6 versus 29.1%, adjusted odds ratio (ORadj ) = 1.56, 95% CI = 1.23-1.98], quit success (21.3 versus 13.9%, ORadj = 2.01, 95% CI = 1.22-3.33) and cessation (8.8 versus 4.1%, ORadj = 2.63, 95% CI = 1.69-4.09) among past-year smokers. Among smokers who tried to quit, there was no significant change in use of evidence-based support (50.0 versus 51.5%, ORadj = 1.10, 95% CI = 0.72-1.68) but use of remote support increased (10.9 versus 2.7%, ORadj = 3.59, 95% CI = 1.56-8.23). Lockdown was associated with increases in high-risk drinking (38.3 versus 25.1%, OR = 1.85, CI = 1.67-2.06), but also alcohol reduction attempts by high-risk drinkers (28.5 versus 15.3%, ORadj = 2.16, 95% CI = 1.77-2.64). Among high-risk drinkers who made a reduction attempt, use of evidence-based support decreased (1.2 versus 4.0%, ORadj = 0.23, 95% CI = 0.05-0.97) and there was no significant change in use of remote support (6.9 versus 6.1%, ORadj = 1.32, 95% CI = 0.64-2.75). CONCLUSIONS Following the March 2020 COVID-19 lockdown, smokers and high-risk drinkers in England were more likely than before lockdown to report trying to quit smoking or reduce alcohol consumption and rates of smoking cessation and use of remote cessation support were higher. However, high-risk drinking prevalence increased post-lockdown and use of evidence-based support for alcohol reduction by high-risk drinkers decreased with no compensatory increase in use of remote support.
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Affiliation(s)
- Sarah E. Jackson
- Department of Behavioural Science and HealthUniversity College LondonUK
- SPECTRUM Consortium, LondonUK
| | - Claire Garnett
- Department of Behavioural Science and HealthUniversity College LondonUK
- SPECTRUM Consortium, LondonUK
| | - Lion Shahab
- Department of Behavioural Science and HealthUniversity College LondonUK
- SPECTRUM Consortium, LondonUK
| | - Melissa Oldham
- Department of Behavioural Science and HealthUniversity College LondonUK
- SPECTRUM Consortium, LondonUK
| | - Jamie Brown
- Department of Behavioural Science and HealthUniversity College LondonUK
- SPECTRUM Consortium, LondonUK
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Perman-Howe PR, Davies EL, Foxcroft DR. The effect of alcohol strength on alcohol consumption: findings from a randomised controlled cross-over pilot trial. Pilot Feasibility Stud 2021; 7:37. [PMID: 33514445 PMCID: PMC7846989 DOI: 10.1186/s40814-021-00777-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/18/2021] [Indexed: 12/20/2022] Open
Abstract
Background Reducing the alcohol content of drinks has the potential to reduce alcohol consumption. The aims of this study are to (1) test the feasibility of a randomised controlled trial (RCT) to assess the effect of alcohol strength on alcohol consumption within licensed premises in the United Kingdom (UK), and to (2) provide data to estimate key parameters for a RCT. Methods This study is a double-blind randomised controlled cross-over pilot trial based within four licensed premises in the UK. Participants (n = 36) purchased and consumed ad libitum a 3.5% lager and a 4.8% lager during two separate study sessions. Descriptive statistics reported the efficacy and efficiency of the study processes, and the rates of licensed premises recruitment, and participant recruitment and attrition. Mean and the 95% confidence interval (CI) compared alcohol consumption between conditions. The mean, standard deviation (SD) and CI of UK units of alcohol consumed were used to calculate a sample size for a RCT. Responses to participant questionnaires and duration of participation in study sessions between conditions were analysed. Results Components of the study protocol were effective and efficient. The venue recruitment rate was less than anticipated. The participant recruitment rate was greater than anticipated. The rate of attrition was 23% and varied by less than 1% according to the arm of the trial. There was a reduction of alcohol consumed under the intervention conditions. Estimated mean difference, and 95% CI (UK units): − 3.76 (− 5.01 to − 2.52). The sample size required for a RCT is 53. Participants did not find one lager more pleasant in taste: (on a scale of one to 10) − 0.95 (− 2.11 to 0.21). Participants found the reduced-strength lager less enjoyable: (on a scale of one to 10) − 1.44 (− 2.64 to − 0.24) and they perceived themselves to be less intoxicated after consuming it: (on a scale of one to 10) − 1.00 (− 1.61 to − 0.40). Conclusion A RCT is feasible with minor alterations to the study protocol and scoping work to establish different brands of alcohol that are more alike and more enjoyable than the products used in the pilot trial. Trial registration Registered in the American Economic Association (AEA) Randomised Controlled Trial (RCT) Registry as of 16 June 2017. Unique identifying number: AEARCTR-0002266. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00777-4.
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Affiliation(s)
- Parvati R Perman-Howe
- King's College London, Addiction Sciences Building, 4 Windsor Walk, Denmark Hill Campus, London, SE5 8BB, UK.
| | - Emma L Davies
- Oxford Brookes University, Gipsy Lane Campus, Gipsy Lane, Oxford, OX3 0BP, UK
| | - David R Foxcroft
- Oxford Brookes University, Gipsy Lane Campus, Gipsy Lane, Oxford, OX3 0BP, UK
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11
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Rosansky JA, Rosenberg H. A systematic review of reasons for abstinence from alcohol reported by lifelong abstainers, current abstainers and former problem‐drinkers. Drug Alcohol Rev 2020; 39:960-974. [DOI: 10.1111/dar.13119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 05/12/2020] [Accepted: 05/20/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Joseph A. Rosansky
- Department of Psychology Bowling Green State University Bowling Green USA
| | - Harold Rosenberg
- Department of Psychology Bowling Green State University Bowling Green USA
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12
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Raggatt M, Wright C, Dietze P, Pennay A, Caluzzi G, Lim M. Correlates of Reduced Alcohol Consumption among a Sample of Young Australians. Alcohol Alcohol 2019; 54:525-531. [PMID: 31250879 DOI: 10.1093/alcalc/agz057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/22/2019] [Accepted: 06/19/2019] [Indexed: 11/14/2022] Open
Abstract
AIMS Population data suggest that a significant proportion of young drinkers are reducing or ceasing their alcohol use; however, there is a lack of information about the characteristics of young people who do so. Our study aimed to determine characteristics associated with self-reported attempted and successful alcohol reduction and cessation among young people in Victoria, Australia. METHODS Data are from a cross-sectional online survey with young people aged 15-29 years living in Victoria, Australia. Participants who reported consuming alcohol in the past 12 months were included in the analysis (N = 1,162). RESULTS Alcohol drinking cessation in the past 12 months was reported by 3.8% (n = 44) and reduced alcohol consumption was reported by 32.1% (n = 371) of participants. Characteristics associated with trying to reduce or cease alcohol consumption were older age, being born overseas, drinking at hazardous levels, experiencing alcohol-related harms and interest in health content on social media. Characteristics associated with successful alcohol reduction or cessation were being born overseas and experiencing alcohol-related harm, while being a member of a religious group was negatively associated. CONCLUSIONS Recent reduction in alcohol consumption was common among young people in this study. Recent reduction in alcohol consumption was common among young people in this study. A combination of factors appear to be correlated with recent attempts to reduce drinking young people including socio-demographic characteristics, religiosity, drinking practices and experience of harm, and interest in health.
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Affiliation(s)
| | - Cassandra Wright
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Paul Dietze
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Gabriel Caluzzi
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Megan Lim
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
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13
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Pennay A, Callinan S, Livingston M, Lubman DI, Holmes J, MacLean S, Herring R, Dietze P. Patterns in Reduction or Cessation of Drinking in Australia (2001-2013) and Motivation for Change. Alcohol Alcohol 2019; 54:79-86. [PMID: 30346513 PMCID: PMC7614938 DOI: 10.1093/alcalc/agy072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 10/14/2018] [Indexed: 11/14/2022] Open
Abstract
AIMS This paper examines: (a) change over time (2001-2013) in recently reducing or ceasing drinking in the Australian population and (b) the reasons given for reducing or ceasing drinking in the most recent survey (2013); stratified by sex and age group. SHORT SUMMARY Rates of reducing and ceasing drinking increased between 2001 and 2013 in Australia. Young people were more likely to modify drinking due to lifestyle and enjoyment reasons; older groups were more likely to report health reasons. These trends contribute to the broader context of declining alcohol consumption in Australia. METHODS Data are from five waves of the National Drug Strategy Household Survey (N = 119,397). Logistic regression models with interaction terms were used to identify a shift in sex or age over time in predicting reduction or cessation of drinking and to predict motivations for reducing or ceasing drinking by sex and age. RESULTS Reports of recently reducing the quantity or frequency of drinking increased from 2001 to 2007 and remained stable between 2007 and 2013. There was a steady increase in the number of Australians reporting recently ceasing drinking from 2001 to 2013, with a significant effect for age (younger groups more likely than older groups to cease drinking in the past two waves). Reasons for reducing or ceasing drinking varied by age, with older people more likely to report health reasons and younger people more likely to report lifestyle reasons or enjoyment. CONCLUSION Increases over time in reports of reduction or cessation of drinking due to health, lifestyle, social and enjoyment reasons suggest that the social position of alcohol in Australia may be shifting, particularly among young people.
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Affiliation(s)
- Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Daniel I. Lubman
- Turning Point, Melbourne, Australia
- Monash University, Melbourne, Australia
| | - John Holmes
- School of Health and Related Research, University of Sheffield, UK
| | - Sarah MacLean
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Rachel Herring
- Drug and Alcohol Research Centre, Department of Mental Health, Social Work and Integrative Medicine, School of Health Education, Middlesex University, London, UK
| | - Paul Dietze
- Centre for Population Health, Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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14
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Garnett C, Perski O, Tombor I, West R, Michie S, Brown J. Predictors of Engagement, Response to Follow Up, and Extent of Alcohol Reduction in Users of a Smartphone App (Drink Less): Secondary Analysis of a Factorial Randomized Controlled Trial. JMIR Mhealth Uhealth 2018; 6:e11175. [PMID: 30552081 PMCID: PMC6315249 DOI: 10.2196/11175] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/28/2018] [Accepted: 08/28/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Digital interventions for alcohol can help achieve reductions in hazardous and harmful alcohol consumption. The Drink Less app was developed using evidence and theory, and a factorial randomized controlled trial (RCT) suggested that 4 of its intervention modules may assist with drinking reduction. However, low engagement is an important barrier to effectiveness, and low response to follow up is a challenge for intervention evaluation. Research is needed to understand what factors influence users' level of engagement, response to follow up, and extent of alcohol reduction. OBJECTIVE This study aimed to investigate associations between user characteristics, engagement, response to follow up, and extent of alcohol reduction in an app-based intervention, Drink Less. METHODS This study involved a secondary data analysis of a factorial RCT of the Drink Less app. Participants (N=672) were aged 18 years or older, lived in the United Kingdom, and had an Alcohol Use Disorders Identification Test score >7 (indicative of excessive drinking). Sociodemographic and drinking characteristics were assessed at baseline. Engagement was assessed in the first month of use (number of sessions, time on app, number of days used, and percentage of available screens viewed). Response to follow up and extent of alcohol reduction (change in past week consumption) were measured after 1 month. Associations were assessed using unadjusted and adjusted linear or logistic regression models. RESULTS Age (all unstandardized regression coefficients [B] >.02, all P<.001) and post-16 educational qualifications (all B>.18, all P<.03) were positively associated with all engagement outcomes. Age (odds ratio [OR] 1.04, P<.001), educational qualifications (OR 2.11, P<.001), and female gender (OR 1.58, P=.02) were positively associated with response to follow up. Engagement outcomes predicted response to follow up (all OR>1.02, all P<.001) but not the extent of alcohol reduction (all -.14.07). Baseline drinking characteristics were the only variables associated with the extent of alcohol reduction among those followed up (all B>.49, all P<.001). CONCLUSIONS Users of the alcohol reduction app, Drink Less, who were older and had post-16 educational qualifications engaged more and were more likely to respond at 1-month follow up. Higher baseline alcohol consumption predicted a greater extent of alcohol reduction among those followed up but did not predict engagement or response to follow up. Engagement was associated with response to follow up but was not associated with the extent of alcohol reduction, which suggests that the Drink Less app does not have a dose-response effect. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number ISRCTN40104069; http://www.isrctn.com/ISRCTN40104069 (Archived by WebCite at http://www.webcitation.org/746HqygIV).
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Affiliation(s)
- Claire Garnett
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Olga Perski
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- Department of Clinical, Education and Health Psychology, University College London, London, United Kingdom
| | - Ildiko Tombor
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Susan Michie
- Department of Clinical, Education and Health Psychology, University College London, London, United Kingdom
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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15
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Perman-Howe PR, Davies EL, Foxcroft DR. The effect of alcohol strength on alcohol consumption: a randomised controlled cross-over pilot trial. Pilot Feasibility Stud 2018; 4:138. [PMID: 30123528 PMCID: PMC6090776 DOI: 10.1186/s40814-018-0328-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 08/01/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Effective interventions are required to reduce alcohol consumption and its associated harms at the population level. Reducing the alcohol content of beverages has the potential to reduce alcohol consumption through non-conscious processes. Before implementing a randomised controlled trial (RCT) to assess the effect of alcohol strength on alcohol consumption, its feasibility needs to be established. This study aims to pilot a RCT and obtain data to estimate key parameters required when designing a RCT. These key parameters include the direction and size of the intervention effect, the efficacy and efficiency of the study processes and the rates of licenced premises recruitment, participant recruitment and attrition. METHODS A double-blind randomised controlled cross-over pilot trial comparing the number of units of reduced strength lager consumed and the number of units of regular strength lager consumed in a single drinking occasion within licenced premises in the UK.Descriptive statistics will report the efficacy and efficiency of the study processes and the rates of licenced premises recruitment, participant recruitment and attrition. Mean and 95% confidence intervals will be used to compare the consumption of alcohol and the duration of participation in study sessions, between the intervention arm and the control arm. The mean and standard deviation of UK units of alcohol consumed will be used to calculate a sample size for a definitive RCT. DISCUSSION This is the first naturalistic experimental study to assess the effect of alcohol strength on alcohol consumption in a single drinking occasion within licenced premises. Results from this pilot study will establish the feasibility of, and inform key data parameters for, a larger scale study. TRIAL REGISTRATION The trial is registered in the American Economic Association (AEA) Randomised Controlled Trial (RCT) Registry as of 16 June 2017. The unique identifying number is AEARCTR-0002266.
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Affiliation(s)
| | - Emma L. Davies
- Oxford Brookes University, Gipsy Lane Campus, Gipsy Lane, Oxford, OX3 0BP UK
| | - David R. Foxcroft
- Oxford Brookes University, Marston Campus, Jack Straw’s Lane, Oxford, OX3 0FL UK
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16
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Kersbergen I, Oldham M, Jones A, Field M, Angus C, Robinson E. Reducing the standard serving size of alcoholic beverages prompts reductions in alcohol consumption. Addiction 2018; 113:1598-1608. [PMID: 29756262 PMCID: PMC6099514 DOI: 10.1111/add.14228] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/13/2017] [Accepted: 03/26/2018] [Indexed: 12/13/2022]
Abstract
AIMS To test whether reducing the standard serving size of alcoholic beverages would reduce voluntary alcohol consumption in a laboratory (study 1) and a real-world drinking environment (study 2). Additionally, we modelled the potential public health benefit of reducing the standard serving size of on-trade alcoholic beverages in the United Kingdom. DESIGN Studies 1 and 2 were cluster-randomized experiments. In the additional study, we used the Sheffield Alcohol Policy Model to estimate the number of deaths and hospital admissions that would be averted per year in the United Kingdom if a policy that reduces alcohol serving sizes in the on-trade was introduced. SETTING A semi-naturalistic laboratory (study 1), a bar in Liverpool, UK (study 2). PARTICIPANTS Students and university staff members (study 1: n = 114, mean age = 24.8 years, 74.6% female), residents from local community (study 2: n = 164, mean age = 34.9 years, 57.3% female). INTERVENTIONS AND COMPARATORS In study 1, participants were assigned randomly to receive standard or reduced serving sizes (by 25%) of alcohol during a laboratory drinking session. In study 2, customers at a bar were served alcohol in either standard or reduced serving sizes (by 28.6-33.3%). MEASUREMENTS Outcome measures were units of alcohol consumed within 1 hour (study 1) and up to 3 hours (study 2). Serving size condition was the primary predictor. FINDINGS In study 1, a 25% reduction in alcohol serving size led to a 20.7-22.3% reduction in alcohol consumption. In study 2, a 28.6-33.3% reduction in alcohol serving size led to a 32.4-39.6% reduction in alcohol consumption. Modelling results indicated that decreasing the serving size of on-trade alcoholic beverages by 25% could reduce the number of alcohol-related hospital admissions and deaths per year in the United Kingdom by 4.4-10.5% and 5.6-13.2%, respectively. CONCLUSIONS Reducing the serving size of alcoholic beverages in the United Kingdom appears to lead to a reduction in alcohol consumption within a single drinking occasion.
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Affiliation(s)
- Inge Kersbergen
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolUK
- UK Centre for Tobacco and Alcohol StudiesUK
| | - Melissa Oldham
- School of Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Andrew Jones
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolUK
- UK Centre for Tobacco and Alcohol StudiesUK
| | - Matt Field
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolUK
- UK Centre for Tobacco and Alcohol StudiesUK
| | - Colin Angus
- UK Centre for Tobacco and Alcohol StudiesUK
- School of Health and Related ResearchThe University of SheffieldSheffieldUK
| | - Eric Robinson
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolUK
- UK Centre for Tobacco and Alcohol StudiesUK
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17
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de Vocht F, Brown J, Beard E, West R, Michie S, Campbell R, Hickman M. Motivation to reduce alcohol consumption and subsequent attempts at reduction and changes in consumption in increasing and higher-risk drinkers in England: a prospective population survey. Addiction 2018; 113:817-827. [PMID: 29368391 PMCID: PMC5947299 DOI: 10.1111/add.14132] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/18/2017] [Accepted: 12/01/2017] [Indexed: 01/06/2023]
Abstract
AIMS To assess how far motivation to reduce alcohol consumption in increasing and higher-risk drinkers in England predicts self-reported attempts to reduce alcohol consumption and changes in alcohol intake during the following 6 months. METHODS This study used self-reported data from 2928 higher-risk drinkers in the Alcohol Toolkit Study (ATS): a series of monthly cross-sectional household surveys of adults aged 16+ years of age in England. Alcohol consumption was measured in an initial survey and in a 6-month telephone follow-up interview using the Alcohol Use Disorders Identification Test (AUDIT)-C questionnaire. Motivation was measured in the initial survey using the Motivation to Reduce Alcohol Consumption (MRAC) scale. Attempts to reduce alcohol consumption during the past 6 months were recorded at follow-up. Data were analysed using repeated-measures difference-in-differences and logistic regression models. RESULTS Participants with higher initial motivation to reduce alcohol consumption were more likely to report that they had made an attempt to reduce consumption at follow-up [adjusted odds ratio (ORadj ) = 2.39, 95% confidence interval (CI) = 1.75-3.29]. There was an overall reduction in alcohol consumption between initial survey and follow-up (ORadj = 0.72, 95% CI = 0.65-0.79), but there was insufficient evidence of an additional effect of motivation to reduce consumption on subsequent changes in alcohol consumption, with the difference-in-differences effect instead suggesting an average increase (ORadj = 1.37, 95% CI = 1.00-1.88). CONCLUSIONS Increasing and higher-risk drinkers in England who report greater motivation to reduce their consumption are more likely to report making an attempt to reduce during the next 6 months, but this may not be associated with a reduction in alcohol consumption.
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Affiliation(s)
- Frank de Vocht
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Jamie Brown
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Emma Beard
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Robert West
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Susan Michie
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Rona Campbell
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Matthew Hickman
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
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18
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Beard E, West R, Michie S, Brown J. Association between smoking and alcohol-related behaviours: a time-series analysis of population trends in England. Addiction 2017; 112:1832-1841. [PMID: 28556467 PMCID: PMC5600127 DOI: 10.1111/add.13887] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/20/2017] [Accepted: 05/19/2017] [Indexed: 11/28/2022]
Abstract
AIMS This paper estimates how far monthly changes in prevalence of cigarette smoking, motivation to quit and attempts to stop smoking have been associated with changes in prevalence of high-risk drinking, and motivation and attempts to reduce alcohol consumption in England. DESIGN Data were used from the Alcohol and Smoking Toolkit Studies between April 2014 and June 2016. These involve monthly household face-to-face surveys of representative samples of ~1700 adults in England. MEASUREMENTS Autoregressive Integrated Moving Average with Exogeneous Input (ARIMAX) modelling was used to assess the association over time between monthly prevalence of (a) smoking and high-risk drinking; (b) high motivation to quit smoking and high motivation to reduce alcohol consumption; and (c) attempts to quit smoking and attempts to reduce alcohol consumption. FINDINGS Mean smoking prevalence over the study period was 18.6% and high-risk drinking prevalence was 13.0%. A decrease of 1% of the series mean smoking prevalence was associated with a reduction of 0.185% of the mean prevalence of high-risk drinking 2 months later [95% confidence interval (CI) = 0.033 to 0.337, P = 0.017]. A statistically significant association was not found between prevalence of high motivation to quit smoking and high motivation to reduce alcohol consumption (β = 0.324, 95% CI = -0.371 to 1.019, P = 0.360) or prevalence of attempts to quit smoking and attempts to reduce alcohol consumption (β = -0.026, 95% CI = -1.348 to 1.296, P = 0.969). CONCLUSION Between 2014 and 2016, monthly changes in prevalence of smoking in England were associated positively with prevalence of high-risk drinking. There was no significant association between motivation to stop and motivation to reduce alcohol consumption, or attempts to quit smoking and attempts to reduce alcohol consumption.
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Affiliation(s)
- Emma Beard
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Robert West
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Susan Michie
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Jamie Brown
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
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19
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Lamberti M, Napolitano F, Napolitano P, Arnese A, Crispino V, Panariello G, Di Giuseppe G. Prevalence of alcohol use disorders among under- and post-graduate healthcare students in Italy. PLoS One 2017; 12:e0175719. [PMID: 28437428 PMCID: PMC5402935 DOI: 10.1371/journal.pone.0175719] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 03/30/2017] [Indexed: 11/19/2022] Open
Abstract
A cross-sectional study was carried out on 641 medical students, 359 students attending a degree course in the healthcare professions, and 500 resident physicians, all undergoing health surveillance at the ambulatory of the Division of Occupational Medicine, Second University of Naples, Italy. 76.1% of the participants drank alcohol, with 85.5% of medical students, 77.4% of resident physicians, and 63% of healthcare-professions students reporting regular alcohol use. In the whole sample, the mean Audit-C score was 1.6 for men and 1.1 for women; only 5.5% of men and 7.1% of women had a hazardous alcohol consumption with an Audit-C score of respectively ≥4 and ≥3. Multivariate regression modeling revealed that regular alcohol use was more likely in individuals who were men, were younger, had a lower body-mass index, were active smokers, were habitual coffee drinkers, and who were resident physicians or medical students rather than healthcare-professions students. This finding identifies a need to assess alcohol use in medical-profession workers in order to identify risky behavior early on and to carry out rapidly effective preventive and curative interventions.
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Affiliation(s)
- Monica Lamberti
- Department of Experimental Medicine, Section of Occupational Medicine, School of Medicine, Second University of Naples, Naples, Italy
- * E-mail:
| | - Francesco Napolitano
- Department of Experimental Medicine, Section of Hygiene, School of Medicine, Second University of Naples, Naples, Italy
| | - Paola Napolitano
- Department of Experimental Medicine, Section of Hygiene, School of Medicine, Second University of Naples, Naples, Italy
| | - Antonio Arnese
- Department of Experimental Medicine, Section of Hygiene, School of Medicine, Second University of Naples, Naples, Italy
| | - Vincenzo Crispino
- Department of Experimental Medicine, Section of Occupational Medicine, School of Medicine, Second University of Naples, Naples, Italy
| | - Gianclaudio Panariello
- Department of Experimental Medicine, Section of Occupational Medicine, School of Medicine, Second University of Naples, Naples, Italy
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, Section of Hygiene, School of Medicine, Second University of Naples, Naples, Italy
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