Drinking context and drinking problems among black, white, and Hispanic men and women in the 1984, 1995, and 2005 U.S. National Alcohol Surveys

Contextual Use of Protective Behavioral Strategies for College Drinking

Background: Alcohol use on college campuses in the United States is a public health concern. Some students engage in protective behavioral strategies (PBS) before, during, or after their alcohol consumption (e.g., designated driver) to try to mitigate negative alcohol-related negative consequences. There is a gap in the literature on the use of different PBS in different situations commonly experienced by students (e.g., game day). The goal of the present study was to determine whether students would use different PBS for different situations, and to determine which PBS they would encourage their peers to use in these same situations. Objectives: A total of 182 undergraduate students were presented with three different hypothetical drinking scenarios (i.e., a friend's 21^st birthday celebration, football game day, and a house party) and asked which PBS they would use (i.e., limit drinking, change their manner of drinking, serious harm reduction strategies) and which they would recommend to their friends. They were also given the option to not drink at all. Results: Overall, students chose different strategies for different situations: they chose to limit their drinking at their friend's 21^st birthday or the game day tailgating event, to alter the manner of their drinking for the game day tailgating event, to reduce the potential of harm at the house party, and to not drink at their friend's 21^st birthday or the house party event. Students' personal choices matched their recommended choices for their friends. Conclusions: Results may have implications for prevention programs that teach harm reduction strategies such as PBS.

Examining how the geographic availability of alcohol within residential neighborhoods, activity spaces, and destination nodes is related to alcohol use by parents of young children

BACKGROUND

Alcohol outlet density and drinking behaviors have been assessed based on where people live, but exposure may differ based on where people spend time. We assessed the relationship between alcohol outlet density (using three measures of geographic availability), frequency of use, and continued volume of alcohol among parents. Parents are a unique population of drinkers where the risk for harm to others can be higher as they are caring for minor children.

METHODS

We conducted a cross-sectional telephone and web-based survey of 1599 parents in 2015 across 30 cities in California. Participants provided information on drinking, residential addresses, and locations of daily activities. We created three measures of alcohol availability using residential neighborhoods, convex hull polygons, and destination nodes. Data were analyzed using zero-inflated negative binomial models.

RESULTS

Density of bars in residential neighborhoods were related to more frequent drinking (b = 0.0139, 95% CI = 0.0016, 0.0261) and higher continued volume (b = 0.0295, 95% CI = 0.0067, 0.0522). Density of bars (b = 0.0070, 95% CI = 0.0019, 0.0121) and restaurants (b = 0.0018, 95% CI = 0.0003, 0.0033) in destination nodes were related to drinking a higher continued volume of alcohol. Higher off-premise outlet density was related to a lower continued volume (b = -0.0026, 95% CI = -0.0049, -0.0002).

CONCLUSIONS

Outlet densities in residential neighborhood and destination nodes are related to frequency of drinking and continued volume of alcohol. Future work should seek to determine why and how residential neighborhoods and nodes are related to alcohol use behaviors and if they differ for parents compared to other adults.

Alcohol Use Frequencies and Associated Problems Across Drinking Contexts

OBJECTIVE

To better quantify the impact of specific on- and off-premise drinking contexts on population-level alcohol-related problems, we evaluated context-specific risks relative to frequency of use of each context.

METHOD

We surveyed 860 adult (21-100 years) past-year drinkers in the California East Bay, sampled in areas of high versus low median household income and off-premise alcohol outlet densities. We examined associations of context-specific drinking frequencies in seven on- and off-premise drinking locations with individual and area characteristics using negative binomial regression. Next, we used heteroscedastic ordered logistic regression to relate context-specific drinking frequencies and continued volumes to five drinking-related problems (Alcohol Use Disorders Identification Test scores, physiological problems, risky sex, social problems, and driving after drinking too much). To estimate population-level effects, we assessed drinking frequencies relative to mean past-year use of each drinking context.

RESULTS

Higher individual annual income (>$60,000) was associated with more frequent drinking in all on-premise drinking contexts (bars/clubs, restaurants, and stadiums). Heavier overall drinking was associated with drinking more frequently at bars. Drinking more frequently in respondents' own homes and heavier drinking at friends'/relatives' homes were associated with most drinking-related problems. The population-level effects of physiological problems and driving after drinking too much were highest for parties and friends'/relatives' homes, whereas that of risky sex outcomes was highest for bars.

CONCLUSIONS

Assessing context-specific risks related to heavy and/or frequent drinking, in combination with scaling these risks to determine population-level impacts, can help tailor interventions to reduce alcohol-related problems across different on- and off-premise contexts.

Concerts, bars, parties, and raves: Differential risk for drug use among high school seniors according to venue attendance

Background: Nightlife attendance is an established risk factor for drug use, but studies have not focused on adolescent general population samples or compared risk according to type(s) of venues attended. We examined whether attendance of various types of venues was associated with drug use. Methods: Data were examined from an annual nationally representative survey of high school seniors in the US (2014-2019, N = 11,565). We determined whether past-year attendance of parties, concerts, bars or nightclubs, and raves or dance music events was associated with past-year drug use using mixed-effects logistic regression. Mall and movie attendance were examined as negative controls. Results: Compared to those who reported not attending specific venues, attending parties was associated with higher odds of using alcohol in particular (aOR = 5.03, 95% CI: 3.92-6.44). Attending concerts was associated with higher odds for use of alcohol, cannabis, ecstasy, and nonmedical use of prescription stimulants and opioids. All drugs examined were concentrated among those who attend bars, nightclubs, raves, and dance parties. Rave or dance party attendance was associated with higher odds for use of ecstasy (aOR = 3.71, 95% CI: 2.50-5.50) and methamphetamine (aOR = 4.92, 95% CI: 2.43-9.96) in particular, and bar or nightclub attendance was associated with higher odds of use of cocaine (aOR = 6.49, 95% CI: 4.37-9.63), ecstasy (aOR = 6.49, 95% CI: 4.54-9.27), and methamphetamine (aOR = 5.49, 95% CI: 2.57-11.72) in particular. Attending movies was associated with lower odds for use of cocaine and nonmedical prescription stimulant use. Conclusion: We determined differential risk of drug use depending on types of venues attended by adolescents.

Drinking and Neighborhood Contexts of Alcohol's Harms from Others

AIMS

Negative consequences of alcohol (or secondhand effects) extend beyond drinkers to affect other people, including both known others (friends, family members, spouses/partners) and strangers. Secondhand effects of alcohol manifest across various social environments, including the places where people drink and the neighborhoods where they live. These neighborhoods are characterized by different levels of alcohol availability and degrees of residential social cohesion. Hence, social environments may confer risk or protect from harms from others' drinking. The current study explores: (a) how drinking venues and neighborhood contexts relate to harms from other people's drinking (both known others and strangers), and (b) whether these associations vary by gender.

METHODS

Using pooled data from the National Alcohol Survey and National Alcohol's Harms to Others Survey (N = 5425), we regressed harms from various drinking others on social environment characteristics (drinking venues, alcohol availability and social cohesion) for the full sample and separately by gender. We used the false discovery rate method to adjust for multiple testing.

RESULTS

Overall, greater neighborhood social cohesion was associated with lower odds of harm from drinking others and, specifically, harm from drinking strangers. The effect of social cohesion was most pronounced for men.

CONCLUSIONS

Social cohesion was the most salient neighborhood factor associated with reduced alcohol-related harms from strangers. Directions for future research and policies to mitigate these harms are discussed.

Alcohol's Harm to Others: Does the Drinking Location Matter?

In order to curb alcohol's harm to others, it is important to identify the contexts where people experience such harm. Objectives: To examine whether frequency of drinking in four different locations was associated with increased likelihood of experiencing harm from others' drinking. Methods: Data stem from surveys conducted in the five Nordic countries in 2015 (N = 7065, aged 18-64 years) as part of the European Union's Joint Action on Reducing Alcohol Related Harm (RARHA). Three types of harm from others' drinking in the past 12 months were measured: verbally abused by, harmed physically by, and experienced a serious argument with someone who had been drinking. Respondents also reported frequency of drinking in their own home, in others' homes, in a pub/bar/club/restaurant, and outdoors the past 12 months. Results: Country-pooled adjusted analyses showed that higher frequency of drinking in pubs/bars/clubs/restaurants, outdoors and in someone else's home was associated with increased likelihood of experiencing all three harms. Frequent drinking in one's own home was weakly associated with experience of harm. Women, young individuals, respondents without tertiary level of education and individuals who reported drinking almost daily were at increased risk of experiencing harm from others' drinking. Conclusions: Frequent drinking on licensed premises and outdoors was most clearly associated with experiencing harm from others' drinking, suggesting that these are important arenas for preventive efforts. Women, young individuals, those with low educational level and the most frequent drinkers are important target groups for preventive efforts.

Correlates of Alcohol Consumption Among a Socially-Disadvantaged Population in Poland

Alcohol consumption at a level exceeding existing recommendations is one of the leading risk factors for death and disability worldwide. The aim of the study was to identify correlates of alcohol drinking among a socially-disadvantaged population in Poland. The cross-sectional study covered 1644 adult social assistance beneficiaries from the Piotrkowski district (rural area in central Poland). A detailed questionnaire filled in during a face-to-face interview allowed for the collection of socio-demographic, lifestyle-related (including alcohol consumption) and health status data. About 42% of the participants, including 67% of the men and 30% of the women, exceeded the recommended level of alcohol consumption. In the adjusted model, the men tended not to follow recommendations for alcohol consumption more frequently than the women (OR = 4.5, p < 0.001). The higher odds of not following alcohol-related recommendations were also observed for the subjects declaring having a permanent or temporary job compared to the unemployed participants (OR = 1.2, p = 0.04). A lower healthy lifestyle index (indicating an unhealthy lifestyle related to a diet, body mass index (BMI), physical activity, and tobacco smoking) was associated with not following recommendations for alcohol consumption (OR = 1.1, p = 0.04). Our study indicates that being men, having a permanent or a temporary job, and coexistence of other unfavorable lifestyle-related factors are important correlates of not following recommendations for alcohol consumption among the beneficiaries of government welfare assistance.

The socio-environmental context of simultaneous alcohol and marijuana use among young adults: Examining day-level associations

INTRODUCTION AND AIMS

Simultaneous alcohol and marijuana (SAM) use is reported by roughly 30% of young adult drinkers. Among SAM users, SAM use days have more negative substance-related consequences than single-substance days. Little information is available about contextual factors contributing to the likelihood of SAM use on a particular day. This study compared days on which individuals reported SAM use relative to days on which they reported alcohol but not marijuana use in terms of physical location, engagement in risky activities and social context of use.

DESIGN AND METHODS

Participants were 148 young adults (57% female) reporting past-month SAM use and past two-week binge drinking. Participants completed up to 14 daily surveys assessing substance use behaviour and socio-environmental characteristics of use.

RESULTS

For those <21 years, only using at home was associated with greater odds of SAM use. For those 21+, using at a friend's house and outdoors were associated with increased odds of use; using at a bar/club was associated with lower odds. Using alone was associated with lower odds of use for those 21+. Engagement in risky activities (pre-gaming and drinking games) was not associated with SAM use.

DISCUSSION AND CONCLUSIONS

SAM days are linked with use in private settings and social situations. Despite experiencing more harms on SAM days, SAM use is not more likely than alcohol use alone to occur in certain environments and situations traditionally found to be linked with increased risk. Findings may provide key insight for developing context-informed interventions focused on SAM use.

Drinking Context-Specific Dose-Response Models of Intimate Partner Violence Among an Urban Emergency Department Sample

OBJECTIVE

This cross-sectional study evaluates the association between physical intimate partner violence (IPV) and frequencies of drinking and volume consumed in six different contexts among a sample of urban emergency department (ED) patients.

METHOD

We obtained survey data from 1,037 married, cohabiting, or partnered patients (53% female; 50% Hispanic; 29% African American) at a Northern California safety-net hospital. Past-year physical IPV was measured with the Revised Conflict Tactics Scale. We asked patients about frequency of drinking and usual number of drinks consumed at bars, restaurants, homes of friends or relatives, own home, public places such as street corners or parking lots, and community centers or large events. Gender-stratified dose-response models were estimated for frequencies of IPV perpetration and victimization, with adjustment for sociodemographic and psychosocial factors, marijuana use, and spouse/partner problem drinking.

RESULTS

None of the women's context-based frequency and volume measures were associated with frequency of IPV victimization. Women's volume of alcohol consumed at home was associated positively with frequency of their IPV perpetration (β = .008, SE = .003, p < .01), and volume consumed in public places was associated negatively with this outcome (β = -.023, SE = .010, p < .05). Among men, none of the context-based frequency and volume measures were associated with frequency of either IPV outcome. Spouse/partner's problem drinking was associated with each gender's IPV victimization, and with IPV perpetration by men.

CONCLUSIONS

Frequency of drinking and volume consumed in specific contexts do not substantively contribute to frequency of IPV perpetration or victimization in this sample of urban ED patients.

Gender-Specific Drinking Contexts Are Associated With Social Harms Resulting From Drinking Among Australian Young Adults at 30 Years

Aims

Understanding contexts in which social harms from drinking occur can help develop context-based harm reduction efforts. However, there is little knowledge of specific drinking contexts where such harms occur and whether these are gender or age specific. We aimed to investigate associations of a range of drinking contexts and social harms from drinking among young adults at age 30.

Methods

We used data from 2187 30-year-old adults. Latent constructs of gender-specific drinking contexts were created using factor analysis. We performed multivariate logistic regression between drinking contexts and a range of social harms from drinking, separately by gender.

Results

After accounting for social roles and binge drinking, gender-specific solitary drinking contexts (‘home drinking’ for men and ‘daytime drinking’ for women) were positively associated with marital problems and problems with other family members and friends. Conversely, ‘social drinking’ was not. Work-related drinking among men was associated with marital/intimate relationship problems and friendship problems. After accounting for mental health symptoms, women’s home drinking was associated with marital problems.

Conclusion

We found that experiences of social harms from drinking at 30 years differ depending on the drinker’s gender and context. Our findings suggest that risky contexts and associated harms are still significant among 30-year-old adults, indicating that a range of gender-specific drinking contexts should be represented in harm reduction campaigns. The current findings also highlight the need to consider gender to inform context-based harm reduction measures and to widen the age target for these beyond emerging adults.

Gender differences in social harms from drinking among young Australians: findings from the Mater University Study of Pregnancy and its Outcomes

Background: Despite the growing interest in investigating social harms from drinking, little is known about drinkers' reports of these harms and their gender differences among Australian young adults at age 30. We aimed to examine gender differences of social harms from drinking as reported by drinkers.Methods: 2,200 young adults at age 30 with complete data on social harms from drinking were drawn from the 30-year follow-up of the Mater-University of Queensland Study of Pregnancy. Measures included percentages of 11 past-year drinkers' self-reported social harms stratified by gender. Logistic regression was used to examine associations between gender and each social harm, accounting for relevant confounding.Results: More than one in five young adults (22%) reported at least one social harm in the past year. Among binge drinkers, 44% reported at least one social harm. After adjustments for social roles and binge drinking, we found no gender differences on several self-reported social harms: friendship problems, people criticizing drinking, non-marital family problems, employment problems, and alcohol-fuelled fights. However, men were more likely to report spousal threats to leave, drink-driving legal problems and financial problems.Conclusions: Our findings demonstrate that young adults are still vulnerable to risky drinking at age 30 and the social harm resulting from drinking. Thus, alcohol prevention campaigns should target this age group and include women in their focus. Strategies aiming to reduce alcohol-related harms, such as screening in clinical settings for risky drinking and alcohol-related harms, followed by motivational behavior interventions, could be beneficial among these vulnerable groups.

Relationships between US state alcohol policies and alcohol outcomes: differences by gender and race/ethnicity

BACKGROUND AND AIMS

Alcohol taxation and availability restrictions are among the most effective methods for reducing alcohol use and problems, yet may affect demographic subgroups differently. Understanding who responds to specific policies can inform approaches for reducing disparities. We examined how state-level beverage-specific taxes and availability restrictions in the United States are associated with consumption and alcohol-related problems across subgroups defined by gender and race/ethnicity.

DESIGN, SETTING AND PARTICIPANTS

Data came from the 2000-15 National Alcohol Surveys (n = 28 251), computer-assisted telephone cross-sectional surveys of United States residents aged 18+. African Americans and Hispanics were oversampled.

MEASUREMENTS

Primary outcomes were beverage-specific (beer, wine, spirits and total) volume, DSM-IV alcohol dependence and alcohol-related consequences. Analyses entailed survey-weighted log-log and logistic regressions adjusting for state-level beer tax, spirits tax, government-controlled spirits sales and sales tax; respondent ZIP-code-level density of off-premise beer outlets, off-premise spirits outlets and on-premise bars; respondent individual-level age, marital status, education, employment and income; and fixed effects for wet/moderate/dry US region and year.

FINDINGS

Higher beer tax was significantly (P < 0.05) associated with lower odds of any drinking among white women [odds ratio (OR) = 0.98] and lower beer volume (price-elasticity = -0.40), total volume (price-elasticity = -0.50) and odds of alcohol-related consequences (OR = 0.84) among African American women. Higher spirits tax was significantly (P < 0.05) associated with both lower beer and total volume among Hispanic women (price-elasticities = -0.73 and - 1.04, respectively) and men (price-elasticities = -1.19 and - 0.92, respectively) and decreased wine volume among Hispanic women (price-elasticity = -0.62). Apparent protective effects of living in a state with government-controlled spirits sales or a neighborhood with lower bar density was greater among white men than other groups.

CONCLUSIONS

The effects of beverage-specific taxes and alcohol availability policies may vary across subgroups, highlighting the importance of considering differential policy impacts in future research and intervention.

Non-pharmacological factors that determine drug use and addiction

Based on their pharmacological properties, psychoactive drugs are supposed to take control of the natural reward system to finally drive compulsory drug seeking and consumption. However, psychoactive drugs are not used in an arbitrary way as pure pharmacological reinforcement would suggest, but rather in a highly specific manner depending on non-pharmacological factors. While pharmacological effects of psychoactive drugs are well studied, neurobiological mechanisms of non-pharmacological factors are less well understood. Here we review the emerging neurobiological mechanisms beyond pharmacological reinforcement which determine drug effects and use frequency. Important progress was made on the understanding of how the character of an environment and social stress determine drug self-administration. This is expanded by new evidence on how behavioral alternatives and opportunities for drug instrumentalization generate different patterns of drug choice. Emerging evidence suggests that the neurobiology of non-pharmacological factors strongly determines pharmacological and behavioral drug action and may, thus, give rise for an expanded system's approach of psychoactive drug use and addiction.

Social Drinking Contexts and Their Influence on Problematic Drinking at Age 30

Aims: Understanding the social contexts in which problematic drinking occurs can inform prevention strategies. In this article, we investigate gender-specific social contexts associated with problematic drinking and depression among adults aged 30 years. Because depression has been consistently linked with harmful alcohol consumption, we will also examine its association with drinking contexts. Methods: We used data from 2490 young adults who completed the 30-year follow-up phase of the Mater-University of Queensland Study of Pregnancy and its Outcomes, a prospective study commenced in 1981. Exploratory and confirmatory factor analyses were used to identify latent constructs of drinking contexts stratified by gender, with subsequent regression analysis to assess the role of these contexts in problematic drinking (measured using the Alcohol Use Disorders Identification Test). Results: Six distinct drinking contexts were identified, which differed by gender, three for men and three for women. For both men and women, "social drinking", was associated with problematic drinking. "Home drinking" was also common to men and women but associations with problematic drinking differed, being risky only among men. "Daytime drinking" (women) was associated with risk but "work-related drinking" (men) was not. Both "home drinking" (men) and "daytime drinking" (women) were linked to depression symptoms. Conclusion: Specific contexts appeared to be associated with problematic drinking for both sexes. Among both men and women, "social drinking" was associated with problematic drinking. Both "home drinking" (men) and "daytime drinking" (women) contexts, were associated with problematic drinking and depressive symptoms. Targeted alcohol-focused interventions need to address co-occurring mental health issues.

Location-Specific Social Norms and Personal Approval of Alcohol Use are Associated with Drinking Behaviors in College Students

Background: Prior research on risky alcohol use points to drinking norms as predictors of drinking behavior. Most research to date has only explored global (versus context-specific) drinking norms as they relate to general drinking behavior. To better understand risky drinking behavior in students, how norms may vary across drinking environments should be considered. Objectives: We sought to explore differences in drinking norms (descriptive and injunctive), personal approval, and alcohol use across specific drinking locations and how these location-specific predictors combine to best predict alcohol consumption in home/dorm locations, bars, and parties. Methods: College student drinkers (N = 115, 76% female) participated in an anonymous online cross-sectional survey in 2015-2016 assessing personal and perceived drinking experiences and attitudes across various locations. Results: Alcohol use, descriptive norms of alcohol use, and injunctive norms of alcohol use (but not personal approval) varied across location. In addition, location-specific descriptive norms were associated with alcohol use in each drinking location, whereas location specific personal approval was associated with alcohol use only at home/dorm and bar locations. Furthermore, descriptive norms and personal approval of drinking in a given location predicted alcohol use in that same location, while norms or approval for other locations did not. Conclusion/Importance: Results highlight the importance of specificity of perceived drinking norms and personal approval for predicting location-specific alcohol use. These findings have implications for interventions, which may benefit from discussions of students' preferred drinking locations and providing location-specific normative feedback.

Alcohol use and binge drinking among U.S. men, pregnant and non-pregnant women ages 18-44: 2002-2017

BACKGROUND

Drinking during pregnancy dropped sharply in the U.S. in the 1980s. More recent time trends in adult drinking and binge drinking in men, non-pregnant and pregnant women have not been directly compared.

METHODS

Using logistic regression and National Surveys on Drug Use and Health (NSDUH) 2002-2017 data on any drinking and 2002-2014 data on binge drinking, trends in men, non-pregnant and pregnant women were compared. Analyses of any drinking included 470,309 participants (221,344 men; 236,197 non-pregnant women; 12,768 pregnant women); of binge drinking, 379,379 participants (178,869 men; 189,923 non-pregnant women; 10,587 pregnant women).

RESULTS

In all participants, drinking decreased (62.2%-60.3%). Among adults ages 18-20, drinking decreased in men, non-pregnant women, and pregnant women (-18.4%; -11.1%; -5.3%), as did binge drinking (-11.8%; -5.6%; -3.7%). Among adults ages 21-44, drinking increased in non-pregnant women (+2.3%), and decreased in men and pregnant women (-2.6% and -3.3%), while binge drinking increased in non-pregnant women (+2.7%), but not in pregnant women (-1.8%) or men (0.0%).

CONCLUSIONS

Drinking increased in U.S. women ages 21-44, but not those who were pregnant. Increases in women and continuing high rates in men indicate the need for better public health efforts. Divergent trends in men, non-pregnant, and pregnant women ages 21-44 suggest differential influences on drinking. Continued low rates in pregnant women are encouraging, but maintaining public health messages about drinking during pregnancy and innovative efforts to prevent such drinking are needed. Different results in ages 18-20 and 21-44 highlight the importance of developmental stages in drinking.

Opposite environmental gating of the experienced utility ('liking') and decision utility ('wanting') of heroin versus cocaine in animals and humans: implications for computational neuroscience

BACKGROUND

In this paper, we reviewed translational studies concerned with environmental influences on the rewarding effects of heroin versus cocaine in rats and humans with substance use disorder. These studies show that both experienced utility ('liking') and decision utility ('wanting') of heroin and cocaine shift in opposite directions as a function of the setting in which these drugs were used. Briefly, rats and humans prefer using heroin at home but cocaine outside the home. These findings appear to challenge prevailing theories of drug reward, which focus on the notion of shared substrate of action for drug of abuse, and in particular on their shared ability to facilitate dopaminergic transmission.

AIMS

Thus, in the second part of the paper, we verified whether our findings could be accounted for by available computational models of reward. To account for our findings, a model must include a component that could mediate the substance-specific influence of setting on drug reward RESULTS: It appears of the extant models that none is fully compatible with the results of our studies.

CONCLUSIONS

We hope that this paper will serve as stimulus to design computational models more attuned to the complex mechanisms responsible for the rewarding effects of drugs in real-world contexts.

Marijuana Use among African American Older Adults in Economically Challenged Areas of South Los Angeles

Purpose: This study explored demographic, social, behavioral, and health factors associated with current marijuana use (MU) among African American older adults who were residing in economically challenged areas of south Los Angeles. Methods: This community-based study recruited a consecutive sample of African American older adults (n = 340), age ≥ 55 years, residing in economically challenged areas of South Los Angeles. Interviews were conducted to collect data. Demographics (age and gender), socioeconomic status (educational attainment, income, and financial strain), marital status, living alone, health behaviors (alcohol drinking and cigarette smoking), health status (number of chronic medical conditions, body mass index, depression, and chronic pain), and current MU were collected. Logistic regression was used to analyze the data. Results: Thirty (9.1%) participants reported current MU. Age, educational attainment, chronic medical conditions, and obesity were negatively associated with current MU. Gender, income, financial strain, living alone, marital status, smoking cigarettes, drinking alcohol, depression, and pain did not correlate with MU. Conclusion: Current MU is more common in younger, healthier, less obese, less educated African American older adults. It does not seem that African American older adults use marijuana for the self-medication of chronic disease, pain, or depression. For African American older adults, MU also does not co-occur with cigarette smoking and alcohol drinking. These results may help clinicians who provide services for older African Americans in economically challenged urban areas.

In-the-Moment Drinking Characteristics: An Examination Across Attention-Deficit/Hyperactivity Disorder History and Race

BACKGROUND

Adults with a history of childhood attention-deficit/hyperactivity disorder (ADHD) and Black drinkers are at elevated risk for alcohol problems and alcohol use disorder. Processes that increase risk for these distinct populations have not focused on in-the-moment behaviors that occur while drinking. The present study examined in-the-moment drinking characteristics (i.e., location, social context, day, time, drink type, speed of consumption) that may differ for individuals with and without ADHD histories or for Black and White drinkers. We also examined the interplay among these in-the-moment drinking characteristics to further understanding of contexts when risk may be momentarily increased.

METHODS

As part of a larger study, 135 individuals (M_age  = 27.81, 69.6% male, 45.9% ADHD, 69.6% White) completed a 10-day ecological momentary assessment protocol that included self-initiated reports following consumption of an alcoholic drink. Hypotheses were tested using multilevel modeling.

RESULTS

Controlling for multiple demographic covariates, Black drinkers drank significantly more quickly than White drinkers and were more likely to consume hard liquor-containing beverages. Differences in drinking speed remained significant when adjusting for Black drinkers' greater likelihood to consume liquor-containing beverages and momentary experience of discrimination; however, Black drinkers' increased likelihood to consume liquor-containing beverages was no longer significant when adjusting for momentary experience of discrimination. Individuals with ADHD histories did not differ from those without ADHD histories in any in-the-moment drinking characteristics. ADHD and race did not interact to predict any drinking characteristic.

CONCLUSIONS

Differences in speed of alcohol consumption and propensity to consume liquor-containing beverages may contribute to increased risk for alcohol problems experienced by Black drinkers compared to White drinkers.

Chronic Respiratory Disease and Health-Related Quality of Life of African American Older Adults in an Economically Disadvantaged Area of Los Angeles

Background. Most of the attention of policy makers, program planners, clinicians, and researchers in the area of physical health disparities among African American older adults has been traditionally focused on cardiometabolic disease and cancer. Among a long list of chronic medical conditions, chronic respiratory conditions (CRCs), such as asthma, chronic bronchitis, and emphysema, have received less attention. Purpose. This study investigated whether CRCs contribute to physical and mental health-related quality of life (HRQoL) of African American older adults who live in economically disadvantaged urban areas, and whether these effects are due to demographic factors, socioeconomic status (SES), health behaviors, and comorbid medical and mental conditions. Methods. This community-based study recruited 617 African American older adults (age ≥ 65 years) from Service Planning Areas (SPA) 6, an economically disadvantaged area in South Los Angeles. Structured face-to-face interviews were used to collect data on demographic factors (age and gender), SES (educational attainment and financial difficulty), living arrangements, marital status, health behaviors (cigarette smoking and alcohol drinking), health (CRC, number of comorbid medical conditions, depressive symptoms, and pain intensity), and physical and mental HRQoL (Physical and Mental Component Summary Scores; PCS and MCS; SF-12). Linear regressions were used to analyze the data. Results. The presence of CRCs was associated with lower PCS and MCS in bivariate analysis. The association between CRCs and PCS remained significant above and beyond all confounders. However, the association between CRCs and MCS disappeared after controlling for confounders. Conclusion. For African American older adults living in economically disadvantaged urban areas, CRCs contribute to poor physical HRQoL. Evaluation and treatment of CRCs in African American older adults may be a strategy for reduction of disparities in HRQoL in this population. As smoking is the major modifiable risk factor for CRCs, there is a need to increase accessibility of smoking cessation programs in economically disadvantaged urban areas. More research is needed on the types, management, and prognosis of CRCs such as asthma, chronic bronchitis, and emphysema in African American older adults who reside in low-income and resource limited urban areas.

Cigarette Smoking among Economically Disadvantaged African-American Older Adults in South Los Angeles: Gender Differences

The current study aims to explore gender differences in the risk of cigarette smoking among African-American (AA) older adults who live in economically disadvantaged urban areas of southern Los Angeles. This cross-sectional study enrolled 576 older AA adults (age range between 65 and 96 years) who were residing in Service Planning Area 6 (SPA 6), one of the most economically challenged areas in southern Los Angeles. All participants had cardiometabolic disease (CMD). Data were collected using structured face-to-face interviews. Demographic factors (age and gender), socioeconomic status (educational attainment and financial difficulty), health (number of comorbid medical conditions and depressive symptoms), and health behaviors (current alcohol drinking and current smoking) were measured. Logistic regressions were used to analyze the data without and with interaction terms between gender and current drinking, depressive symptoms, and financial difficulty. AA men reported more smoking than AA women (25.3% versus 9.3%; p < 0.05). Drinking showed a stronger association with smoking for AA men than AA women. Depressive symptoms, however, showed stronger effects on smoking for AA women than AA men. Gender did not interact with financial difficulty with regard to current smoking. As AA older men and women differ in psychological and behavioral determinants of cigarette smoking, gender-specific smoking cessation interventions for AA older adults who live in economically deprived urban areas may be more successful than interventions and programs that do not consider gender differences in determinants of smoking. Gender-tailored smoking cessation programs that address drinking for AA men and depression for AA women may help reduce the burden of smoking in AA older adults in economically disadvantaged urban areas. Given the non-random sampling, there is a need for replication of these findings in future studies.

Identifying Triggers of Alcohol Craving to Develop Effective Virtual Environments for Cue Exposure Therapy

Background: Many studies have indicated that alcohol craving is a core mechanism in the acquisition, maintenance, and precipitation of relapse in alcohol use disorder (AUD). A common treatment approach in AUD is cue exposure therapy (CET). New technologies like virtual reality (VR) have the potential to enhance the effectiveness of CET by creating realistic scenarios in naturalistic environments. In this study, we aimed to determine relevant triggers of alcohol craving in patients with AUD.

Methods: We enrolled 75 outpatients diagnosed with AUD according to the DSM-5 criteria Participants completed the Alcohol Use Disorder Identification Test and a self-administered questionnaire to assess alcohol craving. The variables included in the craving questionnaire were as follows: presence of others, situations, time of the day, day of the week, mood, and type of alcoholic beverage.

Results: Greater levels of alcohol craving were seen in many situations, including being at a party, in a restaurant, in a bar or pub, and at home. Drinking alone and drinking with two or more friends were equally associated with higher levels of craving. Drinking at night and drinking at weekends also emerged as triggers for alcohol craving. Emotional states like anxiety or tension, sadness, stress, frustration, or irritability were highly associated with urges to drink alcohol. The alcoholic drinks most highly associated with increased levels of craving were beer, wine, and whisky. Gender and age implications were discussed.

Conclusion: This study is part of a larger project aiming to develop and validate CET based on VR technology for patients with AUD who are resistant to classical treatment. The identified triggers have been used to develop relevant VR environments for CET, and further research is ongoing to implement our findings.

Risk of Alcohol-Related Injury: Does Societal Drinking Context Make a Difference?

OBJECTIVE

The aim of this study is to examine whether country-level frequency of drinking in a public context and in a private context is associated with rates of alcohol-related injury in emergency department studies from those same countries.

METHOD

Emergency department data on 5,104 injured patients in 10 countries from the International Collaborative Alcohol and Injury Study (ICAIS) and aggregate level drinking context data from the Gender, Alcohol and Culture: An International Study (GENACIS) are analyzed. The association of societal drinking context (public and private) with variation in the rate of self-reported drinking before injury is examined using multilevel modeling.

RESULTS

Controlling for demographic characteristics, individual-level volume and drinking pattern, study-level volume, and country-level drinking pattern and alcohol control policy, societal public drinking context was significantly predictive of an alcohol-related injury (odds ratio [OR] = 1.08, CI [1.02, 1.13]), whereas societal private drinking context was not. Public drinking context was predictive of violence-related injury (OR = 1.09, CI [1.01, 1.17]), whereas private drinking context was predictive of injuries from falls (OR = 1.01, CI [1.01, 1.02]). Neither societal drinking context was significantly predictive of traffic-related injuries whereas both public (OR = 1.06, CI [1.01, 1.12]) and private (OR = 1.01, CI [1.01, 1.03]) contexts were predictive of injuries from other causes.

CONCLUSIONS

These data suggest that societal drinking context does make a difference in the likelihood of an alcohol-related injury, which is important for a better understanding of the role of drinking context in a country in the occurrence of an alcohol-related injury and may inform future recommendations for reducing this harmful consequence.

The Effects of Mothers' Protective Parenting and Alcohol Use on Emerging Adults' Alcohol Use: Testing Indirect Effects Through Prototype Favorability Among African American Youth

BACKGROUND

We examined how mothers' protective parenting and alcohol use influenced changes in offspring's heavy drinking among a sample of African American youth. The conceptual model also tested indirect effects of mothers' behaviors, through changes in the youths' social images (i.e., prototypes) of heavy drinkers, derived from the prototype willingness (PW) model.

METHODS

Participants were 686 emerging adults (55% female) from the Family and Community Health Study (FACHS), an ongoing prospective study of African American families. Three waves of FACHS data were used as follows: T3 during 10th grade (M age = 16.3 years), T4 shortly after high school (M age = 19.4 years), and T5 3 years later (M age = 22.1 years). Mothers' self-reports of protective parenting and alcohol use were assessed at T4. Two separate path models tested the study hypotheses. The first model specified direct and indirect effects of mothers' protective parenting and alcohol use. The second model added interaction terms between the protective parenting behaviors and mothers' alcohol use. The analyses were first conducted using the full sample and then repeated separately for female and male participants.

RESULTS

Maternal alcohol use had a positive and direct effect on offspring's alcohol use. Mothers' endorsement of alcohol-related rules inhibited normative increases in the favorability of the offspring's social image of heavy drinkers (prototype) while her warmth was positively related to these increases. Maternal alcohol use amplified the positive association between mothers' warmth and the daughters' increased drinking. For sons, maternal alcohol use increased the positive association between alcohol-related rules and increased prototype favorability.

CONCLUSIONS

Results indicated clear gender differences in how mothers' behaviors influence her offspring's alcohol use during the transition to emerging adulthood. Interventions that target culturally specific risk and protective factors within the family environment are needed to reduce health disparities among this vulnerable population of youth.

Sexual Coercion, Drinking to Cope Motives, and Alcohol-Related Consequences among Self-Identified Bisexual Women

BACKGROUND

Given higher sexual victimization and greater alcohol use among bisexual women, a critical public health challenge is to understand within-group variation that may heighten or explain these associations in bisexual women.

OBJECTIVES

The present study tested a moderated-mediation model in which sexual coercion was hypothesized to be associated with alcohol-related consequences via drinking to cope motives in self-identified bisexual women who reported at least occasional binge drinking. Negative affect was hypothesized to moderate the sexual coercion-drinking to cope motives association.

METHODS

Participants were a community sample of 107 self-identified bisexual women (age M = 20.97, SD = 2.11) who completed an online survey and reported at least one binge drinking episode as well as engaging in sexual activity in the past 30 days.

RESULTS

Of these participants, 57 (53.3%) reported one or more experiences of sexual coercion in the past 30 days. Sexual coercion was associated with negative alcohol-related consequences via drinking to cope motives. Negative affect moderated the association between sexual coercion and drinking to cope motives such that the association was stronger among women with greater negative affect. Conclusions/Importance: Methods of addressing vulnerability to sexual coercion and educating young bisexual women about the association between sexual coercion and potentially problematic affective coping through alcohol use are needed.

Review: Environmental influences on alcohol use: Informing research on the joint effects of genes and the environment in diverse U.S. populations

BACKGROUND AND OBJECTIVES

This review aimed to inform the current state of alcohol research on the joint effects of genes and the environment conducted in U.S. racial/ethnic minority populations, focusing on African Americans, Latinos/Hispanics, Asians, and American Indians.

METHODS

A key-word and author-based search was conducted and supplemented with direct contact to researchers in this area to ensure a comprehensive inclusion of published, peer-reviewed studies. These studies were considered in terms of the racial/ethnic population groups, phenotypes, genetic variants, and environmental influences covered. Research findings from alcohol epidemiologic studies were highlighted to introduce some potential environmental variables for future studies of gene and environment (G-E) relationships.

RESULTS

Twenty-six (N = 26) studies were reviewed. They predominantly involved African American and Asian samples and had a very limited focus on Latinos/Hispanics and American Indians. There was a wide range of alcohol-related phenotypes examined, and studies almost exclusively used a candidate gene approach. Environmental influences focused on the most proximate social network relationships with family and peers. There was far less examination of community- and societal-level environmental influences on drinking. Epidemiologic studies informing the selection of potential environmental factors at these higher order levels suggest inclusion of indicators of drinking norms, alcohol availability, socioeconomic disadvantage, and unfair treatment.

CONCLUSIONS

The review of current literature identified a critical gap in the study of environments: There is the need to study exposures at community and societal levels.

SCIENTIFIC SIGNIFICANCE

These initial studies provide an important foundation for evolving the dialogue and generating other investigations of G-E relationships in diverse racial/ethnic groups. (Am J Addict 2017;26:446-460).

Protective behavioral strategies as a context-specific mediator: A multilevel examination of within- and between-person associations of daily drinking

Research indicates that a drinker's environmental and social context can be differentially associated with drinking outcomes. Further, although many researchers have identified that more frequent use of protective behavioral strategies (PBS) is associated with lower alcohol consumption and negative consequences, scant research has examined how one's drinking context may promote or hinder PBS use. The present study examined how the context of drinking each day (i.e., where and with whom) is associated with level of consumption and reported alcohol-related problems among n = 284 college drinkers (69.0% female) directly, as well as indirectly through the use of PBS. Two different dimensions of PBS are examined (i.e., "Limits" or limiting consumption, and "Avoidance" or avoiding alcohol in general or specific alcohol situations), as well as their relationship with daily drinking. Moreover, we explored these relationships intraindividually (within-person across time), as well as interindividually (between people). Daily drinking was assessed using a weekly diary design. Using multilevel structural equation modeling, we found that environmental context (i.e., drinking at a bar or party) is associated with heavier alcohol use directly and indirectly through PBS that involve limiting one's drinking; these effects occurred only at the daily (within-person) level. Additionally, social context (i.e., drinking with friends) predicts elevated drinking but is unrelated to PBS use. Similar findings were present for alcohol-related problems, controlling for consumption level. College student drinking interventions may benefit from a focus on increasing the use of PBS within potentially risky drinking environments to help reduce problematic alcohol use. (PsycINFO Database Record

Alcohol Mixed with Energy Drinks: Daily Context of Use

BACKGROUND

The link between use of alcohol mixed with energy drinks (AmEDs) and alcohol-related harms is well established, but limited research has examined the context in which AmEDs are consumed. Identifying the social and environmental characteristics of use may illuminate whether AmEDs are used in settings that could increase the likelihood of engaging in risky behaviors or experiencing harms. This study used a 2-week daily diary assessment to compare days in which AmEDs were consumed ("AmED days") and days where other types of alcohol were used ("non-AmED days") on where, when, and with whom drinking occurred.

METHODS

Participants were 122 (90 women) heavy drinking college students who reported mixing caffeine with alcohol at least once in the past week. Data were collected across 389 drinking days; 40 of these days involved AmED use.

RESULTS

Multilevel modeling findings revealed that odds of drinking AmEDs were higher on days where individuals drank at a bar or club and drank at home relative to other locations. In addition, odds of pregaming were higher on AmED days as compared to non-AmED days. AmED use was linked with lower odds of drinking game behavior.

CONCLUSIONS

Overall, AmEDs appear to be consumed in potentially risky contexts. In combination with prior findings that AmED days are linked with heavier alcohol use and more harms experienced, these findings support the unique nature of AmED consumption in terms of the factors that may predict or maintain potentially hazardous drinking patterns.

Acute alcohol intoxication among adolescents-the role of the context of drinking

This study aims (1) to describe the context of drinking among adolescents with acute alcohol intoxication (AAI) by gender, (2) to explore temporal changes in the context of drinking and (3) to analyse the association between the context of drinking and blood alcohol concentration (BAC). A retrospective chart review of 12- to 17-year-old inpatients with AAI (n = 1441) of the years 2000 to 2006 has been conducted in five participating hospitals in Germany. Gender differences in the context of drinking were tested with t test and chi² test. Differences over time were analysed using logistic regressions. Multivariate linear regression was used to predict BAC. Girls and boys differed in admission time, drinking situation, drinking occasion and admission context. No temporal changes in drinking situation and in admission to hospital from public locations or places were found. Higher BAC coincided with male gender and age. Moreover, BAC was higher among patients admitted to hospital from public places and lower among patients who drank for coping.

CONCLUSION

The results suggest gender differences in the context of drinking. The context of drinking needs to be considered in the development and implementation of target group-specific prevention and intervention measures. What is known: • The context of drinking, e.g. when, where, why and with whom is associated with episodic heavy drinking among adolescents. What is new: • Male and female inpatients with acute alcohol intoxication differ with regards to the context of drinking, i.e. in admission time, drinking situation, drinking occasion and admission context. • Being admitted to hospital from public places is associated with higher blood alcohol concentration.

Drinking context and alcohol's harm from others among men and women in the 2010 US National Alcohol Survey

BACKGROUND

Little is known about how drinking in different contexts is associated with harms from someone else's drinking, including marital problems, financial problems, and assault. We examined how drinking in four different contexts was associated with alcohol's harm from others (AHFO).

METHODS

We utilized the landline sample of the 2010 US National Alcohol Survey (n = 5,885) to examine associations between drinking context and AHFO using weighted binary logistic regression.

RESULTS

For women, drinking when friends dropped over was positively associated with assault and financial troubles due to someone else's drinking. Drinking when friends dropped over was negatively associated with assault for men. For men, drinking at a bar, party, or during a quiet evening at home were each significantly associated with more assault by someone who had been drinking. Bar drinking among women was significantly associated with more marital problems, whereas drinking at a party at someone else's home was associated with significantly less marital problems.

CONCLUSIONS

Context-specific drinking has differential associations with specific types of harms from someone else's drinking for men and women. Additional research on drinking context, relationship to the harmer, and violence experienced by men and women is needed.

Patterns of 'at-home' alcohol-related injury presentations to emergency departments

AIMS AND OBJECTIVES

This study aimed to establish the scale of alcohol-related injuries originating in the home.

BACKGROUND

Despite recent media and public attention on alcohol-related injuries occurring at licensed venues, many occur in other locations including the home.

DESIGN

A retrospective observational study.

METHODS

Emergency department surveillance data sourced from the Queensland Injury Surveillance Unit were interrogated for alcohol-related emergency department presentations from 2003-2012 (n = 12,296). Descriptive analysis was undertaken to assess alcohol involvement in injury, and analysis of variance was used to determine the differences among group means and their associated presentations. The relationship between demographic variables and injury location was assessed using p value of <0·05 as statistically significant.

RESULTS

Of all injuries that were positively identified as being alcohol related, 41·07% occurred at the 'other' location, 36·14% 'at home', 13·00% on the street and 9·78% at licensed premises. Of these, males (n = 2635; 59%) represented a higher proportion than females (n = 1807; 41%). Of injuries identified as domestic violence by spouse or partner (n = 510), 59·5% occurred 'at home'.

CONCLUSIONS

This is the first study to investigate alcohol-related injuries occurring at home. The home accounts for a greater proportion of injuries than the frequently assessed licensed premises location. Further research is required to validate these findings in a wider setting.

RELEVANCE TO CLINICAL PRACTICE

A public health campaign is required to minimise harm associated with alcohol-related injuries in the home, and nurses are positioned to inform health policy makers around this issue. Furthermore, emergency department nurses are in a unique position to provide brief interventions around safe alcohol consumption and injury prevention.

Trends in Alcohol's Harms to Others (AHTO) and Co-occurrence of Family-Related AHTO: The Four US National Alcohol Surveys, 2000-2015

Various harms from others' drinking have been studied individually and at single points in time. We conducted a US population 15-year trend analysis and extend prior research by studying associations of depression with combinations of four harms - family/marriage difficulties, financial troubles, assault, and vandalism - attributed to partners or family members. Data come from four National Alcohol Surveys conducted by telephone in 2000, 2005, 2010, and 2015 (analytic sample = 21,184). Weighted logistic regression models estimated time trends adjusting for victim characteristics (gender, age, race/ethnicity, marital status, poverty, employment, family history of alcohol problems, and drinking maximum). The 2015 survey asked the source of the harm; we used similar models to examine characteristics, including anxiety and depression, associated with various combinations of family/marriage, financial, and assault harms due to partner's/spouse's/family members' drinking. A significant upward trend (P <0.001) from 2000 to 2015 was seen for financial troubles but not for other harms due to someone else's drinking. In 2015, depression and/or anxiety were strongly associated with exposures to harms and combinations of harms identified as stemming from drinking spouse/partner and/or family members. The results shed new light on 15-year trends and associations of harms with personal characteristics. A replicated finding is how the victim's own heavy drinking pattern is implicated in risks for exposures to harms from someone else's drinking. Documenting risk factors for and mental health impacts is important for interventions to reduce alcohol's harm to others.

Alcohol Myopia Revisited: Clarifying Aggression and Other Acts of Disinhibition Through a Distorted Lens

The alcohol myopia model (AMM; Steele & Josephs, 1990) is reviewed in light of its unique ability to account for a variety of alcohol and nonalcohol-related disinhibited behaviors, particularly aggression. The AMM posits that alcohol has a narrowing, or a "myopic," effect on one's ability to attend to competing instigatory and inhibitory cues. Disinhibited behavior is presumed to occur when attention is directed toward salient provocative or instigatory cues rather than inhibitory cues. AMM research is reviewed with regard to stress and anxiety, risky sexual behavior, drinking and driving, suicide, disinhibited eating, smoking, and alcohol-related aggression. The AMM is also expanded by proposing five key mechanisms (i.e., negative affect, angry affect, hostile cognitive rumination, self-awareness, and empathy) that are likely to explain how the model is specifically involved in the alcohol-aggression relation. Finally, a number of public health interventions, extrapolated from the AMM, are proposed to stimulate future research directed at reducing the prevalence of alcohol-related violence.

Differential vulnerability to relapse into heroin versus cocaine-seeking as a function of setting

RATIONALE

Previous studies have shown that the effect of setting on drug-taking is substance specific in both humans and rats. In particular, we have shown that when the setting of drug self-administration (SA) coincides with the home environment of the rats (resident rats), the rats tend to prefer heroin to cocaine. The opposite was found in nonresident rats, for which the SA chambers represented a distinct environment.

OBJECTIVES

The aim of the present study was to investigate the influence of setting on the ability of different doses of cocaine and heroin to prime cocaine- versus heroin-seeking in rats that had been trained to self-administer both drugs and had then undergone an extinction procedure.

METHODS

Resident (N = 62) and nonresident (N = 63) rats with double-lumen intra-jugular catheters were trained to self-administer cocaine (400 μg/kg/infusion) and heroin (25 μg/kg/infusion) on alternate days for 10 consecutive daily sessions (3 h each). After the extinction phase, independent groups of rats were given a noncontingent intravenous infusion of heroin (25, 50, or 100 μg/kg) or cocaine (400, 800, or 1600 μg/kg), and drug-seeking was quantified by counting nonreinforced lever presses.

RESULTS

All resident and nonresident rats acquired heroin and cocaine SA. However, cocaine primings reinstated cocaine-seeking only in nonresident rats, whereas heroin primings reinstated heroin-seeking only in resident rats.

CONCLUSIONS

We report here that the susceptibility to relapse into drug-seeking behavior is drug-specific and setting-specific, confirming the crucial role played by drug, set, and setting interactions in drug addiction.

Alcohol outlet density, drinking contexts and intimate partner violence: a review of environmental risk factors

Alcohol use is a robust predictor of intimate partner violence (IPV). A critical barrier to progress in preventing alcohol-related IPV is that little is known about how an individual's specific drinking contexts (where, how often, and with whom one drinks) are related to IPV, or how these contexts are affected by environmental characteristics, such as alcohol outlet density and neighborhood disadvantage. The putative mechanism is the social environment in which drinking occurs that may promote or strengthen aggressive norms. Once these contexts are known, specific prevention measures can be put in place, including policy-oriented (e.g., regulating outlet density) and individually oriented (e.g., brief interventions to reduce risk for spousal aggression) measures targeting at-risk populations. This paper reviews applicable theories and empirical research evidence that links IPV to drinking contexts and alcohol outlet density, highlights research gaps, and makes recommendations for future research.

Risks of alcohol use disorders related to drinking patterns in the U.S. general population

OBJECTIVE

The purpose of this study was to examine the relations between drinking (mean quantity and heavy drinking patterns) and alcohol use disorders (AUDs) in the U.S. general population.

METHOD

Data from three telephone National Alcohol Surveys (in 2000, 2005, and 2010) were pooled, with separate analyses for men and women restricted to current drinkers (ns = 5,922 men, 6,270 women). Predictors were 12-month volume (mean drinks per day), rates of heavy drinking (5+/4+ drinks in a day for men/women), and very heavy drinking (8+, 12+, and 24+ drinks in a day). Outcomes were negative alcohol-related consequences constituting abuse (1+ of 4 DSM-IV-based domains assessed by 13 items) and alcohol dependence (symptoms in 3+ of 7 DSM-IV-based domains), together taken to indicate an AUD. Segmentation analyses were used to model risks of problem outcomes from drinking patterns separately by gender.

RESULTS

In the general population, men and women who consumed ≤1 drink/day on average with no heavy drinking days did not incur substantial risks of an AUD (<10%). Men who drank from 1 to 2 drinks/day on average but never 5+ incurred a 16% risk of reporting an AUD (3.5% alcohol dependence). At higher volumes, men and women who indicated higher rates of drinking larger amounts per day and/or involving 8+ and 12+ drinks/day (and even 24+ drinks/day for men) showed much higher risks of experiencing AUDs.

CONCLUSIONS

The findings provide quantitative guidance for primary care practitioners who wish to make population-based recommendations to patients who might benefit by reducing both overall intake and amounts per occasion in an effort to lower their risks of developing AUDs.

Gender differences in associations of neighbourhood disadvantage with alcohol's harms to others: a cross-sectional study from the USA

INTRODUCTION AND AIMS

To examine whether alcohol's harms to others are more prevalent in socioeconomically disadvantaged neighbourhoods and whether men or women are at differential risk in these neighbourhoods.

DESIGN AND METHODS

Cross-sectional survey data from 2000 and 2005 National Alcohol Surveys were linked to geo-referenced indicators of neighbourhood disadvantage from the US 2000 Decennial Census. The pooled sample included 10,121 adults (54% female; average age 44.4 years; 69% White; 13% African-American; 13% Hispanic). A dichotomous indicator denoted neighbourhoods based on the top quartile on a five-item measure of disadvantage (alpha = 0.90). We examined past-year family problems due to someone else's drinking (marriage difficulties and/or financial trouble) and victimisation by someone who had been drinking (having property vandalised and/or being pushed, hit or assaulted).

RESULTS

During the prior 12 months, 6% of women and 3% of men experienced family problems from someone else's drinking, and 4% of women and 7% of men reported being victimised by drinkers. Multivariate logistic regression models adjusting for individual-level socioeconomic status and other demographic characteristics showed the relationship between neighbourhood disadvantage and harms from someone else's drinking was moderated by gender, with significantly higher odds of family problems in disadvantaged neighbourhoods for men but not for women, as well as significantly higher odds of crime victimisation in disadvantaged neighbourhoods for women but not men.

DISCUSSION AND CONCLUSIONS

Experiences of harms from someone else's drinking in disadvantaged neighbourhoods vary for men and women. Targeted intervention strategies are needed to reduce alcohol's harm to others.

Gender and Social Pressure to Change Drinking Behavior: Results from the National Alcohol Surveys from 1984-2010

OBJECTIVE

Research shows social and institutional pressure influences drinking, yet determinants of who receives pressure are understudied. This paper examines age, time period, and birth cohort (APC) effects on pressure to stop or reduce drinking among U.S. men and women.

METHODS

Data were drawn from six National Alcohol Surveys (NAS) conducted from 1984 to 2010 (N=32,534). Receipt of pressure during the past year to quit or change drinking from formal (police, doctor, work) and informal (spouse, family, friends) sources was assessed.

RESULTS

Determinants of pressure were similar for men and women but varied in strength. They included younger age, less education, and younger cohort groups. Cohort effects were stronger for women than men.

CONCLUSIONS

Cohort effects among women may be due to increased alcohol marketing to younger women and the changing social contexts of their drinking. Future studies should assess associations between drinking contexts, pressures, and outcomes.

Less drinking, yet more problems: understanding African American drinking and related problems

Researchers have found that, compared to European Americans, African Americans report later initiation of drinking, lower rates of use, and lower levels of use across almost all age groups. Nevertheless, African Americans also have higher levels of alcohol problems than European Americans. After reviewing current data regarding these trends, we provide a theory to understand this apparent paradox as well as to understand variability in risk among African Americans. Certain factors appear to operate as both protective factors against heavy use and risk factors for negative consequences from use. For example, African American culture is characterized by norms against heavy alcohol use or intoxication, which protects against heavy use but also provides within-group social disapproval when use does occur. African Americans are more likely to encounter legal problems from drinking than European Americans, even at the same levels of consumption, perhaps thus resulting in reduced consumption but more problems from consumption. There appears to be one particular group of African Americans, low-income African American men, who are at the highest risk for alcoholism and related problems. We theorize that this effect is due to the complex interaction of residential discrimination, racism, age of drinking, and lack of available standard life reinforcers (e.g., stable employment and financial stability). Further empirical research will be needed to test our theories and otherwise move this important field forward. A focus on within-group variation in drinking patterns and problems is necessary. We suggest several new avenues of inquiry.

Drinking context-specific associations between intimate partner violence and frequency and volume of alcohol consumption

AIMS

To quantify two specific aspects of drinking in various venues (past-year frequency of drinking in each venue and volume consumed per venue) and assess their relationships with intimate partner violence.

DESIGN, SETTING AND PARTICIPANTS

A geographic sample of married or cohabiting couples residing in 50 medium-to-large cities in California, USA (n = 1585 couples) was obtained. Cross-sectional survey data were collected via confidential telephone interviews.

MEASUREMENTS

Each partner in the couple provided information about past-year male-to-female and female-to-male intimate partner violence (IPV), drinking contexts and psychosocial and demographic factors. Frequency of drinking in six contexts and volume consumed in those contexts were used in censored Tobit models to evaluate associations between IPV and male and female drinking contexts.

FINDINGS

Risks for IPV differed among drinking contexts and were sometimes related to heavier volumes consumed. In fully adjusted models, male partners' frequency of drinking at parties at another's home {β [standard error (SE) 0.130 (0.060]; P = 0.030} was associated with risk for male-to-female IPV and frequency of drinking during quiet evenings at home was associated with risk for female-to-male IPV [β (SE) 0.017 (0.008); P = 0.033]. Female partners' frequency of drinking with friends at home [β (SE) -0.080 (0.037); P = 0.030] was associated with decreased male-to-female IPV, but volume consumed was associated with increased risk [β (SE) 0.049 (0.024); P = 0.044].

CONCLUSIONS

The social context in which drinking occurs appears to play a role in violence against partners, with male violence being linked to drinking away from home and female violence being linked to drinking at home.

The relationship between group size, intoxication and continuing to drink after bar attendance

OBJECTIVE

The present study was undertaken to explore multilevel determinants of planning to continue to drink alcohol after leaving public drinking events. We assessed whether individual-level factors, group-related factors, or event-level bar characteristics were associated with post-bar drinking.

METHOD

We recruited a total of 642 participants from 30 participating bars in urban Southern California. Groups who arrived to patron a bar were interviewed upon their entrance and exit. Given data nesting, we employed a multilevel modeling approach to data analysis.

RESULTS

More than one-third (40%) of our sample reported the intention to continue drinking as they exited the bar. Results of our multilevel model indicated eight individual-level variables significantly associated with intending to continue to drink. Time of night moderated the relationship between BrAC change and intentions to continue to drink. Although none of the group factors were significant in our model, a significant cross-level interaction between BrAC change and number of group members indicated the effect of intoxication on planning to continue to drink increases as group members increase. At the bar level, the presence of temporary bars and server offers of non-alcoholic drinks significantly decreased intentions to continue to drink.

CONCLUSIONS

Given the large percentage of participants who reported the intention to continue drinking after exiting a bar, this study draws attention to the fact that field studies of drinking behavior may assess drinking mid-event rather than at the end of a drinking event.

Drinking context and intimate partner violence: evidence from the California community health study of couples

OBJECTIVE

Couples in which one or both partners is a heavy or problem drinker are at elevated risk for intimate partner violence (IPV), yet little is known about the extent to which each partner's drinking in different contexts (volume consumed per setting in bars, parties, at home, or in public places) increases the likelihood that partner aggression will occur. This study examined associations between the volume consumed in different settings by each partner and the occurrence and frequency of IPV.

METHOD

We obtained a geographic sample of married or cohabiting couples residing in 50 medium to large California cities. Cross-sectional survey data were collected via confidential telephone interviews (60% response rate). Logistic and negative binomial regression analyses were based on 1,585 couples who provided information about past-12-month IPV, drinking contexts (number of times attended, proportion of drinking occasions when attended, average number of drinks), frequency of intoxication, and psychosocial and demographic factors. Drinking context-IPV associations for each partner were adjusted for the other partner's volume for that context and other covariates.

RESULTS

Male partner's volume per setting for bars and parks or public places was associated with the occurrence and frequency of male-to-female IPV and female-to-male IPV. Male's volume per setting for quiet evening at home was associated with the occurrence of female-to-male IPV; female partner's volume for this setting was associated with the frequency of male-to-female IPV and female-to-male IPV.

CONCLUSIONS

Among couples in the general population, each partner's drinking in certain contexts is an independent risk factor for the occurrence and frequency of partner aggression.

A critical systematic review of alcohol-related outcome expectancies

To assess the validity of the research into alcohol-related outcome expectancies a systematic review of 80 articles published between 1970 and 2013 was conducted. Participant gender, age, and contextual influences are highlighted as possible causes of the observed variations in research findings. There is a need for fuller consideration of the influences of demographics and environmental and social contexts on research findings. It is recommended that alcohol intake measures should be standardized to a greater degree in future research. Contextual influences on expectancies also require extensive future investigation to increase the validity of research and improve alcohol-related interventions.

Substance-specific environmental influences on drug use and drug preference in animals and humans

Epidemiological, clinical, and preclinical evidence indicate that the setting of drug use can exert a powerful modulatory influence on drug reward and that this influence is substance-specific. When heroin and cocaine co-abusers, for example, report on the circumstances of drug use, they indicate distinct settings for the two drugs: heroin being used preferentially at home and cocaine being used preferentially outside the home. Similar results were obtained in laboratory rats. These findings will be interpreted in the light of a novel model of drug reward, based on the emotional appraisal of central and peripheral drug effects as a function of environmental context. I argue here that drug addiction research has not paid sufficient attention to the substance-specific aspects of drug abuse and this may have contributed to the present dearth of effective treatments. Pharmacological and cognitive-behavioral therapy, for example, should be tailored so as to allow the addict to anticipate, and cope with, the risks associated, in a substance-specific manner, to the different settings of drug use.