A 10-year national trend study of alcohol consumption, 1984-1995: is the period of declining drinking over?

Pattern recognition receptor CD14 gene polymorphisms in alcohol use disorder patients and its Influence on liver disease susceptibility

Background

Alcohol use disorders (AUDs) leading to liver disease is major concern over other spectrum of disorder. Excessive alcohol consumption resulting in leaky gut syndrome is attributed to alcohol-induced liver injury through portal translocation of bacterial endotoxin. Susceptibility to alcoholic liver disease (ALD) in AUD patients could be dependent upon genes responsible for inflammation and alcohol metabolism. The pattern recognition receptor CD14 gene is a major player in endotoxin-mediated inflammation and susceptibility to ALD. This study investigated the genetic association of CD14 polymorphisms and other mechanisms relevant to altered inflammatory responses leading to ALD.

Methods

Patients with alcohol use disorder with ALD (n = 128) and without liver disease (ALC, n = 184) and controls without alcohol use disorder (NALC, n = 152) from North India were enrolled. The CD4 gene polymorphisms in the North Indian population were evaluated by RFLP and sequencing. Secretory CD14 (sCD14), LBP, TLR4, MD2, TNFα, IL1b, IFNγ, IL6, IL10, and IL4 levels in serum were measured by ELISA among groups. The influence of polymorphisms on CD14 gene promoter activity and circulatory bacterial DNA level was determined.

Results

The CD14 gene promoter and exonic region SNPs were found to be monomorphic, except for SNP rs2569190 for the North Indian population. The genetic association of SNP rs2569190(C/T) with the risk of developing ALD was found significant for TT genotype [OR_TT, 95% CI = 2.19, 1.16–4.13 for ALD vs. ALC and OR, 2.09, 1.18–3.72 for ALD vs. NALC]. An increased sCD14 level was observed in AUD patients compared to NALC control. Increased levels of LBP, TLR4, TNFα, IL1β, IFNγ, and IL6 and reduced levels of MD2, IL10, and IL4 were observed among the ALD patients compared to the other two control groups. Elevated levels of pro-inflammatory and reduced levels of anti-inflammatory cytokines were observed in the risk genotype TT groups of ALD patients and the ALC group compared to NALC. Promoter activity was observed in the intronic region flanking SNPs and risk genotype can influence reporter activity, indicating CD14 gene expression.

Conclusion

Enhanced CD14 expression associated with inflammatory responses increases susceptibility to ALD in the TT genotype of AUD patients.

Emerging prevalence of fatty liver disease in HIV

Fatty liver disease is a growing concern in people living with HIV, the main drivers are alcoholic liver disease and nonalcoholic fatty liver disease. It has shown to negatively impact HIV care continuum and result in notable non-HIV related morbidity and mortality. With the advancement in antiretroviral therapy and effective direct acting antivirals, fatty liver disease is surfacing as the next big challenge in this population like that observed in the general population. This review article summarizes the gravity of these two common diseases in HIV-infected people and aims to sheds light on an unmet need to develop effective methods to identify, screen and manage fatty liver disease in this unique population.

Gender Differences in Alcohol Treatment

AIMS

Alcohol consumption is a threat to health worldwide and leads to substantial expenses for society. Previous studies have found differences between women and men regarding drinking behaviour and concluded that women need a more multipart type of alcohol use disorder (AUD) treatment. This study aims to examine the differences in outcome between women and men who have completed public outpatient alcohol treatment.

METHODS

A total of 3452 patients, who completed AUD treatment from 2006 to 2018, were included in this follow-up study. Data were collected from the Odense Alcohol Treatment Database. Analyses were performed using a χ2 test and multiple logistic regression.

RESULTS

The calculations showed that women in AUD treatment had a better outcome if they had children (AOR 0.46, P ≤ 0.001) or were living with a partner with AUD (AOR 0.25-0.33, P ≤ 0.001). Women had a worse outcome if they had a higher educational level (AOR 1.40-1.69, P ≤ 0.001) or were employed (AOR 1.66-1.78, P ≤ 0.001).

CONCLUSIONS

This study found that women had more problems associated with alcohol consumption than men, both before and after completion of AUD treatment. Women with employment or education had a poorer outcome than their male counterparts, whereas childcare responsibilities or having a partner with AUD provided a better outcome.

Trends in the incidence and survival of patients with esophageal cancer: A SEER database analysis

BACKGROUND

Recent studies have indicated that the incidence of esophageal cancer has declined in the past decade in the U.S. However, trends in the incidence and survival have not been thoroughly examined.

METHODS

Data from 46 063 patients with esophageal cancer between 1973 and 2015 were collected from the Surveillance, Epidemiology, and End Results database. The trends in the age-adjusted incidence and survival were analyzed using joinpoint regression models.

RESULTS

The age-adjusted incidence of esophageal cancer increased from 5.55 to 7.44 per 100 000 person-years between 1973 and 2004. Later, it decreased at an annual percentage change of 1.23%. In the last 40 years, the strong male predominance increased slightly. Importantly, the percentage of patients with localized stage of squamous cell cancer decreased. It was observed that the incidence of esophageal squamous cell carcinoma declined since 1986, while the incidence of esophageal adenocarcinoma sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men. Consistently, the estimated 40-year limited-duration prevalence of esophageal adenocarcinoma was higher than that of esophageal squamous cell carcinoma. Additionally, we observed a modest but significant improvement in survival during the study period.

CONCLUSION

The incidence of esophageal squamous cell carcinoma has decreased significantly over the past four decades in the U.S., while the incidence of adenocarcinoma has increased, particularly among men. Overall, the long-term survival of patients with esophageal cancer is poor but it has improved over the past decades, especially for the localized disease.

KEY POINTS

Significant findings of the study The incidence of esophageal cancer has decreased at an annual percentage change of 1.23% since 2004. The incidence of esophageal adenocarcinoma has sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men. What this study adds There has been a shift in the prevalence of esophageal cancer histological subtypes over the past decades in the U.S. We found that the incidence of esophageal squamous cell carcinoma has continued to decrease, while the esophageal adenocarcinoma rate has continued to increase.

Alcohol Use Disorder and Comorbid Depression: A Randomized Controlled Trial Investigating the Effectiveness of Supportive Text Messages in Aiding Recovery

AIM

The aim of this randomized controlled trial was to examine the impact of daily supportive text messages over a 6-month treatment period on mood and alcohol consumption in individuals with a dual diagnosis of alcohol use disorder (AUD) and depression following completion of an inpatient treatment programme.

METHOD

Ninety-five adult participants with AUD and comorbid depression were recruited into this randomized control trial, which took place after completing a 30-day rehabilitation programme. The intervention group (n = 47) received twice-daily supportive text messages over 6-months while control participants (n = 48) had treatment as usual for a 6-month period, with an added 6-month post-treatment follow-up for both groups. Drinking history in the previous 90 days as well as symptoms of depression, anxiety and stress were measured at baseline, 3- and 6-month treatment points and 6-month post treatment follow up.

RESULTS

Depression scores (P = 0.02) and perceived stress scores (P < 0.01) were significantly reduced at 3-month treatment point in the intervention group relative to control participants with small to medium effect. The intervention group also showed a significantly greater reduction in units per drinking day from baseline to 6-month treatment point compared to the control group with a medium effect size (P = 0.03). There were no differences in drinking or mood measures at 6-month post treatment follow-up.

CONCLUSIONS

Supportive text messages provide an early initial benefit in decreasing symptoms of depression and stress, with a further positive impact on alcohol consumption following a longer treatment period. Benefits did not persist six months after the intervention ended.

Ten-Year Trend in Women's Reasons for Abstaining or Limiting Drinking: The 2000 and 2010 United States National Alcohol Surveys

BACKGROUND

Data on individual and cultural factors contributing to drinking can inform screening and brief intervention in clinical practice. Our aims were to examine 10-year trends in women's reasons for abstaining/limiting drinking and to document changes in associations with drinking status for population subgroups defined by race/ethnicity and age.

MATERIALS AND METHODS

Using repeated cross-sectional data from White, Black and Hispanic women in the 2000 and 2010 United States National Alcohol Surveys (combined N = 5501), population-weighted multiple linear and multinomial logistic regression models assessed changes in three reasons for abstaining or limiting drinking (health concerns, religious prohibition, and upsetting family or friends) and drinking status (past-year abstainer, low-risk drinker, or at-risk drinker), and their associations over time.

RESULTS

Adjusting for key demographics, reasons for limiting alcohol consumption declined in importance over time, with reductions in both health concerns and religious prohibition particularly noteworthy for older women of all three racial/ethnic backgrounds. Despite these reductions in importance, both health concerns and religious prohibition were most consistently associated with increased abstinence relative to low-risk drinking; these reasons were not strongly associated with at-risk drinking, however.

CONCLUSIONS

It is essential for healthcare providers and others to disseminate accurate information about the risks of drinking to counter cultural shifts that suggest greater acceptance of moderate-to-heavy drinking by women aged 40 and older.

Genetic polymorphism in cytochrome P450 2E1 and alcoholic pancreatitis sus-ceptibility: a meta-analysis

BACKGROUND

The association between cytochrome P450 2E1 (CYP2E1) polymorphism and the risk of alcoholic pancreatitis is contentious. This meta-analysis aimed to demonstrate the association between CYP2E1 RsaI/PstI, or DraI polymorphisms and the susceptibility of alcoholic pancreatitis.

MATERIALS AND METHODS

We searched for sources and background in Pubmed, Medline, Web of science and CNKI (Chinese national knowledge infrastructure), using the following keywords: "cytochrome P450 2E1" or "CYP2E1", "polymorphism" or "genotype", in combination with "alcoholic pancreatitis". All meta-analyses were performed with Stata 12.0. Subgroup analyses on ethnicity and type of alcoholic pancreatitis were conducted as well.   Results: Eleven articles, which met the inclusion criteria, included 595 patients with alcoholic pancreatitis, and 1767 controls. For the general population, our analysis suggested no obvious association between CYP2E1 RsaI/PstI or DraI polymorphisms and the risk of alcoholic pancreatitis. However, in the non-Asian subgroup, significant associations were found between the risk for alcoholic pancreatitis and CYP2E1 RsaI/PstI polymorphism [dominant model: odds ratio (OR) =1.92, 95 % confidence interval (CI): 1.25-2.95, p =0.003; allelic contrast model: OR =1.99, 95 % CI: 1.35-2.92, p <0.001. There was not a significant association found within the Asian group. Meanwhile, the susceptibilities of chronic alcoholic pancreatitis were significantly increased for dominant and allelic contrast models of CYP2E1 RsaI/PstI polymorphism [OR =1.62, 95 % CI: 1.12-2.34; p =0.011; OR =1.62, 95 % CI: 1.17-2.24, p = 0.004, respectively] but not for acute alcoholic pancreatitis for all population.

CONCLUSIONS

CYP2E1 RsaI/PstI polymorphism may increase the risk of alcoholic pancreatitis in the non-Asian population. Additionally, the CYP2E1 RsaI/PstI polymorphism may increase the susceptibility for chronic alcoholic pancreatitis for all population. HIPPOKRATIA 2018, 22(2): 60-67.

Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013: Results From the National Epidemiologic Survey on Alcohol and Related Conditions

IMPORTANCE

Lack of current and comprehensive trend data derived from a uniform, reliable, and valid source on alcohol use, high-risk drinking, and DSM-IV alcohol use disorder (AUD) represents a major gap in public health information.

OBJECTIVE

To present nationally representative data on changes in the prevalences of 12-month alcohol use, 12-month high-risk drinking, 12-month DSM-IV AUD, 12-month DSM-IV AUD among 12-month alcohol users, and 12-month DSM-IV AUD among 12-month high-risk drinkers between 2001-2002 and 2012-2013.

DESIGN, SETTING, AND PARTICIPANTS

The study data were derived from face-to-face interviews conducted in 2 nationally representative surveys of US adults: the National Epidemiologic Survey on Alcohol and Related Conditions, with data collected from April 2001 to June 2002, and the National Epidemiologic Survey on Alcohol and Related Conditions III, with data collected from April 2012 to June 2013. Data were analyzed in November and December 2016.

MAIN OUTCOMES AND MEASURES

Twelve-month alcohol use, high-risk drinking, and DSM-IV AUD.

RESULTS

The study sample included 43 093 participants in the National Epidemiologic Survey on Alcohol and Related Conditions and 36 309 participants in the National Epidemiologic Survey on Alcohol and Related Conditions III. Between 2001-2002 and 2012-2013, 12-month alcohol use, high-risk drinking, and DSM-IV AUD increased by 11.2%, 29.9%, and 49.4%, respectively, with alcohol use increasing from 65.4% (95% CI, 64.3%-66.6%) to 72.7% (95% CI, 71.4%-73.9%), high-risk drinking increasing from 9.7% (95% CI, 9.3%-10.2%) to 12.6% (95% CI, 12.0%-13.2%), and DSM-IV AUD increasing from 8.5% (95% CI, 8.0%-8.9%) to 12.7% (95% CI, 12.1%-13.3%). With few exceptions, increases in alcohol use, high-risk drinking, and DSM-IV AUD between 2001-2002 and 2012-2013 were also statistically significant across sociodemographic subgroups. Increases in all of these outcomes were greatest among women, older adults, racial/ethnic minorities, and individuals with lower educational level and family income. Increases were also seen for the total sample and most sociodemographic subgroups for the prevalences of 12-month DSM-IV AUD among 12-month alcohol users from 12.9% (95% CI, 12.3%-17.5%) to 17.5% (95% CI, 16.7%-18.3%) and 12-month DSM-IV AUD among 12-month high-risk drinkers from 46.5% (95% CI, 44.3%-48.7%) to 54.5% (95% CI, 52.7%-56.4%).

CONCLUSIONS AND RELEVANCE

Increases in alcohol use, high-risk drinking, and DSM-IV AUD in the US population and among subgroups, especially women, older adults, racial/ethnic minorities, and the socioeconomically disadvantaged, constitute a public health crisis. Taken together, these findings portend increases in many chronic comorbidities in which alcohol use has a substantial role.

Cross-cultural variation in the association between family's socioeconomic status and adolescent alcohol use

INTRODUCTION AND AIMS

This study estimates cross-country variation in socioeconomic disparities in adolescent alcohol use and identifies country-level characteristics associated with these disparities.

DESIGN AND METHODS

The association between socioeconomic status (family wealth and parental education) and alcohol use (lifetime use and episodic heavy drinking) of 15- to 16-year-olds from 32 European countries was investigated. Country-level characteristics were national income, income inequality and per capita alcohol consumption. Multilevel modelling was applied.

RESULTS

Across countries, lifetime use was lower in wealthy than in less wealthy families (odds ratio [OR]_(girls)  = 0.95, OR_(boys)  = 0.94). The risk of episodic heavy drinking, in contrast, was higher for children from wealthier families (OR_(girls)  = 1.04, OR_(boys)  = 1.08) and lower when parents were highly educated (ORs = 0.95-0.98). Socioeconomic disparities varied substantially between countries. National wealth and income inequality were associated with cross-country variation of disparities in lifetime use in few comparisons, such that among girls, the (negative) effect of family wealth was greatest in countries with unequally distributed income (OR = 0.86). Among boys, the (negative) effect of family wealth was greatest in low-income countries (OR = 1.00), and the (positive) effect of mothers' education was greatest in countries with high income inequality (OR = 1.11).

DISCUSSION AND CONCLUSIONS

Socioeconomic disparities in adolescent alcohol use vary across European countries. Broad country-level indicators can explain this variation only to a limited extent, but results point towards slightly greater socioeconomic disparities in drinking in countries of low national income and countries with a high income inequality. [Gomes de Matos E, Kraus L, Hannemann T-V, Soellner R, Piontek D. Cross-cultural variation in the association between family's socioeconomic status and adolescent alcohol use.

Emerging insights into recurrent and metastatic human papillomavirus-related oropharyngeal squamous cell carcinoma

Objective

To review recent literature on human papillomavirus‐related (HPV‐positive) oropharyngeal squamous cell carcinoma (OPC) and focus on implications of recurrent and metastatic disease.

Methods

Primary articles from 1990 to 2016 indexed in MEDLINE (1) pertaining to the epidemiology of HPV‐positive OPC and (2) providing clinical insight into recurrent and metastatic OPC.

Results

The incidence of HPV‐positive OPC is increasing globally. HPV‐positive OPC is a subtype with distinct molecular and clinical features including enhanced treatment response and improved overall survival. While disease recurrence is less common in patients with HPV‐positive OPC, up to 36% of patients experience treatment failure within eight years. Recurrent and metastatic OPC has historically signified poor prognosis, however recent data are challenging this dogma. Here, we discuss recurrent and metastatic OPC in the context of HPV tumor status.

Conclusion

HPV‐positive OPC exhibits distinct genetic, cellular, epidemiological, and clinical features from HPV‐negative OPC. HPV tumor status is emerging as a marker indicative of improved prognosis after disease progression in both locoregionally recurrent and distant metastatic OPC.

Level of Evidence

N/A.

Poor, persecuted, young, and alone: Toward explaining the elevated risk of alcohol problems among Black and Latino men who drink

BACKGROUND

Even given equivalent drinking patterns, Black and Latino men experience substantially more dependence symptoms and other consequences than White men, particularly at low/no heavy drinking. No known studies have identified factors driving these disparities. The current study examines this question.

METHODS

The 2005 and 2010 National Alcohol Surveys were pooled. Surveys are nationally representative, telephone interviews of the U.S. including Black and Latino oversamples; male drinkers were analyzed (N=4182). Preliminary analyses included negative binomial regressions of dependence symptom and consequence counts testing whether effects for race/ethnicity were diminished when entering potential explanatory factors individually. Additional analyses re-examined effects for race/ethnicity when using propensity score weighting to weight Blacks to Whites, and Latinos to Whites, first on heavy drinking alone, and then on heavy drinking and all explanatory factors supported by preliminary analyses.

RESULTS

Preliminary regressions suggested roles for lower individual SES, greater prejudice and unfair treatment, and younger age in the elevated risk of alcohol problems among Black and Latino (vs. White) men at low heavy drinking levels; additional support emerged for single (vs. married) status among Blacks and neighborhood disadvantage among Latinos. When Blacks and Latinos were weighted to Whites on the above variables, effects for race/ethnicity on dependence counts were reduced to nonsignificance, while racial/ethnic disparities in consequence counts were attenuated (by >43% overall).

CONCLUSIONS

Heavy drinking may be especially risky for those who are poor, exposed to prejudice and unfair treatment, young, and unmarried, and these factors may contribute to explaining racial/ethnic disparities in alcohol problems.

A Study of the Alcohol Policy Development Process in the United States: Theory, Goals, and Methods

The project identified factors influencing U.S. federal alcohol policy formation and especially the role of research. It explored the applicability of John Kingdon's “Policy Stream” model involving three interacting policy streams: problem recognition, policy alternatives, and politics. Each stream is necessary but insufficient for policy formation, and coupling streams in “windows of opportunity” is a key to moving legislation. Federal alcohol-policy cases studied included excise taxes, alcohol promotion policies, federal agency reauthorization, and federally mandated health warnings. Data sources included key-informant interviewing with snowball sampling and archival data. We qualitatively analyzed government documents, scientific journals, print and electronic media, trade magazines, and newsletters. Sixty-four in-depth interviews were completed with public health activists, alcohol industry representatives, researchers, journalists, and people in executive and legislative branches of the government. We summarize methods used and challenges overcome, and provides an overview of the project's activities, with results detailed elsewhere in this special issue.

Public Opinion on Alcohol Policy: A Review of U.S. Research

Public opinion on alcohol policy has received little research attention until recently, although a coherent research agenda in this area holds promise of a better understanding of the public health policymaking process. This paper reviews and critiques the major analyses of policy opinion in the United States, discusses national support for specific policy options, and addresses trends in policy opinion. The dynamics of policy opinion are complex, allowing for few generalizations. Environmentally based alcohol policies receive mixed levels of public support, and, overall, support decreased somewhat throughout the early 1990s. Recommendations for continued monitoring and improved assessment of policy opinions are made.

Alcohol Policy Opinions in the United States over a 15-Year Period of Dynamic per Capita Consumption Changes: Implications for Today's Public Health Practice

We examine 1989–2005 trends in United States (US) public opinion using 11 alcohol policy items (seven national telephone surveys) during a dynamic drop in per capita intake until the mid-1990s, followed by the first sustained upturn seen since 1980. In the 2000 U.S. National Alcohol Survey (NAS) survey 14 available policy items were factor analyzed, forming four factor-based scales replicated in 2005. Linear regression examined changing demographic correlates of support for the four policy areas between 2000 and 2005. Several empirically effective policy levers have weak support, which continues to erode. Between 2000 and 2005 support weakened by an average of 1% for all except two policies, both of which declined since 1989. Even support for alcohol warning labels has turned down for the first time since 1989. Implications of the declining endorsement of alcohol policies are discussed, given the upturn in consumption. Community-based strategies are needed to inform the public of benefits of alcohol policies.

Number of Drinks to "Feel a Buzz" by HIV Status and Viral Load in Men

The impact of HIV and its treatment on the effects of alcohol remain unclear. Blood alcohol concentrations have been noted to be higher in HIV infected individuals prior to antiretroviral initiation. Our goal was to compare number of drinks to "feel a buzz or high" among HIV infected and uninfected men, stratified by viral load (VL) suppression. Data includes 1478 HIV infected and 1170 uninfected men in the veterans aging cohort study who endorsed current drinking. Mean (SD) number of drinks to feel a buzz was 3.1 (1.7) overall. In multivariable analyses, HIV infected men reported a lower mean number of drinks to feel a buzz compared to uninfected men (coef = -14 for VL < 500; -34 for VL ≥ 500; p ≤ .05). Men with HIV, especially those with a detectable VL, reported fewer drinks to feel a buzz. Future research on the relationship between alcohol and HIV should consider the role of VL suppression.

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.

Myeloperoxidase formation of PAF receptor ligands induces PAF receptor-dependent kidney injury during ethanol consumption

Cytochrome P450 2E1 (CYP2E1) induction and oxidative metabolism of ethanol in hepatocytes inflame and damage liver. Chronic ethanol ingestion also induces kidney dysfunction, which is associated with mortality from alcoholic hepatitis. Whether the kidney is directly affected by ethanol or is secondary to liver damage is not established. We found that CYP2E1 was induced in kidney tubules of mice chronically ingesting a modified Lieber-deCarli liquid ethanol diet. Phospholipids of kidney tubules were oxidized and fragmented in ethanol-fed mice with accumulation of azelaoyl phosphatidylcholine (Az-PC), a nonbiosynthetic product formed only by oxidative truncation of polyunsaturated phosphatidylcholine. Az-PC stimulates the inflammatory PAF receptor (PTAFR) abundantly expressed by neutrophils and kidney tubules, and inflammatory cells and myeloperoxidase-containing neutrophils accumulated in the kidneys of ethanol-fed mice after significant hysteresis. Decreased kidney filtration and induction of the acute kidney injury biomarker KIM-1 in tubules temporally correlated with leukocyte infiltration. Genetic ablation of PTAFR reduced accumulation of PTAFR ligands and reduced leukocyte infiltration into kidneys. Loss of this receptor in PTAFR(-/-) mice also suppressed oxidative damage and kidney dysfunction without affecting CYP2E1 induction. Neutrophilic inflammation was responsible for ethanol-induced kidney damage, because loss of neutrophil myeloperoxidase in MPO(-/-) mice was similarly protective. We conclude that ethanol catabolism in renal tubules results in a self-perpetuating cycle of CYP2E1 induction, local PTAFR ligand formation, and neutrophil infiltration and activation that leads to myeloperoxidase-dependent oxidation and damage to kidney function. Hepatocytes do not express PTAFR, so this oxidative cycle is a local response to ethanol catabolism in the kidney.

Second-hand drinking may increase support for alcohol policies: new results from the 2010 National Alcohol Survey

INTRODUCTION AND AIMS

The harms of second-hand smoke motivated tobacco control legislation. Documenting the effects of harms from others' drinking might increase popular and political will for enacting alcohol policies. We investigated the individual-level relationship between having experienced such harms and favouring alcohol policy measures, adjusting for other influences.

DESIGN AND METHODS

We used the landline sample (n = 6957) of the 2010 National Alcohol Survey, a computer-assisted telephone interview survey based on a random household sample in the USA. Multivariable regression models adjusted for personal characteristics, including drinking pattern (volume and heavy drinking), were used to investigate the ability of six harms from others' drinking to predict a three-item measure of favour for stronger alcohol policies.

RESULTS

Adjusting for demographics and drinking pattern, number of harms from others' drinking predicted support for alcohol policies (P < 0.001). In a similar model, family- and aggression-related harms, riding with a drink driver and being concerned about another's drinking all significantly influenced favour for stronger alcohol policy.

DISCUSSION

Although cross-sectional data cannot prove a causal influence or directionality, the association found is consistent with the hypothesis that experiencing harms from others' drinking (experienced by a majority) makes one more likely to favour alcohol policies. Other things equal, women, racial/ethnic minorities, lower-income individuals and lighter drinkers tend to be more supportive of alcohol controls and policies.

CONCLUSIONS

Studies that estimate the impact of harms from other drinkers on those victimised are important and now beginning. Next we need to learn how such information could affect decision makers and legislators.

Tears in your beer: Gender differences in coping drinking motives, depressive symptoms and drinking

This study evaluates associations between coping drinking motives (CDM; drinking to regulate negative affect), depressive symptoms, and drinking behavior and extends the literature by also taking into account gender differences. Two hundred forty-three college students (Mean age = 22.93, SD = 6.29, 82% female) participated. Based on previous research, we expected that CDM would be positively associated with drinking and problems, particularly among those higher in depressive symptoms, as individuals experiencing higher levels of negative affect (i.e. depressive symptoms) and who drink to cope are likely to drink more and experience more alcohol-related problems. Lastly, based on established gender differences, we expected that CDM would be positively associated with drinking and problems, especially among females higher in depressive symptoms. Unexpectedly, findings suggested that CDMs were positively related to peak drinking, especially among those lower in depressive symptoms. Results further revealed a significant three-way interaction between CDM, depressive symptoms, and gender when predicting alcohol-related problems and drinking frequency. Specifically, we found that CDM were more strongly associated with problems among women who were lower in depressive symptoms; whereas CDM were more strongly associated with problems among men who were higher in depressive symptoms. These findings offer a more comprehensive depiction of the relationship between depressive symptoms, CDM, and drinking behavior by taking into account the importance of gender differences. These results provide additional support for considering gender when designing and implementing alcohol intervention strategies.

Glutathione S-transferase M1 and glutathione S-transferase T1 genotype in chronic pancreatitis: a meta-analysis

OBJECTIVE

A meta-analysis to determine the association between chronic pancreatitis and glutathione-S transferase (GST) mu 1 (GSTM1) and theta 1 (GSTT1) deletions.

METHODS

Case-control studies concerning the relationship between chronic pancreatitis and GSTM1 or GSTT1 deletions were identified (up to October 2013). Meta-analyses of the association between GSTM1 and GSTT1 genotype and chronic pancreatitis or alcoholic chronic pancreatitis (ACP) were performed.

RESULTS

Seven studies were included in the meta-analysis (650 patients/1382 controls for GSTM1 and 536 patients/1304 controls for GSTT1). There were no significant relationships between GSTM1/GSTT1 and chronic pancreatitis or GSTT1 and ACP. There was a significant association between GSTM1 null genotype and ACP (odds ratio 1.16, 95% confidence intervals 1.03, 1.30).

CONCLUSION

The GSTM1 null genotype was significantly associated with ACP risk.

Interactions among drinking identity, gender and decisional balance in predicting alcohol use and problems among college students

BACKGROUND

The aim of the present study was to test promising constructs (decisional balance and drinking identity) and their interaction with gender as predictors of risky college drinking. We expected that, consistent with previous work, drinking identity would be positively associated with alcohol consumption and problems. We further expected that drinking identity would be more strongly related to outcomes among individuals scoring low in decisional balance. Additionally, we expect the relationship between drinking identity and alcohol behavior to vary as a function of decisional balance.

METHODS

Participants included 329 undergraduates (M=23.11; SD=5.63; 74.47% female) who met heavy drinking criteria (defined as women who consumed 4 or more drinks per occasion and men who consumed 5 or more drinks per occasion) and completed an online survey comprised of self-report measures.

RESULTS

Decisional balance was negatively correlated with both drinking and problems, which partially supported expectations. As expected, drinking identity was positively correlated with drinking and problems. A two-way interaction emerged between drinking identity and decisional balance regarding problems, indicating that drinking identity was associated with more problems, especially among those lower in decisional balance. A three-way interaction between drinking identity, decisional balance, and gender emerged regarding problems such that drinking identity was associated with more problems for those lower in decisional balance and this effect was stronger among men.

DISCUSSION

Findings lend support to the perspective that decisional balance, drinking identity, and gender are all influential factors that are associated with the experience of alcohol problems.

Drinking patterns and alcohol use disorders in São Paulo, Brazil: the role of neighborhood social deprivation and socioeconomic status

BACKGROUND

Research conducted in high-income countries has investigated influences of socioeconomic inequalities on drinking outcomes such as alcohol use disorders (AUD), however, associations between area-level neighborhood social deprivation (NSD) and individual socioeconomic status with these outcomes have not been explored in Brazil. Thus, we investigated the role of these factors on drink-related outcomes in a Brazilian population, attending to male-female variations.

METHODS

A multi-stage area probability sample of adult household residents in the São Paulo Metropolitan Area was assessed using the WHO Composite International Diagnostic Interview (WMH-CIDI) (n = 5,037). Estimation focused on prevalence and correlates of past-year alcohol disturbances [heavy drinking of lower frequency (HDLF), heavy drinking of higher frequency (HDHF), abuse, dependence, and DMS-5 AUD] among regular users (RU); odds ratio (OR) were obtained.

RESULTS

Higher NSD, measured as an area-level variable with individual level variables held constant, showed an excess odds for most alcohol disturbances analyzed. Prevalence estimates for HDLF and HDHF among RU were 9% and 20%, respectively, with excess odds in higher NSD areas; schooling (inverse association) and low income were associated with male HDLF. The only individual-level association with female HDLF involved employment status. Prevalence estimates for abuse, dependence, and DSM-5 AUD among RU were 8%, 4%, and 8%, respectively, with excess odds of: dependence in higher NSD areas for males; abuse and AUD for females. Among RU, AUD was associated with unemployment, and low education with dependence and AUD.

CONCLUSIONS

Regular alcohol users with alcohol-related disturbances are more likely to be found where area-level neighborhood characteristics reflect social disadvantage. Although we cannot draw inferences about causal influence, the associations are strong enough to warrant future longitudinal alcohol studies to explore causal mechanisms related to the heterogeneous patterns of association and male-female variations observed herein. Hopefully, these findings may help guide future directions for public health.

Factor analysis of the Drinking Motives Questionnaire in a young adult U.S. Army sample

Reasons for alcohol consumption are often conceptualized as deriving from internal and external sources and positive and negative reinforcement. The revised Drinking Motives Questionnaire (DMQ-R) was developed to classify reasons or motives for alcohol use which are associated with different drinking patterns. The factor structure of a subset of DMQ-R items was examined using exploratory factor analysis on a U.S. Army sample, to assess whether the DMQ-R subscales represent drinking motives typically identified by military service members. This study used the Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel, which sampled 10,400 Army soldiers. A total of 4,475 responses were included in the analysis, which corresponded with a weighted sample of 391,185 soldiers. Principal-axis factor analysis with promax rotation identified two factors representing pleasure-seeking/enjoyment and avoiding rejection/"fitting in." These factors may be useful in investigating relationships between drinking motives and alcohol use patterns within the U.S. Army population.

Genome-wide association study identifies variants in PMS1 associated with serum ferritin in a Chinese population

Only a small proportion of genetic variation in serum ferritin has been explained by variant genetic studies, and genome-wide association study (GWAS) for serum ferritin has not been investigated widely in Chinese population. We aimed at exploring the novel genetic susceptibility to serum ferritin, and performed this two stage GWAS in a healthy Chinese population of 3,495 men aged 20–69 y, including 1,999 unrelated subjects in the first stage and 1,496 independent individuals in the second stage. Serum ferritin was measured with electrochemiluminescence immunoassay, and DNA samples were collected for genotyping. A total of 1,940,243 SNPs were tested by using multivariate linear regression analysis. After adjusting for population stratification, age and BMI, the rs5742933 located in the 5′UTR region of PMS1 gene on chromosome 2 was the most significantly associated with ferritin concentrations (P-combined = 2.329×10⁻¹⁰) (β = −0.11, 95% CI: −0.14, −0.07). Moreover, this marker was about 200kb away from the candidate gene SLC40A1 which is responsible for iron export. PMS1 gene was the novel genetic susceptibility to serum ferritin in Chinese males and its relation to SLC40A1 needs further study.

Chronic ethanol ingestion induces oxidative kidney injury through taurine-inhibitable inflammation

Chronic ethanol ingestion mildly damages liver through oxidative stress and lipid oxidation, which is ameliorated by dietary supplementation with the anti-inflammatory β-amino acid taurine. Kidney, like liver, expresses cytochrome P450 2E1 that catabolizes ethanol with free radical formation, and so also may be damaged by ethanol catabolism. Sudden loss of kidney function, and not liver disease itself, foreshadows mortality in patients with alcoholic hepatitis [J. Altamirano, Clin. Gastroenterol. Hepatol. 2012, 10:65]. We found that ethanol ingestion in the Lieber-deCarli rat model increased kidney lipid oxidation, 4-hydroxynonenal protein adduction, and oxidatively truncated phospholipids that attract and activate leukocytes. Chronic ethanol ingestion increased myeloperoxidase-expressing cells in kidney and induced an inflammatory cell infiltrate. Apoptotic terminal deoxynucleotidyl transferase nick-end labeling-positive cells and active caspase-3 increased in kidney after ethanol ingestion, with reduced filtration with increased circulating blood urea nitrogen (BUN) and creatinine. These events were accompanied by release of albumin, myeloperoxidase, and the acute kidney injury biomarkers kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin, and cystatin c into urine. Taurine sequesters HOCl from myeloperoxidase of activated leukocytes, and taurine supplementation reduced renal lipid oxidation, reduced leukocyte infiltration, and reduced the increase in myeloperoxidase-positive cells during ethanol feeding. Taurine supplementation also normalized circulating BUN and creatinine levels and suppressed enhanced myeloperoxidase, albumin, KIM-1, and cystatin c in urine. Thus, chronic ethanol ingestion oxidatively damages kidney lipids and proteins, damages renal function, and induces acute kidney injury through an inflammatory cell infiltrate. The anti-inflammatory nutraceutical taurine effectively interrupts this ethanol-induced inflammatory cycle in kidney.

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.

A review of studies of drinking patterns in the United States since 1940

OBJECTIVE

This article reviews changes in drinking patterns in the general U.S. population since the first appearance of the Quarterly Journal of Studies on Alcohol in June 1940.

METHOD

Contents of the three iterations of the journal (Quarterly Journal of Studies on Alcohol, Journal of Studies on Alcohol, and Journal of Studies on Alcohol and Drugs) were reviewed along with additional prominent key articles on the subject known to the author.

RESULTS

Early articles in the field tended to focus on alcoholics and alcoholism, usually with a biological emphasis. The earliest "scientific investigation" of drinking patterns that appeared in iterations of JSAD reported data based on a survey in 1946, and the earliest report of trends in drinking patterns compared the 1946 data with data from 1963. Since then, there have been numerous evaluations of drinking patterns in the general U.S. population.

CONCLUSIONS

There have been major changes over the past 75 years in the manner in which drinking patterns are measured and summarized. Perhaps the biggest change was the introduction of probability sampling. Additional major changes continue to occur, responding to technological changes (e.g., the use of computers, cell phones, and broadband connections) in how people interact with their environment.

Biomedical consequences of alcohol use disorders in the HIV-infected host

Alcohol abuse is the most common and costly form of drug abuse in the United States. It is well known that alcohol abuse contributes to risky behaviors associated with greater incidence of human immunodeficiency virus (HIV) infections. As HIV has become a more chronic disease since the introduction of antiretroviral therapy, it is expected that alcohol use disorders will have an adverse effect on the health of HIV-infected patients. The biomedical consequences of acute and chronic alcohol abuse are multisystemic. Based on what is currently known of the comorbid and pathophysiological conditions resulting from HIV infection in people with alcohol use disorders, chronic alcohol abuse appears to alter the virus infectivity, the immune response of the host, and the progression of disease and tissue injury, with specific impact on disease progression. The combined insult of alcohol abuse and HIV affects organ systems, including the central nervous system, the immune system, the liver, heart, and lungs, and the musculoskeletal system. Here we outline the major pathological consequences of alcohol abuse in the HIV-infected individual, emphasizing its impact on immunomodulation, erosion of lean body mass associated with AIDS wasting, and lipodystrophy. We conclude that interventions focused on reducing or avoiding alcohol abuse are likely to be important in decreasing morbidity and improving outcomes in people living with HIV/AIDS.

The relationships among socioeconomic status, fruit and vegetable intake, and alcohol consumption

PURPOSE

We examined the relationships among fruit and vegetable intake, alcohol consumption, and socioeconomic status (SES). We hypothesized that fruit and vegetable consumption would be inversely associated with alcohol consumption and the relationship would differ by SES.

DESIGN

A cross-sectional analysis.

SETTING

Large, urban Midwestern county.

SUBJECTS

A unique, racially/ethnically diverse sample of 9959 adults (response rate: 66.3%).

MEASURES

Fruit and vegetable intake was measured using two items that assessed servings per day. Alcohol consumption was measured in terms of volume of alcohol consumed and binge drinking. Individual measures of SES included education and household income.

ANALYSIS

Weighted multivariate linear and Poisson regression were used to estimate effects.

RESULTS

The relationship between fruit and vegetable intake and alcohol consumption varied by SES. Those with lower household incomes who consumed five or more servings of fruits and vegetables per day were less likely to engage in binge drinking relative to those consuming zero to one servings of fruits and vegetables per day (risk ratio  =  .66; 95% confidence interval: .46, .95). No association was observed for higher-household-income individuals.

CONCLUSION

We observed an inverse relationship between fruit and vegetable consumption and alcohol intake in those with lower household incomes but not in those with higher household incomes. Results suggest that the relationship between diet and alcohol consumption may be more relevant in populations with more restricted economic choices. Results are, however, based on cross-sectional data.

Are the 1976-1985 birth cohorts heavier drinkers? Age-period-cohort analyses of the National Alcohol Surveys 1979-2010

AIMS

To estimate age-period-cohort models predicting alcohol volume, heavy drinking and beverage-specific alcohol volume in order to evaluate whether the 1976-1985 birth cohorts drink relatively heavily.

DESIGN

Data from seven cross-sectional surveys of the USA conducted between 1979 and 2010 were utilized in negative binomial generalized linear models of age, period and cohort effects predicting alcohol measures.

SETTING

General population surveys of the USA.

PARTICIPANTS

Thirty-six thousand four hundred and thirty-two US adults (aged 18 years or older).

MEASUREMENTS

Monthly number of alcohol drinks, beer, wine and spirits drinks, and days drinking five or more drinks in the past year derived from beverage-specific graduated frequency questions.

FINDINGS

Relative to the reference 1956-60 birth cohort, men in the 1976-1980 cohort for were found to consume more alcohol [incidence rate ratio (IRR) = 1.222: confidence interval (CI) 1.07-1.39) and to have more 5+ days (the number of days having five or more drinks) (IRR = 1.365: CI 1.09-1.71) as were men in the 1980-85 cohort for volume (IRR = 1.284: CI 1.10-1.50) and 5+ days (IRR = 1.437: CI 1.09-1.89). For women, those in the 1980-85 cohort were found to have higher alcohol volume (IRR = 1.299: CI 1.07-1.58) and more 5+ days (IRR = 1.547: CI 1.01-2.36). Beverage-specific models found different age patterns of volume by beverage with a flat age pattern for both genders' spirits and women's wine, an increasing age pattern for men's wine and a declining age pattern from those in their early 20s for beer.

CONCLUSIONS

In the USA, men born between 1976 and 1985, and women born between 1981 and 1985 have higher alcohol consumption than in earlier or later years.

Mobile phone text message intervention to reduce binge drinking among young adults: study protocol for a randomized controlled trial

BACKGROUND

Heavy episodic (binge) drinking is common among young adults and can lead to injury and illness. Young adults who seek care in the Emergency Department (ED) may be disproportionately affected with binge drinking behavior, therefore provide an opportunity to reduce future risk through screening, brief intervention and referral to treatment (SBIRT). Mobile phone text messaging (SMS) is a common form of communication among young adults and has been shown to be effective at providing behavioral support to young adult drinkers after ED discharge. Efficacy of SMS programs to reduce binge drinking remains unknown.

METHODS/DESIGN

We will conduct a three parallel arm, randomized trial. A convenience sample of adults aged 18 to 25 years attending three EDs in Pittsburgh, PA and willing to participate in the study will be screened for hazardous alcohol consumption. Participants identified as hazardous drinkers will then be allocated to either 12 weeks of weekly SMS drinking assessments with feedback (SA+F), SMS drinking assessments without feedback (SA), or a control group. Randomization will be via an independent and remote computerized randomization and will be stratified by study site. The SA+F group will be asked to provide pre-weekend drinking intention as well as post-weekend consumption via SMS and will receive feedback messages focused on health consequences of alcohol consumption, personalized normative feedback, protective drinking strategies and goal setting. Follow-up data on alcohol use and injury related to alcohol will be collected through a password-protected website three, six and nine months later. The primary outcome for the study is binge drinking days (≥4 drinks for women; ≥5 drinks for men) during the previous month, and the main secondary outcome is the proportion of participants who report any injury related to alcohol in the prior three months.

DISCUSSION

This study will test the hypothesis that a mobile phone text-messaging program will result in immediate and durable reductions in binge drinking among at-risk young adults. By testing an intervention group to an assessment-only and control group, we will be able to separate the effect of assessment reactivity. By collecting pre-weekend drinking intentions and post-weekend consumption data in the SA+F group, we will be able to better understand mechanism of change.

TRIAL REGISTRATION

Clinicaltrials.gov NCT01688245.

Alcohol-attributable cancer deaths and years of potential life lost in the United States

OBJECTIVES

Our goal was to provide current estimates of alcohol-attributable cancer mortality and years of potential life lost (YPLL) in the United States.

METHODS

We used 2 methods to calculate population-attributable fractions. We based relative risks on meta-analyses published since 2000, and adult alcohol consumption on data from the 2009 Alcohol Epidemiologic Data System, 2009 Behavioral Risk Factor Surveillance System, and 2009-2010 National Alcohol Survey.

RESULTS

Alcohol consumption resulted in an estimated 18,200 to 21,300 cancer deaths, or 3.2% to 3.7% of all US cancer deaths. The majority of alcohol-attributable female cancer deaths were from breast cancer (56% to 66%), whereas upper airway and esophageal cancer deaths were more common among men (53% to 71%). Alcohol-attributable cancers resulted in 17.0 to 19.1 YPLL for each death. Daily consumption of up to 20 grams of alcohol (≤ 1.5 drinks) accounted for 26% to 35% of alcohol-attributable cancer deaths.

CONCLUSIONS

Alcohol remains a major contributor to cancer mortality and YPLL. Higher consumption increases risk but there is no safe threshold for alcohol and cancer risk. Reducing alcohol consumption is an important and underemphasized cancer prevention strategy.

Income inequality, alcohol use, and alcohol-related problems

OBJECTIVES

We examined the relationship between state-level income inequality and alcohol outcomes and sought to determine whether associations of inequality with alcohol consumption and problems would be more evident with between-race inequality measures than with the Gini coefficient. We also sought to determine whether inequality would be most detrimental for disadvantaged individuals.

METHODS

Data from 2 nationally representative samples of adults (n = 13,997) from the 2000 and 2005 National Alcohol Surveys were merged with state-level inequality and neighborhood disadvantage indicators from the 2000 US Census. We measured income inequality using the Gini coefficient and between-race poverty ratios (Black-White and Hispanic-White). Multilevel models accounted for clustering of respondents within states.

RESULTS

Inequality measured by poverty ratios was positively associated with light and heavy drinking. Associations between poverty ratios and alcohol problems were strongest for Blacks and Hispanics compared with Whites. Household poverty did not moderate associations with income inequality.

CONCLUSIONS

Poverty ratios were associated with alcohol use and problems, whereas overall income inequality was not. Higher levels of alcohol problems in high-inequality states may be partly due to social context.

Drinking settings, alcohol consumption, and sexual risk behavior among gay men

We sought to 1) describe the settings or groups of settings where men who have sex with men (MSM) consume alcohol in 16 U.S. metropolitan statistical areas (MSA); and 2) investigate whether certain drinking settings or groups of settings are associated with higher levels of alcohol consumption, problem drinking, and sexual risk behavior. Latent class analysis was used to develop our measure of drinking settings. The final latent class model consisted of four distinct classes which captured the typical settings where MSM consumed alcohol: "home" "social," "bar/social," and "general" drinkers (i.e., drinks in all settings). Regression models showed that "general" drinkers were more likely than "social" drinkers to engage in frequent heavy drinking. Compared to 'social' drinkers, general drinkers were also more likely to engage in unprotected anal intercourse (UAIMP) and UAIMP with men met in bars and other venues (e.g., private parties, bath houses) while intoxicated. Assessment of drinking settings may be a means of identifying MSM who are at greater risk for frequent, heavy drinking and related sexual risk behavior.

Missed and inconsistent classification of current drinkers: results from the 2005 US National Alcohol Survey

AIMS

This study compares current 12-month drinkers who do not report drinking in the last 30 days with current drinkers who drank in the last 30 days and assesses possible misclassification errors from use of a 30-day consumption measure.

DESIGN

Data are from the 2005 US National Alcohol Survey (n = 6919), a national household probability survey.

SETTING

Telephone interviews were used to measure alcohol use and alcohol-related problems.

PARTICIPANTS

This study compared 1300 current drinkers who did not drink in the last 30 days with 2956 current drinkers who drank in the last 30 days.

MEASUREMENTS

Volume was measured by quantity/frequency scales (12-month and 30-day) and a graduated frequency scale (12-month). Both groups were compared by demographic, alcohol volume, days of five or more drinks, social consequences and dependence measures.

FINDINGS

Results indicate a significantly lower prevalence rate of current drinking for 30-day measures-47.3% (45.8%, 48.8%) versus 67.3% (66.0%, 68.7%) with 12-month measures. Further, 385 non-30-day drinkers reported 12-month drinking frequencies of once a month or more often, suggesting possible inconsistent reporting of their alcohol use. When this group of 'inconsistent' respondents is compared with the 915 non-30-day current drinkers who reported less than monthly drinking, they reported significantly higher yearly volume, days of five or more drinks, mean social consequences and proportion reporting alcohol dependence.

CONCLUSIONS

In population surveys assessing alcohol use, asking about the previous 12 months rather than the past 30 days provides higher estimates of current use, including more days of heavy episodic use.

Changes in alcohol use and relationship satisfaction in Norwegian couples during pregnancy

Background

Numerous studies have documented a profound reduction in alcohol use among pregnant women, whereas research on expectant fathers has been scarce. The aim of this study was to measure changes in alcohol consumption from before pregnancy to 17 weeks in gestation for mothers and fathers, differentiating between parents with and without any previous children, and to measure how level and change in alcohol consumption into early pregnancy was associated with relationship satisfaction.

Methods

The data collection was conducted as part of the Norwegian Mother and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health. This cohort now includes 108 000 children, 90 700 mothers and 71 500 fathers recruited from 1999 to 2008. The present study comprises 82 362 couples. Alcohol consumption was assessed using a questionnaire including items about usual drinking frequency, quantities, and number of occasions with heavy episodic drinking (HED). Relationship satisfaction was measured by five items scored on a Likert agreement scale.

Results

The findings indicate that both mothers and fathers reduce their drinking significantly during pregnancy. Reduction was apparent for all three measures of alcohol consumption. First-time fathers reduced their alcohol consumption more than experienced fathers, from initially higher levels. The gap between the fathers and their pregnant partner was greater for first-time parents compared to parents with previous children. Drinking pre-pregnancy and relationship satisfaction during pregnancy were weakly related within each partner, whereas no association across partners was observed.

Conclusions

Both expectant mothers and fathers changed their alcohol consumption patterns when expecting a child. Almost all mothers stopped drinking, whereas fathers reduced their drinking to a considerable degree. Relationship satisfaction was only slightly related to their drinking patterns. The findings may have important policy implications, mainly with regard to developing alcohol preventive strategies.

Drinking habits of older Canadians: a comparison of the 1994 and 2004 national surveys

ABSTRACT This study examines changes in the alcohol consumption of Canadians aged 55 and older from the 1990s to the 2000s and investigates whether the differences persist after controlling for the socio-demographic composition of the samples. The data included two subsamples of respondents 55 to 74 years of age from two cross-sectional Canadian surveys: the 1994 CADS (1,071 men and 1,446 women) and the 2004 GENACIS (1,494 men and 2,176 women). One-way ANOVAs revealed significantly higher rates of drinkers and binge drinking in 2004 but no differences in drinking profiles. Regression analyses showed that the observed differences did not disappear when controlling for socio-demographic composition. The higher rates of drinkers in 2004 may be explained by a social and environmental context that was more favourable to alcohol consumption in the 2000s. More research is needed to disentangle the age-cohort-period effects on alcohol consumption among Canadian older adults.

Genome-wide scan identifies variant in TNFSF13 associated with serum IgM in a healthy Chinese male population

IgM provides a first line of defense during microbial infections. Serum IgM levels are detected routinely in clinical practice. And IgM is a genetically complex trait. We conducted a two-stage genome-wide association study (GWAS) to identify genetic variants affecting serum IgM levels in a Chinese population of 3495, including 1999 unrelated subjects in the first stage and 1496 independent individuals in the second stage. Our data show that a common single nucleotide polymorphism (SNP), rs11552708 located in the TNFSF13 gene was significantly associated with IgM levels (p = 5.00×10⁻⁷ in first stage, p = 1.34×10⁻³ in second stage, and p = 4.22×10⁻⁹ when combined). Besides, smoking was identified to be associated with IgM levels in both stages (P<0.05), but there was no significant interaction between smoking and the identified SNP (P>0.05). It is suggested that TNFSF13 may be a susceptibility gene affecting serum IgM levels in Chinese male population.

The social location of heavy episodic alcohol consumption in the Victorian population

INTRODUCTION AND AIMS

To examine heavy episodic drinking across demographic subgroups to identify where heavy episodic drinking is socially located in an Australian state.

DESIGN AND METHODS

Cross-sectional survey, 2483 adult Victorians using Computer Assisted Telephone Interviewing. Two measures of heavy drinking were used: (i) heavy episodic drinking-more than five standard drinks at least weekly; and (ii) typically heavy drinking-50% or more of all drinking occasions involving consumption of 5+ standard drinks. Associations between heavy episodic drinking and eight potential sociodemographic correlates (gender, age, education, income, marital status, ethnic origin, religion and geographical remoteness) were examined.

RESULTS

There were few significant correlates of heavy episodic drinking apart from gender and age, once gender and age were controlled. Men were more likely to report heavy episodic drinking than women, but this was attenuated in the measure of typically heavy drinking, suggesting that women reporting heavy episodic drinking were more likely to typically drink that much when they drank. Younger people were more likely to report weekly heavy episodic drinking and more likely to report engaging in this pattern on at least half of their drinking occasions, and this was also true for those unmarried or in de facto relationships. Those of Asian background were less likely to report heavy drinking. In multivariate analysis, the remaining sociodemographic variables were largely unrelated to the drinking measures.

DISCUSSION AND CONCLUSION

The study clearly shows that the prevalence of heavy episodic drinking varies particularly across gender and age groups in Victoria. These variations appear to hold across key sociodemographic variables such as income and education.

Trends in alcohol use among women with and without myocardial infarction in the United States: 1997-2008

OBJECTIVE

This study examined the frequency and temporal trends of alcohol use among women with and without myocardial infarction (MI) in the United States.

METHOD

We pooled yearly surveys from the nationally representative Behavioral Risk Factor Surveillance System between 1997 and 2008. Subjects for this study were 1,186,951 women, of whom 50,055 had a previous MI. Yearly weighted prevalence rates and frequencies of drinking behaviors were calculated for alcohol use in women with and without previous MI.

RESULTS

Fewer post-MI women consumed alcohol than other women (24% vs. 46%), but the prevalence of drinking increased over time in both groups. Nearly one third of post-MI women and half of all women consumed more than one drink per day. Heavy episodic drinking (four or more drinks per day) increased over time in both groups. After multivariable adjustment, post-MI women were less likely to report any drinking or consuming more than one drink per day, but the prevalence of heavy episodic drinking and the increasing trends over time were similar in both groups.

CONCLUSIONS

Heavy alcohol use and heavy episodic drinking among women in the United States increased over the past decade, regardless of MI history. Although this may have reflected the influence of national guidelines on alcohol consumption, the increase in heavy episodic drinking suggests that better efforts to educate clinicians and women about the harms from excessive alcohol are required.

Formal and informal substance use treatment utilization and alcohol abstinence over seven years: is the relationship different for blacks and whites?

BACKGROUND

This study examines whether the effects of formal substance use treatment utilization and Alcoholics Anonymous (AA) on 30-day abstinence vary for black versus white Americans.

METHODS

The current analysis utilizes data from a longitudinal sample of 1013 black and white, dependent and problem drinkers across a 7-year period. Participants were identified through a probability survey in the general population and consecutive intakes in chemical dependency treatment programs in a California County. Generalized Estimating Equations assessing interactions between race and treatment utilization incorporated variables from four post-baseline interviews, controlling for baseline variables.

RESULTS

Formal treatment utilization was associated with 30-day abstinence (OR:1.6, 95%CI: 1.3, 2.1), yet this relationship did not differ for blacks and whites. In contrast, there was a significant interaction between AA utilization, race and 30-day abstinence. While both whites and blacks who attended AA were more likely to report 30-day abstinence compared to their non-AA attending counterparts (white OR:4.0, 95%CI: 3.2-5.1 and black OR:2.2, 95%CI: 1.5-3.2), the relationship was stronger for whites. Among those who did not attend AA, blacks were more likely than whites to be abstinent. Post hoc analyses suggest that these latter findings may be related to greater religiosity and "drier" social networks among black Americans.

CONCLUSIONS

While utilization of formal treatment may yield similar benefits for blacks and whites, AA utilization may be more important for maintaining abstinence among whites than blacks. Future research should investigate racial differences in social network drinking patterns and religious reinforcement of sobriety, and the role these may play in AA outcomes.

Heavy drinking occasions in relation to ischaemic heart disease mortality-- an 11-22 year follow-up of the 1984 and 1995 US National Alcohol Surveys

BACKGROUND

The relationship between alcohol consumption and ischaemic heart disease (IHD) risk is complex and several issues remain unresolved because many studies used rather crude exposure measures often based on one or two questions. The objective of this study was to investigate the association between heavy drinking occasions and IHD mortality while controlling for average daily alcohol intake and separating former drinkers from lifetime abstainers.

METHODS

Cox regression analyses were used with IHD mortality as the outcome in a sample of 9934 participants of the US National Alcohol Surveys conducted in 1984 and 1995.

RESULTS

To the end of 2006, 326 deaths from IHD were recorded in the 11- to 22-year follow-up period. Any past heavy drinking occasions in former drinkers [hazard ratio (HR) = 2.06; 95% confidence interval (95% CI): 1.10-3.85] compared with former drinkers without such drinking occasions, and any heavy drinking occasion in current drinkers at baseline (HR = 2.05; 95% CI: 1.03-3.98) compared with current drinkers with average daily intake of one to two drinks, were associated with higher IHD mortality in men and any heavy drinking occasions among drinkers of up to 1 drink average consumption in women with similar effect size. Confounding effects from age, race, education, employment, income, marital status, geographical region, depression score, survey period or other drug use were small.

CONCLUSIONS

Among former and current drinkers, heavy drinking occasions should be taken into account when examining the complex association of alcohol consumption on IHD mortality risk.

Racial prejudice and unfair treatment: interactive effects with poverty and foreign nativity on problem drinking

OBJECTIVE

Although racial and ethnic minorities are often disadvantaged in multiple ways, little research has examined the interactive effects of multiple forms of disadvantage in these populations. The current study describes the independent and interactive effects of perceived prejudice, perceived unfair treatment, poverty, and foreign nativity on problem drinking outcomes among Black and Latino adults.

METHOD

The data source was Black (n = 504) and Latino (n = 766) drinkers from the nationally representative, weighted 2005 National Alcohol Survey. Perceived prejudice was assessed using a composite measure of racial stigma consciousness; perceived unfair treatment was assessed using a single item. Respondents whose per capita household income was below the 2004 poverty guidelines were coded as "poor"; nativity status was assessed among Latinos. Outcomes included past-year drinking to drunkenness, any drinking-related consequences, and two or more dependence symptoms.

RESULTS

In bivariate tests, higher levels of unfair treatment were significantly associated with all three outcomes among Blacks (marginally so for drunkenness) and dependence symptoms among Latinos. Further, higher racial stigma was significantly associated with higher rates of any drinking consequences among Latinos. In multivariate logistic regressions, six significant or marginally significant interactions emerged. For each, the pattern of results suggested stronger associations between perceived prejudice/unfair treatment and problem drinking given either poverty or foreign nativity.

CONCLUSIONS

Although findings were somewhat mixed, the pattern of results tentatively supports the hypothesis that associations between problem drinking and both prejudice and unfair treatment can be exacerbated given the presence of other stressors, particularly among Latinos. Results extend the literature on the health consequences of prejudice and discrimination, highlighting important effects of cumulative adversity and suggesting a need to focus particularly on drinkers exposed to the combined effects of multiple stressors in prevention and treatment efforts.

Reports of alcohol-related problems and alcohol dependence for demographic subgroups using interactive voice response versus telephone surveys: the 2005 US National Alcohol Survey

INTRODUCTION AND AIMS

Interactive voice response (IVR), a computer-based interviewing technique, can be used within a computer-assisted telephone interview (CATI) survey to increase privacy and the accuracy of reports of sensitive attitudes and behaviours. Previous research using the 2005 National Alcohol Survey indicated no overall significant differences between IVR and CATI responses to alcohol-related problems and alcohol dependence. To determine if this result holds for demographic subgroups that could respond differently to modes of data collection, this study compares the prevalence rates of lifetime and last-year alcohol-related problems by gender, ethnicity, age and income subgroups obtained by IVR versus continuous CATI interviewing.

DESIGN AND METHODS

As part of the 2005 National Alcohol Survey, subsamples of English-speaking respondents were randomly assigned to an IVR group that received an embedded IVR module on alcohol-related problems (n = 450 lifetime drinkers) and a control group that were asked identical alcohol-related problem items using continuous CATI (n = 432 lifetime drinkers).

RESULTS

Overall, there were few significant associations. Among lifetime drinkers, higher rates of legal problems were found for white and higher income respondents in the IVR group. For last-year drinkers, a higher percentage of indicators of alcohol dependence was found for Hispanic respondents and women respondents in the CATI group.

DISCUSSION AND CONCLUSION

Data on alcohol problems collected by CATI provide largely comparable results to those from an embedded IVR module. Thus, incorporation of IVR technology in a CATI interview does not appear strongly indicated even for several key subgroups.

Buffering effects of general and medication-specific social support on the association between substance use and HIV medication adherence

The success of highly active antiretroviral therapy (HAART) among persons living with HIV is largely dependent on strict medication adherence. Recent research suggests that alcohol and other drug use (AOD) may be an important barrier to HAART adherence. In this study, we examined the impact of AOD on HAART adherence as well as the moderating effects of general and medication-specific social support. The data were collected as part of a longitudinal randomized control trial with 224 HIV-positive patients at an HIV primary care clinic in the northwestern United States. Findings indicated that AOD use was negatively associated with HAART adherence and that medication-specific (but not general) social support moderated the AOD-adherence association at 3 (but not at 6 or 9) months. Results indicate the importance of medication-specific social support to treat comorbid AOD use and HIV; implications for future research and intervention programs for HIV-positive AOD users are discussed.

Prevalence and Correlates of Drinking Behaviors of Previously Deployed Military Personnel and Matched Civilian Population

We examined drinking behaviors (frequency of use, quantity of use, and frequency of binge drinking) and correlates of frequency of use and binge drinking in a representative sample of previously deployed personnel from the US military (n = 1887). Drinking behaviors were compared with a matched sample of adults in U.S. households (n = 17,533). Comparable patterns of alcohol consumption were reported in both samples: 70% of previously deployed personnel and 69% of US adults reported drinking alcohol in the past 30 days though, civilians drank on average more drinks on the days that they drank than did previously deployed military personnel. Regression analyses indicated that among previously deployed military personnel, deployment-related experiences (e.g., combat-related traumas) and psychological distress (e.g., symptoms associated with posttraumatic stress disorder) were associated with frequency of drinking behaviors. We discuss the implication of our findings for developing interventions to modify drinking behaviors for military personnel.