1
|
Black N, Noghrehchi F, Yuen WS, Aiken A, Clare PJ, Chan G, Kypri K, McBride N, Bruno R, Slade T, Boland V, Mattick R, Peacock A. Transitions to polysubstance use: Prospective cohort study of adolescents in Australia. Addiction 2024. [PMID: 38499496 DOI: 10.1111/add.16468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/23/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND AND AIMS Adolescent polysubstance use has been associated with adverse social and health outcomes. Our aim was to measure rates and transitions to polysubstance use during adolescence and identify factors associated with initiation and discontinuation of polysubstance use. DESIGN Prospective cohort study. Multistate Markov modelling was used to estimate rates and identify correlates of transitions between substance use states. SETTING AND PARTICIPANTS Adolescent-parent dyads (n = 1927; adolescents in grade 7, age ≈13 years) were recruited from Australian schools during 2010/11 (Wave 1). Adolescents were surveyed annually until 2016/17 (n = 1503; age ≈19 years; Wave 7) and parents were surveyed annually until 2014/15 (Wave 5). MEASUREMENTS Alcohol, tobacco, cannabis and 3,4-methylenedioxymethamphetamine (MDMA) use outcomes were collected at Waves 3-7. Potential confounders were collected at Waves 1-6 and consisted of sex, anxiety and depression symptoms and externalizing problems, parental monitoring, family conflict and cohesion, parental substance use and peer substance use. Covariates were age and family socioeconomic status. FINDINGS Few adolescents engaged in polysubstance use at earlier waves (Wave 3: 5%; Wave 4: 8%), but proportions increased sharply across adolescence (Waves 5-7: 17%, 24%, 36%). Rates of transitioning to polysubstance use increased with age, with few (<9%) adolescents transitioning out. More externalizing problems (odds ratio [OR] = 1.10; 99.6% confidence interval [CI] = 1.07-1.14), parental heavy episodic drinking (OR = 1.22; 99.6% CI = 1.07-1.40), parental illicit substance use (OR = 3.56; 99.6% CI = 1.43-8.86), peer alcohol use (OR = 5.68; 99.6% CI = 1.59-20.50) and peer smoking (OR = 4.18; 99.6% CI = 1.95-8.81) were associated with transitioning to polysubstance use. CONCLUSIONS Polysubstance use in Australia appears to be rare during early adolescence but more common in later adolescence with low rates of transitioning out. Externalizing problems and greater parental and peer substance use are risk factors for adolescent polysubstance use that may be suitable intervention targets.
Collapse
Affiliation(s)
- Nicola Black
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Firouzeh Noghrehchi
- Biomedical Informatics and Digital Health, The University of Sydney, Camperdown, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Philip J Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
- Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
| | - Gary Chan
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Shenton Park, Australia
| | - Raimondo Bruno
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| |
Collapse
|
2
|
Owen KB, Foley BC, Smith BJ, Manera KE, Corbett L, Lim M, Phongsavan P, Qualter P, Ding D, Clare PJ. Sport Participation for Academic Success: Evidence From the Longitudinal Study of Australian Children. J Phys Act Health 2024; 21:238-246. [PMID: 38141604 DOI: 10.1123/jpah.2023-0506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/29/2023] [Accepted: 11/21/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND We aimed to identify long-term patterns of sport participation (overall, team, and individual sport) from childhood into adolescence, and to examine the association between these patterns and academic outcomes. METHODS This cohort study used data from the Longitudinal Study of Australian Children in wave 3 (4-5 y) to wave 9 (20-21 y). The participants were a nationally representative sample of 4241 children. We conducted latent class analyses to identify sport participation trajectories and assessed the association between these trajectories and academic outcomes. RESULTS Continued sport participation was associated with lower odds of being absent from school (OR = 0.44; 95% confidence intervals [CIs], 0.26 to 0.74), better performance on attention (B = -0.010; 95% CIs, -0.019 to -0.002) and working memory (B = -0.013; 95% CIs, -0.023 to -0.003), higher numeracy (B = 20.21; 95% CIs, 14.56 to 25.86) and literacy scores (B = 9.42; 95% CIs, 2.82 to 16.02), higher end of school academic performance (B = 3.28; 95% CIs, 1.47 to 5.09), and higher odds of studying at university (OR = 1.78; 95% CIs, 1.32 to 2.40). Team sport participation was associated with reduced absenteeism, better performance on attention and working memory, and being awarded the Higher School Certificate. Whereas individual sport participation was associated with higher literacy scores and end of school academic performance. CONCLUSIONS Team and individual sport participation both benefit academic outcomes, but differently. Given the decline in sport participation during adolescence, these findings highlight the need to develop educational policies to establish an environment that promotes sport participation, which in turn could improve academic outcomes.
Collapse
Affiliation(s)
- Katherine B Owen
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Bridget C Foley
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Ben J Smith
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Karine E Manera
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Lucy Corbett
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Lim
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Philayrath Phongsavan
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Pamela Qualter
- Manchester Institute of Education, The University of Manchester, Manchester, United Kingdom
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Philip J Clare
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
3
|
Surkalim DL, Clare PJ, Eres R, Gebel K, Bauman AE, Ding D. Exercise to socialize? Bidirectional relationships between physical activity and loneliness in middle-aged and older American adults. Am J Epidemiol 2024:kwae001. [PMID: 38319704 DOI: 10.1093/aje/kwae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 12/08/2023] [Indexed: 02/07/2024] Open
Abstract
Physical inactivity and loneliness are both associated with health risks and can affect each other through various social and behavioral mechanisms. However, current evidence on this relationship is equivocal and mostly based on cross-sectional data. This longitudinal study aims to determine whether current levels of physical activity (moderate- and vigorous-intensity) and loneliness are associated with future respective states of themselves and each other. Data from waves 6-14 (2002-2018) of the Health and Retirement Study were used (n=20,134) in a mixed-effects and random intercept cross-lagged panel model. Analysis showed that current loneliness and physical activity were associated with each future respective state. Additionally, weekly participation in moderate-intensity, but not vigorous-intensity, physical activity was associated with a lower likelihood of becoming lonely in the future (RR: 0.94; 95% CI: 0.90-0.99). However, changes in physical activity were not associated with deviation from a person's typical level of loneliness (vigorous-intensity mean deviation (MD): 0.00; 95% CI: -0.04-0.03, moderate-intensity MD: 0.01; 95% CI: -0.03-0.04). Loneliness was not associated with moderate- or vigorous-intensity physical activity in subsequent waves. This suggests that while lower physical activity levels can be associated with future loneliness, changing levels of physical activity has little impact on loneliness at the individual level.
Collapse
Affiliation(s)
- D L Surkalim
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre (D17), The University of Sydney, Camperdown, New South Wales, Australia
| | - P J Clare
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - R Eres
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - K Gebel
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - A E Bauman
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre (D17), The University of Sydney, Camperdown, New South Wales, Australia
| | - D Ding
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre (D17), The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
4
|
McKetin R, Clare PJ, Castle D, Turner A, Kelly PJ, Lubman DI, Arunogiri S, Manning V, Berk M. How does a family history of psychosis influence the risk of methamphetamine-related psychotic symptoms: Evidence from longitudinal panel data. Addiction 2023; 118:1975-1983. [PMID: 37157055 PMCID: PMC10952942 DOI: 10.1111/add.16230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
AIMS To determine whether the risk of psychotic symptoms during weeks of methamphetamine use was dependent on, increased by, or independent of having a family history of psychosis. DESIGN Secondary analysis of 13 contiguous 1-week periods of data (1370 weeks). A risk modification framework was used to test each scenario. SETTING Geelong, Wollongong and Melbourne, Australia. PARTICIPANTS Participants in a randomized controlled trial of treatment for methamphetamine dependence (n = 148) who did not have a primary psychotic disorder on enrolment. MEASUREMENTS Psychotic symptoms in the previous week were defined as a score of 3+ on any of the Brief Psychiatric Rating Scale items of hallucinations, unusual thought content or suspiciousness. Any (vs no) methamphetamine use in the previous week was assessed using the Timeline Followback method. Self-reported family history of psychosis was assessed using the Diagnostic Interview for Psychosis. FINDINGS The risk of psychotic symptoms in the past week was independently associated with methamphetamine use in that week (relative risk [RR] = 2.3, 95% CI = 1.3-4.3) and with having a family history of psychosis (RR = 2.4, 95% CI = 0.9-7.0); the joint risk among participants with a family history of psychosis during weeks when they were using methamphetamine was large (RR = 4.0, 95% CI = 2.0-7.9). There was no significant interaction between a family history of psychosis and methamphetamine use in predicting psychotic symptoms (interaction RR = 0.7 95% CI = 0.3-1.8), but there was a small non-significant excess risk due to the interaction (0.20 95% CI = -1.63 to 2.03). CONCLUSIONS Among people dependent on methamphetamine, the relative risk of psychotic symptoms during weeks of methamphetamine use does not appear to be dependent on, or increased by, having a family history of psychosis. However, a family history of psychosis does appear to be an independent risk factor that contributes to the absolute risk of psychotic symptoms in this population.
Collapse
Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
| | - Philip J. Clare
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
- Prevention Research Collaboration, School of Public HealthUniversity of SydneyCamperdownAustralia
- Charles Perkins CentreUniversity of SydneyCamperdownAustralia
| | - David Castle
- Centre for Addiction and Mental Health and Department of PsychiatryUniversity of TorontoTorontoCanada
| | - Alyna Turner
- Deakin University, IMPACT Institute for Innovation in Physical and Mental Health and Clinical TranslationSchool of MedicineGeelongAustralia
| | - Peter J. Kelly
- School of Psychology and Illawarra Health and Medical Research InstituteUniversity of WollongongWollongongAustralia
| | - Dan I. Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneAustralia
- Turning Point, Eastern HealthRichmondAustralia
| | - Shalini Arunogiri
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneAustralia
- Turning Point, Eastern HealthRichmondAustralia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneAustralia
- Turning Point, Eastern HealthRichmondAustralia
| | - Michael Berk
- Deakin University, IMPACT Institute for Innovation in Physical and Mental Health and Clinical TranslationSchool of MedicineGeelongAustralia
- Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry, and the Florey Institute of Neuroscience and Mental HealthThe University of MelbourneParkvilleAustralia
| |
Collapse
|
5
|
Surkalim DL, Clare PJ, Eres R, Gebel K, Bauman A, Ding D. Have Middle-Aged and Older Americans Become Lonelier? 20-Year Trends From the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2023:7180758. [PMID: 37279542 DOI: 10.1093/geronb/gbad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVES Despite media and public dialog portraying loneliness as a worsening problem, little is known about how the prevalence of loneliness has changed over time. Our study aims to identify (a) temporal trends in episodic and sustained loneliness (lonely in 1 wave vs consistently lonely in 3 consecutive waves); (b) trends across sociodemographic subgroups by sex, race/ethnicity, birth cohort, education, employment status, marital status, and living alone; and (c) longitudinal predictors of loneliness in middle-aged and older Americans (≥50 years). METHODS Based on Waves 3 (1996) to 14 (2018) of the Health and Retirement Study (n = 18,841-23,227), we conducted a series of lagged mixed-effects Poisson regression models to assess trends of episodic and sustained loneliness in the overall and sociodemographic subgroup samples (by sex, race/ethnicity, birth cohort, education, employment, relationship, and living alone status). To examine the predictors of episodic and sustained loneliness, we used a multivariate mixed-effects Poisson regression model with all sociodemographic variables entered into the same model. RESULTS Episodic loneliness prevalence decreased from 20.1% to 15.5% and sustained loneliness from 4.6% to 3.6%. Trends were similar across most subgroups. Males, Caucasians, those born in 1928-1945, with university education, working, married/partnered, and those not living alone reported lower episodic and sustained loneliness, although associations with sustained loneliness were stronger. DISCUSSION Contrary to common perceptions, loneliness has decreased over 20 years of follow-up in middle-aged and older Americans. Several sociodemographic subgroups have been identified as having a higher risk of loneliness, prompting targeted public health attention.
Collapse
Affiliation(s)
- Daniel L Surkalim
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre (D17), The University of Sydney, Camperdown, New South Wales, Australia
| | - Philip J Clare
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Robert Eres
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Klaus Gebel
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Adrian Bauman
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre (D17), The University of Sydney, Camperdown, New South Wales, Australia
| | - Ding Ding
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre (D17), The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
6
|
HaGani N, Surkalim DL, Clare PJ, Merom D, Smith BJ, Ding D. Health Care Utilization Following Interventions to Improve Social Well-Being: A Systematic Review and Meta-analysis. JAMA Netw Open 2023; 6:e2321019. [PMID: 37382954 DOI: 10.1001/jamanetworkopen.2023.21019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
Importance It has been suggested that interventions that aim to improve social well-being may contribute to decreased health care use; however, such evidence has not been fully systematically synthesized. Objective To systematically review and meta-analyze available evidence on the associations between psychosocial interventions and health care utilization. Data Sources Medline, Embase, PsycInfo, Cumulated Index to Nursing and Allied Health Literature, Cochrane, Scopus, Google Scholar, and reference lists of systematic reviews were searched from inception until November 31, 2022. Study Selection Included studies were randomized clinical trials reporting on both health care utilization and social well-being outcomes. Data Extraction and Synthesis The reporting of the systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Full-text and quality assessments were conducted by 2 reviewers independently. Multilevel random-effects meta-analyses were used to synthesize the data. Subgroup analyses were conducted to examine the characteristics associated with decreased health care use. Main Outcomes and Measures The outcome of interest was health care utilization, including primary, emergency, inpatient, and outpatient care services. Social well-being was measured as social support, social participation, social relationships, community support, social integration, or loneliness. Results A total of 41 studies were retrieved from 18 969 citations; 37 studies were eligible for meta-analysis. Data were analyzed for 7842 participants, including 2745 older adults, 1579 young women considered to be at risk of social and mental health disadvantages, 1118 people with chronic illnesses, 1597 people with mental illnesses, and 803 caregivers. The odds ratio (OR) random-effects model showed an overall reduction in health care use (OR, 0.75; 95% CI, 0.59 to 0.97), but the standardized mean difference (SMD) random effect model showed no association. An improvement in health care utilization was observed in association with social support interventions (SMD, 0.25; 95% CI, 0.04 to 0.45) but not in loneliness interventions. Subgroup analysis indicated a reduced length of inpatient visits (SMD, -0.35; 95% CI, -0.61 to -0.09) and number of emergency care visits (OR, 0.64; 95% CI, 0.43 to 0.96) following the intervention. However, an increase in outpatient care associated with psychosocial interventions was observed (SMD, 0.34; 95% CI, 0.05 to 0.62). The largest reductions in health care use were associated with interventions among caregivers (OR, 0.23; 95% CI, 0.07 to 0.71) and individuals with mental illnesses (OR, 0.31; 95% CI, 0.13 to 0.74). Conclusions These findings suggest that psychosocial interventions were associated with most measures of health care utilization. As the association differed by participant and intervention delivery characteristics, these characteristics should be considered in the design of future interventions.
Collapse
Affiliation(s)
- Neta HaGani
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, the University of Sydney, Sydney, Australia
| | - Daniel L Surkalim
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, the University of Sydney, Sydney, Australia
| | - Philip J Clare
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
- Charles Perkins Centre, the University of Sydney, Sydney, Australia
| | - Dafna Merom
- School of Health Science, Western Sydney University, Sydney, Australia
| | - Ben J Smith
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, the University of Sydney, Sydney, Australia
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, the University of Sydney, Sydney, Australia
| |
Collapse
|
7
|
Freeman B, Owen K, Rickards S, Brooks A, Clare PJ, Dessaix A. E-cigarette use by people who smoke or have recently quit, New South Wales, 2016-2020. Med J Aust 2023; 218:131-137. [PMID: 36494187 DOI: 10.5694/mja2.51811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To examine e-cigarette use by adults who smoke or have recently quit, and demographic characteristics associated with their use; to assess reasons for using e-cigarettes. DESIGN The Cancer Institute NSW Tobacco Tracking Survey (CITTS) is an ongoing, serial, cross-sectional telephone survey study (40 interviews each week). This report is based on interviews during 4 January 2016 - 31 December 2020. SETTING, PARTICIPANTS Randomly selected New South Wales adults who are current smokers (smoked cigarettes, pipes, or other tobacco products daily, weekly, or less often) or recent quitters (smoked tobacco products in the past twelve months but who no longer smoked). MAIN OUTCOMES E-cigarette use by age group; reasons for using e-cigarettes. RESULTS CITTS callers rang 1 494 233 randomly selected numbers; in 203 203 answered calls (13.6%), 11 125 people were eligible for the survey (5.5% of answered calls), of whom 10 004 completed the survey interview, including the question about whether they used e-cigarettes (89.9%). Overall e-cigarette use increased from 6.6% of respondents in 2016 to 13.0% in 2020 (adjusted odds ratio, 1.86; 95% confidence interval [CI], 1.47-2.36). The proportion of respondents aged 18-24 years who reported e-cigarette use increased from 18.4% (95% CI, 12.9-23.9%) in 2018 to 27.2% (95% CI, 20.5-33.9%) in 2020, a larger proportion than for any other age group. The leading reasons offered for e-cigarette use were "to help me quit smoking" (33%; 95% CI, 30-37%) and "to cut down on the number of cigarettes I smoke" (25%; 95% CI, 22-28%). CONCLUSION The increase between 2016 and 2020 in the proportions of young adults who smoke or have recently quit who use e-cigarettes undermines claims that these products are designed for older smokers who have struggled to quit using other methods.
Collapse
Affiliation(s)
- Becky Freeman
- Sydney School of Public Health, the University of Sydney, Sydney, NSW
| | - Katherine Owen
- Sydney School of Public Health, the University of Sydney, Sydney, NSW
| | | | | | - Philip J Clare
- Sydney School of Public Health, the University of Sydney, Sydney, NSW
| | | |
Collapse
|
8
|
Upton E, Clare PJ, Aiken A, Boland VC, Torres CD, Bruno R, Hutchinson D, Kypri K, Mattick R, McBride N, Peacock A. Changes in mental health and help-seeking among young Australian adults during the COVID-19 pandemic: a prospective cohort study. Psychol Med 2023; 53:687-695. [PMID: 33966686 PMCID: PMC8144825 DOI: 10.1017/s0033291721001963] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/11/2021] [Accepted: 04/27/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Young people may have elevated risk for poorer mental health during the coronavirus disease 2019 (COVID-19) pandemic, yet longitudinal studies documenting this impact are lacking. This study assessed changes in mental health and help-seeking since COVID-19 restrictions in young Australians, including gender differences. METHODS Data were drawn from a recent subsample (n = 443; 60% female; Mage = 22.0) of a prospective cohort originally recruited in secondary school to complete annual surveys. The subsample completed an additional COVID-19 survey during COVID-19 restrictions (May-June 2020), which was compared to responses from their latest annual survey (August 2019-March 2020). Mixed effect models with time and gender as the primary predictors were conducted for: (i) scores on the Patient Health Questionnaire Depression 9-item (PHQ-9) and Generalised Anxiety Disorder 7-item (GAD-7) modules assessed before and during COVID-19 restrictions, and (ii) self-reported help-seeking from a health professional in February 2020, and the month preceding May-June 2020. RESULTS Mean symptom scores increased from before to during COVID-19 restrictions on the PHQ-9 (coefficient: 1.29; 95% CI 0.72-1.86) and GAD-7 (0.78; 95% CI 0.26-1.31), but there was no increase in help-seeking over time (odds ratio 0.50; 95% CI 0.19-1.32). There was no evidence of differential changes by gender. CONCLUSIONS This study found increases in depression and anxiety symptoms but not greater help-seeking among young Australian adults during the first wave of the pandemic. Increasing availability and awareness of accessible treatment options and psychoeducation is critical, as well as further research into risk and protective factors to help target treatment to this vulnerable age group.
Collapse
Affiliation(s)
- Emily Upton
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Philip J. Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Prevention Research Collaboration, The University of Sydney, Sydney, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Veronica C. Boland
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Clara De Torres
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Raimondo Bruno
- School of Psychological Sciences, University of Tasmania, Tasmania, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Centre for Social and Early Emotional Development, Deakin University, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Parkville, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| |
Collapse
|
9
|
Erthal-Williamson J, Clare PJ, Gisev N, Santoso C, Berterame S. Trends in pharmaceutical opioid consumption in the WHO Eastern Mediterranean Region, 2010-2019. East Mediterr Health J 2022; 28:788-797. [PMID: 36515442 DOI: 10.26719/emhj.22.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 08/01/2022] [Indexed: 12/15/2022]
Abstract
Background Pharmaceutical opioid consumption has been increasing worldwide, but disparities in access to these medications exist. Few countries of the WHO Eastern Mediterranean Region have well defined pain management policies. Aims This study presents trends in the consumption of pharmaceutical opioids in the 22 countries in the Eastern Mediterranean Region from 2010 to 2019, with comparative intra- and extra-regional analyses; the correlation between pharmaceutical opioid consumption and human development index rankings; and pharmaceutical opioids use in the region. Methods We calculated the defined daily doses for statistical purposes (S-DDD) per million inhabitants per day of pharmaceutical opioids from 2010 to 2019, and used the mixed effects models to assess changes in consumption. We used regression analyses to establish the strength of associations between human development index level and consumption in the region and elsewhere. Results Pharmaceutical opioid use has fluctuated in the region since 2010, with a mean sum of S-DDD of 2547 for 2010-2019. Consumption is relatively low in the region irrespective of the human development index. The highest-consuming country reported 369 S-DDD in 2019 and the lowest reported 1 S-DDD. The most used pharmaceutical opioids in the region were fentanyl, morphine, pethidine, oxycodone, and codeine. Conclusion Consumption could be considered inadequate in several countries of the region. Supporting these countries to improve collection and reporting of consumption data, and providing humanitarian assistance to enhance access to pain relief, should be a priority for the international community.
Collapse
Affiliation(s)
| | - Philip J Clare
- School of Public Health, University of Sydney, Sydney, Australia
| | - Natasa Gisev
- Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Cornelia Santoso
- Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | | |
Collapse
|
10
|
O'Dean SM, Mewton L, Chung T, Clay P, Clare PJ, Bruno R, Yuen WS, McBride N, Swift W, Isik A, Upton E, Tibbetts J, Johnson P, Kypri K, Slade T. Definition matters: assessment of tolerance to the effects of alcohol in a prospective cohort study of emerging adults. Addiction 2022; 117:2955-2964. [PMID: 35792050 PMCID: PMC9796318 DOI: 10.1111/add.15991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/12/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS Tolerance to the effects of alcohol is an important element in the diagnosis of alcohol use disorders (AUD); however, there is ongoing debate about its utility in the diagnosis AUD in adolescents and young adults. This study aimed to refine the assessment of tolerance in young adults by testing different definitions of tolerance and their associations with longitudinal AUD outcomes. DESIGN Prospective cohort study. SETTINGS Australia. PARTICIPANTS A contemporary cohort of emerging adults across Australia (n = 565, mean age = 18.9, range = 18-21 at baseline). MEASUREMENTS Clinician-administered Structured Clinical Interview for DSM-IV Research Version (SCID-IV-RV) assessed for AUD criteria across five interviews, at 6-month intervals over 2.5 years. Tolerance definitions were operationalized using survey-type response (yes/no), clinician judgement (SCID-IV-RV), different initial drinking quantity and percentage increase thresholds and average heavy consumption metrics. AUD persistence was operationalized by the number of times AUD was present across the 2.5-year study period (n = 491), and new-onset AUD was operationalized as any new incidence of AUD during the follow-up period (n = 461). FINDINGS The (i) SCID-IV-RV clinician judgement [odds ratio (OR) = 2.50, P = 0.005], (ii) an initial drinking quantity threshold of four to five drinks and 50% minimum increase (OR = 2.48, P = 0.007) and (iii) 50% increase only (OR = 2.40, P = 0.005) were the tolerance definitions more strongly associated with any new onset of AUD throughout the four follow-up time-points than other definitions. However, these definitions were not associated with persistent AUD (Ps > 0.05). Average heavy consumption definitions of tolerance were most strongly associated with persistent AUD (OR = 6.66, P = 0.001; OR = 4.65, P = 0.004) but not associated with new-onset AUD (Ps > 0.05). CONCLUSIONS Initial drink and percentage change thresholds appear to improve the efficacy of change-based tolerance as an indicator for new-onset alcohol use disorder diagnosis in self-report surveys of young adults. When predicting persistent alcohol use disorder, average heavy consumption-based indicators appear to be a better way to measure tolerance than self-reported change-based definitions.
Collapse
Affiliation(s)
- Siobhan M. O'Dean
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| | - Louise Mewton
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyNSWAustralia
| | - Tammy Chung
- Department of Psychiatry, RutgersThe State University of New Jersey, Institute for Health, Healthcare Policy and Aging ResearchNew JerseyUSA
| | - Peter Clay
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| | - Philip J. Clare
- Prevention Research CollaborationUniversity of SydneySydneyAustralia,National Drug and Alcohol Research Centre, UNSWSydneyAustralia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSWSydneyAustralia,School of Psychological SciencesUniversity of TasmaniaHobartTASAustralia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, UNSWSydneyAustralia
| | - Nyanda McBride
- National Drug Research Institute and enAble InstituteCurtin UniversityPerthAustralia
| | - Wendy Swift
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred HospitalCamperdownNSWAustralia
| | - Ashling Isik
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| | - Emily Upton
- National Drug and Alcohol Research Centre, UNSWSydneyAustralia
| | - Joel Tibbetts
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| | - Phoebe Johnson
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| | - Kypros Kypri
- School of Medicine and Public HealthUniversity of NewcastleNSWAustralia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyAustralia
| |
Collapse
|
11
|
Ahmadi MN, Clare PJ, Katzmarzyk PT, del Pozo Cruz B, Lee IM, Stamatakis E. Vigorous physical activity, incident heart disease, and cancer: how little is enough? Eur Heart J 2022; 43:4801-4814. [PMID: 36302460 PMCID: PMC9726449 DOI: 10.1093/eurheartj/ehac572] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 08/22/2022] [Accepted: 09/28/2022] [Indexed: 01/12/2023] Open
Abstract
AIMS Vigorous physical activity (VPA) is a time-efficient way to achieve recommended physical activity levels. There is a very limited understanding of the minimal and optimal amounts of vigorous physical activity in relation to mortality and disease incidence. METHODS AND RESULTS A prospective study in 71 893 adults [median age (IQR): 62.5 years (55.3, 67.7); 55.9% female] from the UK Biobank cohort with wrist-worn accelerometry. VPA volume (min/week) and frequency of short VPA bouts (≤2 min) were measured. The dose-response associations of VPA volume and frequency with mortality [all-cause, cardiovascular disease (CVD) and cancer], and CVD and cancer incidence were examined after excluding events occurring in the first year. During a mean post-landmark point follow-up of 5.9 years (SD ± 0.8), the adjusted 5-year absolute mortality risk was 4.17% (95% confidence interval: 3.19%, 5.13%) for no VPA, 2.12% (1.81%, 2.44%) for >0 to <10 min, 1.78% (1.53%, 2.03%) for 10 to <30 min, 1.47% (1.21%, 1.73%) for 30 to <60 min, and 1.10% (0.84%, 1.36%) for ≥60 min. The 'optimal dose' (nadir of the curve) was 53.6 (50.5, 56.7) min/week [hazard ratio (HR): 0.64 (0.54, 0.77)] relative to the 5th percentile reference (2.2 min/week). There was an inverse linear dose-response association of VPA with CVD mortality. The 'minimal' volume dose (50% of the optimal dose) was ∼15 (14.3, 16.3) min/week for all-cause [HR: 0.82 (0.75, 0.89)] and cancer [HR: 0.84 (0.74, 0.95)] mortality, and 19.2 (16.5, 21.9) min/week [HR: 0.60 (0.50, 0.72)] for CVD mortality. These associations were consistent for CVD and cancer incidence. There was an inverse linear association between VPA frequency and CVD mortality. 27 (24, 30) bouts/week was associated with the lowest all-cause mortality [HR: 0.73 (0.62, 0.87)]. CONCLUSION VPA of 15-20 min/week were associated with a 16-40% lower mortality HR, with further decreases up to 50-57 min/week. These findings suggest reduced health risks may be attainable through relatively modest amounts of VPA accrued in short bouts across the week.
Collapse
Affiliation(s)
| | - Philip J Clare
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia,Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia,National Drug and Alcohol Research Centre, UNSW Sydney, NSW, Australia
| | - Peter T Katzmarzyk
- Population and Public Health Sciences, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Borja del Pozo Cruz
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - I Min Lee
- Division of Preventive Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, USA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | |
Collapse
|
12
|
Aiken A, Chan G, Yuen WS, Clare PJ, Hutchinson D, McBride N, Najman JM, McCambridge J, Upton E, Slade T, Boland VC, De Torres C, Bruno R, Kypri K, Wadolowski M, Mattick RP, Peacock A. Trajectories of parental and peer supply of alcohol in adolescence and associations with later alcohol consumption and harms: A prospective cohort study. Drug Alcohol Depend 2022; 237:109533. [PMID: 35752023 DOI: 10.1016/j.drugalcdep.2022.109533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 05/17/2022] [Accepted: 06/06/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Supply of alcohol to adolescents is associated with increased alcohol consumption and harms including alcohol use disorder (AUD). We aimed to identify: (1) trajectories of alcohol supply to adolescents; (2) sociodemographic characteristics associated with supply trajectory; (3) patterns of alcohol consumption by supply trajectory; and (4) supply trajectory associations with adverse alcohol outcomes. METHODS We used Australian longitudinal survey data (N = 1813) to model latent trajectories of parent and peer alcohol supply over five annual follow-ups (Waves 2-6; Mage 13.9-17.8 years). Regression models assessed associations between supply trajectories and Wave 1 (Mage=12.9 years) sociodemographic factors and associations between supply trajectories and Wave 7 (Mage=18.8 years) alcohol outcomes. RESULTS We identified five alcohol supply classes: (1) minimal supply (n = 739, 40.8%); (2) early parent sips, late peer/parent whole drinks (n = 254, 14.0%); (3) late peer/parent whole drinks (n = 419, 23.1%); (4) early parent sips, mid peer/parent whole drinks (n = 293, 16.2%); (5) early peer/parent whole drinks (n = 108, 6.0%). Compared to minimal supply, the other classes were 2.7-12.9 times as likely to binge drink, 1.6-3.0 times as likely to experience alcohol-related harms, and 2.1-8.6 times as likely to report AUD symptoms at age 19. CONCLUSION Earlier supply of whole drinks, particularly from peers, was associated with increased risk of early adulthood adverse alcohol outcomes. While minimal supply represented the lowest risk, supplying sips only in early-mid adolescence and delaying supply of whole drinks until late adolescence is likely to be less risky than earlier supply of whole drinks.
Collapse
Affiliation(s)
- Alexandra Aiken
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia.
| | - Gary Chan
- National Centre For Youth Substance Use Research, The University of Queensland, St Lucia, QLD 4067, Australia
| | - Wing See Yuen
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Philip J Clare
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; Prevention Research Collaboration, The Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Delyse Hutchinson
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia; Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA 6845, Australia
| | - Jackob M Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD 4072, Australia
| | - Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, United Kingdom
| | - Emily Upton
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Tim Slade
- Sydney Medical School / The Matilda Centre, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Veronica C Boland
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Clara De Torres
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Raimondo Bruno
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; School of Psychology, University of Tasmania, Hobart, TAS 7000, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Monika Wadolowski
- Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia
| | - Richard P Mattick
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Amy Peacock
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; School of Psychology, University of Tasmania, Hobart, TAS 7000, Australia
| |
Collapse
|
13
|
Ding D, Van Buskirk J, Nguyen B, Stamatakis E, Elbarbary M, Veronese N, Clare PJ, Lee IM, Ekelund U, Fontana L. Physical activity, diet quality and all-cause cardiovascular disease and cancer mortality: a prospective study of 346 627 UK Biobank participants. Br J Sports Med 2022; 56:bjsports-2021-105195. [PMID: 35811091 DOI: 10.1136/bjsports-2021-105195] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine independent and interactive associations of physical activity and diet with all-cause, cardiovascular disease (CVD) and physical activity, diet and adiposity-related (PDAR) cancer mortality. METHODS This population-based prospective cohort study (n=346 627) is based on the UK Biobank data with linkage to the National Health Service death records to 30 April 2020. A left-truncated Cox proportional hazards model was fitted to examine the associations between exposures (self-reported total moderate-to-vigorous intensity physical activity (MVPA), vigorous-intensity physical activity (VPA) and a diet quality index (score ranged 0-3)) and outcomes (all-cause, CVD and PDAR cancer mortality). RESULTS During a median follow-up of 11.2 years, 13 869 participants died from all causes, 2650 from CVD and 4522 from PDAR cancers. Compared with quartile 1 (Q1, 0-210 min/week), Q2-Q4 of MVPA were associated with lower risks of all-cause (HR ranged from 0.87 (95% CI: 0.83 to 0.91) to 0.91 (95% CI: 0.87 to 0.96)), CVD (HR ranged from 0.85 (95% CI: 0.76 to 0.95) to 0.90 (95% CI: 0.81 to 1.00)) and PDAR cancer mortality (HR ranged from 0.86 (95% CI: 0.79 to 0.93) to 0.94 (95% CI: 0.86 to 1.02)). Compared with no VPA, any VPA was associated with lower risk for all-cause and CVD mortality (HR ranged from 0.85 (95% CI: 0.80 to 0.89) to 0.88 (95% CI: 0.84 to 0.93) and from 0.75 (95% CI: 0.68 to 0.83) to 0.90 (95% CI: 0.80 to 1.02), respectively). Although not reaching statistical significance for all-cause and CVD mortality, being in the best dietary category (diet quality index=2-3) was associated with a reduction in PDAR cancer mortality (HR=0.86, 95% CI: 0.78 to 0.93). No additive or multiplicative interactions between physical activity categories and dietary quality was found. When comparing across physical activity and diet combinations, the lowest risk combinations consistently included the higher levels of physical activity and the highest diet quality score. CONCLUSIONS Adhering to both quality diet and sufficient physical activity is important for optimally reducing the risk of mortality from all causes, CVD and PDAR cancers.
Collapse
Affiliation(s)
- Ding Ding
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Joe Van Buskirk
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Binh Nguyen
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, Camperdown, New South Wales, Australia
| | - Mona Elbarbary
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Philip J Clare
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - I-Min Lee
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ulf Ekelund
- Norwegian School of Sports Sciences, Oslo, Norway
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Luigi Fontana
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| |
Collapse
|
14
|
Cranney L, McGill B, Clare PJ, Bauman A. Trends in risk factors and management strategies used by people with type 2 diabetes in New South Wales, Australia. Prev Med 2022; 157:107004. [PMID: 35240142 DOI: 10.1016/j.ypmed.2022.107004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/28/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
Adopting healthy lifestyle behaviours is an important component of Type 2 diabetes (T2D) self-management, which can lower risks of further health complications. Monitoring lifestyle risk factors including overweight or obesity, healthy diet and physical activity behaviours, alcohol consumption, smoking and psychological distress remain important. This study examined prevalence trends in these factors and adoption of three diabetes lifestyle self-management strategies in adults (aged 40+) with T2D in New South Wales (NSW), Australia. Analyses were conducted on NSW Adult Population Health Survey data, 2004-2019 (n = 142,168), using predicted probabilities from generalised linear models, weighted to population estimates. Throughout the study period overweight or obesity prevalence remained higher amongst those with T2D (83.1% to 81.7%) compared to those without diabetes (61.0 to 61.2%); only 8.9% of those with T2D were trying to lose weight. During the study period, there were declines in the proportions of those with T2D reporting sufficient fruit consumption [63.9% to 50.1%], moderate vegetable consumption (3 serves) [49.0% to 37.7%], and achieving sufficient physical activity [40.0% to 34.0%]. There were also declines in those reporting they manage their diabetes through following a special diet [73.6% to 55.9%] and exercising most days [33.5% to 22.2%]. This study highlights potential gaps in T2D secondary prevention and suggests more targeted diabetes education services are needed to address lifestyle risks. Increased understanding of why fewer people with T2D adopt these lifestyle management strategies is needed to inform policy and practice.
Collapse
Affiliation(s)
- Leonie Cranney
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia; The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia.
| | - Bronwyn McGill
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia; The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Philip J Clare
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia; The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia; National Drug and Alcohol Research Centre, UNSW, Sydney, New South Wales, Australia
| | - Adrian Bauman
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia; The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia
| |
Collapse
|
15
|
Yuen WS, Bruno R, Chan GCK, McCambridge J, Slade T, Clare PJ, Aiken A, Kypri K, Hutchinson D, McBride N, Boland V, Upton E, Farrell M, Mattick RP, Peacock A. The experience of physiological and psychosocial alcohol-related harms across adolescence and its association with alcohol use disorder in early adulthood: A prospective cohort study. Alcohol Clin Exp Res 2021; 45:2518-2527. [PMID: 34921682 DOI: 10.1111/acer.14726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/27/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Different forms of alcohol-related harm (e.g., hangovers, fighting) may confer differential risk of clinically relevant alcohol problems. We examine: (i) patterns of transition in experiencing alcohol-related harms across adolescence; (ii) whether factors in early adolescence predict transition patterns; and (iii) whether transition patterns predict later alcohol use disorder (AUD) symptoms. METHODS We used a longitudinal Australian cohort (n = 1828) to model latent class transition patterns of alcohol-related harms across three timepoints (Mage = 13.9, 16.8, 18.8 years). Regression models assessed whether child, peer, and parent factors in early adolescence (Mage = 12.9) predicted harms transition patterns and whether these patterns predicted AUD symptoms in early adulthood (Mage = 19.8). RESULTS Five transition patterns characterized most of the cohort (n ≈ 1609, 88.0%): (i) minimal harms (n ≈ 381, 20.8%); (ii) late physiological harms (n ≈ 702, 38.4%); (iii) early physiological harms (n ≈ 226, 12.4%); (iv) late all harms (n ≈ 131, 7.2%); and (v) gradual all harms (n ≈ 169, 9.2%). With late physiological harms as the reference, females had increased risk of experiencing early physiological harms (relative risk [RR]: 2.15; 99.5% CI: 1.19, 3.90). Late all harms (RR: 1.71; CI: 1.19, 2.47) and gradual all harms (RR: 1.84; CI: 1.37, 2.47) were each associated with increased odds of meeting criteria for AUD, even when patterns of alcohol consumption are considered. CONCLUSIONS Adolescents display heterogeneous transition patterns across physiological and psychosocial alcohol-related harms. Females are at greater risk of experiencing early physiological harms. Experience of both physiological and psychosocial harms in late adolescence is an important and potentially modifiable precursor to clinically relevant alcohol problems in early adulthood.
Collapse
Affiliation(s)
- Wing See Yuen
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Raimondo Bruno
- School of Psychological Sciences, University of Tasmania, Sandy Bay, Tasmania, Australia
| | - Gary C K Chan
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Queensland, Australia
| | | | - Tim Slade
- The Matilda Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Philip J Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.,Prevention Research Collaboration, The Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.,Centre for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia.,Department of Paediatrics, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Emily Upton
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.,School of Psychological Sciences, University of Tasmania, Sandy Bay, Tasmania, Australia
| |
Collapse
|
16
|
Clare PJ, Aiken A, Yuen WS, Upton E, Kypri K, Degenhardt L, Bruno R, McCambridge J, McBride N, Hutchinson D, Slade T, Mattick R, Peacock A. Alcohol use among young Australian adults in May-June 2020 during the COVID-19 pandemic: a prospective cohort study. Addiction 2021; 116:3398-3407. [PMID: 34105838 PMCID: PMC8212116 DOI: 10.1111/add.15599] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 01/20/2021] [Accepted: 05/26/2021] [Indexed: 01/07/2023]
Abstract
AIMS To estimate change in young people's alcohol consumption during COVID-19 restrictions in Australia in early-mid 2020, and test whether those changes were consistent by gender and level of consumption prior to the pandemic. DESIGN Prospective longitudinal cohort. SETTING Secondary schools in New South Wales, Tasmania and Western Australia. PARTICIPANTS Subsample of a cohort (n = 443) recruited in the first year of secondary school in 2010-11. Analysis data included three waves collected in September 2017-July 2018, September 2018-May 2019 and August 2019-January 2020), and in May-June 2020. MEASUREMENTS The primary predictors were time, gender and level of consumption prior to the pandemic. Outcome variables, analysed by mixed-effects models, included frequency and typical quantity of alcohol consumption, binge drinking, peak consumption, alcohol-related harm and drinking contexts. FINDINGS Overall consumption (frequency × quantity) during the restrictions declined by 17% [incidence rate ratio (IRR) = 0.83; 95% confidence interval (CI) = 0.73, 0.95] compared to February 2020, and there was a 35% decline in the rate of alcohol-related harms in the same period (IRR = 0.66; 95% CI = 0.54, 0.79). Changes in alcohol consumption were largely consistent by gender. CONCLUSIONS From a survey of secondary school students in Australia, there is evidence for a reduction in overall consumption and related harms during the COVID-19 restrictions.
Collapse
Affiliation(s)
- Philip J. Clare
- Prevention Research CollaborationUniversity of SydneyCamperdownNSWAustralia,National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Alexandra Aiken
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Wing See Yuen
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Emily Upton
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Kypros Kypri
- School of Medicine and Public HealthUniversity of NewcastleCallaghanNSWAustralia
| | - Louisa Degenhardt
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Raimondo Bruno
- School of Psychological SciencesUniversity of TasmaniaHobartTasmaniaAustralia
| | | | - Nyanda McBride
- National Drug Research InstituteCurtin UniversityPerthWAAustralia
| | - Delyse Hutchinson
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia,Centre for Social and Early Emotional DevelopmentDeakin UniversityMelbourneVICAustralia,Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia,Murdoch Children's Research Institute, Royal Children's HospitalUniversity of MelbourneMelbourneVICAustralia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyNSWAustralia
| | - Richard Mattick
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Amy Peacock
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| |
Collapse
|
17
|
Najman JM, Clare PJ, Kypri K, Aiken A, Wadolowski M, Hutchinson D, Slade T, Bruno R, Vogl L, Degenhardt L, Mattick RP. Gender differences in the supply of alcohol to adolescent daughters and sons. Am J Drug Alcohol Abuse 2021; 47:508-520. [PMID: 34383569 DOI: 10.1080/00952990.2021.1927066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: Parents are the main supplier of alcohol to children but it is not known whether mothers and fathers equally contribute to the supply of alcohol to their female and male children as these children transition to adulthood.Objectives: i) to determine whether the gender of the parent is associated with the gender of the adolescent offspring when alcohol is supplied and ii) whether the gender of the parent supplying is associated with gender differences in adolescent binge drinking and alcohol related harms.Methods: Longitudinal cohort of 1,927 (males = 1052) Australian adolescents (mean age 12.9 years), recruited in 2010/11 from schools in Australia and surveyed annually for six years. We assessed the association between adolescent and parent gender related to subsequent adolescent drinking, binge drinking (>4 standard drinks), and alcohol-related harms.Results: At mean age of 12.9 years about one in ten children report parental supply of alcohol which increases to about four in ten children by 17.8 years. Mothers consistently more often supply their daughters with alcohol than their sons, [Wave 5 OR 1.77 (1.53,2.05)], while mothers less often supply sons than their daughters, [Wave 5 OR 0.82 (0.71,0.95)]. Mothers' supply of alcohol to daughters predicts substantially increased odds of daughters binge drinking, [OR 1.67 (1.10,2.53)] and experiencing alcohol related harms, [OR 1.65 (1.10,2.48)].Conclusion: There is a need to involve both mothers and fathers and to equally target female and male children in programs to reduce the harmful consequences of parental supply of alcohol to their children.
Collapse
Affiliation(s)
- Jackob M Najman
- School of Public Health, University of Queensland, Herston, Australia
| | - Philip J Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, Australia
| | - Kypros Kypri
- School of Medicine & Public Health, University of Newcastle, Newcastle, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, Australia
| | - Monika Wadolowski
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, Australia
| | | | - Tim Slade
- School of Medicine, The University of Sydney, Sydney, Australia
| | - Raimondo Bruno
- School of Medicine, University of Tasmania, Hobart, Australia
| | - Laura Vogl
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, Australia
| |
Collapse
|
18
|
McKetin R, Dean OM, Turner A, Kelly PJ, Quinn B, Lubman DI, Dietze P, Carter G, Higgs P, Sinclair B, Reid D, Baker AL, Manning V, Pas NT, Thomas T, Bathish R, Raftery DK, Wrobel A, Saunders L, Arunogiri S, Cordaro F, Hill H, Hall S, Clare PJ, Mohebbi M, Berk M. N-acetylcysteine (NAC) for methamphetamine dependence: A randomised controlled trial. EClinicalMedicine 2021; 38:101005. [PMID: 34308314 PMCID: PMC8283342 DOI: 10.1016/j.eclinm.2021.101005] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Methamphetamine dependence is a significant global health concern for which there are no approved medications. The cysteine prodrug, N-acetylcysteine (NAC), has been found to ameliorate glutamate dysregulation in addiction, and to reduce craving for methamphetamine and other drugs. We evaluated the efficacy and safety of NAC as a pharmacotherapy for methamphetamine dependence. METHODS A parallel double-blind randomised placebo-controlled trial of people dependent on methamphetamine recruited from Geelong, Melbourne and Wollongong, Australia, between July 2018 and December 2019. Participants were randomised to receive either 12 weeks of oral NAC (2400 mg/day) or matched placebo, delivered as a take-home medication. The primary outcome was methamphetamine use, measured in two ways: (a) change in days of use in the past 4 weeks from baseline to weeks 4, 8 and 12, assessed using the Timeline Followback; and (b) methamphetamine-positive oral fluid samples taken weekly. Analyses were intention-to-treat and based on imputed data. Secondary outcomes were craving, severity of dependence, withdrawal severity and psychiatric symptoms (depression, suicidality, hostility and psychotic symptoms). Significance levels were p < 0.025 for primary outcomes and p < 0.01 for secondary outcomes. Adverse events were compared between groups by system organ class. The study was prospectively registered, ACTRN12618000366257. RESULTS Participants (N = 153; 59% male, mean [SD] age 38 [8]) were randomised to placebo (n = 77) or NAC (n = 76). Both groups had a median (IQR) of 24 (15-28) days of methamphetamine use in the 4 weeks prior to baseline. Both groups significantly reduced methamphetamine use (mean [SE] reduction of 7.3 [1.2]) days for placebo, 6.8 [1.2] for NAC) but NAC did not reduce days of methamphetamine use more than placebo (group difference of 0.5 days, 97.5% CI -3.4-4.3). There was no significant effect of NAC on methamphetamine-positive oral fluid samples (placebo 79%, NAC 76%; mean difference -2.6, 97.5% CI -12.6-7.4). NAC did not significantly reduce craving, severity of dependence, withdrawal, suicidality, depression, hostility or psychotic symptoms relative to placebo. Adverse events did not differ significantly between placebo and NAC groups. INTERPRETATION These findings suggest that take-home oral NAC has no significant effect on methamphetamine use or most clinically related outcomes amongst people who are dependent on the drug.
Collapse
Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
- Corresponding author.
| | - Olivia M. Dean
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Alyna Turner
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Peter J. Kelly
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Brendan Quinn
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
| | - Dan I. Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
- Turning Point, Eastern Health, Richmond, Australia
| | - Paul Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
- National Drug Research Institute, Curtin University, Australia
| | - Gregory Carter
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Peter Higgs
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Barbara Sinclair
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - David Reid
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Amanda L. Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
- Turning Point, Eastern Health, Richmond, Australia
| | - Nina te Pas
- National Drug Research Institute, Curtin University, Australia
| | - Tamsin Thomas
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Ramez Bathish
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
- Turning Point, Eastern Health, Richmond, Australia
| | - Dayle K. Raftery
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Anna Wrobel
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Lucy Saunders
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Shalini Arunogiri
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia
| | - Frank Cordaro
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Harry Hill
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia
| | - Scott Hall
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia
| | - Philip J. Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
- Prevention Research Collaboration, School of Public Health, University of Sydney, Australia
| | - Mohammadreza Mohebbi
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, Australia
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
- Department of Psychiatry, University of Melbourne, Parkville, Australia
- Health Drug and Alcohol Services, Geelong, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, Australia
| |
Collapse
|
19
|
Yuen WS, Chan G, Bruno R, Clare PJ, Aiken A, Mattick R, Farrell M, Kypri K, Slade T, Hutchinson D, McBride N, McCambridge J, Boland V, Peacock A. Trajectories of alcohol-induced blackouts in adolescence: early risk factors and alcohol use disorder outcomes in early adulthood. Addiction 2021; 116:2039-2048. [PMID: 33464664 DOI: 10.1111/add.15415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/10/2020] [Accepted: 01/06/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Experience of alcohol-induced memory blackouts in adolescence may be an important risk factor for later harms. This longitudinal study (i) modelled trajectories of alcohol-related blackouts throughout adolescence, (ii) explored early-adolescent predictors of blackout trajectories and (iii) examined the association between blackout trajectories and alcohol use disorder (AUD) symptoms. DESIGN Longitudinal study in which data from six annual surveys of a longitudinal cohort of Australian adolescents were used to model latent class growth trajectories of blackouts, adjusting for alcohol consumption frequency and typical quantity. Regression models were used to determine whether parent, child and peer factors at baseline (mean age = 12.9) predicted profiles of blackout trajectory membership and whether blackout trajectories predicted meeting criteria for AUD in early adulthood (mean age = 19.8). SETTING AND PARTICIPANTS Australian adolescents (n = 1821; mean age = 13.9-18.8 years). MEASUREMENTS Alcohol-related blackouts, alcohol consumption frequency, typical consumption quantity and DSM-5 AUD in early adulthood were all self-reported. FINDINGS We identified a three-class solution: delayed alcohol initiation, rare blackouts (n = 701; 38.5%); early initiation, rare blackouts (n = 869; 47.7%); and early initiation, increasing blackouts (n = 251; 13.8%). Female sex was associated with increased risk of early initiation, increasing blackouts relative to delayed initiation, rare blackouts [relative risk ratio (RRR) = 3.90; 99.5% confidence interval (CI) = 1.96, 7.76] and relative to early initiation, rare blackouts (RRR = 2.89; 99.5% CI = 1.42, 5.87). Early initiation, rare blackouts [odds ratio (OR) = 1.96; 99.5% CI = 1.17, 3.29] and early initiation, increasing blackouts (OR = 4.93; 99.5% CI = 2.32, 10.48) were each associated with increased odds of meeting criteria for AUD in early adulthood relative to delayed initiation, rare blackouts. Early initiation, increasing blackouts was associated with increased odds of meeting criteria for AUD in early adulthood relative to early initiation, rare blackouts (OR = 2.51; 99.5% CI = 1.18, 5.38). CONCLUSIONS Females in Australia appear to be at higher risk of adolescent alcohol-related blackouts independent of alcohol consumption levels and age of initiation. Alcohol-related blackouts may be associated with later alcohol use disorder.
Collapse
Affiliation(s)
- Wing See Yuen
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Gary Chan
- Centre for Youth Substance Abuse, The University of Queensland, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales, Australia.,School of Psychological Sciences, University of Tasmania, Australia
| | - Philip J Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales, Australia.,Centre for Social and Early Emotional Development, Deakin University, Australia.,Department of Paediatrics, The University of Melbourne, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Australia
| | | | - Veronica Boland
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Australia.,School of Psychological Sciences, University of Tasmania, Australia
| |
Collapse
|
20
|
Degenhardt L, Hungerford P, Nielsen S, Bruno R, Larance B, Clare PJ, Dobbins T, Hall W, Cohen M, Blyth F, Lintzeris N, Farrell M, Campbell G. Pharmaceutical Opioid Use Patterns and Indicators of Extramedical Use and Harm in Adults With Chronic Noncancer Pain, 2012-2018. JAMA Netw Open 2021; 4:e213059. [PMID: 33835176 PMCID: PMC8035647 DOI: 10.1001/jamanetworkopen.2021.3059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
IMPORTANCE Despite concern about harms related to long-term prescribed opioid use among individuals with chronic noncancer pain (CNCP), no study has examined whether the same patients engage in a risky pattern of use consistently for the long term. OBJECTIVE To examine the prevalence, incidence, persistence, and cessation of a range of opioid behaviors, indicators of extramedical use, and harm among individuals who are prescribed opioids. DESIGN, SETTING, AND PARTICIPANTS This 5-year prospective cohort study in communities across Australia included 1514 adults who were prescribed opioids for CNCP. Data collection took place from August 2012 to December 2018, and data analysis took place from February to November 2020. EXPOSURE Prescription opioid use. MAIN OUTCOMES AND MEASURES High-dose opioid use (≥200 oral morphine equivalent [OME] mg/d); requesting an increase in opioid dose; requesting an early prescription renewal; tampering with opioid medication; diversion of medication to others; and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision opioid dependence. Cessation of opioid use was also assessed. RESULTS Of the 1514 participants, 672 (44.39%) were men, the mean (SD) age was 58 (19) years, and 737 (48.68%) were unemployed. At each annual interview, approximately 1 in 8 people (10.98% [95% CI, 10.33%-11.63%] to 14.73% [95% CI, 13.98%-15.48%] at any given interview) were taking more than 200 OME mg/d; comparatively more had requested an increased dosage in the previous 3 months (8.46% [95% CI, 7.89%-9.03%] to 23.77% [95% CI, 22.82%-24.73%]); and fewer asked for an early prescription renewal (4.61% [95% CI, 4.19%-5.03%] to 13.97% [95% CI, 13.24%-14.70%]). In any given interview, between 3.06% (95% CI, 2.72%-3.40%) and 7.86% (95% CI, 7.31%-8.41%) of respondents reported tampering and between 0.47% (95% CI, 0.33%-0.60%) and 1.39% (95% CI, 1.16%-1.62%) reported diversion to others. Between 8.28% (95% CI, 7.71%-8.84%) and 13.06% (95% CI, 12.35%-13.77%) met criteria for opioid dependence at each interview. Opioid cessation increased across interviews, from year 1 (9.15% [95% CI, 8.55%-9.74%]) to year 5 (20.02% [19.14%-20.89%]). There was considerable incidence and cessation in all behaviors from 1 interview to the next: most who engaged in any of these behaviors only did so at only 1 interview. For pharmaceutical opioid dependence, between 55.26% (95% CI, 53.81%-56.71%) and 64.44% (95% CI, 62.87%-66.00%) of cases in 1 interview did not meet dependence criteria in the following interview. CONCLUSIONS AND RELEVANCE These findings suggest considerable fluidity in opioid use, extramedical behaviors, and opioid dependence among people with CNCP. This reinforces the need for reassessment of the effectiveness and safety of prescription opioid use over time.
Collapse
Affiliation(s)
- Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Phillip Hungerford
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Suzanne Nielsen
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Monash University, Melbourne, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- School of Psychological Sciences, University of Tasmania, Australia
| | - Briony Larance
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Philip J. Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, Australia
| | - Timothy Dobbins
- School of Population Health, University of New South Wales Medicine, Sydney, Australia
| | - Wayne Hall
- Centre for Youth Substance Abuse Research, University of Queensland, Queensland, Australia
- National Addiction Centre, Kings College, London, England
| | - Milton Cohen
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Fiona Blyth
- Centre for Education and Research on Ageing, University of Sydney, Concord Hospital, Sydney, Australia
| | - Nicholas Lintzeris
- Discipline of Addiction Medicine, University of Sydney, Australia
- The Langton Centre, South East Sydney Local Health District Drug and Alcohol Services, Sydney, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Gabrielle Campbell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- School of Health and Behavioral Sciences, University of the Sunshine Coast, Queensland, Australia
| |
Collapse
|
21
|
Boland VC, Clare PJ, Yuen WS, Peacock A, Aiken A, Wadolowski M, Hutchinson D, Najman J, Slade T, Bruno R, McBride N, Degenhardt L, Kypri K, Mattick RP. The association between parental supply of alcohol and supply from other sources to young people: a prospective cohort. Addiction 2020; 115:2140-2147. [PMID: 32141130 DOI: 10.1111/add.15033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/21/2019] [Accepted: 03/04/2020] [Indexed: 12/21/2022]
Abstract
AIMS Despite legal age limits set for alcohol consumption, parents are one of the main suppliers of alcohol to underage minors. Although supply from non-parental sources has been found to be associated with greater risk of harm compared with parental supply, the association between parental supply and supply from other sources is unclear. This study investigated the associations between parental supply of sips and whole serves of alcohol on subsequent other supply, conditional on current supply from non-parental sources. METHODS Data from the Australian Parental Supply of Alcohol Longitudinal Study cohort of adolescents was used. A cohort of 1927 Australian children recruited in grade 7 (mean age 12.9 years) was surveyed annually from 2010 to 2016 (94%, n = 1821 included for analyses). The primary outcome was alcohol exposure from other sources ('other supply'), including alcohol supply from other adults, friends, siblings, or self-supply, compared with adolescents reporting no supply from these sources. Analyses were conducted using random intercept logistic regression (to account for within-respondent correlation). RESULTS Parental supply of alcohol alone was associated with increased odds of receiving alcohol from other non-parental sources in subsequent years (OR: 1.99; 95% CI: 1.65-2.39) after adjusting for confounders. Increased odds of subsequent other supply were associated with current parental supply of sips (OR: 1.92; 95% CI: 1.56-2.36) and whole drinks (OR: 2.76; 95% CI: 1.85-4.11). CONCLUSIONS Parental supply of alcohol appears to increase the risk of subsequent supply of alcohol from other sources in certain contexts.
Collapse
Affiliation(s)
- Veronica C Boland
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Philip J Clare
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Monika Wadolowski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, NSW, 2109, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University Geelong, Geelong, Victoria, 3220, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, 3052, Australia
| | - Jackob Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD, 4072, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, 2006, Australia
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, Hobart, TAS, 7000, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, GPO Box U1987, Perth, , WA, 6845, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Newcastle, , NSW, 2308, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, , NSW, 2052, Australia
| |
Collapse
|
22
|
Clare PJ, Dobbins T, Bruno R, Peacock A, Boland V, Yuen WS, Aiken A, Degenhardt L, Kypri K, Slade T, Hutchinson D, Najman JM, McBride N, Horwood J, McCambridge J, Mattick RP. The overall effect of parental supply of alcohol across adolescence on alcohol-related harms in early adulthood-a prospective cohort study. Addiction 2020; 115:1833-1843. [PMID: 32034841 DOI: 10.1111/add.15005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/18/2019] [Accepted: 02/02/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIMS Recent research suggests that parental supply of alcohol is associated with more risky drinking and alcohol-related harm among adolescents. However, the overall effect of parental supply throughout adolescence remains unclear, because parental supply of alcohol varies during adolescence. Due to the complexity of longitudinal data, standard analytical methods can be biased. This study examined the effect of parental supply of alcohol on alcohol-related outcomes in early adulthood using robust methods to minimize risk of bias. DESIGN Prospective longitudinal cohort study. SETTING Australia PARTICIPANTS: A cohort of school students (n = 1906) recruited in the first year of secondary school (average age 12.9 years) from Australian schools in 2010-11, interviewed annually for 7 years. MEASUREMENTS The exposure variable was self-reported parental supply of alcohol (including sips/whole drinks) during 5 years of adolescence (waves 1-5). Outcome variables were self-reported binge drinking, alcohol-related harm and symptoms of alcohol use disorder, measured in the two waves after the exposure period (waves 6-7). To reduce risk of bias, we used targeted maximum likelihood estimation to assess the (counterfactual) effect of parental supply of alcohol in all five waves versus no supply on alcohol-related outcomes. FINDINGS Parental supply of alcohol throughout adolescence saw greater risk of binge drinking [risk ratios (RR) = 1.53; 95% confidence interval (CI) = 1.27-1.84] and alcohol-related harms (RR = 1.44; 95% CI = 1.22-1.69) in the year following the exposure period compared with no supply in adolescence. Earlier initiation of parental supply also increased risk of binge drinking (RR = 1.10; 95% CI = 1.05-1.14), and any alcohol-related harm (RR = 1.09; 95% CI = 1.05-1.13) for each year earlier parental supply began compared with later (or no) initiation. CONCLUSIONS Adolescents whose parents supply them with alcohol appear to have an increased risk of alcohol-related harm compared with adolescents whose parents do not supply them with alcohol. The risk appears to increase with earlier initiation of supply.
Collapse
Affiliation(s)
- Philip J Clare
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Timothy Dobbins
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.,School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.,School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Victoria, Australia.,Department of Paediatrics, Royal Children's Hospital, The University of Melbourne, Victoria, Australia
| | - Jackob M Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| |
Collapse
|
23
|
Clare PJ, Dobbins TA, Mattick RP. Causal models adjusting for time-varying confounding-a systematic review of the literature. Int J Epidemiol 2020; 48:254-265. [PMID: 30358847 DOI: 10.1093/ije/dyy218] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Obtaining unbiased causal estimates from longitudinal observational data can be difficult due to exposure-affected time-varying confounding. The past decade has seen considerable development in methods for analysing such complex longitudinal data. However, the extent to which those methods have been implemented is unclear. This study describes and characterizes the state of the field in methods adjusting for exposure-affected time-varying confounding, and examines their use in the literature. METHODS We systematically reviewed the literature from 2000 to 2016 for studies adjusting for time-dependent confounding, including use of specific methods like inverse probability of treatment weighting (IPTW). Articles were coded based on the methods used and, for applied articles, the topic areas covered. RESULTS We screened 4239 abstracts, and subsequently reviewed 1100 articles, leaving 542 relevant articles in the analyses. The number of published articles increased from two in 2000, to 112 in 2016. This increase was primarily in applied articles using IPTW, which increased from one study in 2000, to 90 in 2016. Of the 432 studies with applications to observed data, 60.9% were on at least one of: HIV (30.6%), cardiopulmonary health (13.2%), kidney disease (11.8%) or mental health (10.0%). CONCLUSIONS There has been marked growth in reports addressing exposure-affected time-varying confounding. This was driven by work in a small number of topic areas, with other areas showing relatively little uptake. In addition, despite developments in more advanced methods such doubly robust techniques and estimation via machine learning, implementation has been largely concentrated on the simpler, yet potentially less robust, IPTW.
Collapse
Affiliation(s)
- Philip J Clare
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Timothy A Dobbins
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| |
Collapse
|
24
|
Clare PJ, Aiken A, Yuen WS, Peacock A, Boland V, Wadolowski M, Hutchinson D, Najman J, Slade T, Bruno R, McBride N, Degenhardt L, Kypri K, Mattick RP. Parental supply of alcohol as a predictor of adolescent alcohol consumption patterns: A prospective cohort. Drug Alcohol Depend 2019; 204:107529. [PMID: 31494442 DOI: 10.1016/j.drugalcdep.2019.06.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 06/21/2019] [Accepted: 06/25/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent research has not supported the idea that parental supply of alcohol to adolescents prevents later alcohol-related harm. Yet the specific role of parental supply in shaping patterns of drinking over time remains unclear. This study investigated the role of parental supply of alcohol in patterns of drinking across adolescence, and assessed whether that role remained consistent over time. METHOD Using a longitudinal cohort of 1927 adolescents (mean age 12.9 years), recruited in 2010 and 2011 from schools across Australia and followed up annually until 2016, we assessed three outcomes using mixed-effect negative binomial regression: frequency of consumption, typical quantity consumed, and overall alcohol consumption in the year (frequency * quantity). Child, parental, familial, and peer confounders of adolescent alcohol consumption were measured and adjusted for in the analyses. FINDINGS Parental supply was associated with greater overall consumption in earlier adolescence: Grade 7-8 (incidence rate ratio [IRR]: 3.61; 95% CI: 2.55, 5.12; no supply IRR: 1.00), Grade 8-9 (IRR: 4.84; 95% CI: 3.66, 6.39; no supply IRR: 1.44) and Grade 9-10 (IRR: 8.33; 95% CI: 6.28, 11.05; no supply IRR: 4.75). Alcohol consumption continued to increase in later adolescence regardless of whether parental supply occurred. CONCLUSIONS Parental supply of alcohol was associated with increased alcohol consumption by their children during early adolescence. While parental supply appears to have less impact on drinking in later adolescence, there was no evidence to suggest it is protective. Parents should be advised to avoid supplying children with alcohol, particularly in early adolescence.
Collapse
Affiliation(s)
- Philip J Clare
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia.
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
| | - Monika Wadolowski
- Discipline of Paediatrics, School of Women's & Children's Health, UNSW, Sydney, NSW 2052, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia; Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria 3220, Australia; The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia; Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia; Royal Children's Hospital, Centre for Adolescent Health, Parkville, Victoria 3052, Australia
| | - Jackob Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD 4072, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW 2006, Australia
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, Hobart, TAS 7000, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, Faculty of Medicine, UNSW Australia, Sydney, NSW 2052, Australia
| |
Collapse
|
25
|
Calabria B, Shakeshaft AP, Clifford A, Stone C, Clare PJ, Allan J, Bliss D. Reducing drug and alcohol use and improving well‐being for Indigenous and non‐Indigenous Australians using the Community Reinforcement Approach: A feasibility and acceptability study. Int J Psychol 2019; 55 Suppl 1:88-95. [DOI: 10.1002/ijop.12603] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/13/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Bianca Calabria
- Centre for Mental Health Research, Research School of Population Health Australian National University Acton ACT Australia
- Research School of Psychology Australian National University Acton ACT Australia
- National Drug and Alcohol Research Centre UNSW Australia Sydney NSW Australia
| | | | - Anton Clifford
- National Drug and Alcohol Research Centre UNSW Australia Sydney NSW Australia
| | - Chiara Stone
- National Drug and Alcohol Research Centre UNSW Australia Sydney NSW Australia
| | - Philip J. Clare
- National Drug and Alcohol Research Centre UNSW Australia Sydney NSW Australia
| | | | - Donna Bliss
- Yoorana Gunya Family Healing Centre Forbes NSW Australia
| |
Collapse
|
26
|
Rowe R, Gavriel Ansara Y, Jaworski A, Higgs P, Clare PJ. What is the alcohol, tobacco, and other drug prevalence among culturally and linguistically diverse groups in the Australian population? A national study of prevalence, harms, and attitudes. J Ethn Subst Abuse 2018; 19:101-118. [PMID: 30064336 DOI: 10.1080/15332640.2018.1484310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In Australia, one in three people are born overseas, and one in five households speak languages other than English. This study explores substance use prevalence, related harms, and attitudes among these large groups in the population. Analysis was conducted using cross-sectional data (N = 22, 696) from the 2013 National Drug Strategy Household Survey. General linear model and binary logistic regression were used to assess substance use and harms, using stabilized inverse propensity score weighting to control for potential confounding variables. Between culturally and linguistically diverse populations and the population born in Australia, United Kingdom, or New Zealand who speak only English at home, there is no statistically significant variation in the likelihood of current smoking; using analgesics, tranquilizers, or sleeping pills; or administering drugs via injection. Culturally diverse populations are less likely to drink alcohol or use cannabis or methamphetamines. No difference between these two major groups in the population is observed in substance-related abuse from strangers; but culturally diverse respondents are less likely to report substance-related abuse from known persons. Lower substance use prevalence is not observed among people from culturally diverse backgrounds who have mental health issues. Australian-, UK-, or New Zealand-born respondents who speak only English at home are more likely to oppose drug and tobacco policies, including a range of harm reduction policies. We discuss the practical and ethical limitations of this major Australian data set for examining the burden of drug-related harms experienced by specific migrant populations. Avenues for potential future research are outlined.
Collapse
Affiliation(s)
- Rachel Rowe
- Drug and Alcohol Multicultural Education Centre (DAMEC), Sydney, NSW, Australia
| | - Y Gavriel Ansara
- Drug and Alcohol Multicultural Education Centre (DAMEC), Sydney, NSW, Australia
| | - Alison Jaworski
- Drug and Alcohol Multicultural Education Centre (DAMEC), Sydney, NSW, Australia
| | - Peter Higgs
- La Trobe University, Melbourne, VIC, Australia
| | | |
Collapse
|
27
|
Mattick RP, Clare PJ, Aiken A, Wadolowski M, Hutchinson D, Najman J, Slade T, Bruno R, McBride N, Kypri K, Vogl L, Degenhardt L. Association of parental supply of alcohol with adolescent drinking, alcohol-related harms, and alcohol use disorder symptoms: a prospective cohort study. Lancet Public Health 2018; 3:e64-e71. [PMID: 29396259 DOI: 10.1016/s2468-2667(17)30240-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/08/2017] [Accepted: 12/08/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Some parents supply alcohol to their children, reportedly to reduce harm, yet longitudinal research on risks associated with such supply is compromised by short periods of observation and potential confounding. We aimed to investigate associations between parental supply and supply from other (non-parental) sources, with subsequent drinking outcomes over a 6-year period of adolescence, adjusting for child, parent, family, and peer variables. METHODS We did this prospective cohort study using data from the Australian Parental Supply of Alcohol Longitudinal Study cohort of adolescents. Children in grade 7 (mean age 12 years), and their parents, were recruited between 2010 and 2011 from secondary schools in Sydney, Perth, and Hobart, Australia, and were surveyed annually between 2010 and 2016. We examined the association of exposure to parental supply and other sources of alcohol in 1 year with five outcomes in the subsequent year: binge drinking (more than four standard drinks on a drinking occasion); alcohol-related harms; and symptoms of alcohol abuse (as defined by Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV]), alcohol dependence, and alcohol use disorder (as defined by DSM-5). This trial is registered with ClinicalTrials.gov, number NCT02280551. FINDINGS Between September, 2010, and June, 2011, we recruited 1927 eligible parents and adolescents (mean age 12·9 years [SD 0·52]). Participants were followed up until 2016, during which time binge drinking and experience of alcohol-related harms increased. Adolescents who were supplied alcohol only by parents had higher odds of subsequent binge consumption (odds ratio [OR] 2·58, 95% CI 1·96-3·41; p<0·0001), alcohol-related harm (2·53, 1·99-3·24; p<0·0001), and symptoms of alcohol use disorder (2·51, 1·46-4·29; p=0·0008) than did those reporting no supply. Parental supply of alcohol was not significantly associated with the odds of reporting symptoms of either alcohol abuse or dependence, compared with no supply from any source. Supply from other sources was associated with significant risks of all adverse outcomes, compared with no supply, with an even greater increased risk of adverse outcomes. INTERPRETATION Providing alcohol to children is associated with alcohol-related harms. There is no evidence to support the view that parental supply protects from adverse drinking outcomes by providing alcohol to their child. Parents should be advised that this practice is associated with risk, both directly and indirectly through increased access to alcohol from other sources. FUNDING Australian Research Council, Australian Rotary Health, Foundation for Alcohol Research and Education, National Drug and Alcohol Research Centre.
Collapse
Affiliation(s)
- Richard P Mattick
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
| | - Philip J Clare
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Alexandra Aiken
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Monika Wadolowski
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Jackob Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD, Australia
| | - Tim Slade
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, Hobart, TAS, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Laura Vogl
- Black Dog Institute, Randwick, NSW, Australia
| | - Louisa Degenhardt
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
28
|
Aiken A, Clare PJ, Wadolowski M, Hutchinson D, Najman JM, Slade T, Bruno R, McBride N, Kypri K, Mattick RP. Age of Alcohol Initiation and Progression to Binge Drinking in Adolescence: A Prospective Cohort Study. Alcohol Clin Exp Res 2017; 42:100-110. [PMID: 29160941 DOI: 10.1111/acer.13525] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 10/09/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Early alcohol initiation is common and has been associated with the development of alcohol problems. Yet, past research on the association of age of initiation with later problem drinking has produced inconsistent findings. Using prospective data from the Australian Parental Supply of Alcohol Longitudinal Study cohort, this study examined age of alcohol initiation, and of first drunkenness, and associations with subsequent drinking in adolescence. METHODS A total of 1,673 parent-child dyads recruited through Australian secondary schools completed annual surveys for 5 years (grades 7 to 11). Limiting the sample to those adolescents who had initiated alcohol use by age 17 (n = 839), multinomial logistic regression models were used to examine associations between (i) age of initiation to alcohol use (consuming at least 1 full serve) and (ii) age of first drunkenness, and 2 outcomes: (i) binge drinking (consuming >4 standard drinks on a single occasion), and (ii) the total number of alcoholic drinks consumed in the past year, adjusted for a range of potential child, parent, family, and peer covariates. RESULTS Fifty percent of adolescents reported alcohol use and 36% reported bingeing at wave 5 (mean age 16.9 years), and the mean age of initiation to alcohol use for drinkers was 15.1 years. Age of initiation was significantly associated with binge drinking and total quantity of alcohol consumed in unadjusted and adjusted models. Age of first drunkenness was associated with total quantity of alcohol consumed in unadjusted models but not adjusted models and was not associated with subsequent bingeing. CONCLUSIONS Initiating alcohol use earlier in adolescence is associated with an increased risk of binge drinking and higher quantity of consumption in late secondary school, supporting an argument for delaying alcohol initiation for as long as possible to reduce the risk for problematic use in later adolescence and the alcohol-related harms that may accompany this use.
Collapse
Affiliation(s)
- Alexandra Aiken
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Philip J Clare
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Monika Wadolowski
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Delyse Hutchinson
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Jackob M Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Tim Slade
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, Hobart, Tasmania, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Richard P Mattick
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| |
Collapse
|
29
|
Mattick RP, Wadolowski M, Aiken A, Clare PJ, Hutchinson D, Najman J, Slade T, Bruno R, McBride N, Degenhardt L, Kypri K. Parental supply of alcohol and alcohol consumption in adolescence: prospective cohort study. Psychol Med 2017; 47:267-278. [PMID: 27702422 DOI: 10.1017/s0033291716002373] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Parents are a major supplier of alcohol to adolescents, yet there is limited research examining the impact of this on adolescent alcohol use. This study investigates associations between parental supply of alcohol, supply from other sources, and adolescent drinking, adjusting for child, parent, family and peer variables. METHOD A cohort of 1927 adolescents was surveyed annually from 2010 to 2014. Measures include: consumption of whole drinks; binge drinking (>4 standard drinks on any occasion); parental supply of alcohol; supply from other sources; child, parent, family and peer covariates. RESULTS After adjustment, adolescents supplied alcohol by parents had higher odds of drinking whole beverages [odds ratio (OR) 1.80, 95% confidence interval (CI) 1.33-2.45] than those not supplied by parents. However, parental supply was not associated with bingeing, and those supplied alcohol by parents typically consumed fewer drinks per occasion (incidence rate ratio 0.86, 95% CI 0.77-0.96) than adolescents supplied only from other sources. Adolescents obtaining alcohol from non-parental sources had increased odds of drinking whole beverages (OR 2.53, 95% CI 1.86-3.45) and bingeing (OR 3.51, 95% CI 2.53-4.87). CONCLUSIONS Parental supply of alcohol to adolescents was associated with increased risk of drinking, but not bingeing. These parentally-supplied children also consumed fewer drinks on a typical drinking occasion. Adolescents supplied alcohol from non-parental sources had greater odds of drinking and bingeing. Further follow-up is necessary to determine whether these patterns continue, and to examine alcohol-related harm trajectories. Parents should be advised that supply of alcohol may increase children's drinking.
Collapse
Affiliation(s)
- R P Mattick
- National Drug and Alcohol Research Centre,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - M Wadolowski
- The Kirby Institute,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - A Aiken
- National Drug and Alcohol Research Centre,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - P J Clare
- National Drug and Alcohol Research Centre,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - D Hutchinson
- School of Psychology,Deakin University,Melbourne, VIC 3125,Australia
| | - J Najman
- Queensland Alcohol and Drug Research and Education Centre,University of Queensland,Brisbane, QLD 4072,Australia
| | - T Slade
- National Drug and Alcohol Research Centre,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - R Bruno
- School of Psychology,University of Tasmania,Hobart, TAS 7000,Australia
| | - N McBride
- National Drug Research Institute,Curtin University,GPO Box U1987,Perth, WA 6845,Australia
| | - L Degenhardt
- National Drug and Alcohol Research Centre,University of New South Wales (UNSW) Australia,Sydney, NSW 2052,Australia
| | - K Kypri
- Centre for Clinical Epidemiology and Biostatistics,School of Medicine and Public Health,University of Newcastle,Newcastle, NSW 2308,Australia
| |
Collapse
|
30
|
Iredale JM, Clare PJ, Courtney RJ, Martire KA, Bonevski B, Borland R, Siahpush M, Mattick RP. Associations between behavioural risk factors and smoking, heavy smoking and future smoking among an Australian population-based sample. Prev Med 2016; 83:70-6. [PMID: 26657795 DOI: 10.1016/j.ypmed.2015.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 11/16/2015] [Accepted: 11/21/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Tobacco smoking co-occurs with behavioural risk factors including diet, alcohol use and obesity. However, the association between behavioural risk factors and heavy smoking (>20cig/day) compared to light-moderate smoking is unknown. The link between behavioural risk factors and future smoking for both ex and current smokers is also unknown. This study sought to examine these relationships. It is hypothesised that behavioural risk factors will be more strongly associated with heavy smoking. METHOD Data from Wave 7 (2007) of the Household and Labour Dynamics in Australia (HILDA) survey was analysed using logistic regression to determine relationships between diet (fruit and vegetable consumption, and unhealthy diet choices), alcohol consumption, obesity and physical activity with light-moderate smoking and heavy smoking. The association between these risk factors and future smoking (2008) was assessed for current and ex-smokers (2007). RESULTS Obese respondents were less likely to be light/moderate smokers (RRR: 0.53; 95% CI: 0.43, 0.66) but not heavy smokers. Those who consume confectionary weekly were less likely to be light/moderate smokers (RRR: 0.73; 95% CI: 0.61, 0.87), but not heavy smokers. Smokers in 2007 were more likely to continue smoking in 2008 if they consumed 1-4 drinks per occasion (OR: 2.52; 95% CI: 1.13, 5.62). Ex-smokers in 2007 were less likely to relapse in 2008 if they consumed recommended levels of both fruit and vegetables (OR: 0.31; CI: 0.10, 0.91). CONCLUSION The relationships between heavy smoking and behavioural risk factors differ from moderate-light smoking. Future primary care interventions would benefit from targeting multiple risk factors, particularly for heavy smokers.
Collapse
Affiliation(s)
- Jaimi M Iredale
- National Drug and Alcohol Research Centre (NDARC), University of NSW, Sydney, NSW 2052, Australia.
| | - Philip J Clare
- National Drug and Alcohol Research Centre (NDARC), University of NSW, Sydney, NSW 2052, Australia.
| | - Ryan J Courtney
- National Drug and Alcohol Research Centre (NDARC), University of NSW, Sydney, NSW 2052, Australia.
| | - Kristy A Martire
- School of Psychology, University of NSW, Sydney, NSW 2052, Australia.
| | - Billie Bonevski
- School of Medicine & Public Health, University of Newcastle, University Dr, Callaghan, NSW 2308, Australia.
| | - Ron Borland
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC 3004, Australia.
| | - Mohammad Siahpush
- College of Public Health, University of Nebraska Medical Centre, 42nd and Emile, Omaha, NE 68198, USA.
| | - Richard P Mattick
- National Drug and Alcohol Research Centre (NDARC), University of NSW, Sydney, NSW 2052, Australia.
| |
Collapse
|