Alcohol consumption and its related harms in The Netherlands since 1960: relationships with planned and unplanned factors.

PubMed

Knibbe, Ronald A; Derickx, Mieke; Allamani, Allaman; Massini, Giulia

2014-10-01

to establish which unplanned (social developments) and planned (alcohol policy measures) factors are related to per capita consumption and alcohol-related harms in the Netherlands. linear regression was used to establish which of the planned and unplanned factors were most strongly connected with alcohol consumption and harms. Artificial Neural Analysis (ANN) was used to inspect the interconnections between all variables. mothers age at birth was most strongly associated with increase in consumption. The ban on selling alcoholic beverages at petrol station was associated with a decrease in consumption. The linear regression of harms did not show any relation between alcohol policy measures and harms. The ANN-analyses indicate a very high interconnectedness between all variables allowing no causal inferences. Exceptions are the relation between price of beer and wine and the consumption of these beverages and the relation between a decrease in transport mortality and the increased use of breathalyzers tests and a restriction of paracommercial selling. unplanned factors are most strongly associated with per capita consumption and harms. ANN-analysis indicates that price of alcoholic beverages, breath testing, and restriction of sales may have had some influence. The study's limitations are noted.

Alcohol policy and harm reduction in Australia.

PubMed

Loxley, Wendy; Gray, Dennis; Wilkinson, Celia; Chikritzhs, Tanya; Midford, Richard; Moore, David

2005-11-01

With consultations having been held across Australia this year as part of the process of developing a new National Alcohol Strategy, it seemed timely to invite my colleagues from the National Drug Research Institute who are experts in the alcohol field to write this Harm Reduction Digest. The authors have canvassed a range of alcohol policy options and discussed their effectiveness in reducing harm for what is arguably Australia's number one drug problem. Australia's response to alcohol and other drug problems has, historically, been based on 'harm minimization--incorporating supply reduction, demand reduction and harm reduction'. At this time where the policy options for alcohol are being set for the next 5 years in a climate of 'small government', removing restrictions of 'fair competition' in business and a belief in the free market, what does the research have to say about recommended policies and strategies to reduce alcohol-related harm?

Effects of the Campus Watch intervention on alcohol consumption and related harm in a university population.

PubMed

Cousins, Kimberly; Connor, Jennie L; Kypri, Kypros

2014-10-01

High levels of drinking and alcohol-related problems are pervasive among university students in New Zealand and other high-income countries, where controls on alcohol availability and promotion are typically weak. Environmental interventions to reduce hazardous drinking and harm have shown promise in general populations, but require further evidence of effectiveness in university settings. The aim of this study was to estimate the effect of a community liaison and security program, Campus Watch, on drinking patterns and alcohol-related harm among university students. The study used a quasi-experimental design with non-equivalent control sites using before (2005) and after (2009) observations. Participants were full-time students aged 17-25 years selected randomly from the enrolment lists of six New Zealand universities. Changes in scores on the alcohol use disorders identification consumption scale (AUDIT-C) and alcohol-related harms at the intervention campus were compared with those at control campuses using linear and logistic regression models. Compared to control campuses, AUDIT-C scores decreased in students at the intervention campus (β=-0.5, 95% CI: -0.6 to -0.3). Campus Watch was associated with reductions in some harms (independent of its effect on drinking), such as aggression (aOR 0.66, 95% CI: 0.46 to 0.94), but not other harms, e.g., blackouts (aOR 1.06, 95% CI: 0.89 to 1.27). While not being focused on alcohol per se, Campus Watch reduced alcohol consumption and some related harms. Such programs may be useful in similar environments where controls on alcohol availability and promotion cannot be affected and where informal controls are weak. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Recommendations on privatization of alcohol retail sales and prevention of excessive alcohol consumption and related harms.

PubMed

2012-04-01

The Community Preventive Services Task Force recommends against privatization of alcohol retail sales in settings with current government control of retail sales, based on strong evidence that privatization results in increased per capita consumption of alcoholic beverages, a well-established proxy for excessive consumption and related harms. Published by Elsevier Inc.

Do managed alcohol programs change patterns of alcohol consumption and reduce related harm? A pilot study.

PubMed

Vallance, Kate; Stockwell, Tim; Pauly, Bernie; Chow, Clifton; Gray, Erin; Krysowaty, Bonnie; Perkin, Kathleen; Zhao, Jinhui

2016-05-09

Managed alcohol programs (MAPs) are a harm reduction strategy for people with severe alcohol dependence and unstable housing. MAPs provide controlled access to alcohol usually alongside accommodation, meals, and other supports. Patterns of alcohol consumption and related harms among MAP participants and controls from a homeless shelter in Thunder Bay, Ontario, were investigated in 2013. Structured interviews were conducted with 18 MAP and 20 control participants assessed as alcohol dependent with most using non-beverage alcohol (NBA). Qualitative interviews were conducted with seven participants and four MAP staff concerning perceptions and experiences of the program. Program alcohol consumption records were obtained for MAP participants, and records of police contacts and use of health services were obtained for participants and controls. Some participants' liver function test (LFT) results were available for before and after MAP entry. Compared with periods off the MAP, MAP participants had 41 % fewer police contacts, 33 % fewer police contacts leading to custody time (x (2) = 43.84, P < 0.001), 87 % fewer detox admissions (t = -1.68, P = 0.06), and 32 % fewer hospital admissions (t = -2.08, P = 0.03). MAP and control participants shared similar characteristics, indicating the groups were broadly comparable. There were reductions in nearly all available LFT scores after MAP entry. Compared with controls, MAP participants had 43 % fewer police contacts, significantly fewer police contacts (-38 %) that resulted in custody time (x (2) = 66.10, P < 0.001), 70 % fewer detox admissions (t = -2.19, P = 0.02), and 47 % fewer emergency room presentations. NBA use was significantly less frequent for MAP participants versus controls (t = -2.34, P < 0.05). Marked but non-significant reductions were observed in the number of participants self-reporting alcohol-related harms in the domains of home life, legal issues, and

A Duty of Care: Non-Drinkers and Alcohol Related Harm among an Australian University Sample

ERIC Educational Resources Information Center

Mikhailovich, Katja; George, Amanda; Rickwood, Debra; Parker, Rhian

2011-01-01

Studies documenting the harm associated with excessive drinking amongst university students are numerous. Fewer studies have explored the experience of non-drinkers in the university setting. In 2008, 826 students aged 18-29 years responded to an online survey aiming to investigate alcohol use and alcohol related harm at an Australian university.…

The cost of harmful alcohol use in South Africa.

PubMed

Matzopoulos, R G; Truen, S; Bowman, B; Corrigall, J

2014-02-01

The economic, social and health costs associated with alcohol-related harms are important measures with which to inform alcohol management policies and laws. This analysis builds on previous cost estimates for South Africa. We reviewed existing international best-practice costing frameworks to provide the costing definitions and dimensions. We sourced data from South African costing literature or, if unavailable, estimated costs using socio-economic and health data from secondary sources. Care was taken to avoid possible causes of cost overestimation, in particular double counting and, as far as possible, second-round effects of alcohol abuse. The combined total tangible and intangible costs of alcohol harm to the economy were estimated at 10 - 12% of the 2009 gross domestic product (GDP). The tangible financial cost of harmful alcohol use alone was estimated at R37.9 billion, or 1.6% of the 2009 GDP. The costs of alcohol-related harms provide a substantial counterbalance to the economic benefits highlighted by the alcohol industry to counter stricter regulation. Curtailing these costs by regulatory and policy interventions contributes directly and indirectly to social well-being and the economy. CONCLUSIONS; Existing frameworks that guide the regulation and distribution of alcohol frequently focus on maximising the contribution of the alcohol sector to the economy, but should also take into account the associated economic, social and health costs. Current interventions do not systematically address the most important causes of harm from alcohol, and need to be informed by reliable evidence of the ongoing costs of alcohol-related harms.

Income inequality and alcohol attributable harm in Australia.

PubMed

Dietze, Paul M; Jolley, Damien J; Chikritzhs, Tanya N; Clemens, Susan; Catalano, Paul; Stockwell, Tim

2009-02-25

There is little research on the relationship between key socioeconomic variables and alcohol related harms in Australia. The aim of this research was to examine the relationship between income inequality and the rates of alcohol-attributable hospitalisation and death at a local-area level in Australia. We conducted a cross sectional ecological analysis at a Local Government Area (LGA) level of associations between data on alcohol caused harms and income inequality data after adjusting for socioeconomic disadvantage and remoteness of LGAs.The main outcome measures used were matched rate ratios for four measures of alcohol caused harm; acute (primarily related to the short term consequences of drinking) and chronic (primarily related to the long term consequences of drinking) alcohol-attributable hospitalisation and acute and chronic alcohol-attributable death. Matching was undertaken using control conditions (non-alcohol-attributable) at an LGA level. A total of 885 alcohol-attributable deaths and 19467 alcohol-attributable hospitalisations across all LGAs were available for analysis. After weighting by the total number of cases in each LGA, the matched rate ratios of acute and chronic alcohol-attributable hospitalisation and chronic alcohol-attributable death were associated with the squared centred Gini coefficients of LGAs. This relationship was evident after adjusting for socioeconomic disadvantage and remoteness of LGAs. For both measures of hospitalisation the relationship was curvilinear; increases in income inequality were initially associated with declining rates of hospitalisation followed by large increases as the Gini coefficient increased beyond 0.15. The pattern for chronic alcohol-attributable death was similar, but without the initial decrease. There was no association between income inequality and acute alcohol-attributable death, probably due to the relatively small number of these types of death. We found a curvilinear relationship between income

Measuring and preventing alcohol use and related harm among young people in Asian countries: a thematic review.

PubMed

Jiang, Heng; Xiang, Xiaojun; Hao, Wei; Room, Robin; Zhang, Xiaojie; Wang, Xuyi

2018-01-01

The paper reviews alcohol consumption patterns and alcohol-related social and health issues among 15-29-year old young people in Asian countries, and discusses strategies for preventing and controlling alcohol use and related harms. We searched Google Scholar, PubMed, and Web of Science for reports, reviews and journal articles published in English between 1st Jan 1990 and 31st August 2016. Forty-one reports, reviews and journal papers were identified and included in the final review. The current drinking levels and prevalence among young people are markedly different between eight included Asian countries, ranging from 4.2% in Malaysia to 49.3% in China. In a majority of the selected Asian countries, over 15% of total deaths among young men and 6% among young women aged 15-29 years are attributable to alcohol use. Alcohol use among young people is associated with a number of harms, including stress, family violence, injuries, suicide, and sexual and other risky behaviours. Alcohol policies, such as controlling sales, social supply and marketing, setting up/raising a legal drinking age, adding health warning labels on alcohol containers, and developing a surveillance system to monitor drinking pattern and risky drinking behaviour, could be potential means to reduce harmful use of alcohol and related harm among young people in Asia. The review reveals that drinking patterns and behaviours vary across eight selected Asian countries due to culture, policies and regional variations. The research evidence holds substantial policy implications for harm reduction on alcohol drinking among young people in Asian countries -- especially for China, which has almost no alcohol control policies at present.

Harmful Alcohol Use on Campus: Impact on Young People at University

ERIC Educational Resources Information Center

Rickwood, Debra; George, Amanda; Parker, Rhian; Mikhailovich, Katja

2011-01-01

Young people at university are more likely to consume alcohol at harmful levels than their same-age peers who are not at university, and harmful alcohol use affects many aspects of campus life. This study aimed to investigate alcohol use and alcohol-related harms, both experienced and witnessed, among students at an Australian university. An…

Unrecorded Alcohol and Alcohol-Related Harm in Rural Sabah, Malaysia: A Socio-economically Deprived Region with Expensive Beer and Cheap Local Spirits.

PubMed

Shoesmith, Wendy Diana; Oo Tha, Naing; Naing, Khin Saw; Abbas, Roslee Bin Haji; Abdullah, Ahmad Faris

2016-11-01

To investigate recorded and unrecorded alcohol and the relation to alcohol-related harm in a region with high taxation, economic deprivation and cultural use of alcohol. Two participants per household were systematically sampled from 12 different villages chosen using stratified random sampling in the North of Sabah, Malaysia. Participants were asked about each type and amount of drink consumed; price paid, whether tax was paid, number of days sick in the last year and whether they had experienced various health problems. A brief screen for mental disorders (PHQ) and an alcohol disorder screening test (AUDIT) were completed. Village heads were also interviewed about alcohol-related problems at village level. 470 people were interviewed. The most commonly drunk beverages were beer and Montoku (a local distilled beverage), which had average prices of RM3.85 and RM0.48 per standard drink respectively. Montoku was more likely to be drunk by problem drinkers. Only 3.1% of alcohol drunk was believed by respondents to be taxed. Men with an AUDIT score of more than 15 were more likely to have had a sick day in the last year and have a female household member with symptoms of mental disorder on PHQ. Change in the taxation structure needs to be considered to reduce alcohol-related harm. Most alcohol consumed in rural Sabah is smuggled or informal. The low price of local spirits is likely to be contributing to alcohol-related harm. Differential effects on minority populations need to be considered when designing alcohol policy. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Influence of Family Factors and Supervised Alcohol Use on Adolescent Alcohol Use and Harms: Similarities Between Youth in Different Alcohol Policy Contexts*

PubMed Central

McMorris, Barbara J.; Catalano, Richard F.; Kim, Min Jung; Toumbourou, John W.; Hemphill, Sheryl A.

2011-01-01

Objective: Harm-minimization policies suggest that alcohol use is a part of normal adolescent development and that parents should supervise their children's use to encourage responsible drinking. Zero-tolerance policies suggest that all underage alcohol use should be discouraged. This article compared hypotheses derived from harm-minimization and zero-tolerance policies regarding the influence of family context and supervised drinking on adolescent alcohol use and related harms among adolescents in Washington State, USA, and Victoria, Australia, two states that have respectively adopted zero-tolerance and harm-minimization policies. Method: Representative samples of seventh-grade students (N = 1,945; 989 females) were recruited from schools in each state. Students completed comprehensive questionnaires on alcohol use, related problem behaviors, and risk and protective factors annually from 2002 to 2004 when they were in ninth grade. Results: Relationships between family context and alcohol use and harmful use were very similar in both states. Adult-supervised settings for alcohol use were associated with higher levels of harmful alcohol consequences. Adult-supervised alcohol use mediated the links between favorable parental attitudes to alcohol use and ninth-grade alcohol use for students in both states. Conclusions: Despite policy differences in the two states, relationships between family context variables and alcohol use and harmful use are remarkably similar. Adult-supervised settings for alcohol use resulted in higher levels of harmful alcohol consequences, contrary to predictions derived from harm-minimization policy. Findings challenge the harm-minimization position that supervised alcohol use or early-age alcohol use will reduce the development of adolescent alcohol problems. PMID:21513678

Influence of family factors and supervised alcohol use on adolescent alcohol use and harms: similarities between youth in different alcohol policy contexts.

PubMed

McMorris, Barbara J; Catalano, Richard F; Kim, Min Jung; Toumbourou, John W; Hemphill, Sheryl A

2011-05-01

Harm-minimization policies suggest that alcohol use is a part of normal adolescent development and that parents should supervise their children's use to encourage responsible drinking. Zero-tolerance policies suggest that all underage alcohol use should be discouraged. This article compared hypotheses derived from harm-minimization and zero-tolerance policies regarding the influence of family context and supervised drinking on adolescent alcohol use and related harms among adolescents in Washington State, USA, and Victoria, Australia, two states that have respectively adopted zero-tolerance and harm-minimization policies. Representative samples of seventh-grade students (N = 1,945; 989 females) were recruited from schools in each state. Students completed comprehensive questionnaires on alcohol use, related problem behaviors, and risk and protective factors annually from 2002 to 2004 when they were in ninth grade. Relationships between family context and alcohol use and harmful use were very similar in both states. Adult-supervised settings for alcohol use were associated with higher levels of harmful alcohol consequences. Adult-supervised alcohol use mediated the links between favorable parental attitudes to alcohol use and ninth-grade alcohol use for students in both states. Despite policy differences in the two states, relationships between family context variables and alcohol use and harmful use are remarkably similar. Adult-supervised settings for alcohol use resulted in higher levels of harmful alcohol consequences, contrary to predictions derived from harm-minimization policy. Findings challenge the harm-minimization position that supervised alcohol use or early-age alcohol use will reduce the development of adolescent alcohol problems.

Diagnosis‐based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?

PubMed Central

Dinh, Michael; Rodgers, Craig; Muscatello, David J.; McGuire, Rhydwyn; Ryan, Therese; Thackway, Sarah

2016-01-01

Abstract Introduction and Aims Acute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms. Design and Methods We selected a random sample of 1000 ED presentations assigned an ED diagnosis code for alcohol harms (the ‘alcohol syndrome’) in the New South Wales, Australia, automatic syndromic surveillance system. The sample was selected from 68 public hospitals during 2014. Nursing triage free‐text fields were independently reviewed to confirm alcohol consumption and classify each presentation into either an ‘acute’ or ‘chronic’ harm. Positive predictive value (PPV) for acute harm was calculated, and predictors of acute harm presentations were estimated using logistic regression. Results The PPV of the alcohol syndrome for acute alcohol harm was 53.5%. Independent predictors of acute harm were ambulance arrival [adjusted odds ratio (aOR) = 3.4, 95% confidence interval (CI) 2.4–4.7], younger age (12–24 vs. 25–39 years: aOR = 3.4, 95% CI 2.2–5.3), not being admitted (aOR 2.2, 95% CI 1.5–3.2) and arriving between 10 pm and 5.59 am (aOR 2.1, 95% CI 1.5–2.8). PPV among 12 to 24‐year‐olds was 82%. Discussion and Conclusions The alcohol syndrome provides moderate precision as an indicator of acute alcohol harms presenting to the ED. Precision for monitoring acute harm in the population is improved by filtering the syndrome by the strongest independent predictors of acute alcohol harm presentations. [Whitlam G, Dinh M, Rodgers C, Muscatello DJ, McGuire R, Ryan T, Thackway S. Diagnosis‐based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level? Drug Alcohol Rev 2016;35:693–701] PMID:27786390

Alcohol-induced blackouts as predictors of other drinking related harms among emerging young adults

PubMed Central

Hingson, Ralph; Zha, Wenxing; Simons-Morton, Bruce; White, Aaron

2016-01-01

Background Alcohol-related blackouts are periods of amnesia that reflect the failure of the brain to record memories of what transpires while drinking. This paper examined the incidence, predictors, and behavioral correlates of blackouts among emerging adults and examined whether questions about blackouts could serve as better markers of risk for other alcohol related harms than questions about levels of consumption. Methods In 2012-2013, 1,463 (68%) of 2,140 respondents one-year past high school reported having consumed alcohol. They were asked whether, in the past six months because of drinking, they forgot where they were or what they did. The survey also explored demographics, substance use behaviors, and other alcohol-related problems in the past six months. Chi square and logistic regression analyses explored bivariate and multivariate predictors of blackouts and other alcohol-related problems. Results Twenty percent of respondents who ever drank alcohol reported a blackout in the past six months. Blackouts were more prevalent among females and those who, in the past 30 days, used multiple drugs, more frequently binged, were drunk, smoked, had lower body weight, and lived in college dorms. After controlling for drinking levels, having a blackout was the strongest independent predictor of most other alcohol problems examined, including in the past six months because of drinking, missing class or work, getting behind in work or school, doing something respondents later regretted, arguing with friends, experiencing an overdose, and total number of alcohol problems reported. It was also an independent predictor of hangovers, damaging property, getting hurt, and trouble with police. Conclusion Because blackouts indicate drinking at levels that result in significant cognitive and behavioral impairment, questions about blackouts could serve as important, simple screeners for the risk of experiencing other alcohol related harms. Additional work on this subject is

Responsibility without legal authority? Tackling alcohol-related health harms through licensing and planning policy in local government.

PubMed

Martineau, F P; Graff, H; Mitchell, C; Lock, K

2014-09-01

The power to influence many social determinants of health lies within local government sectors that are outside public health's traditional remit. We analyse the challenges of achieving health gains through local government alcohol control policies, where legal and professional practice frameworks appear to conflict with public health action. Current legislation governing local alcohol control in England and Wales is reviewed and analysed for barriers and opportunities to implement effective population-level health interventions. Case studies of local government alcohol control practices are described. Addressing alcohol-related health harms is constrained by the absence of a specific legal health licensing objective and differences between public health and legal assessments of the relevance of health evidence to a specific place. Local governments can, however, implement health-relevant policies by developing local evidence for alcohol-related health harms; addressing cumulative impact in licensing policy statements and through other non-legislative approaches such as health and non-health sector partnerships. Innovative local initiatives-for example, minimum unit pricing licensing conditions-can serve as test cases for wider national implementation. By combining the powers available to the many local government sectors involved in alcohol control, alcohol-related health and social harms can be tackled through existing local mechanisms. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

Recommendations on dram shop liability and overservice law enforcement initiatives to prevent excessive alcohol consumption and related harms.

PubMed

2011-09-01

The Task Force on Community Preventive Services recommends the use of dram shop liability laws, on the basis of strong evidence of effectiveness in preventing and reducing alcohol-related harms. The Task Force found insufficient evidence to determine the effectiveness of overservice law enforcement initiatives as a means to reduce excessive alcohol consumption and related harms, because too few studies were identified and findings were inconsistent. Published by Elsevier Inc.

Smoking and Alcohol Drinking Related to Experience of Harmful Shops among Korean Adolescents.

PubMed

Kim, Jinyoung; Sohn, Aeree

2014-06-01

This study was conducted in order to determine any correlation between experience of harmful shops and adolescent smoking and alcohol drinking in middle and high school students. The survey was conducted using a self-administered questionnaire online via the homepage of the Ministry of Education student Health Information Center; 1888 and 1563 questionnaires were used for middle and high school students, respectively, for a total of 3451 questionnaires in the final analysis. The collected data were processed using SPSS version 21.0 and examined using frequency analysis and hierarchical linear regression. In this research, 8.3% of all participants were found to have experienced smoking and 17.0% alcohol drinking. Regarding the types of harmful shops, 81.8% said they had been to a gaming place; 21.2% to a lodging place; 16.0% to a sex and entertainment place; and 6.8% to a harmful sex industry location. Sociodemographic variables had a significant effect on adolescent smoking and alcohol drinking. Regarding environmental variables, a significant difference was observed for living with parents and school location. Among adolescent experience of harmful shops, both smoking and alcohol drinking showed a significant association with harmful sex industry locations. National government-level management and supervision on this issue will be necessary to prevent adolescent access to harmful shops, along with more studies exploring methods for implementation of policies with more systematic control of harmful shops.

Alcohol-Induced Blackouts as Predictors of Other Drinking Related Harms Among Emerging Young Adults.

PubMed

Hingson, Ralph; Zha, Wenxing; Simons-Morton, Bruce; White, Aaron

2016-04-01

Alcohol-related blackouts are periods of amnesia that reflect the failure of the brain to record memories of what transpires while drinking. This paper examined the incidence, predictors, and behavioral correlates of blackouts among emerging adults and examined whether questions about blackouts could serve as better markers of risk for other alcohol related harms than questions about levels of consumption. In 2012 to 2013, 1,463 (68%) of 2,140 respondents 1-year past high school reported having consumed alcohol. They were asked whether, in the past 6 months because of drinking, they forgot where they were or what they did. The survey also explored demographics, substance use behaviors, and other alcohol-related problems in the past 6 months. Chi-square and logistic regression analyses explored bivariate and multivariate predictors of blackouts and other alcohol-related problems. Twenty percent of respondents who ever drank alcohol reported a blackout in the past 6 months. Blackouts were more prevalent among females and those who, in the past 30 days, used multiple drugs, more frequently binged, were drunk, smoked, had lower body weight, and lived in college dorms. After controlling for drinking levels, having a blackout was the strongest independent predictor of most other alcohol problems examined, including in the past 6 months because of drinking, missing class or work, getting behind in work or school, doing something respondents later regretted, arguing with friends, experiencing an overdose, and total number of alcohol problems reported. It was also an independent predictor of hangovers, damaging property, getting hurt, and trouble with police. Because blackouts indicate drinking at levels that result in significant cognitive and behavioral impairment, questions about blackouts could serve as important, simple screeners for the risk of experiencing other alcohol related harms. Additional work on this subject is warranted. Published 2016. This article is a U

Effects of dram shop liability and enhanced overservice law enforcement initiatives on excessive alcohol consumption and related harms: Two community guide systematic reviews.

PubMed

Rammohan, Veda; Hahn, Robert A; Elder, Randy; Brewer, Robert; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci L; Chattopadhyay, Sajal K; Zometa, Carlos

2011-09-01

Dram shop liability holds the owner or server(s) at a bar, restaurant, or other location where a patron, adult or underage, consumed his or her last alcoholic beverage responsible for harms subsequently inflicted by the patron on others. Liability in a state can be established by case law or statute. Overservice laws prohibit the sale of alcoholic beverages to intoxicated patrons drinking in on-premises retail alcohol outlets (i.e., premises where the alcohol is consumed where purchased); enhanced enforcement of these laws is intended to ensure compliance by premises personnel. Both of these interventions are ultimately designed to promote responsible beverage service by reducing sales to intoxicated patrons, underage youth, or both. This review assesses the effectiveness of dram shop liability and the enhanced enforcement of overservice laws for preventing excessive alcohol consumption and related harms. Studies assessing alcohol-related harms in states adopting dram shop laws were evaluated, as were studies assessing alcohol-related harms in regions with enhanced overservice enforcement. Methods previously developed for systematic reviews for the Guide to Community Preventive Services were used. Eleven studies assessed the association of state dram shop liability with various outcomes, including all-cause motor vehicle crash deaths, alcohol-related motor vehicle crash deaths (the most common outcome assessed in the studies reviewed), alcohol consumption, and other alcohol-related harms. There was a median reduction of 6.4% (range of values 3.7% to 11.3% reduction) in alcohol-related motor vehicle fatalities associated with the presence of dram shop liability in jurisdictions where premises are licensed. Other alcohol-related outcomes also showed a reduction. Only two studies assessed the effects of enhanced enforcement initiatives on alcohol-related outcomes; findings were inconsistent, some indicating benefit and others none. According to Community Guide rules

How the alcohol industry relies on harmful use of alcohol and works to protect its profits.

PubMed

Casswell, Sally; Callinan, Sarah; Chaiyasong, Surasak; Cuong, Pham Viet; Kazantseva, Elena; Bayandorj, Tsogzolmaa; Huckle, Taisia; Parker, Karl; Railton, Renee; Wall, Martin

2016-11-01

The alcohol industry have attempted to position themselves as collaborators in alcohol policy making as a way of influencing policies away from a focus on the drivers of the harmful use of alcohol (marketing, over availability and affordability). Their framings of alcohol consumption and harms allow them to argue for ineffective measures, largely targeting heavier consumers, and against population wide measures as the latter will affect moderate drinkers. The goal of their public relations organisations is to 'promote responsible drinking'. However, analysis of data collected in the International Alcohol Control study and used to estimate how much heavier drinking occasions contribute to the alcohol market in five different countries shows the alcohol industry's reliance on the harmful use of alcohol. In higher income countries heavier drinking occasions make up approximately 50% of sales and in middle income countries it is closer to two-thirds. It is this reliance on the harmful use of alcohol which underpins the conflicting interests between the transnational alcohol corporations and public health and which militates against their involvement in the alcohol policy arena. [Caswell S, Callinan S, Chaiyasong S, Cuong PV, Kazantseva E, Bayandorj T, Huckle T, Parker K, Railton R, Wall M. How the alcohol industry relies on harmful use of alcohol and works to protect its profits. Drug Alcohol Rev 2016;35:661-664]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Can screening and brief intervention lead to population-level reductions in alcohol-related harm?

PubMed Central

2012-01-01

A distinction is made between the clinical and public health justifications for screening and brief intervention (SBI) against hazardous and harmful alcohol consumption. Early claims for a public health benefit of SBI derived from research on general medical practitioners’ (GPs’) advice on smoking cessation, but these claims have not been realized, mainly because GPs have not incorporated SBI into their routine practice. A recent modeling exercise estimated that, if all GPs in England screened every patient at their next consultation, 96% of the general population would be screened over 10 years, with 70-79% of excessive drinkers receiving brief interventions (BI); assuming a 10% success rate, this would probably amount to a population-level effect of SBI. Thus, a public health benefit for SBI presupposes widespread screening; but recent government policy in England favors targeted versus universal screening, and in Scotland screening is based on new registrations and clinical presentation. A recent proposal for a national screening program was rejected by the UK National Health Service’s National Screening Committee because 1) there was no good evidence that SBI led to reductions in mortality or morbidity, and 2) a safe, simple, precise, and validated screening test was not available. Even in countries like Sweden and Finland, where expensive national programs to disseminate SBI have been implemented, only a minority of the population has been asked about drinking during health-care visits, and a minority of excessive drinkers has been advised to cut down. Although there has been research on the relationship between treatment for alcohol problems and population-level effects, there has been no such research for SBI, nor have there been experimental investigations of its relationship with population-level measures of alcohol-related harm. These are strongly recommended. In this article, conditions that would allow a population-level effect of SBI to occur are

Drinker Types, Harm, and Policy-Related Variables: Results from the 2011 International Alcohol Control Study in New Zealand.

PubMed

Wall, Martin; Casswell, Sally

2017-05-01

The aim was to identify a typology of drinkers in New Zealand based on alcohol consumption, beverage choice, and public versus private drinking locations and investigate the relationship between drinker types, harms experienced, and policy-related variables. Model-based cluster analysis of male and female drinkers including volumes of alcohol consumed in the form of beer, wine, spirits, and ready-to-drinks (RTDs) in off- and on-premise settings. Cluster membership was then related to harm measures: alcohol dependence, self-rated health; and to 3 policy-relevant variables: liking for alcohol adverts, price paid for alcohol, and time of purchase. Males and females were analyzed separately. Men fell into 4 and women into 14 clearly discriminated clusters. The male clusters consumed a relatively high proportion of alcohol in the form of beer. Women had a number of small extreme clusters and some consumed mainly spirits-based RTDs, while others drank mainly wine. Those in the higher consuming clusters were more likely to have signs of alcohol dependency, to report lower satisfaction with their health, to like alcohol ads, and to have purchased late at night. Consumption patterns are sufficiently distinctive to identify typologies of male and female alcohol consumers. Women drinkers are more heterogeneous than men. The clusters relate differently to policy-related variables. Copyright © 2017 by the Research Society on Alcoholism.

The acceptability to Aboriginal Australians of a family-based intervention to reduce alcohol-related harms.

PubMed

Calabria, Bianca; Clifford, Anton; Shakeshaft, Anthony; Allan, Julaine; Bliss, Donna; Doran, Christopher

2013-05-01

Cognitive-behavioural interventions that use familial and community reinforcers in an individual's environment are effective for reducing alcohol-related harms. Such interventions have considerable potential to reduce the disproportionately high burden of alcohol-related harm among Aboriginal Australians if they can be successfully tailored to their specific needs and circumstances. The overall aim of this paper is to describe the perceived acceptability of two cognitive-behavioural interventions, the Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT), to a sample of Aboriginal people. Descriptive survey was administered to 116 Aboriginal people recruited through an Aboriginal Community Controlled Health Service and a community-based drug and alcohol treatment agency in rural New South Wales, Australia. Participants perceived CRA and CRAFT to be highly acceptable for delivery in their local Aboriginal community. Women were more likely than men to perceive CRAFT as highly acceptable. Participants expressed a preference for counsellors to be someone they knew and trusted, and who has experience working in their local community. CRA was deemed most acceptable for delivery to individuals after alcohol withdrawal and CRAFT for people who want to help a relative/friend start alcohol treatment. There was a preference for five or more detailed sessions. Findings of this study suggest that CRA and CRAFT are likely to be acceptable for delivery to some rural Aboriginal Australians, and that there is potential to tailor these interventions to specific communities. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Reducing alcohol-related harm and social disorder in a university community: a framework for evaluation.

PubMed

Cousins, Kimberly; Connor, Jennie L; Kypri, Kypros

2010-10-01

In New Zealand and other middle to high income countries, university student are at high risk of alcohol-related injury and other problems due to their typical pattern of episodic heavy drinking. In 2007, one university implemented Campus Watch, a novel and extensive programme to reduce social disorder, including alcohol-related injury, in the university area. To quantify the effects of this complex intervention. A large public university campus and surrounding community in New Zealand. A health promotion evaluation model was used, examining: (1) how the programme was developed, introduced and received by the community? (process); (2) whether the programme affected behaviour? (impact); and (3) whether the programme reduced social disorder and alcohol-related harm in particular? (outcome). The outcome phase uses a non-equivalent control group design to measure changes occurring in the Campus Watch area compared with other universities, and with a same-city control site. Programme staff, university students and other community members. Interviews with university administrators and Campus Watch staff; surveys of local residents' views; Campus Watch incident data; national surveys of university students in 2005, 2007 and 2009; police data; fire department data. Prevalence of heavy episodic drinking; number of acute alcohol-related harms; incidence of antisocial behaviour, assault and street fires. Regression analyses will be used to examine changes in the intervention site relative to changes in the control areas.

The Long-Term Effectiveness of a Selective, Personality-Targeted Prevention Program in Reducing Alcohol Use and Related Harms: A Cluster Randomized Controlled Trial

ERIC Educational Resources Information Center

Newton, Nicola C.; Conrod, Patricia J.; Slade, Tim; Carragher, Natacha; Champion, Katrina E.; Barrett, Emma L.; Kelly, Erin V.; Nair, Natasha K.; Stapinski, Lexine; Teesson, Maree

2016-01-01

Background: This study investigated the long-term effectiveness of Preventure, a selective personality-targeted prevention program, in reducing the uptake of alcohol, harmful use of alcohol, and alcohol-related harms over a 3-year period. Methods: A cluster randomized controlled trial was conducted to assess the effectiveness of Preventure.…

Population-level interventions to reduce alcohol-related harm: an overview of systematic reviews.

PubMed

Martineau, Fred; Tyner, Elizabeth; Lorenc, Theo; Petticrew, Mark; Lock, Karen

2013-10-01

To analyse available review-level evidence on the effectiveness of population-level interventions in non-clinical settings to reduce alcohol consumption or related health or social harm. Health, social policy and specialist review databases between 2002 and 2012 were searched for systematic reviews of the effectiveness of population-level alcohol interventions on consumption or alcohol-related health or social outcomes. Data were extracted on review research aim, inclusion criteria, outcome indicators, results, conclusions and limitations. Reviews were quality-assessed using AMSTAR criteria. A narrative synthesis was conducted overall and by policy area. Fifty-two reviews were included from ten policy areas. There is good evidence for policies and interventions to limit alcohol sale availability, to reduce drink-driving, to increase alcohol price or taxation. There is mixed evidence for family- and community-level interventions, school-based interventions, and interventions in the alcohol server setting and the mass media. There is weak evidence for workplace interventions and for interventions targeting illicit alcohol sales. There is evidence of the ineffectiveness of interventions in higher education settings. There is a pattern of support from the evidence base for regulatory or statutory enforcement interventions over local non-regulatory approaches targeting specific population groups. © 2013.

Prevalence of responsible hospitality policies in licensed premises that are associated with alcohol-related harm.

PubMed

Daly, Justine B; Campbell, Elizabeth M; Wiggers, John H; Considine, Robyn J

2002-06-01

This study aimed to determine the prevalence of responsible hospitality policies in a group of licensed premises associated with alcohol-related harm. During March 1999, 108 licensed premises with one or more police-identified alcohol-related incidents in the previous 3 months received a visit from a police officer. A 30-item audit checklist was used to determine the responsible hospitality policies being undertaken by each premises within eight policy domains: display required signage (three items); responsible host practices to prevent intoxication and under-age drinking (five items); written policies and guidelines for responsible service (three items); discouraging inappropriate promotions (three items); safe transport (two items); responsible management issues (seven items); physical environment (three items) and entry conditions (four items). No premises were undertaking all 30 items. Eighty per cent of the premises were undertaking 20 of the 30 items. All premises were undertaking at least 17 of the items. The proportion of premises undertaking individual items ranged from 16% to 100%. Premises were less likely to report having and providing written responsible hospitality documentation to staff, using door charges and having entry/re-entry rules. Significant differences between rural and urban premises were evident for four policies. Clubs were significantly more likely than hotels to have a written responsible service of alcohol policy and to clearly display codes of dress and conditions of entry. This study provides an indication of the extent and nature of responsible hospitality policies in a sample of licensed premises that are associated with a broad range of alcohol related harms. The finding that a large majority of such premises appear to adopt responsible hospitality policies suggests a need to assess the validity and reliability of tools used in the routine assessment of such policies, and of the potential for harm from licensed premises.

Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol.

PubMed

Anderson, Peter; Chisholm, Dan; Fuhr, Daniela C

2009-06-27

This paper reviews the evidence for the effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol, in the areas of education and information, the health sector, community action, driving while under the influence of alcohol (drink-driving), availability, marketing, pricing, harm reduction, and illegally and informally produced alcohol. Systematic reviews and meta-analyses show that policies regulating the environment in which alcohol is marketed (particularly its price and availability) are effective in reducing alcohol-related harm. Enforced legislative measures to reduce drink-driving and individually directed interventions to already at-risk drinkers are also effective. However, school-based education does not reduce alcohol-related harm, although public information and education-type programmes have a role in providing information and in increasing attention and acceptance of alcohol on political and public agendas. Making alcohol more expensive and less available, and banning alcohol advertising, are highly cost-effective strategies to reduce harm. In settings with high amounts of unrecorded production and consumption, increasing the proportion of alcohol that is taxed could be a more effective pricing policy than a simple increase in tax.

The effectiveness of strategies such as health warning labels to reduce alcohol-related harms - an Australian perspective.

PubMed

Stockley, C S.

2001-07-01

The efficacy of health warning labels for products such as alcoholic beverages continue to be debated internationally and now in Australia as a means of mitigating the misuse of alcohol within community groups. This paper discusses evidence emanating primarily from the USA that has adopted a health warning label for both alcohol and tobacco, and from Australia that has adopted a health warning label for tobacco, on the effectiveness of such a strategy in changing consumer behaviour. The conclusion drawn is that such labelling is generally ineffective in changing consumer behaviour and hence such a strategy is inappropriate for reducing alcohol-related harms. The paper also discusses briefly what advertising and messages influence consumers, positively and negatively, and what specific strategies have been shown to better educate consumers and change their consumption from excessive to light to moderate as defined by the (Australian) National Health and Medical Research Council, which is the present premise of harm minimisation in Australia.

Harm reduction with pharmacotherapy for homeless people with alcohol dependence: Protocol for a randomized controlled trial

PubMed Central

Collins, Susan E.; Saxon, Andrew J.; Duncan, Mark H.; Smart, Brian F.; Merrill, Joseph O.; Malone, Daniel K.; Jackson, T. Ron; Clifasefi, Seema L.; Joesch, Jutta; Ries, Richard K.

2014-01-01

Background Interventions requiring abstinence from alcohol are neither preferred by nor shown to be highly effective with many homeless individuals with alcohol dependence. It is therefore important to develop lower-threshold, patient-centered interventions for this multimorbid and high-utilizing population. Harm-reduction counseling requires neither abstinence nor use reduction and pairs a compassionate style with patient-driven goal-setting. Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving and may support achievement of harm-reduction goals. Together, harm-reduction counseling and XR-NTX may support alcohol harm reduction and quality-of-life improvement. Aims Study aims include testing: a) the relative efficacy of XR-NTX and harm-reduction counseling compared to a community-based, supportive-services-as-usual control, b) theory-based mediators of treatment effects, and c) treatment effects on publicly funded service costs. Methods This RCT involves four arms: a) XR-NTX+harm-reduction counseling, b) placebo+harm-reduction counseling, c) harm-reduction counseling only, and d) community-based, supportive-services-as-usual control conditions. Participants are currently/formerly homeless, alcohol dependent individuals (N=300). Outcomes include alcohol variables (i.e., craving, quantity/frequency, problems and biomarkers), health-related quality of life, and publicly funded service utilization and associated costs. Mediators include 10-point motivation rulers and the Penn Alcohol Craving Scale. XR-NTX and harm-reduction counseling are administered every 4 weeks over the 12-week treatment course. Follow-up assessments are conducted at weeks 24 and 36. Discussion If found efficacious, XR-NTX and harm-reduction counseling will be well-positioned to support reductions in alcohol-related harm, decreases in costs associated with publicly funded service utilization, and increases in quality of life among

Harm reduction with pharmacotherapy for homeless people with alcohol dependence: protocol for a randomized controlled trial.

PubMed

Collins, Susan E; Saxon, Andrew J; Duncan, Mark H; Smart, Brian F; Merrill, Joseph O; Malone, Daniel K; Jackson, T Ron; Clifasefi, Seema L; Joesch, Jutta; Ries, Richard K

2014-07-01

Interventions requiring abstinence from alcohol are neither preferred by nor shown to be highly effective with many homeless individuals with alcohol dependence. It is therefore important to develop lower-threshold, patient-centered interventions for this multimorbid and high-utilizing population. Harm-reduction counseling requires neither abstinence nor use reduction and pairs a compassionate style with patient-driven goal-setting. Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving and may support achievement of harm-reduction goals. Together, harm-reduction counseling and XR-NTX may support alcohol harm reduction and quality-of-life improvement. Study aims include testing: a) the relative efficacy of XR-NTX and harm-reduction counseling compared to a community-based, supportive-services-as-usual control, b) theory-based mediators of treatment effects, and c) treatment effects on publicly funded service costs. This RCT involves four arms: a) XR-NTX+harm-reduction counseling, b) placebo+harm-reduction counseling, c) harm-reduction counseling only, and d) community-based, supportive-services-as-usual control conditions. Participants are currently/formerly homeless, alcohol dependent individuals (N=300). Outcomes include alcohol variables (i.e., craving, quantity/frequency, problems and biomarkers), health-related quality of life, and publicly funded service utilization and associated costs. Mediators include 10-point motivation rulers and the Penn Alcohol Craving Scale. XR-NTX and harm-reduction counseling are administered every 4weeks over the 12-week treatment course. Follow-up assessments are conducted at weeks 24 and 36. If found efficacious, XR-NTX and harm-reduction counseling will be well-positioned to support reductions in alcohol-related harm, decreases in costs associated with publicly funded service utilization, and increases in quality of life among homeless, alcohol

Deconstructing the Alcohol Harm Paradox: A Population Based Survey of Adults in England

PubMed Central

Beard, Emma; Brown, Jamie; West, Robert; Angus, Colin; Brennan, Alan; Holmes, John; Kaner, Eileen; Meier, Petra; Michie, Susan

2016-01-01

Background The Alcohol Harm Paradox refers to observations that lower socioeconomic status (SES) groups consume less alcohol but experience more alcohol-related problems. However, SES is a complex concept and its observed relationship to social problems often depends on how it is measured and the demographic groups studied. Thus this study assessed socioeconomic patterning of alcohol consumption and related harm using multiple measures of SES and examined moderation of this patterning by gender and age. Method Data were used from the Alcohol Toolkit Study between March and September 2015 on 31,878 adults (16+) living in England. Participants completed the AUDIT which includes alcohol consumption, harm and dependence modules. SES was measured via qualifications, employment, home and car ownership, income and social-grade, plus a composite of these measures. The composite score was coded such that higher scores reflected greater social-disadvantage. Results We observed the Alcohol Harm Paradox for the composite SES measure, with a linear negative relationship between SES and AUDIT-Consumption scores (β = -0.036, p<0.001) and a positive relationship between lower SES and AUDIT-Harm (β = 0.022, p<0.001) and AUDIT-Dependence (β = 0.024, p<0.001) scores. Individual measures of SES displayed different, and non-linear, relationships with AUDIT modules. For example, social-grade and income had a u-shaped relationship with AUDIT-Consumption scores while education had an inverse u-shaped relationship. Almost all measures displayed an exponential relationship with AUDIT-Dependence and AUDIT-Harm scores. We identified moderating effects from age and gender, with AUDIT-Dependence scores increasing more steeply with lower SES in men and both AUDIT-Harm and AUDIT-Dependence scores increasing more steeply with lower SES in younger age groups. Conclusion Different SES measures appear to influence whether the Alcohol Harm Paradox is observed as a linear trend across SES groups or

Pills and pints: risky drinking and alcohol-related harms among regular ecstasy users in Australia.

PubMed

Kinner, Stuart A; George, Jessica; Johnston, Jennifer; Dunn, Matthew; Degenhardt, Louisa

2012-05-01

A significant proportion of young Australians engage in risky alcohol consumption, and an increasing minority are regular ecstasy (3,4-methylenedioxymethamphetamine) users. Risky alcohol use, alone or in combination with ecstasy, is associated with a range of acute and chronic health risks. The aim of this study was to document the incidence and some health-related correlates of alcohol use, and concurrent alcohol and ecstasy use, among a large, national sample of regular ecstasy users (REU) in Australia. National, cross-sectional surveys of REU in Australia 2003-2008. Among REU in 2008 (n=678) usual alcohol use, psychological distress and health-related quality of life were measured using the Alcohol Use Disorders Identification Test, Kessler Psychological Distress Scale and Short Form-8 Survey respectively. Among REU in 2008, 36% reported high-risk patterns of usual alcohol consumption, 62% reported usually consuming more than five standard drinks with ecstasy, and 24% reported currently experiencing high or very high levels of psychological distress. Controlling for age and education, high-risk drinking among REU was associated with higher levels of psychological distress and poorer health-related functioning; however, the associations between concurrent alcohol and ecstasy use, and health outcomes, were not significant (P>0.05). A large and increasing proportion of REU in Australia engage in high-risk patterns of alcohol consumption, including in combination with ecstasy. High-risk alcohol consumption among this group is associated with adverse health-related outcomes. Prevention and harm reduction interventions for REU should incorporate messages about the risks associated with alcohol use. There is an ongoing need for youth-specific, coordinated alcohol and other drug and mental health services. © 2011 Australasian Professional Society on Alcohol and other Drugs.

Drinking and alcohol-related harm among New Zealand university students: findings from a national Web-based survey.

PubMed

Kypri, Kypros; Paschall, Mallie J; Langley, John; Baxter, Joanne; Cashell-Smith, Martine; Bourdeau, Beth

2009-02-01

Alcohol-related harm is pervasive among college students in the United States of America and Canada, where a third to half of undergraduates binge drink at least fortnightly. There have been no national studies outside North America. We estimated the prevalence of binge drinking, related harms, and individual risk factors among undergraduates in New Zealand. A web survey was completed by 2,548 undergraduates (63% response) at 5 of New Zealand's 8 universities. Drinking patterns and alcohol-related problems in the preceding 4 weeks were measured. Drinking diaries for the preceding 7 days were completed. Multivariate analyses were used to identify individual risk factors. A total of 81% of both women and men drank in the previous 4 weeks, 37% reported 1 or more binge episodes in the last week, 14% of women and 15% of men reported 2+ binge episodes in the last week, and 68% scored in the hazardous range (4+) on the AUDIT consumption subscale. A mean of 1.8 (95% confidence interval 1.4, 2.3) distinct alcohol-related risk behaviors or harmful consequences were reported, e.g., 33% had a blackout, 6% had unprotected sex, and 5% said they were physically aggressive toward someone, in the preceding 4 weeks. Drink-driving or being the passenger of a drink-driver in the last 4 weeks was reported by 9% of women and 11% of men. Risk factors for frequent binge drinking included: lower age, earlier age of drinking onset, monthly or more frequent binge drinking in high school, and living in a residential hall or a shared house (relative to living with parents). These correlates were similar to those identified in U.S. and Canadian studies. Strategies are needed to reduce the availability and promotion of alcohol on and around university campuses in New Zealand. Given the high prevalence of binge drinking in high school and its strong association with later binge drinking, strategies aimed at youth drinking are also a priority. In universities, high-risk drinkers should be

[Harmful alcohol consumption: prevalence, trends, health burden, reduction strategy].

PubMed

Грузева, Татьяна С; Дуфинец, Василий А; Замкевич, Виктория Б

2016-01-01

Harmful alcohol consumption constitutes a significant cause of the global burden of disease, causing more than 200 different diseases, 5.9% of all deaths worldwide, causing substantial medical and social costs, major economic loss, slowing progress towards the strategic goals of human development. to substantiate approaches to the formation of a national strategy to combat the harmful use of alcohol in Ukraine based on the analysis of the prevalence of alcohol consumption and related health and social problems and international experience and recommendations of WHO. The study was based on analysis of the extent and patterns of alcohol consumption in Ukraine, levels, structure and dynamics of morbidity and mortality from diseases associated with alcohol abuse; investigation of preventive activities in primary healthcare, the existing problems and doctors' needs for prevention alcohol abuse, national and international experience on this problem.This work usesbibliosemantic, medical, statistical, sociological, epidemiological methods. The information base are: European Health for All Database (HFA-DB)for 2000-2012,Center of Medical Statistics, Ministry of Health of Ukraine for 2000-2015, questionnaire survey of physicians in primary care, strategic and policy documents of WHO, WHO Regional Office for Europe. In Ukraine, as in most countries in the WHO European Region prevalence of alcohol is high. In the ranking of the WHO European Region Ukraine ranks fifth in alcohol consumption per capita. The structure of consumption of alcoholic drinks is dominated by strong spirits (48%). There has been a negative trend for this indicator from 5.4 liters in 2002 to 15.6 liters in 2012.The dominant pattern of alcohol consumption is characterized by early onset of alcohol consumption, significant frequency, large doses, mostly strong alcohol beverages, with significant share of low-quality alcohol. This factor contributes to high levels of morbidity. A total of546.3 thousandpeople

The alcohol harm paradox: using a national survey to explore how alcohol may disproportionately impact health in deprived individuals.

PubMed

Bellis, Mark A; Hughes, Karen; Nicholls, James; Sheron, Nick; Gilmore, Ian; Jones, Lisa

2016-02-18

Internationally, studies show that similar levels of alcohol consumption in deprived communities (vs. more affluent) result in higher levels of alcohol-related ill health. Hypotheses to explain this alcohol harm paradox include deprived drinkers: suffering greater combined health challenges (e.g. smoking, obesity) which exacerbate effects of alcohol harms; exhibiting more harmful consumption patterns (e.g. bingeing); having a history of more harmful consumption; and disproportionately under-reporting consumption. We use a bespoke national survey to assess each of these hypotheses. A national telephone survey designed to test this alcohol harm paradox was undertaken (May 2013 to April 2014) with English adults (n = 6015). Deprivation was assigned by area of residence. Questions examined factors including: current and historic drinking patterns; combined health challenges (smoking, diet, exercise and body mass); and under-reported consumption (enhanced questioning on atypical/special occasion drinking). For each factor, analyses examined differences between deprived and more affluent individuals controlled for total alcohol consumption. Independent of total consumption, deprived drinkers were more likely to smoke, be overweight and report poor diet and exercise. Consequently, deprived increased risk drinkers (male >168-400 g, female >112-280 g alcohol/week) were >10 times more likely than non-deprived counterparts to drink in a behavioural syndrome combining smoking, excess weight and poor diet/exercise. Differences by deprivation were significant but less marked in higher risk drinkers (male >400 g, female >280 g alcohol/week). Current binge drinking was associated with deprivation independently of total consumption and a history of bingeing was also associated with deprivation in lower and increased risk drinkers. Deprived increased/higher drinkers are more likely than affluent counterparts to consume alcohol as part of a suite of health challenging behaviours

Alcohol industry corporate social responsibility initiatives and harmful drinking: a systematic review.

PubMed

Mialon, Melissa; McCambridge, Jim

2018-04-25

There is growing awareness of the detrimental effects of alcohol industry commercial activities, and concern about possible adverse impacts of its corporate social responsibility (CSR) initiatives, on public health. The aims of this systematic review were to summarize and examine what is known about CSR initiatives undertaken by alcohol industry actors in respect of harmful drinking globally. We searched for peer-reviewed studies published since 1980 of alcohol industry CSR initiatives in seven electronic databases. The basic search strategy was organized around the three constructs of 'alcohol', 'industry' and 'corporate social responsibility'. We performed the searches on 21 July 2017. Data from included studies were analyzed inductively, according to the extent to which they addressed specified research objectives. A total of 21 studies were included. We identified five types of CSR initiatives relevant to the reduction of harmful drinking: alcohol information and education provision; drink driving prevention; research involvement; policy involvement and the creation of social aspects organizations. Individual companies appear to undertake different CSR initiatives than do industry-funded social aspects organizations. There is no robust evidence that alcohol industry CSR initiatives reduce harmful drinking. There is good evidence, however, that CSR initiatives are used to influence the framing of the nature of alcohol-related issues in line with industry interests. This research literature is at an early stage of development. Alcohol policy measures to reduce harmful drinking are needed, and the alcohol industry CSR initiatives studied so far do not contribute to the attainment of this goal.

The Association Between Secondhand Harms From Alcohol and Mental Health Outcomes Among Postsecondary Students.

PubMed

Thompson, Kara; Davis-MacNevin, Parnell; Teehan, Michael; Stewart, Sherry

2017-01-01

There is a paucity of research on the prevalence and consequences of secondhand harms from alcohol. The current study (a) investigated whether secondhand harms can be clustered into latent factors that reflect distinct but related types of harms and (b) examined the associations between experiencing secondhand harms and mental health outcomes, including anxiety, depression, and subjective mental well-being, among first-year Canadian postsecondary students. The moderating effect of living arrangement (i.e., living on campus or not) on the associations was also tested. The sample included 1,885 first-year undergraduate students (49.8% female; mean age = 18.31 years) from three Canadian universities. Exploratory and confirmatory factor analyses were used to determine the factor structure of the harms measure. Path analysis was used to assess the association between harms and mental health outcomes. Models accounted for age, sex, and frequency of heavy drinking. Seventy-one percent of the sample reported experiencing at least one type of secondhand harm. The harms examined clustered into two distinct but related factors: strains (e.g., interrupted sleep) and threats (e.g., being harassed or insulted). Both threats and strains were associated with higher levels of anxiety and depression and poorer subjective well-being. Associations were stronger for threats and did not differ by living arrangement. Experiencing secondhand harms from alcohol, particularly threats, may have negative implications for student mental health over and above students' own drinking. Programs and policies on university campuses targeting both alcohol use and mental health should consider how to reduce both the prevalence and impact of secondhand harms from alcohol on students.

Indicators of alcohol consumption and attributable harm for monitoring and surveillance in European Union countries.

PubMed

Rehm, Jürgen; Scafato, Emanuele

2011-03-01

Alcohol is a major risk factor for burden of disease and injury in Europe, and contributes markedly to between region differences in life expectancy. Monitoring and surveillance systems have shown to be a key factor in implementing effective policies. The aim of this paper is to propose a system of indicators for alcohol consumption and attributable harm which can be used as an over-time monitoring tool at the country level as well as for comparisons between countries. A systematic research in electronic data bases was conducted but most of the information was derived from ongoing international efforts to establish alcohol monitoring and surveillance systems. European Union. Countries. Exposure to alcohol, mortality, burden of disease. Adult per capita alcohol consumption, prevalence of abstention, and frequency of drinking more than 60 g pure alcohol in one occasion are proposed as a minimal set of alcohol exposure indicators, which can quickly be implemented in all EU countries. With respect to health harm indicators, the best minimal choice which can be implemented quickly in all countries of the EU would be alcohol-attributable years of life lost due to premature death. In addition, country specific indicators could be added, when alcohol places specific burden on specific diseases. National and European Union-wide monitoring systems for alcohol exposure and attributable harm to inform public health-related policy decisions could be implemented easily. The establishement of such monitoring systems would follow the recent World Assembly resolution for a global strategy to reduce alcohol-related harm. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Establishments licensed to serve alcohol and their contribution to police-recorded crime in Australia: further opportunities for harm reduction.

PubMed

Rowe, Shelley C; Wiggers, John H; Wolfenden, Luke; Francis, J Lynn

2010-11-01

Although strategies exist to minimize alcohol-related harms associated with establishments licensed to serve alcohol, such establishments are associated with a disproportionate level of harm. To date, understanding the association between such establishments and alcohol-related harms, and hence the opportunities for reducing harm, has been limited by inadequate information regarding incidents of alcohol-related crime. To address this deficiency, this study was undertaken to describe the association between such establishments and incidents of crime using enhanced police-recorded, alcohol-related crime intelligence. A descriptive analysis was undertaken of intoxicated people who had last consumed alcohol in establishments licensed to serve alcohol (841 bars, 551 licensed social clubs, 11 nightclubs, and 18 other locations) preceding their involvement in police-recorded incidents of violence, disorder, or motor vehicle crashes. The study area encompassed 21 nonmetropolitan police commands in the state of New South Wales, Australia. Among intoxicated persons involved in incidents of violence, disorder, or motor vehicle crashes, the risk of being recorded as having last consumed alcohol in a bar or nightclub before the incident was at least twice that of licensed social clubs and other establishments. Approximately 20% of establishments accounted for 80% of intoxicated persons involved in such incidents, and 6% of establishments were in the top 20% of establishments for all three offense types. The disproportionate burden of alcohol-related crime associated with establishments licensed to serve alcohol may be reduced if harm-reduction strategies address the specific risks posed by bars and nightclubs, and individual high-risk establishments.

Explaining trends in alcohol-related harms in Scotland 1991-2011 (II): policy, social norms, the alcohol market, clinical changes and a synthesis.

PubMed

McCartney, G; Bouttell, J; Craig, N; Craig, P; Graham, L; Lakha, F; Lewsey, J; McAdams, R; MacPherson, M; Minton, J; Parkinson, J; Robinson, M; Shipton, D; Taulbut, M; Walsh, D; Beeston, C

2016-03-01

To provide a basis for evaluating post-2007 alcohol policy in Scotland, this paper tests the extent to which pre-2007 policy, the alcohol market, culture or clinical changes might explain differences in the magnitude and trends in alcohol-related mortality outcomes in Scotland compared to England & Wales (E&W). Rapid literature reviews, descriptive analysis of routine data and narrative synthesis. We assessed the impact of pre-2007 Scottish policy and policy in the comparison areas in relation to the literature on effective alcohol policy. Rapid literature reviews were conducted to assess cultural changes and the potential role of substitution effects between alcohol and illicit drugs. The availability of alcohol was assessed by examining the trends in the number of alcohol outlets over time. The impact of clinical changes was assessed in consultation with key informants. The impact of all the identified factors were then summarised and synthesised narratively. The companion paper showed that part of the rise and fall in alcohol-related mortality in Scotland, and part of the differing trend to E&W, were predicted by a model linking income trends and alcohol-related mortality. Lagged effects from historical deindustrialisation and socio-economic changes exposures also remain plausible from the available data. This paper shows that policy differences or changes prior to 2007 are unlikely to have been important in explaining the trends. There is some evidence that aspects of alcohol culture in Scotland may be different (more concentrated and home drinking) but it seems unlikely that this has been an important driver of the trends or the differences with E&W other than through interaction with changing incomes and lagged socio-economic effects. Substitution effects with illicit drugs and clinical changes are unlikely to have substantially changed alcohol-related harms: however, the increase in alcohol availability across the UK is likely to partly explain the rise in

Socioeconomic status as an effect modifier of alcohol consumption and harm: analysis of linked cohort data.

PubMed

Katikireddi, Srinivasa Vittal; Whitley, Elise; Lewsey, Jim; Gray, Linsay; Leyland, Alastair H

2017-06-01

Alcohol-related mortality and morbidity are high in socioeconomically disadvantaged populations compared with individuals from advantaged areas. It is unclear if this increased harm reflects differences in alcohol consumption between these socioeconomic groups, reverse causation (ie, downward social selection for high-risk drinkers), or a greater risk of harm in individuals of low socioeconomic status compared with those of higher status after similar consumption. We aimed to investigate whether the harmful effects of alcohol differ by socioeconomic status, accounting for alcohol consumption and other health-related factors. The Scottish Health Surveys are record-linked cross-sectional surveys representative of the adult population of Scotland. We obtained baseline demographics and data for alcohol consumption (units per week and binge drinking) from Scottish Health Surveys done in 1995, 1998, 2003, 2008, 2009, 2010, 2011, and 2012. We matched these data to records for deaths, admissions, and prescriptions. The primary outcome was alcohol-attributable admission or death. The relation between alcohol-attributable harm and socioeconomic status was investigated for four measures (education level, social class, household income, and area-based deprivation) using Cox proportional hazards models. The potential for alcohol consumption and other risk factors (including smoking and body-mass index [BMI]) mediating social patterning was explored in separate regression models. Reverse causation was tested by comparing change in area deprivation over time. 50 236 participants (21 777 men and 28 459 women) were included in the analytical sample, with 429 986 person-years of follow-up. Low socioeconomic status was associated consistently with strikingly raised alcohol-attributable harms, including after adjustment for weekly consumption, binge drinking, BMI, and smoking. Evidence was noted of effect modification; for example, relative to light drinkers living in

How do public health policies tackle alcohol-related harm: a review of 12 developed countries.

PubMed

Crombie, Iain K; Irvine, Linda; Elliott, Lawrence; Wallace, Hilary

2007-01-01

To identify how current public health policies of 12 developed countries assess alcohol-related problems, the goals and targets that are set and the strategic directives proposed. Policy documents on alcohol and on general public heath were obtained through repeated searches of government websites. Documents were reviewed by two independent observers. All the countries studied state that alcohol causes substantial harm to individual health and family well-being, increases crime and social disruption, and results in economic loss through lost productivity. All are concerned about consumption of alcohol by young adults and by heavy and problem drinkers. Few aim to reduce total consumption. Only five of the countries set specific targets for changes in drinking behaviour. Countries vary in their commitment to intervene, particularly on taxation, drink-driving, the drinking environment and for high-risk groups. Australia and New Zealand stand out as having coordinated intervention programmes in most areas. Policies differ markedly in their organization, the goals and targets that are set, the strategic approaches proposed and areas identified for intervention. Most countries could improve their policies by following the recommendations in the World Heath Organization's European Alcohol Action Plan.

Harmful Interactions: Mixing Alcohol with Medicines

MedlinePlus

... Interactions Print version Harmful Interactions Mixing Alcohol With Medicines You’ve probably seen this warning on medicines ... falls and serious injuries, especially among older people. Medicines may have many ingredients Some medications—including many ...

Evidence of reducing ethanol content in beverages to reduce harmful use of alcohol.

PubMed

Rehm, Jürgen; Lachenmeier, Dirk W; Llopis, Eva Jané; Imtiaz, Sameer; Anderson, Peter

2016-09-01

Alcohol use is a major contributor to the burden of gastrointestinal disease. WHO's global strategy to reduce harmful use of alcohol encourages the alcohol industry to contribute to this effort. However, evidence that alcohol producers have contributed to the reduction of harmful use of alcohol is scarce. Reduction of alcoholic strength of beer has been proposed and initiated as one potential way forward. We examine the evidence base for the success of such an initiative. Direct evidence from natural experiments or other controlled studies is scarce. We identified three potential mechanisms for how reduction of alcoholic strength could affect harmful use of alcohol: by current drinkers replacing standard alcoholic beverages with similar beverages of lower alcoholic strength, without increasing the quantity of liquid consumed; by current drinkers switching to no alcohol alternatives for part of the time, thereby reducing their average amount of ethanol consumed; and by initiating alcohol use in current abstainers. The first mechanism seems to be the most promising to potentially reduce harm, but much will depend on actual implementation, and only an independent assessment will be able to identify effects on harmful drinking. The potential of alcoholic strength reduction is independent of initiation by law or by self-initiative of the industry. Copyright © 2016 Elsevier Ltd. All rights reserved.

Measuring costs of alcohol harm to others: a review of the literature.

PubMed

Navarro, Héctor José; Doran, Christopher M; Shakeshaft, Anthony P

2011-04-01

People other than the drinker experience harmful consequences from alcohol misuse, accounting for part of the economic burden to society. Little has been done on costing harm to others. A literature review was undertaken of various databases, government publications, dissertations, conference papers and reference materials. Publications were included for analysis if they reported costs on alcohol harm to others. Methodological adequacy of costing studies was assessed using a checklist modified from the Drummond 10-point checklist. In total, 25 publications including costs on alcohol harm to others were reviewed. Fetal alcohol syndrome (FAS) was the harm to others most frequently cost. The cost-of-illness (COI) framework was used in 24 of the publications, while 1 employed a cost-benefit analysis (CBA) serving as starting point for further studies estimating intangible costs (e.g. victim's quality-of-life (QoL) loss). Indirect costs (e.g. victim's lost productivity) were quantified most frequently with the human capital approach. The majority of publications critically assessed on costing received an average quality score (17/25). Few studies have reported costs on the magnitude from harm to people other than the drinker, therefore the overall economic burden of risky alcohol consumption across countries is underestimated. This review may be considered a starting point for future research on costing alcohol harm to others. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Effect of alcohol dose on deliberate self-harm in men and women.

PubMed

Berman, Mitchell E; Fanning, Jennifer R; Guillot, Casey R; Marsic, Angelika; Bullock, Joshua; Nadorff, Michael R; McCloskey, Michael S

2017-09-01

Nonexperimental survey and field research support the notion that alcohol use may be associated with deliberate self-harm (DSH) across the spectrum of lethality, from nonsuicidal self-injury (NSSI) through suicide. Nonexperimental studies, however, provide limited information about potential causal relationships between alcohol consumption and DSH. Two previous experiments showed that a relatively high-dose of alcohol increases the likelihood of engaging in DSH in men, with DSH defined by the self-administration of a "painful" shock (the self-aggression paradigm [SAP]; Berman & Walley, 2003; McCloskey & Berman, 2003). In this study, we examined whether (a) lower doses of alcohol also elicit DSH, (b) this effect occurs for women as well as men, and (c) individual differences in past nonsuicidal self-injury (NSSI) moderate alcohol's effects on DSH. Nonalcohol dependent men and women (N = 210) were assigned either to .00%, .05%, .075%, or .100% blood alcohol concentration (BAC) drink conditions and completed a self-rating scale of NSSI (the Deliberate Self-Harm Inventory [DSHI]; Gratz, 2001). As in previous SAP studies, DSH was operationalized by shock setting behavior during a competitive reaction time (RT) game. Overall, a greater proportion of participants in the .075% and .100% (but not .050%) alcohol conditions self-selected a "painful" shock to administer compared to participants in the placebo condition. NSSI predicted self-administration of painful shocks, but did not moderate the alcohol effect. Results provide experimental evidence to support the notion that interventions for self-harm should include processes to monitor and limit alcohol intake. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Drinking and displacement: a systematic review of the influence of forced displacement on harmful alcohol use.

PubMed

Weaver, Heather; Roberts, Bayard

2010-11-01

This paper systematically reviews evidence about factors associated with harmful alcohol use amongst forcibly displaced persons, including refugees and internally displaced persons. Bibliographic and humanitarian-related databases were searched. The number of quantitative and qualitative studies that were screened and reviewed was 1108. Only 10 studies met inclusion criteria. Risk factors identified included gender, age, exposure to traumatic events and resulting posttraumatic stress disorder, prior alcohol consumption-related problems, year of immigration, location of residence, social relations, and postmigration trauma and stress. The evidence base was extremely weak, and there is a need to improve the quantity and quality of research about harmful alcohol use by forcibly displaced persons.

Alcohol harm reduction advertisements: a content analysis of topic, objective, emotional tone, execution and target audience.

PubMed

Dunstone, Kimberley; Brennan, Emily; Slater, Michael D; Dixon, Helen G; Durkin, Sarah J; Pettigrew, Simone; Wakefield, Melanie A

2017-04-11

Public health mass media campaigns may contribute to reducing the health and social burden attributed to alcohol consumption, but little is known about which advertising characteristics have been used, or have been effective, in alcohol harm reduction campaigns to date. As a first step towards encouraging further research to identify the impact of various advertising characteristics, this study aimed to systematically identify and examine the content of alcohol harm reduction advertisements (ads). Ads were identified through an exhaustive internet search of Google, YouTube, Vimeo, and relevant government and health agency websites. Eligible ads were: English language, produced between 2006 and 2014, not primarily focused on drink-driving or alcohol in pregnancy, and not alcohol industry funded. Systematic content analysis of all ads was performed; each ad was double-coded. In total, 110 individual ads from 72 different alcohol harm reduction campaigns were identified, with the main source countries being Australia (40%) and the United Kingdom (26%). The dominant topic for 52% of ads was short-term harms, while 10% addressed long-term harms, 18% addressed underage drinking, 17% communicated a how-to-change message, and 3% advocated for policy change. The behavioural objective of most ads was to motivate audiences to reduce their alcohol consumption (38%) or to behave responsibly and/or not get drunk when drinking (33%). Only 10% of all ads mentioned low-risk drinking guidelines. Eighty-seven percent of ads used a dramatisation execution style and 74% had a negative emotional tone. Ninety percent of ads contained messages or content that appeared to target adults, and 36% specifically targeted young adults. Some message attributes have been employed more frequently than others, suggesting several promising avenues for future audience or population-based research to compare the relative effectiveness of different characteristics of alcohol harm reduction ads. Given

Individual and household-level socioeconomic position is associated with harmful alcohol consumption behaviours among adults.

PubMed

Giskes, Katrina; Turrell, Gavin; Bentley, Rebecca; Kavanagh, Anne

2011-06-01

To examine associations between individual-, household- and neighbourhood-level socioeconomic position (SEP) and harmful alcohol consumption. Adults aged 18-76 residing in 50 neighbourhoods in Melbourne completed a postal questionnaire (n= 2349, 58.7% response rate). Alcohol-related behaviours were classified by risk of short- and long-term harm. Individual-, household- and neighbourhood-level SEP were ascertained by education, household income and proportion of low-income households, respectively. The association were examined by multi-level logistic regression. Participants lower education or household income were less likely to consume alcohol frequently compared to their more-advantaged counterparts. Lower-educated men were more likely to be at risk of short-term harm [OR 1.75 (1.23 - 2.48)]. Low-income women were less likely to be at risk of short-term harm [OR 0.44 (0.23 - 0.81)]. Neighbourhood disadvantage was not associated with alcohol consumption. Men and women from socioeconomically advantaged backgrounds were more frequent consumers of alcohol, whereas their disadvantaged counterparts drank less frequently but in greater quantities on each drinking occasion. Socioeconomic disadvantage at the individual and household levels may be an important determinant of alcohol consumption among Australian adults. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

Impacts of changes to trading hours of liquor licences on alcohol-related harm: a systematic review 2005-2015.

PubMed

Wilkinson, Claire; Livingston, Michael; Room, Robin

2016-09-30

Legislative limits on trading hours for licensed premises have a long history in Australia as a key policy approach to managing alcohol-related problems. In recent years, following substantial extensions to permitted hours of sale, there has been renewed attention to policies aimed at reducing late-night trading hours. Restrictions on on-premise alcohol sales have been implemented in Australia after 3.30 am in Newcastle, and after 3 am in Kings Cross and the Sydney central business district in New South Wales. In July 2016, similar restrictions were introduced state-wide after 2 am, or 3 am in 'safe night precincts', in Queensland. Similar policy changes have occurred internationally (e.g. in the UK and the Nordic countries) and there is a growing body of research examining the impacts of trading hour policies on alcohol-related harm. Although there has been a series of reviews of the research in this area, the most recent is now 5 years old and limited to studies published before March 2008. Objective and importance of study: To examine recent (2005-2015) research about the impact of changing the hours of sale of alcohol on alcohol-related harms. The ongoing public discussion about trading hours policy in Australia can benefit from an up-to-date and comprehensive review of the research. Systematic review of the literature that considered the impact of policies that extended or restricted trading hours. MEDLINE, Core Collection, PsychINFO and EMBASE databases were searched from January 2005 to December 2015. Articles were summarised descriptively, focusing on studies conducted in Australia and published since the previous reviews. The search identified 21 studies, including seven from Australia. There were 14 studies published since previous reviews. A series of robust, well-designed Australian studies demonstrate that reducing the hours during which on-premise alcohol outlets can sell alcohol late at night can substantially reduce rates of violence. The Australian

A multi‐faceted intervention to reduce alcohol misuse and harm amongst sports people in Ireland: A controlled trial

PubMed Central

O'Farrell, Anne; Kenny, Susan; Eldin, Nazih; Wiggers, John; Wolfenden, Luke; Allwright, Shane

2017-01-01

Abstract Introduction and Aims Alcohol misuse and harm are more prevalent amongst sports people than non‐sports people. Few studies have trialled interventions to address alcohol misuse for this group. The study aimed to test the effectiveness of an intervention to reduce alcohol misuse and related harms amongst amateur sports people in Ireland. Design and Methods A controlled trial was conducted in two counties in Ireland. A random selection of sports clubs in one county received a 4 month multi‐faceted intervention. All sports clubs in a non‐adjacent county acted as control sites. Consumption of more than 21 units of alcohol per week and six or more standard drinks on a single occasion at least once per week was the primary study outcome. Alcohol Use Disorders Identification Test scores and number of alcohol‐related harms were also reported. Outcomes were assessed for cross‐sectional samples of players at pre‐intervention and post‐intervention and paired samples of players who completed surveys at both times. Generalised linear mixed model analysis was used. Results There was no evidence of effect for the primary outcomes or Alcohol Use Disorders Identification Test scores. There was a statistically significant difference in the median number of alcohol‐related harms reported by intervention group players compared with control group players at post‐intervention for the paired samples [intervention: 0; control: 3; incident rate ratio 0.56 (0.37, 0.84); P = 0.005]. Discussion and Conclusions Intervention in community sports clubs may be effective in reducing the number of alcohol‐related harms. Low levels of intervention participation and inadequate intervention dose are possible reasons for lack of a broader intervention effect. [O'Farrell A, Kingsland M, Kenny S, Eldin N, Wiggers J, Wolfenden L, Allwright S. A multi‐faceted intervention to reduce alcohol misuse and harm amongst sports people in Ireland: A controlled trial. Drug Alcohol Rev

The enigma of 'harmful' alcohol consumption: evidence from a mixed methods study involving female drinkers in Scotland.

PubMed

Gill, Jan S; Rush, Robert; Black, Heather; O'May, Fiona P; Chick, Jonathan; Rees, Cheryl; McPake, Barbara

2016-01-01

An appreciation of the drinking patterns of population subgroups may usefully inform tailored interventions. For this purpose, research has highlighted a need to better describe the drinking behaviour of UK women. This study aims to characterise the purchasing and consumption behaviour of female heavy, harmed, drinkers in contact with Scottish health services in two cities and to explore the factors that influence the link to harm. Mixed methods study involving cross-sectional survey questionnaires and one-to-one interviews (5). The questionnaires documented (1) demographic data (including derived deprivation score), last week's (or 'typical' weekly) consumption (type, brand, volume, price, place of purchase), self-reported illnesses, and (2) Alcohol-Related Problem Questionnaire score. A total of 181 patients with serious health problems linked to alcohol were recruited within National Health Service (NHS) hospital clinics (in- and outpatient settings), in two Scottish cities during 2012. Median consumption was 157.6 UK units for the recorded week, with almost exclusive purchase from 'off-sale' retail outlets. Preferred drinks were white cider, vodka and white wine. Increasing problems was positively associated with drinking more in the week, being younger and belonging to Glasgow. For Scottish women, the current definition of 'harmful' consumption likely captures a fourfold variation in alcohol intake, with gender differences less apparent. While current alcohol-related harm is positively associated with dose and being younger, there is clear evidence of an influence of the less tangible 'Glasgow effect'. Future harm concerns are warranted by data relating to pattern, alcohol dose and cigarette use. © Royal Society for Public Health 2015.

Is local alcohol outlet density related to alcohol-related morbidity and mortality in Scottish cities?

PubMed Central

Richardson, E.A.; Hill, S.E.; Mitchell, R.; Pearce, J.; Shortt, N.K.

2015-01-01

Alcohol consumption may be influenced by the local alcohol retailing environment. This study is the first to examine neighbourhood alcohol outlet availability (on- and off-sales outlets) and alcohol-related health outcomes in Scotland. Alcohol-related hospitalisations and deaths were significantly higher in neighbourhoods with higher outlet densities, and off-sales outlets were more important than on-sales outlets. The relationships held for most age groups, including those under the legal minimum drinking age, although were not significant for the youngest legal drinkers (18–25 years). Alcohol-related deaths and hospitalisations were higher in more income-deprived neighbourhoods, and the gradient in deaths (but not hospitalisations) was marginally larger in neighbourhoods with higher off-sales outlet densities. Efforts to reduce alcohol-related harm should consider the potentially important role of the alcohol retail environment. PMID:25840352

An investigation into the role of alcohol in self-harm in rural Sri Lanka: a protocol for a multimethod, qualitative study

PubMed Central

Sørensen, Jane Brandt; Rheinländer, Thilde; Sørensen, Birgitte Refslund; Pearson, Melissa; Agampodi, Thilini; Siribaddana, Sisira; Konradsen, Flemming

2014-01-01

Introduction Sri Lanka has one of the highest suicide and self-harm rates in the world and although alcohol has been found to be a risk factor for self-harm in Sri Lanka, we know little about the connection between the two. This paper comprises a protocol for a qualitative study investigating alcohol's role in self-harm in rural Sri Lanka at three levels: the individual, community and policy level. The analysis will bring new understanding of the link between alcohol and self-harm in Sri Lanka, drawing on structural, cultural and social concepts. It will equip researchers, health systems and policy makers with vital information for developing strategies to address alcohol-related problems as they relate to self-harm. Methods and analysis To capture the complexity of the link between alcohol and self-harm in the Anuradhapura district in the North Central Province in Sri Lanka, qualitative methods will be utilised. Specifically, the data will consist of serial narrative life-story interviews with up to 20 individuals who have non-fatally self-harmed and where alcohol directly or indirectly was involved in the incidence as well as with their significant others; observations in communities and families; six focus group discussions with community members; and key-informant interviews with 15–25 stakeholders who have a stake in alcohol distribution, marketing, policies, prevention and treatment as they relate to self-harm. Ethics and dissemination The study has received ethical approval from the Ethical Review Committee of the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka. A sensitive data collection technique will be used and ethical issues will be considered throughout the study. Results The results will be disseminated in scientific peer-reviewed articles in collaboration with Sri Lankan and other international research partners. PMID:25293385

Is local alcohol outlet density related to alcohol-related morbidity and mortality in Scottish cities?

PubMed

Richardson, E A; Hill, S E; Mitchell, R; Pearce, J; Shortt, N K

2015-05-01

Alcohol consumption may be influenced by the local alcohol retailing environment. This study is the first to examine neighbourhood alcohol outlet availability (on- and off-sales outlets) and alcohol-related health outcomes in Scotland. Alcohol-related hospitalisations and deaths were significantly higher in neighbourhoods with higher outlet densities, and off-sales outlets were more important than on-sales outlets. The relationships held for most age groups, including those under the legal minimum drinking age, although were not significant for the youngest legal drinkers (18-25 years). Alcohol-related deaths and hospitalisations were higher in more income-deprived neighbourhoods, and the gradient in deaths (but not hospitalisations) was marginally larger in neighbourhoods with higher off-sales outlet densities. Efforts to reduce alcohol-related harm should consider the potentially important role of the alcohol retail environment. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Examination of associations between early life victimisation and alcohol's harm from others.

PubMed

Kaplan, Lauren M; Greenfield, Thomas K; Karriker-Jaffe, Katherine J

2018-03-01

Study aims were to examine: (i) how physical and sexual victimisation in early life are associated with alcohol's harm from others; and (ii) whether respondents' current drinking is a mediator of the association between early life victimisation and alcohol's harm from others among men and women. Data were from national computer-assisted telephone interviews, using the landline sample (3335 men and 3520 women ages ≥18) from the 2010 US National Alcohol Survey. Harms from someone else's drinking included family/marital problems, financial troubles, assault and vandalism in the past 12 months. Victimisation was measured with severe physical abuse or sexual assault before age 18. Severe physical or sexual victimisation before age 18 was reported by 3.4% of men and 8.1% of women. Significantly more men (5.2%) than women (2.4%) reported assault by other drinkers, and significantly more women reported family/marital (5.3%) and financial problems (2.8%) than did men (2.6 and 1% respectively). Severe early life victimisation was robustly associated with a greater likelihood of experiencing past-year harms from other drinkers for both men and women. Men's drinking partially mediated associations between early life victimisation and recent assaults and vandalism by other drinkers. Early life victimisation may increase risk of harms from someone else's drinking. Health services and interventions that screen for histories of victimisation may help decrease risk of later harms from others' drinking. Reductions in drinking among men with histories of victimisation also could help reduce their exposure to such harms. [Kaplan LM, Greenfield TK, Karriker-Jaffe KJ. Examination of associations between early life victimisation and alcohol's harm from others. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Prevalence and patterns of hazardous and harmful alcohol consumption assessed using the AUDIT among Bhutanese refugees in Nepal.

PubMed

Luitel, Nagendra P; Jordans, Mark; Murphy, Adrianna; Roberts, Bayard; McCambridge, Jim

2013-01-01

This study sought to ascertain the prevalence of hazardous and harmful alcohol consumption among Bhutanese refugees in Nepal and to identify predictors of elevated risk in order to better understand intervention need. Hazardous and harmful alcohol consumption was assessed using the Alcohol Use Disorder Identification Test (AUDIT) administered in a face-to-face interview in a census of two camps comprising ∼8000 refugees. Approximately 1/5 men and 1/14 women drank alcohol and prevalence of hazardous drinking among current drinkers was high and comparable to that seen in Western countries with longstanding alcohol cultures. Harmful drinking was particularly associated with the use of other substances including tobacco. Assessment of the alcohol-related needs of Bhutanese refugees has permitted the design of interventions. This study adds to the small international literature on substance use in forced migration populations, about which there is growing concern.

Use of fake identification to purchase alcohol amongst 15-16 year olds: a cross-sectional survey examining alcohol access, consumption and harm.

PubMed

Morleo, Michela; Cook, Penny A; Bellis, Mark A; Smallthwaite, Linda

2010-06-22

Despite legislation and enforcement activities to prevent underage access to alcohol, underage individuals continue to be able to access alcohol and to do so at levels which put them at significant risk of alcohol-related harm. An opportunistic survey of 15-16 year olds (n = 9,833) across North West England was used to examine alcohol consumption, methods of access and related harms experienced (such as regretted sex). Associations between these were analysed using chi square and logistic regression techniques. Over a quarter (28.3%) of 15-16 year old participants who drank reported having bought their own alcohol. One seventh (14.9%) of these owned at least one form of fake identification for which by far the most common purchase method was online. Logistic regression analyses showed that those who owned fake identification were significantly more likely to be male (AOR = 2.0; 95% CI = 1.7-2.5; P < 0.001) and to receive a higher personal weekly income (comparing those who received > pound30 with those who received < or = pound10: AOR = 3.7; 95% CI = 2.9-4.9; P < 0.001). After taking into account differences in demographic characteristics and personal weekly income, ownership of fake identification was significantly associated with binge drinking (AOR = 3.5, 95% CI = 2.8-4.3; P < 0.001), frequent drinking (AOR = 3.0, 95% CI = 2.5-3.7; P < 0.001) and public drinking (AOR = 3.3, 95% CI = 2.5-4.1; P < 0.001) compared with those who did not own fake identification. Further, those who reported owning fake identification were significantly more likely to report experiencing a variety of alcohol-related harms such as regretted sex after drinking (chi square, all P < 0.001). Young people (aged 15-16 years) who have access to fake identification are at a particularly high risk of reporting hazardous alcohol consumption patterns and related harm. Owning fake identification should be considered a risk factor for involvement in risky drinking behaviours. Information on these

[Attitudes of alcoholics to addiction-related topics].

PubMed

Wetterling, T; Krömer-Olbrisch, T; Löw, R; Schneider, U

2001-11-01

In Germany the attitudes towards alcohol consumption and smoking are rather heterogeneous. Although it is well accepted that both behaviours are harmful and often lead to addiction, thus far the attitudes of alcoholics to addiction-related topics have not been evaluated. In this investigation 228 alcoholics were asked to complete a questionnaire of addiction-related topics. The attitudes were rather realistic, concerning the harmful effects of alcohol. The beliefs were only slightly influenced by personal involvement (e.g. divorce). Different opinions were given as to the riskiness of illegal drugs. The attitude towards the reasons of alcoholism are most important for therapeutical decisions. Only a third of the patients believed that they themselves were responsible for their addictive behaviour while nearly half accused socioeconomical factors. The curability of their alcoholism as well as their own competence to overcome alcoholism was estimated rather realistically by the patients. The results could not be generalized since the sample mainly consisted of alcoholics who themselves sought an alcohol-specific treatment service. Furthermore the data analysis shows that about 90 % of them regarded themselves as alcoholics. Future studies have to show whether these attitudes differ from those of the general population and from alcoholics not seeking-help.

An investigation into the role of alcohol in self-harm in rural Sri Lanka: a protocol for a multimethod, qualitative study.

PubMed

Sørensen, Jane Brandt; Rheinländer, Thilde; Sørensen, Birgitte Refslund; Pearson, Melissa; Agampodi, Thilini; Siribaddana, Sisira; Konradsen, Flemming

2014-10-07

Sri Lanka has one of the highest suicide and self-harm rates in the world and although alcohol has been found to be a risk factor for self-harm in Sri Lanka, we know little about the connection between the two. This paper comprises a protocol for a qualitative study investigating alcohol's role in self-harm in rural Sri Lanka at three levels: the individual, community and policy level. The analysis will bring new understanding of the link between alcohol and self-harm in Sri Lanka, drawing on structural, cultural and social concepts. It will equip researchers, health systems and policy makers with vital information for developing strategies to address alcohol-related problems as they relate to self-harm. To capture the complexity of the link between alcohol and self-harm in the Anuradhapura district in the North Central Province in Sri Lanka, qualitative methods will be utilised. Specifically, the data will consist of serial narrative life-story interviews with up to 20 individuals who have non-fatally self-harmed and where alcohol directly or indirectly was involved in the incidence as well as with their significant others; observations in communities and families; six focus group discussions with community members; and key-informant interviews with 15-25 stakeholders who have a stake in alcohol distribution, marketing, policies, prevention and treatment as they relate to self-harm. The study has received ethical approval from the Ethical Review Committee of the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka. A sensitive data collection technique will be used and ethical issues will be considered throughout the study. The results will be disseminated in scientific peer-reviewed articles in collaboration with Sri Lankan and other international research partners. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Alcohol-related crime in city entertainment precincts: Public perception and experience of alcohol-related crime and support for strategies to reduce such crime.

PubMed

Tindall, Jenny; Groombridge, Daniel; Wiggers, John; Gillham, Karen; Palmer, Darren; Clinton-McHarg, Tara; Lecathelinais, Christophe; Miller, Peter

2016-05-01

Bars, pubs and taverns in cities are often concentrated in entertainment precincts that are associated with higher rates of alcohol-related crime. This study assessed public perception and experiences of such crime in two city entertainment precincts, and support for alcohol-related crime reduction strategies. A cross-sectional household telephone survey in two Australian regions assessed: perception and experiences of crime; support for crime reduction strategies; and differences in such perceptions and support. Six hundred ninety-four people completed the survey (32%). Most agreed that alcohol was a problem in their entertainment precinct (90%) with violence the most common alcohol-related problem reported (97%). Almost all crime reduction strategies were supported by more than 50% of participants, including visitors to the entertainment precincts, with the latter being slightly less likely to support earlier closing and restrictions on premises density. Participants in one region were more likely to support earlier closing and lock-out times. Those at-risk of acute alcohol harm were less likely to support more restrictive policies. High levels of community concern and support for alcohol harm-reduction strategies, including restrictive strategies, provide policy makers with a basis for implementing evidence-based strategies to reduce such harms in city entertainment precincts. [Tindall J, Groombridge D, Wiggers J, Gillham K, Palmer D, Clinton-McHarg T, Lecathelinais C, Miller P. Alcohol-related crime in city entertainment precincts: Public perception and experience of alcohol-related crime and support for strategies to reduce such crime. Drug Alcohol Rev 2016;35:263-272]. © 2015 The Authors. Drug and Alcohol Review published by Wiley Publishing Asia Pty Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

'We lost because of his drunkenness': the social processes linking alcohol use to self-harm in the context of daily life stress in marriages and intimate relationships in rural Sri Lanka.

PubMed

Sørensen, Jane Brandt; Agampodi, Thilini; Sørensen, Birgitte Refslund; Siribaddana, Sisira; Konradsen, Flemming; Rheinländer, Thilde

2017-01-01

Harmful alcohol use has been found to cause detriment to the consumers and those around them. Research carried out in Sri Lanka has described the socioeconomic consequences to families owing to alcohol consumption. However, the social processes around alcohol use and how it could result in behaviour such as self-harm was unclear. With an outset in daily life stressors in marriages and intimate relationships we explored alcohol use in families with a recent case of self-harm. Qualitative data were collected for 11 months in 2014 and 2015 in the North Central and North Western provinces of Sri Lanka. Narrative life story interviews with 19 individuals who had self-harmed where alcohol was involved and 25 of their relatives were conducted. Ten focus group discussions were carried out in gender and age segregated groups. An inductive content analysis was carried out. Participants experienced two types of daily life stressors: non-alcohol-related stressors, such as violence and financial difficulties, and alcohol-related stressors. The alcohol-related stressors aggravated the non-alcohol-related daily life stressors within marriages and intimate relationships, which resulted in conflict between partners and subsequent self-harm. Women were disproportionately influenced by daily life stressors and were challenged in their ability to live up to gendered norms of marriage. Further, women were left responsible for their own and their husband's inappropriate behaviour. Self-harm appeared to be a possible avenue of expressing distress. Gendered alcohol and marriage norms provided men with acceptable excuses for their behaviour, whether it was alcohol consumption, conflicts or self-harm. This study found that participants experienced both alcohol-related and non-alcohol-related daily life stressors. These two categories of daily life stressors, gender inequalities and alcohol norms should be considered when planning alcohol and self-harm prevention in this setting. Life

Alcohol and public health in Africa: can we prevent alcohol-related harm from increasing?

PubMed

Ferreira-Borges, Carina; Dias, Sonia; Babor, Thomas; Esser, Marissa B; Parry, Charles D H

2015-09-01

According to the World Health Organization (WHO), the total amount of alcohol consumed in the African region is expected to increase due to the growth of new alcohol consumers, especially young people and women. With the changing alcohol environment, increases in the alcohol-attributable burden of disease are inevitable. To our knowledge, there has not been a comprehensive analysis of the factors that could be driving those increases. The objective of this study was to examine the evidence from peer reviewed literature regarding the factors that could be instrumental in this process, in order to inform strategic policy-related decisions. A narrative review was conducted using a thematic analysis approach. We searched papers published between January 2000 and July 2014 in PubMed, the WHO's Global Health Library and African Journals Online. Our analysis identified seven factors (demographics, rapid urbanization, economic development, increased availability, corporate targeting, weak policy infrastructure and trade agreements) which are potentially tied to changes in alcohol consumption in Africa. Driven largely by globalization, a potential convergence of these various factors is likely to be associated with continued growth in alcohol consumption and alcohol-related morbidity and mortality. To address the emerging risk factors associated with increased alcohol consumption, African governments need to take a more active role in protecting the public's health. In particular, important strategic shifts are needed to increase implementation of intersectoral strategies, community involvement in the policy dialogue, health services re-orientation and better regulation of the alcohol beverage industry. © 2015 Society for the Study of Addiction.

Qualitatively and quantitatively evaluating harm-reduction goal setting among chronically homeless individuals with alcohol dependence

PubMed Central

Collins, Susan E.; Grazioli, Véronique S.; Torres, Nicole I.; Taylor, Emily M.; Jones, Connor B.; Hoffman, Gail E.; Haelsig, Laura; Zhu, Mengdan D.; Hatsukami, Alyssa S.; Koker, Molly J.; Herndon, Patrick; Greenleaf, Shawna M.; Dean, Parker E.

2015-01-01

Most treatment programs for alcohol dependence have prioritized alcohol abstinence as the primary treatment goal. However, abstinence-based goals are not always considered desirable or attainable by more severely affected populations, such as chronically homeless people with alcohol dependence. Because these individuals comprise a multimorbid and high-utilizing population, they are in need of more focused research attention that elucidates their preferred treatment goals. The aim of this secondary study was therefore to qualitatively and quantitatively document participant-generated treatment goals. Participants were currently or formerly chronically homeless individuals (N=31) with alcohol dependence who participated in a pilot of extended-release naltrexone and harm-reduction counseling. Throughout the treatment period, study interventionists elicited participants’ goals and recorded them on an open-ended grid. In subsequent weeks, progress towards and achievement of goals was obtained via self-report and recorded by study interventionists. Conventional content analysis was performed to classify participant-generated treatment goals. Representation of the three top categories remained stable over the course of treatment. In the order of their frequency, they included drinking-related goals, quality-of-life goals and health-related goals. Within the category of drinking-related goals, participants consistently endorsed reducing drinking and alcohol-related consequences ahead of abstinence-based goals. Quantitative analyses indicated participants generated an increasing number of goals over the course of treatment. Proportions of goals achieved and progressed toward kept pace with this increase. Findings confirmed hypotheses that chronically homeless people with alcohol dependence can independently generate and achieve treatment goals toward alcohol harm reduction and quality-of-life improvement. PMID:25697724

Measuring the effectiveness of in-hospital and on-base Prevent Alcohol and Risk-related Trauma in Youth (P.A.R.T.Y.) programs on reducing alcohol related harms in naval trainees: P.A.R.T.Y. Defence study protocol.

PubMed

Watterson, Jason; Gabbe, Belinda; Dietze, Paul; Thompson, Jennifer; Oborn, Michael; Rosenfeld, Jeffrey V

2017-05-02

Reducing alcohol related harms in Australian Defence Force (ADF) trainees has been identified as a priority, but there are few evidence-based prevention programs available for the military setting. The study aims to test whether the P.A.R.T.Y. program delivered in-hospital or on-base, can reduce harmful alcohol consumption among ADF trainees. The study is a 3-arm randomized controlled trial, involving 953 Royal Australian Navy trainees from a single base. Trainees, aged 18 to 30 years, will be randomly assigned to the study arms: i. in-hospital P.A.R.T.Y.; ii. On-base P.A.R.T.Y.; and iii. All groups will receive the routine ADF annual alcohol awareness training. The primary outcome is the proportion of participants reporting an Alcohol Use Disorders Identification Test (AUDIT) score of 8 or above at 12 months' post-intervention. The secondary outcome is the number of alcohol related incidents reported to the Royal Australian Navy (RAN) in the 12 months' post-intervention. This is the first trial of the use of the P.A.R.T.Y. program in the military. If the proposed intervention proves efficacious, it may be a useful program in the early education of RAN trainees. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614001332617 , date of registration: 18/12/2014 'retrospectively registered'.

Harm reduction-a systematic review on effects of alcohol reduction on physical and mental symptoms.

PubMed

Charlet, Katrin; Heinz, Andreas

2017-09-01

Based on the knowledge that alcohol misuse causes a multitude of diseases and increased mortality, this systematic review examines whether a reduction of the individual alcohol consumption can contribute to a minimization of health risks within a harm reduction approach. In fact, the reviewed 63 studies indicate that interventions aiming at alcohol reduction (including total abstinence as one possible therapeutic aim) indeed resulted in or were associated with positive effects in harmful, hazardous or alcohol-dependent drinkers. Major benefits were observed for reducing alcohol-associated injuries, recovery of ventricular heart function in alcoholic cardiomyopathy, blood pressure lowering, normalization of biochemical parameter, body weight reduction, histological improvement in pre-cirrhotic alcohol-related liver disease and slowed progression of an already existing alcohol-attributable liver fibrosis. Furthermore, reduced withdrawal symptoms, prevalence of psychiatric episodes and duration of in-patient hospital days, improvement of anxiety and depression symptoms, self-confidence, physical and mental quality of life, fewer alcohol-related adverse consequences as well as lower psychosocial stress levels and better social functioning can result from reduced alcohol intake. The reviewed literature demonstrated remarkable socioeconomic cost benefits in areas such as the medical health-care system or workforce productivity. Individuals with heightened vulnerability further benefit significantly from alcohol reduction (e.g. hypertension, hepatitis C, psychiatric co-morbidities, pregnancy, but also among adolescents and young adults). Concluding, the reviewed studies strongly support and emphasize the importance and benefits of early initial screening for problematic alcohol use followed by brief and other interventions in first contact medical health-care facilities to reduce alcohol intake. © 2016 Society for the Study of Addiction.

Harmful Use of Alcohol: A Shadow over Sub-Saharan Africa in Need of Workable Solutions.

PubMed

Ferreira-Borges, Carina; Parry, Charles D H; Babor, Thomas F

2017-03-27

Alcohol consumption and alcohol-attributable burden of disease in Africa are expected to rise in the near future, yet. increasing alcohol-related harm receives little attention from policymakers and from the population in general. Even where new legislation is proposed it is rarely enacted into law. Being at the center of social and cultural activities in many countries, alcohol's negative role in society and contribution to countries' burden of disease are rarely questioned. After the momentum created by the adoption in 2010 of the WHO Global Strategy and the WHO Regional Strategy (for Africa) to Reduce the Harmful Use of Alcohol, and the WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases, in 2013, little seems to have been done to address the increasing use of alcohol, its associated burden and the new challenges that derive from the growing influence of the alcohol industry in Africa. In this review, we argue that to have a positive impact on the health of African populations, action addressing specific features of alcohol policy in the continent is needed, namely focusing on particularities linked to alcohol availability, like unrecorded and illicit production, outlet licensing, the expansion of formal production, marketing initiatives and taxation policies.

Crystalline methamphetamine use and methamphetamine-related harms in Australia.

PubMed

Degenhardt, Louisa; Sara, Grant; McKetin, Rebecca; Roxburgh, Amanda; Dobbins, Timothy; Farrell, Michael; Burns, Lucinda; Hall, Wayne D

2017-03-01

Concerns about crystal methamphetamine use and harm have increased in multiple countries. This paper describes how changes in the availability and use of crystal methamphetamine have impacted on methamphetamine-related harms in Australia. Data on methamphetamine use were obtained from population-level surveys, health service data and surveys of drug use among sentinel groups of ecstasy users and people who inject drugs. Data were obtained on seizures, arrests, clandestine laboratory detections, hospital separations, mental health unit admissions, drug telephone helpline calls and drug treatment episodes. Segmented linear regression models were fitted to identify changes in these series using log-transformed data where appropriate. The availability of crystal methamphetamine has increased as evidenced by increased laboratory detections, domestic seizures and purity of the seized drug. Population surveys do not report an increase in the number of people who used at least once in the past year. However, more users report using crystal methamphetamine rather than lower-purity powder methamphetamine and more regular use. Indicators of methamphetamine-related harms have increased in parallel with this change. Amphetamine-related helpline calls, drug treatment, arrests and hospital admissions for amphetamine disorders and psychosis all peaked in the mid-2000s, declined for several years and have increased steeply since 2010. The increased availability and use of crystal methamphetamine have been associated with increased regular use and harms. Treatment is required for those experiencing problems and the capacity of health services to provide care needs to be enhanced.[Degenhardt L, Sara G, Connor JP, McKetin R, Roxburgh A, Dobbins T, Farrell M, Burns L, Hall WD. Crystalline methamphetamine use and methamphetamine-related harms in Australia. Drug Alcohol Rev 2017;36:160-170]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Pricing of alcohol in Canada: A comparison of provincial policies and harm-reduction opportunities.

PubMed

Giesbrecht, Norman; Wettlaufer, Ashley; Thomas, Gerald; Stockwell, Tim; Thompson, Kara; April, Nicole; Asbridge, Mark; Cukier, Samantha; Mann, Robert; McAllister, Janet; Murie, Andrew; Pauley, Chris; Plamondon, Laurie; Vallance, Kate

2016-05-01

Alcohol pricing is an effective prevention policy. This paper compares the 10 Canadian provinces on three research-based alcohol pricing policies-minimum pricing, pricing by alcohol content and maintaining prices relative to inflation. The selection of these three policies was based on systematic reviews and seminal research papers. Provincial data for 2012 were obtained from Statistics Canada and relevant provincial ministries, subsequently sent to provincial authorities for verification, and then scored by team members. All provinces, except for Alberta, have minimum prices for at least one beverage type sold in off-premise outlets. All provinces, except for British Columbia and Quebec, have separate (and higher) minimum pricing for on-premise establishments. Regarding pricing on alcohol content, western and central provinces typically scored higher than provinces in Eastern Canada. Generally, minimum prices were lower than the recommended $1.50 per standard drink for off-premise outlets and $3.00 per standard drink in on-premise venues. Seven of 10 provinces scored 60% or higher compared to the ideal on indexing prices to inflation. Prices for a representative basket of alcohol products in Ontario and Quebec have lagged significantly behind inflation since 2006. While examples of evidence-based alcohol pricing policies can be found in every jurisdiction in Canada, significant inter-provincial variation leaves substantial unrealised potential for further reducing alcohol-related harm and costs. This comparative assessment of alcohol price policies provides clear indications of how individual provinces could adjust their pricing policies and practices to improve public health and safety. [Giesbrecht N, Wettlaufer A, Thomas G, Stockwell T, Thompson K, April N, Asbridge M, Cukier S, Mann R, McAllister J, Murie A, Pauley C, Plamondon L, Vallance K. Pricing of alcohol in Canada: A comparison of provincial policies and harm-reduction opportunities. Drug Alcohol Rev

Harmful Use of Alcohol: A Shadow over Sub-Saharan Africa in Need of Workable Solutions

PubMed Central

Ferreira-Borges, Carina; Parry, Charles D.H.; Babor, Thomas F.

2017-01-01

Alcohol consumption and alcohol-attributable burden of disease in Africa are expected to rise in the near future, yet. increasing alcohol-related harm receives little attention from policymakers and from the population in general. Even where new legislation is proposed it is rarely enacted into law. Being at the center of social and cultural activities in many countries, alcohol’s negative role in society and contribution to countries’ burden of disease are rarely questioned. After the momentum created by the adoption in 2010 of the WHO Global Strategy and the WHO Regional Strategy (for Africa) to Reduce the Harmful Use of Alcohol, and the WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases, in 2013, little seems to have been done to address the increasing use of alcohol, its associated burden and the new challenges that derive from the growing influence of the alcohol industry in Africa. In this review, we argue that to have a positive impact on the health of African populations, action addressing specific features of alcohol policy in the continent is needed, namely focusing on particularities linked to alcohol availability, like unrecorded and illicit production, outlet licensing, the expansion of formal production, marketing initiatives and taxation policies. PMID:28346373

Depressive symptoms and hazardous/harmful alcohol use are prevalent and correlate with stigma among TB-HIV patients in Lesotho.

PubMed

Hayes-Larson, E; Hirsch-Moverman, Y; Saito, S; Frederix, K; Pitt, B; Maama-Maime, L; Howard, A A

2017-11-01

Limited data exist on the prevalence and correlates, including stigma, of mental health conditions, including depressive symptoms and alcohol use, among patients co-infected with tuberculosis (TB) and the human immunodeficiency virus (HIV) in sub-Saharan Africa, despite their negative impact on health outcomes. To assess the prevalence and correlates of depressive symptoms and hazardous/harmful alcohol use among TB-HIV patients in the Start TB patients on ART and Retain on Treatment (START) study. START, a mixed-methods cluster-randomized trial, evaluated a combination intervention package vs. standard of care (SOC) to improve treatment outcomes in TB-HIV co-infected patients in Lesotho. Moderate/severe depressive symptoms and hazardous/harmful alcohol use were measured using baseline questionnaire data collected from April 2013 to March 2015. Demographic, psychosocial, and TB- and HIV-related knowledge and attitudes, including stigma, were assessed for association with both conditions using generalized linear mixed models. Among 371 participants, 29.8% reported moderate/severe depressive symptoms, and 24.7% reported hazardous/harmful alcohol use; 7% reported both. Depressive symptoms were significantly associated with less education, more difficulty understanding written medical information, non-disclosure of TB, greater TB stigma, and the SOC study arm. Hazardous/harmful alcohol use was significantly associated with male sex, as well as greater TB and external HIV stigma. Prevalence of depressive symptoms and hazardous/harmful alcohol use were high, suggesting a need for routine screening for, and treatment of, mental health disorders in TB-HIV patients.

City-based action to reduce harmful alcohol use: review of reviews.

PubMed

Anderson, Peter; Jané-Llopis, Eva; Hasan, Omer Syed Muhammad; Rehm, Jürgen

2018-01-01

Background: The World Health Organization global strategy on alcohol called for municipal policies to reduce the harmful use of alcohol. Yet, there is limited evidence that documents the impact of city-level alcohol policies. Methods: Review of reviews for all years to July 2017. Searches on OVID Medline, Healthstar, Embase, PsycINFO, AMED, Social Work Abstracts, CAB Abstracts, Mental Measurements Yearbook, Health and Psychosocial Instruments, International Pharmaceutical Abstracts, International Political Science Abstracts, NASW Clinical Register, and Epub Ahead of Print databases. All reviews that address adults, without language or date restrictions resulting from combining the terms ("review" or "literature review" or "review literature" or "data pooling" or "comparative study" or "systematic review" or "meta-analysis" or "pooled analysis"), and "alcohol", and "intervention" and ("municipal" or "city" or "community"). Results: Five relevant reviews were identified. Studies in the reviews were all from high income countries and focussed on the acute consequences of drinking, usually with one target intervention, commonly bars, media, or drink-driving. No studies in the reviews reported the impact of comprehensive city-based action. One community cluster randomized controlled trial in Australia, published after the reviews, failed to find convincing evidence of an impact of community-based interventions in reducing adult harmful use of alcohol.     Conclusions: To date, with one exception, the impact of adult-oriented comprehensive community and municipal action to reduce the harmful use of alcohol has not been studied. The one exception failed to find a convincing effect. We conclude with recommendations for closing this evidence gap.

What next? Sustaining a successful small-scale alcohol consumption harm minimization project.

PubMed

Milne, Sharon; Greenaway, Sarah; Conway, Kim; Henwood, Wendy

2007-01-01

Engaging communities in alcohol consumption-related action projects requires the application of a range of flexible and responsive evidence-based methods. These include: establishing collaborative relationships, implementing strategies to improve age verification practices, encouraging organizational change, and raising awareness of local alcohol issues. The focus of this article is the sustainability of an alcohol harm minimization project for young people in Hawera (a small New Zealand town) that has produced some encouraging results. The Hawera Alcohol and Young People project began in 2000 along with external formative and impact evaluation components. This article will draw on the evaluation findings to date and the experience of community action projects in New Zealand to explore what makes a sustainable community action project and to examine the extent to which this has been achieved by the Hawera Alcohol and Young People project. The limitations of the study are noted.

Evaluation of work-based screening for early signs of alcohol-related liver disease in hazardous and harmful drinkers: the PrevAIL study.

PubMed

Cook, Penny A; Morleo, Michela; Billington, David; Sanderson-Shortt, Kevin; Jones, Colin; Gabbay, Mark; Sheron, Nick; Bellis, Mark A; Phillips-Howard, Penelope A; Gilmore, Ian T

2015-06-04

The direct cost of excessive alcohol consumption to health services is substantial but dwarfed by the cost borne by the workplace as a result of lost productivity. The workplace is also a promising setting for health interventions. The Preventing Alcohol Harm in Liverpool and Knowsley (PrevAIL) project aimed to evaluate a mechanism for detecting the prevalence of alcohol related liver disease using fibrosis biomarkers. Secondary aims were to identify the additive effect of obesity as a risk factor for early liver disease; to assess other impacts of alcohol on work, using a cross-sectional survey. Participants (aged 36-55 y) from 13 workplaces participated (March 2011-April 2012). BMI, waist circumference, blood pressure and self-reported alcohol consumption in the previous week was recorded. Those consuming more than the accepted UK threshold (men: >21 units; female: >14 units alcohol) provided a 20 ml venous blood sample for a biomarker test (Southampton Traffic Light Test) and completed an alcohol questionnaire (incorporating the Severity of Alcohol Dependence Questionnaire). The screening mechanism enrolled 363 individuals (52 % women), 39 % of whom drank above the threshold and participated in the liver screen (n = 141, complete data = 124 persons). Workplaces with successful participation were those where employers actively promoted, encouraged and facilitated attendance. Biomarkers detected that 30 % had liver disease (25 %, intermediate; 5 % probable). Liver disease was associated with the frequency of visits to the family physician (P = 0.036) and obesity (P = 0.052). The workplace is an important setting for addressing alcohol harm, but there are barriers to voluntary screening that need to be addressed. Early detection and support of cases in the community could avert deaths and save health and social costs. Alcohol and obesity should be addressed simultaneously, because of their known multiplicative effect on liver disease risk, and because employers

‘We lost because of his drunkenness’: the social processes linking alcohol use to self-harm in the context of daily life stress in marriages and intimate relationships in rural Sri Lanka

PubMed Central

Sørensen, Jane Brandt; Agampodi, Thilini; Sørensen, Birgitte Refslund; Siribaddana, Sisira; Konradsen, Flemming; Rheinländer, Thilde

2017-01-01

Introduction Harmful alcohol use has been found to cause detriment to the consumers and those around them. Research carried out in Sri Lanka has described the socioeconomic consequences to families owing to alcohol consumption. However, the social processes around alcohol use and how it could result in behaviour such as self-harm was unclear. With an outset in daily life stressors in marriages and intimate relationships we explored alcohol use in families with a recent case of self-harm. Methods Qualitative data were collected for 11 months in 2014 and 2015 in the North Central and North Western provinces of Sri Lanka. Narrative life story interviews with 19 individuals who had self-harmed where alcohol was involved and 25 of their relatives were conducted. Ten focus group discussions were carried out in gender and age segregated groups. An inductive content analysis was carried out. Results Participants experienced two types of daily life stressors: non-alcohol-related stressors, such as violence and financial difficulties, and alcohol-related stressors. The alcohol-related stressors aggravated the non-alcohol-related daily life stressors within marriages and intimate relationships, which resulted in conflict between partners and subsequent self-harm. Women were disproportionately influenced by daily life stressors and were challenged in their ability to live up to gendered norms of marriage. Further, women were left responsible for their own and their husband’s inappropriate behaviour. Self-harm appeared to be a possible avenue of expressing distress. Gendered alcohol and marriage norms provided men with acceptable excuses for their behaviour, whether it was alcohol consumption, conflicts or self-harm. Conclusions This study found that participants experienced both alcohol-related and non-alcohol-related daily life stressors. These two categories of daily life stressors, gender inequalities and alcohol norms should be considered when planning alcohol and self-harm

Understanding the alcohol harm paradox: an analysis of sex- and condition-specific hospital admissions by socio-economic group for alcohol-associated conditions in England.

PubMed

Sadler, Susannah; Angus, Colin; Gavens, Lucy; Gillespie, Duncan; Holmes, John; Hamilton, Jean; Brennan, Alan; Meier, Petra

2017-05-01

In many countries, conflicting gradients in alcohol consumption and alcohol-associated mortality have been observed. To understand this 'alcohol harm paradox' we analysed the socio-economic gradient in alcohol-associated hospital admissions to test whether it was greater in conditions which were: (1) chronic (associated with long-term drinking) and partially alcohol-attributable, (2) chronic and wholly alcohol-attributable, (3) acute (associated with intoxication) and partially alcohol-attributable and (4) acute and wholly alcohol-attributable. Our aim was to clarify how (1) drinking patterns (e.g. intoxication linked to acute admissions or dependence linked to chronic conditions) and (2) non-alcohol causes (e.g. smoking and poor diet which are risks for partially alcohol-attributable conditions) contribute to the paradox. Regression analysis testing the modifying effects of condition-group (1-4 above) and sex on the relationship between area-based deprivation and admissions. England, April 2010-March 2013. A total of 9 239 629 English hospital admissions where a primary or secondary cause was one of 36 alcohol-associated conditions. Admissions by condition and deciles of Index of Multiple Deprivation (IMD). Socio-economic gradient measured as the relative index of inequality (RII, the slope of a linear regression of IMD on admissions adjusted for overall admission rate). Conditions were categorized by ICD-10 code. A socio-economic gradient in hospitalizations was seen for all conditions, except partially attributable chronic conditions. The gradient was significantly steeper for conditions which were wholly attributable to alcohol and for acute conditions than for conditions partially alcohol-attributable and for chronic conditions. Gradients were steeper for men than for women in cases of wholly alcohol attributable conditions. There is a socio-economic gradient in English hospital admission for most alcohol-associated conditions. The greatest inequalities are in

Quantification of alcohol-related mortality in Sweden.

PubMed

Sjögren, H; Eriksson, A; Broström, G; Ahlm, K

2000-01-01

The main aim of the present study was to estimate total alcohol-related mortality in Sweden. For natural deaths, a meta-analysis carried out in Australia was updated to the end of March 1998, and pooled estimates of the relative risks were calculated for different diseases based on data from scientific studies that have been published in the international literature. The proportion of current alcohol drinkers from recent Swedish surveys, and the pooled relative risk estimates were used to estimate disease-specific alcohol-attributable fractions. Natural deaths 'caused' or 'prevented' by alcohol were estimated for the period 1992-1996. For unnatural deaths, all cases from 1992 through 1996 in Sweden were analysed (n = 23 132). Alcohol was regarded to attribute to the death: if the deceased was a 'known alcoholic'; if the underlying or contributing cause of death was alcohol-related; if the deceased had an alcohol-related in-patient diagnosis during a 3-year period prior to death; if the case tested positive for blood alcohol. Person years of life lost/gained (<70 years) due to alcohol were also assessed. The assumptions underlying the attributable risk methods used to analyse alcohol-related mortality due to natural causes need to be borne in mind when interpreting the results on natural deaths. Moreover, the preventive effect of alcohol on coronary heart disease and stroke is still controversial. The findings of alcohol-related mortality due to unnatural causes were much more reliable. About 3.5% of deaths were attributed to alcohol; alcohol involvement was more than twice as common in deaths of males (4.8%) than in those of females (2.0%). About one-quarter of the deaths in those aged below 50 years were attributed to alcohol. In those (alcohol had a net harmful effect in that it 'caused' more deaths than it 'prevented'; 7% of deaths were in net 'caused'. More person years of life were in net lost than were saved by alcohol, suggesting that alcohol

Do community characteristics predict alcohol-related crime?

PubMed

Breen, Courtney; Shakeshaft, Anthony; Slade, Tim; Love, Stephanie; D'Este, Catherine; Mattick, Richard P

2011-01-01

Alcohol-related crime is a substantial community problem. There is evidence to suggest that certain geographic areas experience higher rates of alcohol-related crime and that both individual and community factors are associated with alcohol-related crime. There is limited research at the community level despite communities being the target of interventions designed to reduce alcohol-related harm. This study aims to determine whether there are differences in alcohol-related crime at the community level and examines whether certain community characteristics are associated with increased alcohol-related crime. Routinely collected police data from 20 rural communities in New South Wales, Australia were analysed. The ratio of alcohol to non-alcohol-related criminal incidents was used as a proxy for alcohol-related crime. Predictor variables were population-adjusted community characteristics, including demographic and resource variables. Regression analyses suggest that there are differences between communities in alcohol-related crime. Less socioeconomic disadvantage and more GPs and licensed premises (pubs and clubs) are associated with greater alcohol-related crime at the community level. Decreasing the socioeconomic well-being of a community is not appropriate; however, introducing additional taxes to increase the cost of alcohol may decrease consumption and therefore alcohol-related crime. Reducing or capping the number of licensed premises, specifically the number of pubs and clubs, may be an appropriate strategy to reduce alcohol-related crime in rural communities.

The role of sensation seeking, perceived peer pressure, and harmful alcohol use in riding with an alcohol-impaired driver.

PubMed

Kim, Jun-Hong; Kim, Kwang Sik

2012-09-01

Alcohol-related motor vehicle collisions have been the top of policy agenda for more than three decades in Korea. Despite implementation of various traffic safety measures, some drivers' alcohol use and abuse has resulted in a high number of alcohol-impaired traffic fatalities every year. This paper presents the association of theoretical factors with behavior of riding with an alcohol-impaired driver (RAID) among all age groups in the Korean adult sample. The theoretical factors of the drivers are personality factor, socio-psychological factor, and alcohol-related behavioral risk factor. We utilized national survey data from 1007 respondents consisting of 703 males and 304 females aged 20-66 collected by Korean Institute of Criminology (KIC) to test our theorized model. Our results indicated that there were three major predictors of RAID involvement: sensation seeking propensity, perceived peer pressure, and frequent harmful drinking. Overall, prediction of RAID behavior by gender was mediated entirely through these predictors. The issue of males' higher risk of RAID involvements was addressed for effective communication strategies such as campaigns. Copyright © 2012 Elsevier Ltd. All rights reserved.

Harm from others' drinking-related aggression, violence and misconduct in five Asian countries and the implications.

PubMed

Waleewong, Orratai; Laslett, Anne-Marie; Chenhall, Richard; Room, Robin

2018-06-01

Harm from alcohol-attributable aggression and violence is linked to diminished personal safety and reduced physical and mental health and wellbeing in many countries. But there has been limited evidence on these harms in low- and middle-income countries (LMICs). This study measured harm from others' drinking-related aggression, violence and misconduct in five Asian LMICs (Thailand, Sri Lanka, India, Vietnam, and Lao PDR), aiming to compare the magnitude and pattern of harm across countries by gender, age group, educational level, rurality, and country-level indicators. Data from 9832 respondents from the WHO/Thai Health International Collaborative Research Project on the Harm from Others' Drinking undertaken between 2012 and 2014 were analysed. 50-73% of respondents from five countries reported being harmed at least once in the past year. Public disorder and feeling unsafe due to someone else's drinking was frequently reported, followed by harassment, assaults and threats, traffic harm, and property damage. In most countries, men were more likely than women to report traffic harms, property harm, and assaults, whereas women were more likely to report feeling unsafe in public. Being young, less educated, living in urban areas, and one's own drinking were significant predictors of more harm from others' drinking for both genders. This study revealed a consistently high prevalence of alcohol-related aggression and violence in the five Asian countries. Patterns of harm within countries and populations at most risk for different forms of harms were identified. Alongside services for those affected, efforts to strengthen alcohol policies are needed in each society. Copyright © 2018 Elsevier B.V. All rights reserved.

Is Personality Associated with Secondhand Harm from Drinking?

PubMed

Davis MacNevin, Parnell; Thompson, Kara; Teehan, Michael; Stuart, Heather; Stewart, Sherry

2017-09-01

Prior research suggests more than 70% of undergraduates have experienced harm from other students' drinking. This study built on the literature by, first, investigating whether secondhand harm cluster into latent factors that reflect distinct but related types of harm. Second, given the paucity of research examining factors that increase students' vulnerability to secondhand harm, we examined dimensions from Castellanos-Ryan and Conrod's 4-factor personality model for alcohol disorders (impulsivity [IMP], sensation seeking [SS], hopelessness [HOP], anxiety sensitivity [AS]) as predictors of secondhand harm exposure. We also investigated the possible mediating role of students' own problematic alcohol use in explaining personality-secondhand harm relationships. An online survey was administered to 1,537 first-year Canadian undergraduates (68% women). Problematic alcohol use was measured by the Alcohol Use Disorders Identification Test, and personality was measured by the Substance Use Risk Profile Scale. Eleven secondhand harm items were included. The secondhand harm clustered into 3 distinct but related factors: "strains" (e.g., interruption of sleep or study), "threats" (e.g., harassment or assault), and "interpersonal harm" (e.g., arguments with peers). Sixty-eight percent of respondents reported strains, 44% threats, and 64% interpersonal harm, and 35% reported experiencing all 3 types of harm, in the last term. All 4 personality dimensions were independently associated with greater secondhand harm exposure. HOP was directly associated with threats and interpersonal harm, and AS was directly associated with all 3 types of harm. SS and IMP were both indirectly associated with all 3 types of harm through students' own problematic alcohol use. In addition, IMP was directly related to threats. The prevalence of secondhand harm from alcohol is high among undergraduates. Findings suggest that distinct personality risks may predispose students to experience secondhand

Does Drinking Location Matter? Profiles of Risky Single-Occasion Drinking by Location and Alcohol-Related Harm among Young Men.

PubMed

Bähler, Caroline; Dey, Michelle; Dermota, Petra; Foster, Simon; Gmel, Gerhard; Mohler-Kuo, Meichun

2014-01-01

In adolescents and young adults, acute consequences like injuries account for a substantial proportion of alcohol-related harm, especially in risky single-occasion (RSO) drinkers. The primary aim of the study was to characterize different drinking profiles in RSO drinkers according to drinking locations and their relationship to negative, alcohol-related consequences. The sample consisted of 2746 young men from the Cohort Study on Substance Use Risk Factors who had reported drinking six or more drinks on a single-occasion at least monthly over the preceding 12 months. Principal component analysis on the frequency and amount of drinking at 11 different locations was conducted, and 2 distinguishable components emerged: a non-party-dimension (loading high on theater/cinema, sport clubs, other clubs/societies, restaurants, and sport events) and a party-dimension (loading high on someone else's home, pubs/bars, discos/nightclubs, outdoor public places, special events, and home). Differential impacts of drinking location profiles were observed on severe negative alcohol-related consequences (SAC). Relative to those classified as low or intermediate in both dimensions, no significant difference experiencing SAC was found among those who were classified as high in the non-party-dimension only. However, those who were classified as high in the party-dimension alone or in both dimensions were more likely to experience SAC. These differential effects remained after adjusting for alcohol consumption (volume and risky single-occasion drinking), personality traits, and peer-influence [adjusted OR = 0.83 (0.68-1.02), 1.57 (1.27-1.96), and 1.72 (1.23-2.41), respectively], indicating independent effects of drinking location on SAC. The inclusion of sociodemographic factors did not alter this association. The fact that this cluster of party-dimension locations seems to predispose young men to experiencing SAC has important implications for alcohol control policies.

Tobacco and hazardous or harmful alcohol use in Thailand: joint prevalence and associations with socioeconomic factors.

PubMed

Aekplakorn, Wichai; Hogan, Margaret C; Tiptaradol, Siriwat; Wibulpolprasert, Suwit; Punyaratabandhu, Porapan; Lim, Stephen S

2008-04-01

This study estimates the individual and joint prevalence of cigarette smoking and alcohol misuse, and examines the association between these risks and socioeconomic factors in Thailand. The self-reported data on cigarette and alcohol use are from a 2004 nationally representative cross-sectional survey of 39290 individuals aged 15 and over. Substantially more men than women were current smokers (45.8% vs. 2.3%; p<0.001) as well as harmful (5.4% vs. 0.9%, p<0.0001) and hazardous alcohol users (11.2% vs. 1.2%, p<0.001). The strongest predictor of alcohol misuse was smoking, and the strongest predictor of smoking was alcohol misuse in both sexes. There was an inverse relationship between education and family income with the odds of current smoking, whereas average levels of family income (not low or high) were associated with higher odds of harmful or hazardous alcohol use. Tobacco and alcohol misuse could be more effectively addressed by targeting and tailoring programs towards those who are most at risk - joint tobacco and harmful or hazardous alcohol users, and those of lower socioeconomic status.

Can harms associated with high-intensity drinking be reduced by increasing the price of alcohol?

PubMed

Byrnes, Joshua; Shakeshaft, Anthony; Petrie, Dennis; Doran, Christopher

2013-01-01

Increasing the price of alcohol is consistently shown to reduce the average level of consumption. However, the evidence for the effect of increasing the price on high-intensity drinking is both limited and equivocal. The aim of this analysis is to estimate the effect of changes in price on patterns of consumption. Self-reported patterns of alcohol consumption and demographic data were obtained from the Australian National Drug Strategy Household Surveys, conducted in 2001, 2004 and 2007. A pooled three-stage least-squares estimator was used to simultaneously model the impact of the price on the frequency (measured in days) of consuming no, low, moderate and high quantities of alcohol. A 1% increase in the price of alcohol was associated with a statistically significant increase of 6.41 days per year on which no alcohol is consumed (P ≤ 0.049), and a statistically significant decrease of 7.30 days on which 1-4 standard drinks are consumed (P ≤ 0.021). There was no statistically significant change for high or moderate-intensity drinking. For Australia, and countries with a similar pattern of predominant high-intensity drinking, taxation policies that increase the price of alcohol and are very efficient at decreasing harms associated with reduced average consumption may be relatively inefficient at decreasing alcohol harms associated with high-intensity drinking. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Low alcohol alternatives: a promising strategy for reducing alcohol related harm.

PubMed

Segal, David S; Stockwell, Tim

2009-03-01

Less than 1% of the beer market in British Columbia comprises beers with an alcohol content below 4%, despite the success of low alcohol beers in other countries, e.g. Australia. A small experimental study is described in which male students were given either unmarked low alcohol beer (3.8%) or regular strength beer (5.3%) to investigate their enjoyment and subjective intoxication. Thirty-four male students who reported drinking 5 or more beers in 1 day at least once in the last month volunteered for the study. In each drinking session, small groups of between 6 and 10 students consumed two servings of beer while playing dominoes. Each subject was his own control in the experiment by attending two group-drinking sessions, drinking a different beverage each time. The different beers were given in balanced order with half the subjects in each group drinking each type of beer. Standard measures of subjective intoxication and enjoyment were used. Blood alcohol levels were tested before, during and after drinking. Although significantly higher blood alcohol levels were obtained with the higher strength beer (means of 0.026 versus 0.033 mg/100 ml at the end of the study, p < 0.001), (i) most participants reported enjoying the two sessions equally or preferred the low alcohol beer session, (ii) most did not report feeling different between the two sessions and (iii) only about half correctly guessed which was the higher alcohol content beer. There was a preference, however, for the taste of the stronger beer. We conclude beer drinkers cannot readily distinguish low and regular strength beers and can enjoy socializing equally with either. We recommend taxation strategies to create incentives for the manufacture, marketing and consumption of low alcohol alternatives.

City-based action to reduce harmful alcohol use: review of reviews

PubMed Central

Anderson, Peter; Jané-Llopis, Eva; Hasan, Omer Syed Muhammad; Rehm, Jürgen

2018-01-01

Background: The World Health Organization global strategy on alcohol called for municipal policies to reduce the harmful use of alcohol. Yet, there is limited evidence that documents the impact of city-level alcohol policies. Methods: Review of reviews for all years to July 2017. Searches on OVID Medline, Healthstar, Embase, PsycINFO, AMED, Social Work Abstracts, CAB Abstracts, Mental Measurements Yearbook, Health and Psychosocial Instruments, International Pharmaceutical Abstracts, International Political Science Abstracts, NASW Clinical Register, and Epub Ahead of Print databases. All reviews that address adults, without language or date restrictions resulting from combining the terms (“review” or “literature review” or “review literature” or “data pooling” or “comparative study” or “systematic review” or “meta-analysis” or “pooled analysis”), and “alcohol”, and “intervention” and (“municipal” or “city” or “community”). Results: Five relevant reviews were identified. Studies in the reviews were all from high income countries and focussed on the acute consequences of drinking, usually with one target intervention, commonly bars, media, or drink-driving. No studies in the reviews reported the impact of comprehensive city-based action. One community cluster randomized controlled trial in Australia, published after the reviews, failed to find convincing evidence of an impact of community-based interventions in reducing adult harmful use of alcohol.     Conclusions: To date, with one exception, the impact of adult-oriented comprehensive community and municipal action to reduce the harmful use of alcohol has not been studied. The one exception failed to find a convincing effect. We conclude with recommendations for closing this evidence gap. PMID:29862017

Regional alcohol consumption and alcohol-related mortality in Great Britain: novel insights using retail sales data.

PubMed

Robinson, Mark; Shipton, Deborah; Walsh, David; Whyte, Bruce; McCartney, Gerry

2015-01-07

Regional differences in population levels of alcohol-related harm exist across Great Britain, but these are not entirely consistent with differences in population levels of alcohol consumption. This incongruence may be due to the use of self-report surveys to estimate consumption. Survey data are subject to various biases and typically produce consumption estimates much lower than those based on objective alcohol sales data. However, sales data have never been used to estimate regional consumption within Great Britain (GB). This ecological study uses alcohol retail sales data to provide novel insights into regional alcohol consumption in GB, and to explore the relationship between alcohol consumption and alcohol-related mortality. Alcohol sales estimates derived from electronic sales, delivery records and retail outlet sampling were obtained. The volume of pure alcohol sold was used to estimate per adult consumption, by market sector and drink type, across eleven GB regions in 2010-11. Alcohol-related mortality rates were calculated for the same regions and a cross-sectional correlation analysis between consumption and mortality was performed. Per adult consumption in northern England was above the GB average and characterised by high beer sales. A high level of consumption in South West England was driven by on-trade sales of cider and spirits and off-trade wine sales. Scottish regions had substantially higher spirits sales than elsewhere in GB, particularly through the off-trade. London had the lowest per adult consumption, attributable to lower off-trade sales across most drink types. Alcohol-related mortality was generally higher in regions with higher per adult consumption. The relationship was weakened by the South West and Central Scotland regions, which had the highest consumption levels, but discordantly low and very high alcohol-related mortality rates, respectively. This study provides support for the ecological relationship between alcohol-related

Global alcohol policy and the alcohol industry.

PubMed

Anderson, Peter

2009-05-01

The WHO is preparing its global strategy on alcohol, and, in so doing, has been asked to consult with the alcohol industry on ways it could contribute in reducing the harm done by alcohol. This review asks which is more effective in reducing harm: the regulatory approaches that the industry does not favour; or the educational approaches that it does favour. The current literature overwhelmingly finds that regulatory approaches (including those that manage the price, availability, and marketing of alcohol) reduce the risk of and the experience of alcohol-related harm, whereas educational approaches (including school-based education and public education campaigns) do not, with industry-funded education actually increasing the risk of harm. The alcohol industry should not be involved in making alcohol policy. Its involvement in implementing policy should be restricted to its role as a producer, distributor, and marketer of alcohol. In particular, the alcohol industry should not be involved in educational programmes, as such involvement could actually lead to an increase in harm.

Shifting categories of the social harms associated with alcohol: examples from late medieval and early modern England.

PubMed Central

Warner, J

1997-01-01

This paper offers a historical perspective on our own attempts to define the social harms associated with the abuse of alcohol. Challenging the notion that categories are necessarily objective and constant, it instead emphasizes the extent to which even harms that are visible and thus susceptible to measurement are in fact socially constructed. English sources from the preindustrial era revealed six broad categories of social harms associated with the abuse of alcohol. Four of the categories consisted of visible harms in the form of income lost, domestic violence, brawling, and accidents, all of which are still recognized as social harms associated with the abuse of alcohol. The other two categories, reversal of the established moral order and susceptibility to trickery, were of an essentially intrinsic or subjective nature and have since dropped from the lexicon of social harms. Images FIGURE 1 FIGURE 3 PMID:9366636

Social anxiety and alcohol-related negative consequences among college drinkers: do protective behavioral strategies mediate the association?

PubMed

Villarosa, Margo C; Moorer, Kayla D; Madson, Michael B; Zeigler-Hill, Virgil; Noble, Jeremy J

2014-09-01

The link between social anxiety and alcohol-related negative consequences among college students has been well documented. Protective behavioral strategies are cognitive-behavioral strategies that college students use in an effort to reduce harm while they are drinking. In the current study we examined the mediating role of the 2 categories of protective behavioral strategies (i.e., controlled consumption and serious harm reduction) in the relationship that social anxiety symptoms have with alcohol-related negative consequences. Participants were 572 undergraduates who completed measures of social anxiety, alcohol use, negative consequences of alcohol use, and protective behavioral strategy use. Only serious harm reduction strategies emerged as a mediator of the association that social anxiety symptoms had with alcohol-related negative consequences. Clinical and research implications are discussed.

Dynamic simulation modelling of policy responses to reduce alcohol-related harms: rationale and procedure for a participatory approach.

PubMed

Atkinson, Jo-An; O'Donnell, Eloise; Wiggers, John; McDonnell, Geoff; Mitchell, Jo; Freebairn, Louise; Indig, Devon; Rychetnik, Lucie

2017-02-15

Development of effective policy responses to address complex public health problems can be challenged by a lack of clarity about the interaction of risk factors driving the problem, differing views of stakeholders on the most appropriate and effective intervention approaches, a lack of evidence to support commonly implemented and acceptable intervention approaches, and a lack of acceptance of effective interventions. Consequently, political considerations, community advocacy and industry lobbying can contribute to a hotly contested debate about the most appropriate course of action; this can hinder consensus and give rise to policy resistance. The problem of alcohol misuse and its associated harms in New South Wales (NSW), Australia, provides a relevant example of such challenges. Dynamic simulation modelling is increasingly being valued by the health sector as a robust tool to support decision making to address complex problems. It allows policy makers to ask 'what-if' questions and test the potential impacts of different policy scenarios over time, before solutions are implemented in the real world. Participatory approaches to modelling enable researchers, policy makers, program planners, practitioners and consumer representatives to collaborate with expert modellers to ensure that models are transparent, incorporate diverse evidence and perspectives, are better aligned to the decision-support needs of policy makers, and can facilitate consensus building for action. This paper outlines a procedure for embedding stakeholder engagement and consensus building in the development of dynamic simulation models that can guide the development of effective, coordinated and acceptable policy responses to complex public health problems, such as alcohol-related harms in NSW.

The Post-Repeal Eclipse in Knowledge About The Harmful Effects of Alcohol

PubMed Central

Katcher, Brian S.

2014-01-01

National Prohibition in the USA (1919 to 1933) was followed by an era in which medical scientists played an important role in minimizing the harmful effects of alcohol. Cirrhosis, cardiomyopathy, adverse fetal effects, and esophageal cancer are examples of alcohol-related health problems that were well known at the beginning of the 20th century but were dismissed during the late 1930’s and early 1940’s, only to be rediscovered during the 1960’s and afterwards. This eclipse in knowledge occurred because of skepticism about earlier claims that had been made in the name of scientific temperance and, most importantly, because of changing standards for medical evidence. The paradigm for disease causation that gave birth to modern medicine was based on microbiology and reinforced by hormone and nutrition discoveries. Most alcohol-related health problems are poorly explained by this paradigm. The more recent epidemiologic paradigm for noninfectious disease is more applicable to the health risks associated with heavy drinking. A transformation of knowledge about alcohol’s relationship to disease has occurred. PMID:8329965

Reversing the sequence: reducing alcohol consumption by overcoming alcohol attentional bias.

PubMed

Fadardi, Javad Salehi; Cox, W Miles

2009-05-01

The aims of the research were to (a) compare the alcohol attentional bias (AAB) of social, hazardous, and harmful drinkers and (b) assess the effects of alcohol attention-control training on the AAB and alcohol consumption of hazardous and harmful drinkers. Participants were social drinkers (N=40), hazardous drinkers (N=89), and harmful drinkers (N=92). Paper-and-pencil measures were used to collect information about participants' socio-demographic characteristics, health status, motivational structure, drinking-related locus of control and situational self-confidence, readiness to change, affect, and alcohol consumption. Computerized classic, alcohol- and concerns-Stroop tests were administered. All participants were tested individually, with the order of tests counterbalanced across participants. After the baseline assessment, the hazardous and harmful drinkers were trained with the Alcohol Attention-Control Training Program (AACTP) for two and four sessions, respectively. Both samples completed a post-training assessment, and the harmful drinkers also completed 3-month follow-up. Results indicated that (a) the harmful drinkers had larger AAB than the hazardous and the social drinkers; (b) the attentional training reduced the hazardous and harmful drinkers' AAB; and (c) the harmful drinkers showed post-training reductions in alcohol consumption and improvements on the other drinking-related indices. The harmful drinkers' improvements were maintained at the 3-month follow-up.

Minimum prices for alcohol and educational disparities in alcohol-related mortality.

PubMed

Herttua, Kimmo; Mäkelä, Pia; Martikainen, Pekka

2015-05-01

Minimum price of alcohol is one of the proposed set of alcohol policies in many high-income countries. However, the extent to which alcohol-related harm is associated with minimum prices across socioeconomic groups is not known. Using Finnish national registers in 1988-2007, we investigated, by means of time-series analysis, the association between minimum prices for alcohol overall, as well as for various types of alcoholic beverages, and alcohol-related mortality, among men and women ages 30-79 years across three educational groups. We defined quarterly aggregations of alcohol-related deaths, based on a sample including 80% of all deaths, in accordance with information on both underlying and contributory causes of death. About 62,500 persons died from alcohol-related causes during the 20-year follow-up. The alcohol-related mortality rate was more than threefold higher among those with a basic education than among those with a tertiary education. Among men with a basic education, an increase of 1% in the minimum price of alcohol was associated with a decrease of 0.03% (95% confidence interval = 0.01, 0.04%) in deaths per 100,000 person-years. Changes in the minimum prices of distilled spirits, intermediate products, and strong beer were also associated with changes in the opposite direction among men with a basic education and among women with a secondary education, whereas among the most highly educated there were no associations between the minimum prices of any beverages and mortality. Moreover, we found no evidence of an association between lower minimum prices for wine and higher rates of alcohol-related mortality in any of the population sub-groups. The results reveal associations between higher minimum prices and lower alcohol-related mortality among men with a basic education and women with a secondary education for all beverage types except wine.

Exploring the Relationship between Experiential Avoidance, Alcohol Use Disorders, and Alcohol-Related Problems among First-Year College Students

ERIC Educational Resources Information Center

Levin, Michael E.; Lillis, Jason; Seeley, John; Hayes, Steven C.; Pistorello, Jacqueline; Biglan, Anthony

2012-01-01

Objective: This study explored the relationship of experiential avoidance (eg, the tendency to avoid, suppress, or otherwise control internal experiences even when doing so causes behavioral harm) to alcohol use disorders and alcohol-related problems. Participants: Cross-sectional data were collected from 240 undergraduate college students in…

Harm Reduction as “Continuum Care” in Alcohol Abuse Disorder

PubMed Central

Maremmani, Icro; Cibin, Mauro; Pani, Pier Paolo; Rossi, Alessandro; Turchetti, Giuseppe

2015-01-01

Alcohol abuse is one of the most important risk factors for health and is a major cause of death and morbidity. Despite this, only about one-tenth of individuals with alcohol abuse disorders receive therapeutic intervention and specific rehabilitation. Among the various dichotomies that limit an effective approach to the problem of alcohol use disorder treatment, one of the most prominent is integrated treatment versus harm reduction. For years, these two divergent strategies have been considered to be opposite poles of different philosophies of intervention. One is bound to the search for methods that aim to lead the subject to complete abstinence; the other prioritizes a progressive decline in substance use, with maximum reduction in the damage that is correlated with curtailing that use. Reduction of alcohol intake does not require any particular setting, but does require close collaboration between the general practitioner, specialized services for addiction, alcohology services and psychiatry. In patients who reach that target, significant savings in terms of health and social costs can be achieved. Harm reduction is a desirable target, even from an economic point of view. At the present state of neuroscientific knowledge, it is possible to go one step further in the logic that led to the integration of psychosocial and pharmacological approaches, by attempting to remove the shadows of social judgment that, at present, are aiming for a course of treatment that is directed towards absolute abstention. PMID:26610535

Managed alcohol as a harm reduction intervention for alcohol addiction in populations at high risk for substance abuse.

PubMed

Muckle, Wendy; Muckle, Jamie; Welch, Vivian; Tugwell, Peter

2012-12-12

Managed alcohol programmes (MAP) are a harm reduction strategy used to minimise the personal harm and adverse societal effects that alcohol dependence can lead to by providing an alternative to zero-tolerance approaches that incorporate drinking goals (abstinence or moderation) that are compatible with the needs of the individual, and promoting access to services by offering low-threshold alternatives. This enables clients to gain access to services despite continued alcohol consumption and works to help the patient understand the risks involved in their behaviour and make decisions about their own treatment goals. To assess the effectiveness of MAP treatment regimens (serving limited quantities of alcohol daily to alcoholics) on their own or as compared to moderate drinking (self-controlled drinking), screening and brief intervention using a harm reduction approach, traditional abstinence-based interventions (12 step programmes) and no intervention. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL and PsycINFO up to March 2012. This search was expanded by handsearching of high-yield journals and conference proceedings that had not already been handsearched on behalf of The Cochrane Collaboration, searching reference lists of all papers and relevant reviews identified, references to ongoing and recently completed clinical trials in the National Research Register and IFPMA Clinical Trials Database (which contains ClinicalTrials.gov, Centerwatch, Current Controlled Trials and ClinicalStudyResults.gov, and Osservatorio Nazionale sulla Sperimentazione Clinica dei Medicinali). Trials registers, grey literature and reference lists were also searched. Individuals, organisations and experts in the field were contacted. Randomised control trials (RCT), controlled clinical trials (CCT), interrupted time series (ITS) studies, and control before and after (CBA) studies involving vulnerable people aged 18 years or older who were

Sexual harassment experiences and harmful alcohol use in a military sample: differences in gender and the mediating role of depression.

PubMed

Gradus, Jaimie L; Street, Amy E; Kelly, Kacie; Stafford, Jane

2008-05-01

Researchers and clinicians alike are interested in the effects of sexual harassment on mental health, including associations with problem drinking. The aim of the current investigation was to examine depression symptoms as a mediator of the association between sexual harassment during military service and current harmful alcohol use in a sample of former military personnel, stratified by gender. Using a cross-sectional design, 3,946 former reservists were surveyed regarding their experiences of sexual harassment in the military and their current depression symptoms and harmful alcohol use. Fifty-nine percent of the final sample were female. As expected, women endorsed experiencing sexual harassment more than men, and men endorsed harmful drinking more than women. Sexual harassment was associated with increased depression symptoms among both men and women; however, depression symptoms mediated the association between sexual harassment and harmful alcohol use among women only. Sexual harassment was not a significant predictor of harmful alcohol use among men. The associations between sexual harassment, depression symptoms, and harmful alcohol use differ between men and women in this sample. Consistent with the self-medication hypothesis, sexual harassment is associated with harmful drinking among women, and this association can be accounted for by symptoms of depression. The high prevalence of harmful drinking among men and the lack of an association with sexual harassment suggest that, in this sample, men's harmful drinking is influenced by factors other than sexual harassment.

Trial protocol: a clustered, randomised, longitudinal, type 2 translational trial of alcohol consumption and alcohol-related harm among adolescents in Australia.

PubMed

Rowland, B; Abraham, C; Carter, R; Abimanyi-Ochom, J; Kelly, A B; Kremer, P; Williams, J W; Smith, R; Hall, J K; Wagner, D; Renner, H; Hosseini, T; Osborn, A; Mohebbi, M; Toumbourou, J W

2018-04-27

This cluster randomised control trial is designed to evaluate whether the Communities That Care intervention (CTC) is effective in reducing the proportion of secondary school age adolescents who use alcohol before the Australian legal purchasing age of 18 years. Secondary outcomes are other substance use and antisocial behaviours. Long term economic benefits of reduced alcohol use by adolescents for the community will also be assessed. Fourteen communities and 14 other non-contiguous communities will be matched on socioeconomic status (SES), location, and size. One of each pair will be randomly allocated to the intervention in three Australian states (Victoria, Queensland and Western Australia). A longitudinal survey will recruit grade 8 and 10 students (M = 15 years old, N = 3500) in 2017 and conduct follow-up surveys in 2019 and 2021 (M = 19 years old). Municipal youth populations will also be monitored for trends in alcohol-harms using hospital and police administrative data. Community-led interventions that systematically and strategically implement evidence-based programs have been shown to be effective in producing population-level behaviour change, including reduced alcohol and drug use. We expect that the study will be associated with significant effects on alcohol use amongst adolescents because interventions adopted within communities will be based on evidence-based practices and target specific problems identified from surveys conducted within each community. The trial was retrospectively registered in September, 2017 ( ACTRN12616001276448 ), as communities were selected prior to trial registration; however, participants were recruited after registration. Findings will be disseminated in peer-review journals and community fora.

Features of alcohol harm reduction advertisements that most motivate reduced drinking among adults: an advertisement response study

PubMed Central

Wakefield, Melanie A; Dunstone, Kimberley; Durkin, Sarah J; Dixon, Helen G; Pettigrew, Simone; Slater, Michael D

2017-01-01

Objectives To improve the effectiveness of alcohol harm reduction mass media campaigns, this study aimed to (1) identify existing advertisements (ads) with greatest potential to motivate reduced alcohol consumption, (2) assess consistency across audience subgroups in ad effectiveness and (3) identify ad features associated with effectiveness. Design Cross-sectional online ad response study with random assignment to view ads. Participants 2174 Australian adult weekly drinkers recruited from an online panel. Procedure Participants were randomly assigned to view three of 83 English-language alcohol harm reduction ads. Each ad was viewed and rated by a mean of 79 participants. Outcome measure After viewing each ad, participants reported the extent to which they felt motivated to reduce their drinking. Ads were ranked from most to least motivating using predicted means adjusted for demographic characteristics and alcohol consumption. We compared the characteristics of the top-ranked 15% of ads (most motivating) with the middle 70% and bottom 15%. Results An ad about the link between alcohol and cancer (‘Spread’) was most motivating, whereas an ad that encouraged drinking water instead of beer (‘Add nothing’) was least motivating. Top-ranked ads were more likely than other ads to feature a ‘why change’ message and less likely to carry a ‘how to change’ message; more likely to address long-term harms; more likely to be aimed at the general adult drinking population and more likely to include drinking guidelines. There was substantial overlap in top-ranked ads for younger versus older adults, men versus women and high-risk versus low-risk drinker subgroups. Conclusions The effectiveness of alcohol harm reduction campaigns may be improved by directly communicating alcohol's long-term harms to the general adult population of drinkers along with drinking guidelines. By doing so, campaigns can also efficiently influence high-risk drinkers and key demographic

Therapy-related assessment of self-harming behaviors in eating disordered patients: a case illustration.

PubMed

Claes, Laurence; Vandereycken, Walter; Vertommen, Hans

2002-01-01

Understanding an individual's self-harming behaviors should be the basis for selecting person-specific therapeutic interventions. For that purpose, the assessment is aimed at identifying the self-harming behaviors and related symptoms as well as analyzing the external (situational) and internal (cognitive and emotional) conditions that contribute directly to the instigation of the self-harming behaviors. In this article, we demonstrate the use of a new assessment procedure that may guide the selection of therapeutic interventions. Data collection and processing are illustrated by an individual case study of an eating-disordered patient showing different types of self-harming behavior such as vomiting, alcohol abuse, cutting, and suicide attempts.

Vulnerability to alcohol-related problems: a policy brief with implications for the regulation of alcohol marketing.

PubMed

Babor, Thomas F; Robaina, Katherine; Noel, Jonathan K; Ritson, E Bruce

2017-01-01

The concern that alcohol advertising can have detrimental effects on vulnerable viewers has prompted the development of codes of responsible advertising practices. This paper evaluates critically the concept of vulnerability as it applies to (1) susceptibility to alcohol-related harm and (2) susceptibility to the effects of marketing, and describes its implications for the regulation of alcohol marketing. We describe the findings of key published studies, review papers and expert reports to determine whether these two types of vulnerability apply to population groups defined by (1) age and developmental history; (2) personality characteristics; (3) family history of alcoholism; (4) female sex and pregnancy risk; and (5) history of alcohol dependence and recovery status. Developmental theory and research suggest that groups defined by younger age, incomplete neurocognitive development and a history of alcohol dependence may be particularly vulnerable because of the disproportionate harm they experience from alcohol and their increased susceptibility to alcohol marketing. Children may be more susceptible to media imagery because they do not have the ability to compensate for biases in advertising portrayals and glamorized media imagery. Young people and people with a history of alcohol dependence appear to be especially vulnerable to alcohol marketing, warranting the development of new content and exposure guidelines focused on protecting those groups to improve current self-regulation codes promoted by the alcohol industry. If adequate protections cannot be implemented through this mechanism, statutory regulations should be considered. © 2016 Society for the Study of Addiction.

Effectiveness of Mass Media Campaigns to Reduce Alcohol Consumption and Harm: A Systematic Review.

PubMed

Young, Ben; Lewis, Sarah; Katikireddi, Srinivasa Vittal; Bauld, Linda; Stead, Martine; Angus, Kathryn; Campbell, Mhairi; Hilton, Shona; Thomas, James; Hinds, Kate; Ashie, Adela; Langley, Tessa

2018-05-01

To assess the effectiveness of mass media messages to reduce alcohol consumption and related harms using a systematic literature review. Eight databases were searched along with reference lists of eligible studies. Studies of any design in any country were included, provided that they evaluated a mass media intervention targeting alcohol consumption or related behavioural, social cognitive or clinical outcomes. Drink driving interventions and college campus campaigns were ineligible. Studies quality were assessed, data were extracted and a narrative synthesis conducted. Searches produced 10,212 results and 24 studies were included in the review. Most campaigns used TV or radio in combination with other media channels were conducted in developed countries and were of weak quality. There was little evidence of reductions in alcohol consumption associated with exposure to campaigns based on 13 studies which measured consumption, although most did not state this as a specific aim of the campaign. There were some increases in treatment seeking and information seeking and mixed evidence of changes in intentions, motivation, beliefs and attitudes about alcohol. Campaigns were associated with increases in knowledge about alcohol consumption, especially where levels had initially been low. Recall of campaigns was high. Mass media health campaigns about alcohol are often recalled by individuals, have achieved changes in knowledge, attitudes and beliefs about alcohol but there is little evidence of reductions in alcohol consumption. There is little evidence that mass media campaigns have reduced alcohol consumption although most did not state that they aimed to do so. Studies show recall of campaigns is high and that they can have an impact on knowledge, attitudes and beliefs about alcohol consumption.

Effectiveness of Mass Media Campaigns to Reduce Alcohol Consumption and Harm: A Systematic Review

PubMed Central

Lewis, Sarah; Katikireddi, Srinivasa Vittal; Bauld, Linda; Stead, Martine; Angus, Kathryn; Campbell, Mhairi; Hilton, Shona; Thomas, James; Hinds, Kate; Ashie, Adela; Langley, Tessa

2018-01-01

Abstract Aims To assess the effectiveness of mass media messages to reduce alcohol consumption and related harms using a systematic literature review. Methods Eight databases were searched along with reference lists of eligible studies. Studies of any design in any country were included, provided that they evaluated a mass media intervention targeting alcohol consumption or related behavioural, social cognitive or clinical outcomes. Drink driving interventions and college campus campaigns were ineligible. Studies quality were assessed, data were extracted and a narrative synthesis conducted. Results Searches produced 10,212 results and 24 studies were included in the review. Most campaigns used TV or radio in combination with other media channels were conducted in developed countries and were of weak quality. There was little evidence of reductions in alcohol consumption associated with exposure to campaigns based on 13 studies which measured consumption, although most did not state this as a specific aim of the campaign. There were some increases in treatment seeking and information seeking and mixed evidence of changes in intentions, motivation, beliefs and attitudes about alcohol. Campaigns were associated with increases in knowledge about alcohol consumption, especially where levels had initially been low. Recall of campaigns was high. Conclusion Mass media health campaigns about alcohol are often recalled by individuals, have achieved changes in knowledge, attitudes and beliefs about alcohol but there is little evidence of reductions in alcohol consumption. Short summary There is little evidence that mass media campaigns have reduced alcohol consumption although most did not state that they aimed to do so. Studies show recall of campaigns is high and that they can have an impact on knowledge, attitudes and beliefs about alcohol consumption. PMID:29329359

Features of alcohol harm reduction advertisements that most motivate reduced drinking among adults: an advertisement response study.

PubMed

Wakefield, Melanie A; Brennan, Emily; Dunstone, Kimberley; Durkin, Sarah J; Dixon, Helen G; Pettigrew, Simone; Slater, Michael D

2017-04-20

To improve the effectiveness of alcohol harm reduction mass media campaigns, this study aimed to (1) identify existing advertisements (ads) with greatest potential to motivate reduced alcohol consumption, (2) assess consistency across audience subgroups in ad effectiveness and (3) identify ad features associated with effectiveness. Cross-sectional online ad response study with random assignment to view ads. 2174 Australian adult weekly drinkers recruited from an online panel. Participants were randomly assigned to view three of 83 English-language alcohol harm reduction ads. Each ad was viewed and rated by a mean of 79 participants. After viewing each ad, participants reported the extent to which they felt motivated to reduce their drinking. Ads were ranked from most to least motivating using predicted means adjusted for demographic characteristics and alcohol consumption. We compared the characteristics of the top-ranked 15% of ads (most motivating) with the middle 70% and bottom 15%. An ad about the link between alcohol and cancer (' Spread ') was most motivating, whereas an ad that encouraged drinking water instead of beer (' Add nothing ') was least motivating. Top-ranked ads were more likely than other ads to feature a 'why change' message and less likely to carry a 'how to change' message; more likely to address long-term harms; more likely to be aimed at the general adult drinking population and more likely to include drinking guidelines. There was substantial overlap in top-ranked ads for younger versus older adults, men versus women and high-risk versus low-risk drinker subgroups. The effectiveness of alcohol harm reduction campaigns may be improved by directly communicating alcohol's long-term harms to the general adult population of drinkers along with drinking guidelines. By doing so, campaigns can also efficiently influence high-risk drinkers and key demographic subgroups. Published by the BMJ Publishing Group Limited. For permission to use (where not

Effects of Beverages on Alcohol Metabolism: Potential Health Benefits and Harmful Impacts

PubMed Central

Wang, Fang; Zhang, Yu-Jie; Zhou, Yue; Li, Ya; Zhou, Tong; Zheng, Jie; Zhang, Jiao-Jiao; Li, Sha; Xu, Dong-Ping; Li, Hua-Bin

2016-01-01

Nonalcoholic beverages are usually consumed accompanying alcoholic drinks, and their effects on alcohol metabolism are unclear in vivo. In this study, the effects of 20 nonalcoholic beverages on alcohol metabolism and liver injury caused by alcohol were evaluated in mice. Kunming mice were orally fed with alcohol (52%, v/v) and beverages. The concentrations of ethanol and acetaldehyde in blood as well as the activities of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) in liver were assessed to indicate alcohol metabolism. The levels of aspartate aminotransferase (AST) and alanine transaminase (ALT) in serum as well as the levels of malonaldehyde (MDA) and superoxide dismutase (SOD) in liver were measured to reflect the alcohol-induced liver injury. The results showed that the treatment of soda water, green tea and honey chrysanthemum tea could accelerate ethanol metabolism and prevent liver injuries caused by alcohol when companied with excessive alcohol drinking. They might be potential dietary supplements for the alleviation of harmful effects from excessive alcohol consumption. On the contrary, some beverages such as fresh orange juice and red bull are not advised to drink when companied with alcohol consumption due to their adverse effects on ethanol induced liver injury. PMID:27005619

Socioeconomic differences in alcohol-related risk-taking behaviours.

PubMed

Livingston, Michael

2014-11-01

There is substantial research showing that low socioeconomic position is a predictor of negative outcomes from alcohol consumption, while alcohol consumption itself does not exhibit a strong social gradient. This study aims to examine socioeconomic differences in self-reported alcohol-related risk-taking behaviour to explore whether differences in risk-taking while drinking may explain some of the socioeconomic disparities in alcohol-related harm. Cross-sectional data from current drinkers (n = 21 452) in the 2010 wave of the Australian National Drug Strategy Household Survey were used. Ten items on risk-taking behaviour while drinking were combined into two risk scores, and zero-inflated Poisson regression was used to assess the relationship between socioeconomic position and risk-taking while controlling for age, sex and alcohol consumption. Socioeconomically advantaged respondents reported substantially higher rates of alcohol-related hazardous behaviour than socioeconomically disadvantaged respondents. Controlling for age, sex, volume of drinking and frequency of heavy drinking, respondents living in the most advantaged quintile of neighbourhoods reported significantly higher rates of hazardous behaviour than those in the least advantaged quintile. A similar pattern was evident for household income. Socioeconomically advantaged Australians engage in alcohol-related risky behaviour at higher rates than more disadvantaged Australians even with alcohol consumption controlled. The significant socioeconomic disparities in negative consequences linked to alcohol consumption cannot in this instance be explained via differences in behaviour while drinking. Other factors not directly related to alcohol consumption may be responsible for health inequalities in outcomes with significant alcohol involvement. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Immediate effects on adult drinkers of exposure to alcohol harm reduction advertisements with and without drinking guideline messages: experimental study.

PubMed

Wakefield, Melanie A; Brennan, Emily; Dunstone, Kimberley; Durkin, Sarah J; Dixon, Helen G; Pettigrew, Simone; Slater, Michael D

2018-06-01

To compare the immediate effects on drinkers of television advertisements focusing upon short- versus long-term harms with and without low-risk drinking guidelines. Between-participants on-line experiment, with random assignment to view: (a) alcohol product advertisements (ALC control); (b) advertisements unrelated to alcohol (NON-ALC control); (c) advertisements featuring short-term harms (STH) of alcohol; (d) advertisements featuring STH plus a STH guideline (STH+G); (e) advertisements featuring long-term harms (LTH); or (f) advertisements featuring LTH plus a LTH guideline (LTH+G). Australia, 2016. A total of 3718 drinkers aged 18-64 years (48.5% male). Post-exposure likelihood that participants provided a correct estimate of drinking levels associated with short- and long-term harms; post-exposure intentions to avoid alcohol or reduce consumption. After exposure to STH+G or LTH+G advertisements, participants were more likely to estimate correctly rather than overestimate drinking levels associated with harm, compared with those exposed to STH (P < 0.001) and LTH advertisements without guidelines, respectively (P = 0.019) and ALC control (STH+G, P < 0.001; LTH+G, P < 0.001) and NON-ALC control conditions (STH+G, P < 0.001; LTH+G, P = 0.011). Drinkers exposed to STH conditions were more likely to intend to reduce next-week alcohol consumption than those exposed to ALC control (both P < 0.001) and NON-ALC control conditions (STH, P = 0.001; STH+G, P < 0.001); a similar pattern was observed for intentions to avoid alcohol. Drinkers exposed to LTH conditions were also more likely than drinkers exposed to ALC or NON-ALC controls to intend to avoid and reduce alcohol in the next week. Additionally, drinkers exposed to LTH+G were more likely to intend to reduce drinking than those exposed to LTH advertisements without guidelines (P = 0.022). Response patterns for low- and high-risk drinkers by condition were similar. Alcohol harm television

Cross-National Comparisons of the Association between Alcohol Consumption and Deliberate Self-Harm in Adolescents

ERIC Educational Resources Information Center

Rossow, Ingeborg; Ystgaard, Mette; Hawton, Keith; Madge, Nicola; van Heeringen, Kees; de Wilde, Erik Jan; DeLeo, Diego; Fekete, Sandor; Morey, Carolyn

2007-01-01

How differences in drinking patterns may affect the impact of alcohol consumption on deliberate self-harm among adolescents is explored in this international comparative study. Schools in Australia, Belgium, England, Hungary, Ireland, the Netherlands, and Norway (N = 30,532) were surveyed. In all countries the risk of deliberate self-harm was…

A Multi-Country Study of Harms to Children Because of Others’ Drinking

PubMed Central

Laslett, Anne-Marie; Rankin, Georgia; Waleewong, Orratai; Callinan, Sarah; Hoang, Hanh T. M.; Florenzano, Ramon; Hettige, Siri; Obot, Isidore; Siengsounthone, Latsamy; Ibanga, Akanidomo; Hope, Ann; Landberg, Jonas; Vu, Hanh T. M.; Thamarangsi, Thaksaphon; Rekve, Dag; Room, Robin

2017-01-01

Objective: This study aims to ascertain and compare the prevalence and correlates of alcohol-related harms to children cross-nationally. Method: National and regional sample surveys of randomly selected households included 7,848 carers (4,223 women) from eight countries (Australia, Chile, Ireland, Lao People’s Democratic Republic [PDR], Nigeria, Sri Lanka, Thailand, and Vietnam). Country response rates ranged from 35% to 99%. Face-to-face or telephone surveys asking about harm from others’ drinking to children ages 0–17 years were conducted, including four specific harms: that because of others’ drinking in the past year children had been (a) physically hurt, (b) verbally abused, (c) exposed to domestic violence, or (d) left unsupervised. Results: The prevalence of alcohol-related harms to children varied from a low of 4% in Lao PDR to 14% in Vietnam. Alcohol-related harms to children were reported by a substantial minority of families in most countries, with only Lao PDR and Nigeria reporting significantly lower levels of harm. Alcohol-related harms to children were dispersed sociodemographically and were concentrated in families with heavy drinkers. Conclusions: Family-level drinking patterns were consistently identified as correlates of harm to children because of others’ drinking, whereas sociodemographic factors showed few obvious correlations. PMID:28317499

Alcoholism and Alcohol Abuse

MedlinePlus

... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... the liver, brain, and other organs. Drinking during pregnancy can harm your baby. Alcohol also increases the ...

Alcohol's harm to others' well-being and health: a comparison between Chile and Australia.

PubMed

Dussaillant, Francisca; Fernandez, Miguel

2015-05-01

To assess the degree to which relationships with heavy drinkers affect health and well-being of the Chilean population, and how this compares with previously published analyses of an Australian sample in order to establish intercultural differences in the effects of others' heavy drinking. Data are from a face-to-face survey of 1500 Chileans. Respondents were asked to identify people in their lives who were heavy drinkers. Information on respondents' well-being and health was collected using the Personal Well-Being Index and the EuroQol Group 5-Dimension Self-Report Questionnaire score (EQ-5D) index. Sociodemographic information was also gathered. Bivariate and multivariate analyses were performed to determine whether heavy drinkers in the respondents' lives (both living in or out of their household) were related to health and well-being. Results were contrasted with those for Australia reported by Livingston et al. [in (2010) Impact of heavy drinkers on others' health and well-being. J Stud Alcohol Drugs 71: , 778-785]. Heavy drinkers inside the household negatively affect the health and well-being of Chileans. Heavy drinkers outside the household have a negative but smaller effect on their health and well-being. This contrasts with Australia where most of the harm seems to arise from heavy drinkers identified outside the household. In both countries, health and well-being are affected by others' heavy drinking. The particular structure of harm may vary across cultures: in Chile, heavy drinkers identified inside the household are the most harmful, whereas in Australia those identified outside the household are the most harmful. This should have an impact on the policy design. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

A time series analysis of alcohol-related presentations to emergency departments in Queensland following the increase in alcopops tax.

PubMed

Kisely, Steve; Lawrence, David

2016-02-01

Raising duty on alcohol across the board can reduce morbidity, mortality and other adverse consequences of alcohol use. However, effectiveness is less certain for measures that target specific types of alcohol beverage in isolation. One example from Australia was the increase in tax on alcopops favoured by young people to curb risky drinking in this demographic. We measured alcohol-related health harms in 15-29-year-olds presenting to emergency departments (EDs) in Queensland following the tax increase. These presentations were compared with following ED controls: (1) 15-29-year-olds with asthma or appendicitis; and (2) 30-49-year-olds presenting with alcohol-related harms. We analysed data over a 5-year period (April 2005-April 2010) using a time series analysis. This covered 3 years before, and 2 years after, the tax increase. We investigated both mental and behavioural consequences (F10 codes), and intentional/unintentional injuries (S and T codes). We fitted an ARIMA (autoregressive integrated moving average) model to test for a change following the increased 'alcopops' tax in April 2008. There was no significant decrease in alcohol-related ED presentations in 15-29-year-olds compared to any of the controls. We found similar results for males and females, narrow and broad definitions of alcohol-related harms, under-19s and ED presentations at night-time and weekends. The increase in tax on 'alcopops' did not result in any reduction in alcohol-related harms in this population. Targeting particular alcoholic drinks may therefore not be as effective as more comprehensive policies such as minimum unit pricing for alcohol. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Harms from other people's drinking: an international survey of their occurrence, impacts on feeling safe and legislation relating to their control.

PubMed

Bellis, Mark A; Quigg, Zara; Hughes, Karen; Ashton, Kathryn; Ferris, Jason; Winstock, Adam

2015-12-23

To examine factors associated with suffering harm from another person's alcohol consumption and explore how suffering such harms relate to feelings of safety in nightlife. Cross-sectional opportunistic survey (Global Drug Survey) using an online anonymous questionnaire in 11 languages promoted through newspapers, magazines and social media. Individuals (participating November 2014-January 2015) aged 18-34 years, reporting alcohol consumption in the past 12 months and resident in a country providing ≥ 250 respondents (n=21 countries; 63,725 respondents). Harms suffered due to others' drinking in the past 12 months, feelings of safety on nights out (on the way out, in bars/pubs, in nightclubs and when travelling home) and knowledge of over-serving laws and their implementation. In the past 12 months, >40% of respondents suffered at least one aggressive (physical, verbal or sexual assault) harm and 59.5% any harm caused by someone drunk. Suffering each category of harm was higher in younger respondents and those with more harmful alcohol consumption patterns. Men were more likely than women to have suffered physical assault (9.2% vs 4.7; p<0.001), with women much more likely to suffer sexual assault or harassment (15.3% vs 2.5%; p<0.001). Women were more likely to feel unsafe in all nightlife settings, with 40.8% typically feeling unsafe on the way home. In all settings, feeling unsafe increased with experiencing more categories of aggressive harm by a drunk person. Only 25.7% of respondents resident in countries with restrictions on selling alcohol to drunks knew about such laws and 75.8% believed that drunks usually get served alcohol. Harms from others' drinking are a threat to people's health and well-being. Public health bodies must ensure that such harms are reflected in measures of the societal costs of alcohol, and must advocate for the enforcement of legislation designed to reduce such harms. Published by the BMJ Publishing Group Limited. For permission to

Disregulated Alcohol-Related Behavior among College Drinkers: Associations with Protective Behaviors, Personality, and Drinking Motives

ERIC Educational Resources Information Center

Isaak, Matthew I.; Perkins, David R.; Labatut, Tiffany R.

2011-01-01

Objective: This study investigated the psychometric properties of the Disregulated Alcohol-Related Behaviors Inventory (DARBI), a measure of harmful alcohol-related behavior, and the relationship between protective behavior use and scores on the DARBI and several other measures. Participants: Participants were 281 undergraduate volunteers (60%…

Data sharing for prevention: a case study in the development of a comprehensive emergency department injury surveillance system and its use in preventing violence and alcohol-related harms.

PubMed

Quigg, Zara; Hughes, Karen; Bellis, Mark A

2012-10-01

To examine emergency department (ED) data sharing via a local injury surveillance system and assess its contribution to the prevention of violence and alcohol-related harms. 6-year (2004-2010) exploratory study analysing injury attendances to one ED in the North West of England using descriptive and trend analyses. Over the 6-year period, there were 242,796 ED injury attendances, including 21,683 for intentional injuries. Compared with unintentional injury patients, intentional injury patients were more likely to be men, aged 18-34 years, live in the most deprived communities, have attended the ED at night/weekends, have been injured in a public place and have consumed alcohol prior to the injury. Detailed data collected on alcohol and violence-related ED attendances were shared with local partners to monitor local trends and inform prevention activity including targeted policing and licensing enforcement. Over the 6-year period, intentional ED injury attendances decreased by 35.6% and alcohol-related assault attendances decreased by 30.3%. The collection of additional ED data on assault details and alcohol use prior to injury, and its integration into multi-agency policy and practice, played an important role in driving local violence prevention activity. Further research is needed to assess the direct contribution ED data sharing makes to reductions in violence.

The gendered trouble with alcohol: young people managing alcohol related violence.

PubMed

Lindsay, Jo

2012-05-01

Alcohol related violence is a troubling backdrop to the social lives and relationships of many young people in post-industrial societies. The development of the night-time economy where young people are encouraged to drink heavily in entertainment precincts has increased the risk of violence. This paper reports on 60 individual structured in-depth interviews about the drinking biographies of young people (aged 20-24) living in Victoria, Australia. Twenty-six males and 34 females participated in the research. The participants discussed their experiences with alcohol over their life course to date. The material on alcohol related violence is analysed in this paper. Just over half of the participants (33/60) recounted negative experiences with alcohol related violence. The findings demonstrate the continuing gendered nature of experiences of perpetration and victimization. Participants reported that aggression and violence perpetrated by some men was fuelled by alcohol consumption and required ongoing management. Experiences of violence were also spatialized. Men were more likely to report managing and avoiding violence in particular public settings whilst more women than men discussed managing violence in domestic settings. The central argument of this paper is that incidents of alcohol related violence and reactions to it are specific gender performances that occur in specific socio-cultural contexts. In contrast to research which has found some young people enjoy the adventure and excitement of alcohol related violence the mainstream participants in this study saw violence as a negative force to be managed and preferably avoided. Understanding violence as a dynamic gender performance complicates the development of policy measures designed to minimize harm but also offers a more holistic approach to developing effective policy in this domain. There is a need for greater acknowledgement that alcohol related violence in public venues and in families is primarily about

Improving control over the impulse for reward: sensitivity of harmful alcohol drinkers to delayed reward but not immediate punishment.

PubMed

Rossiter, Sarah; Thompson, Julian; Hester, Robert

2012-09-01

Cognitive control dysfunction has been identified in dependent alcohol users and implicated in the transition from abuse to dependence, although evidence of dyscontrol in chronic but non-dependent 'harmful' alcohol abusers is mixed. The current study examined harmful alcohol users response inhibition over rewarding stimuli in the presence of monetary reward and punishment, to determine whether changes in sensitivity to these factors, noted in imaging studies of dependent users, influences impulse control. Harmful (n=30) and non-hazardous (n=55) alcohol users were administered a Monetary Incentive Go/No-go task that required participants to inhibit a prepotent motor response associated with reward. Harmful alcohol users showed a significantly poorer ability to withhold their impulse for a rewarding stimulus in the presence of immediate monetary punishment for failure, while retaining equivalent response inhibition performance under neutral conditions (associated with neither monetary loss or gain), and significantly better performance under delayed reward conditions. The results of the present study suggest that non-dependent alcohol abusers have altered sensitivity to reward and punishment that influences their impulse control for reward, in the absence of gross dyscontrol that is consistent with past findings in which such performance contingencies were not used. The ability of delayed monetary reward, but not punishment, to increase sustained impulse control in this sample has implications for the mechanism that might underlie the transition from alcohol abuse to dependence, as well as intervention strategies aimed at preventing this transition. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Mortality for alcohol-related harm by country of birth in Scotland, 2000-2004: potential lessons for prevention.

PubMed

Bhala, Neeraj; Fischbacher, Colin; Bhopal, Raj

2010-01-01

Deaths caused by alcohol have increased in the UK, and Scotland in particular, but the change in the rates of alcohol-related deaths for migrants are uncertain, and could yield insights for the general population. Alcohol-related mortality in immigrants among Scotland's residents was assessed using 2001 census data and mortality data from 2000 to 2004. Mortality from direct alcohol-related causes accounted for nearly 1500 deaths per year in Scotland. Age-standardized mortality ratios were comparatively low for people born in Pakistan, other parts of the UK (largely England and Wales) and those from elsewhere in the world. Scotland's propensity to alcohol-related deaths is not shared by all its residents. Studying such variations in more depth could yield lessons for prevention.

Alcohol: taking a population perspective.

PubMed

Gilmore, William; Chikritzhs, Tanya; Stockwell, Tim; Jernigan, David; Naimi, Timothy; Gilmore, Ian

2016-07-01

Alcohol consumption is a global phenomenon, as is the resultant health, social and economic harm. The nature of these harms varies with different drinking patterns and with the societal and political responses to the burden of harm; nevertheless, alcohol-related chronic diseases have a major effect on health. Strong evidence exists for the effectiveness of different strategies to minimize this damage and those policies that target price, availability and marketing of alcohol come out best, whereas those using education and information are much less effective. However, these policies can be portrayed as anti-libertarian and so viewing them in the context of alcohol-related harm to those other than the drinker, such as the most vulnerable in society, is important. When this strategy is successful, as in Scotland, it has been possible to pass strong and effective legislation, such as for a minimum unit price for alcohol.

Data sharing for prevention: a case study in the development of a comprehensive emergency department injury surveillance system and its use in preventing violence and alcohol-related harms

PubMed Central

Quigg, Zara; Hughes, Karen; Bellis, Mark A

2012-01-01

Objective To examine emergency department (ED) data sharing via a local injury surveillance system and assess its contribution to the prevention of violence and alcohol-related harms. Methods 6-year (2004–2010) exploratory study analysing injury attendances to one ED in the North West of England using descriptive and trend analyses. Results Over the 6-year period, there were 242 796 ED injury attendances, including 21 683 for intentional injuries. Compared with unintentional injury patients, intentional injury patients were more likely to be men, aged 18–34 years, live in the most deprived communities, have attended the ED at night/weekends, have been injured in a public place and have consumed alcohol prior to the injury. Detailed data collected on alcohol and violence-related ED attendances were shared with local partners to monitor local trends and inform prevention activity including targeted policing and licensing enforcement. Over the 6-year period, intentional ED injury attendances decreased by 35.6% and alcohol-related assault attendances decreased by 30.3%. Conclusions The collection of additional ED data on assault details and alcohol use prior to injury, and its integration into multi-agency policy and practice, played an important role in driving local violence prevention activity. Further research is needed to assess the direct contribution ED data sharing makes to reductions in violence. PMID:22210640

Alcohol Consumption and Harm among Adolescents in Sweden: Is Smuggled Alcohol More Harmful?

ERIC Educational Resources Information Center

Svensson, Johan

2012-01-01

As a consequence of Sweden joining the European Union, privately imported alcohol is increasingly sold within illegal contexts (i.e., smuggled alcohol). One implication of the smuggled alcohol is that alcohol becomes more available to underage drinkers. In the Swedish debate, smuggled alcohol has been formulated as a youth problem. The aim of this…

Assessing the Representativeness of Population-Sampled Health Surveys Through Linkage to Administrative Data on Alcohol-Related Outcomes

PubMed Central

Gorman, Emma; Leyland, Alastair H.; McCartney, Gerry; White, Ian R.; Katikireddi, Srinivasa Vittal; Rutherford, Lisa; Graham, Lesley; Gray, Linsay

2014-01-01

Health surveys are an important resource for monitoring population health, but selective nonresponse may impede valid inference. This study aimed to assess nonresponse bias in a population-sampled health survey in Scotland, with a focus on alcohol-related outcomes. Nonresponse bias was assessed by examining whether rates of alcohol-related harm (i.e., hospitalization or death) and all-cause mortality among respondents to the Scottish Health Surveys (from 1995 to 2010) were equivalent to those in the general population, and whether the extent of any bias varied according to sociodemographic attributes or over time. Data from consenting respondents (aged 20–64 years) to 6 Scottish Health Surveys were confidentially linked to death and hospitalization records and compared with general population counterparts. Directly age-standardized incidence rates of alcohol-related harm and all-cause mortality were lower among Scottish Health Survey respondents compared with the general population. For all years combined, the survey-to-population rate ratios were 0.69 (95% confidence interval: 0.61, 0.76) for the incidence of alcohol-related harm and 0.89 (95% confidence interval: 0.83, 0.96) for all-cause mortality. Bias was more pronounced among persons residing in more deprived areas; limited evidence was found for regional or temporal variation. This suggests that corresponding underestimation of population rates of alcohol consumption is likely to be socially patterned. PMID:25227767

Linked randomised controlled trials of face-to-face and electronic brief intervention methods to prevent alcohol related harm in young people aged 14-17 years presenting to Emergency Departments (SIPS junior).

PubMed

Deluca, Paolo; Coulton, Simon; Alam, M Fasihul; Cohen, David; Donoghue, Kim; Gilvarry, Eilish; Kaner, Eileen; Maconochie, Ian; McArdle, Paul; McGovern, Ruth; Newbury-Birch, Dorothy; Patton, Robert; Phillips, Ceri; Phillips, Thomas; Russell, Ian; Strang, John; Drummond, Colin

2015-04-10

Alcohol is a major global threat to public health. Although the main burden of chronic alcohol-related disease is in adults, its foundations often lie in adolescence. Alcohol consumption and related harm increase steeply from the age of 12 until 20 years. Several trials focusing upon young people have reported significant positive effects of brief interventions on a range of alcohol consumption outcomes. A recent review of reviews also suggests that electronic brief interventions (eBIs) using internet and smartphone technologies may markedly reduce alcohol consumption compared with minimal or no intervention controls. Interventions that target non-drinking youth are known to delay the onset of drinking behaviours. Web based alcohol interventions for adolescents also demonstrate significantly greater reductions in consumption and harm among 'high-risk' drinkers; however changes in risk status at follow-up for non-drinkers or low-risk drinkers have not been assessed in controlled trials of brief alcohol interventions. The study design comprises two linked randomised controlled trials to evaluate the effectiveness and cost-effectiveness of two intervention strategies compared with screening alone. One trial will focus on high-risk adolescent drinkers attending Emergency Departments (Eds) and the other will focus on those identified as low-risk drinkers or abstinent from alcohol but attending the same ED. Our primary (null) hypothesis is similar for both trials: Personalised Feedback and Brief Advice (PFBA) and Personalised Feedback plus electronic Brief Intervention (eBI) are no more effective than screening alone in alcohol consumed at 12 months after randomisation as measured by the Time-Line Follow-Back 28-day version. Our secondary (null) hypothesis relating to economics states that PFBA and eBI are no more cost-effective than screening alone. In total 1,500 participants will be recruited into the trials, 750 high-risk drinkers and 750 low-risk drinkers or

The effect of short-term alcohol restriction on risk of alcohol-related injury: A state wide population-based study.

PubMed

Liang, Wenbin; Gilmore, William; Chikritzhs, Tanya

2016-02-01

Alcohol consumption and related harms are largely determined by both demand and supply of alcohol. Across Western Australia, under state licensing laws, there are state-wide alcohol sales restrictions imposed on Good Friday and Christmas Day each year. This study aimed to evaluate the effect of the Good Friday and Christmas Day state-wide alcohol restrictions on the risk of alcohol-related injuries presenting at emergency departments. This is a population-based cohort study using ED injury presentation data for the period 1st January 2002 to 1st January 2015. Risk of injury during the alcohol-related time of day affected by the alcohol restrictions (intervention periods, including Good Friday and Christmas Day) were compared to the same time of day over a number of control days. Multivariable Poisson regression model was used to perform the analysis. The crude injury risk was considerably lower during the alcohol restriction periods compared to control periods in both metropolitan and non-metropolitan areas. The protective effect observed on the days of the alcohol restrictions remained significant, and largely unchanged, when potential confounding effects were controlled for. The significant reduction in alcohol-related injury presentations observed for public holiday periods with alcohol restrictions were likely caused by the alcohol restriction policy and its direct effect on alcohol supply. Copyright © 2015 Elsevier B.V. All rights reserved.

Comparing Alcohol Marketing and Alcohol Warning Message Policies Across Canada.

PubMed

Wettlaufer, Ashley; Cukier, Samantha N; Giesbrecht, Norman

2017-08-24

In order to reduce harms from alcohol, evidence-based policies are to be introduced and sustained. To facilitate the dissemination of policies that reduce alcohol-related harms by documenting, comparing, and sharing information on effective alcohol polices related to restrictions on alcohol marketing and alcohol warning messaging in 10 Canadian provinces. Team members developed measurable indicators to assess policies on (a) restrictions on alcohol marketing, and (b) alcohol warning messaging. Indicators were peer-reviewed by three alcohol policy experts, refined, and data were collected, submitted for validation by provincial experts, and scored independently by two team members. The national average score was 52% for restrictions on marketing policies and 18% for alcohol warning message policies. Most provinces had marketing regulations that went beyond the federal guidelines with penalties for violating marketing regulations. The provincial liquor boards' web pages focused on product promotion, and there were few restrictions on sponsorship activities. No province has implemented alcohol warning labels, and Ontario was the sole province to have legislated warning signs at all points-of-sale. Most provinces provided a variety of warning signs to be displayed voluntarily at points-of-sale; however, the quality of messages varied. Conclusions/Importance: There is extensive alcohol marketing with comparatively few messages focused on the potential harms associated with alcohol. It is recommended that governments collaborate with multiple stakeholders to maximize the preventive impact of restrictions on alcohol marketing and advertising, and a broader implementation of alcohol warning messages.

Changing Collective Social Norms in Favour of Reduced Harmful Use of Alcohol: A Review of Reviews.

PubMed

Anderson, Peter; Jané-Llopis, Eva; Hasan, Omer Syed Muhammad; Rehm, Jürgen

2018-05-01

Public sector bodies have called for policies and programmes to shift collective social norms in disfavour of the harmful use of alcohol. This article aims to identify and summarize the evidence and propose how policies and programmes to shift social norms could be implemented and evaluated. Review of reviews for all years to July 2017. Searches on OVID Medline, Healthstar, Embase, PsycINFO, AMED, Social Work Abstracts, CAB Abstracts, Mental Measurements Yearbook, Joanna Briggs Institute EBP, Health and Psychosocial Instruments, International Pharmaceutical Abstracts, International Political Science Abstracts, NASW Clinical Register and Epub Ahead of Print databases. All reviews, without language or date restrictions resulting from combining the terms ((review or literature review or review literature or data pooling or comparative study or systematic review or meta-analysis or pooled analysis) and (social norms or culture) and (alcohol drinking)). Two relevant reviews were identified. One review of community-based interventions found one study that demonstrated small changes in parental disapproval of under-age drinking. One review stressed that collective social norms about drinking are malleable and not uniform in any one country. Three factors are proposed to inform programmes: provide information about the consequences of the harmful use of alcohol, and their causes and distribution; act on groups, not individuals; and strengthen environmental laws, regulations and approaches. Purposeful policies and programmes could be implemented to change collective social norms in disfavour of the harmful use of alcohol; they should be evidence-based and fully evaluated for their impact.

Assessing university students' self-efficacy to employ alcohol-related harm reduction strategies.

PubMed

Rosenberg, Harold; Bonar, Erin E; Hoffmann, Erica; Kryszak, Elizabeth; Young, Kathleen M; Kraus, Shane W; Ashrafioun, Lisham; Bannon, Erin E; Pavlick, Michelle

2011-01-01

Develop and evaluate key psychometric properties of a self-report questionnaire specifically designed to assess student drinkers' self-confidence to employ a variety of strategies intended to reduce unhealthy consequences of high-risk drinking. Four hundred ninety-eight participants rated their confidence (from "not at all confident" to "completely confident") to employ 17 harm reduction strategies when drinking. Factor analysis and internal consistency reliability analyses indicated that the 17 items constitute a single scale with good test-retest reliability. Consistent with other research examining previous use of such strategies, women in our sample reported significantly higher harm reduction self-efficacy than did men. Harm reduction self-efficacy was also associated with reported number of high-risk drinking episodes in the previous 2 weeks. This brief and easily administered questionnaire holds promise as a clinical tool to identify individuals with low harm reduction self-efficacy and as an outcome measure for health promotion and educational interventions.

Alcohol Consumption and Negative Sex-Related Consequences among College Women: The Moderating Role of Alcohol Protective Behavioral Strategies

ERIC Educational Resources Information Center

Moorer, Kayla D.; Madson, Michael B.; Mohn, Richard S.; Nicholson, Bonnie C.

2013-01-01

Alcohol protective behavioral strategies (PBS) limit overall negative consequences; however, less is known about the relationship between PBS and negative sex-related consequences. The purpose of the current study was to examine the moderating effects of 2 distinct types of PBS--controlled consumption strategies and serious harm reduction…

A time series analysis of presentations to Queensland health facilities for alcohol-related conditions, following the increase in 'alcopops' tax.

PubMed

Kisely, Steve; Crowe, Elizabeth; Lawrence, David; White, Angela; Connor, Jason

2013-08-01

In response to concerns about the health consequences of high-risk drinking by young people, the Australian Government increased the tax on pre-mixed alcoholic beverages ('alcopops') favoured by this demographic. We measured changes in admissions for alcohol-related harm to health throughout Queensland, before and after the tax increase in April 2008. We used data from the Queensland Trauma Register, Hospitals Admitted Patients Data Collection, and the Emergency Department Information System to calculate alcohol-related admission rates per 100,000 people, for 15 - 29 year-olds. We analysed data over 3 years (April 2006 - April 2009), using interrupted time-series analyses. This covered 2 years before, and 1 year after, the tax increase. We investigated both mental and behavioural consequences (via F10 codes), and intentional/unintentional injuries (S and T codes). We fitted an auto-regressive integrated moving average (ARIMA) model, to test for any changes following the increased tax. There was no decrease in alcohol-related admissions in 15 - 29 year-olds. We found similar results for males and females, as well as definitions of alcohol-related harms that were narrow (F10 codes only) and broad (F10, S and T codes). The increased tax on 'alcopops' was not associated with any reduction in hospital admissions for alcohol-related harms in Queensland 15 - 29 year-olds.

Investigating local policy drivers for alcohol harm prevention: a comparative case study of two local authorities in England.

PubMed

Mooney, John D; Holmes, John; Gavens, Lucy; de Vocht, Frank; Hickman, Matt; Lock, Karen; Brennan, Alan

2017-10-18

The considerable challenges associated with implementing national level alcohol policies have encouraged a renewed focus on the prospects for local-level policies in the UK and elsewhere. We adopted a case study approach to identify the major characteristics and drivers of differences in the patterns of local alcohol policies and services in two contrasting local authority (LA) areas in England. Data were collected via thirteen semi-structured interviews with key informants (including public health, licensing and trading standards) and documentary analysis, including harm reduction strategies and statements of licensing policy. A two-stage thematic analysis was used to categorize all relevant statements into seven over-arching themes, by which document sources were then also analysed. Three of the seven over-arching themes (drink environment, treatment services and barriers and facilitators), provided for the most explanatory detail informing the contrasting policy responses of the two LAs: LA1 pursued a risk-informed strategy via a specialist police team working proactively with problem premises and screening systematically to identify riskier drinking. LA2 adopted a more upstream regulatory approach around restrictions on availability with less emphasis on co-ordinated screening and treatment measures. New powers over alcohol policy for LAs in England can produce markedly different policies for reducing alcohol-related harm. These difference are rooted in economic, opportunistic, organisational and personnel factors particular to the LAs themselves and may lead to closely tailored solutions in some policy areas and poorer co-ordination and attention in others.

Understanding gambling related harm: a proposed definition, conceptual framework, and taxonomy of harms.

PubMed

Langham, Erika; Thorne, Hannah; Browne, Matthew; Donaldson, Phillip; Rose, Judy; Rockloff, Matthew

2016-01-27

Harm from gambling is known to impact individuals, families, and communities; and these harms are not restricted to people with a gambling disorder. Currently, there is no robust and inclusive internationally agreed upon definition of gambling harm. In addition, the current landscape of gambling policy and research uses inadequate proxy measures of harm, such as problem gambling symptomology, that contribute to a limited understanding of gambling harms. These issues impede efforts to address gambling from a public health perspective. Data regarding harms from gambling was gathered using four separate methodologies, a literature review, focus groups and interviews with professionals involved in the support and treatment of gambling problems, interviews with people who gamble and their affected others, and an analysis of public forum posts for people experiencing problems with gambling and their affected others. The experience of harm related to gambling was examined to generate a conceptual framework. The catalogue of harms experienced were organised as a taxonomy. The current paper proposes a definition and conceptual framework of gambling related harm that captures the full breadth of harms that gambling can contribute to; as well as a taxonomy of harms to facilitate the development of more appropriate measures of harm. Our aim is to create a dialogue that will lead to a more coherent interpretation of gambling harm across treatment providers, policy makers and researchers.

Alcohol-related emergency department injury presentations in Queensland adolescents and young adults over a 13-year period.

PubMed

Hides, Leanne; Limbong, Jesani; Vallmuur, Kirsten; Barker, Ruth; Daglish, Mark; Young, Ross McD

2015-03-01

The rate of alcohol-related emergency department (ED) presentations in young people has increased dramatically in recent decades. Injuries are the most common type of youth alcohol-related ED presentation, yet little is known about these injuries in young people. This paper describes the characteristics of alcohol-related ED injury presentations in young people over a 13-year period and determines if they differ by gender and/or age group (adolescents: 12-17 years; young adults: 18-24 years). The Queensland Injury Surveillance Unit (QISU) database collects injury surveillance data at triage in participating EDs throughout Queensland, Australia. A total of 4667 cases of alcohol-related injuries in young people (aged 12-24 years) were identified in the QISU database between January 1999 and December 2011, using an injury surveillance code and nursing triage text-based search strategy. Overall, young people accounted for 38% of all QISU alcohol-related ED injury presentations in patients aged 12 years or over. The majority of young adults presented with injuries due to violence and falls, whereas adolescents presented due to self-harm or intoxication without other injury. Males presented with injuries due to violence, whereas females presented with alcohol-related self-harm and intoxication. There is a need for more effective ways of identifying the degree of alcohol involvement in injuries among young people presenting to EDs. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Influence of affordability of alcohol on educational disparities in alcohol-related mortality in Finland and Sweden: a time series analysis.

PubMed

Herttua, Kimmo; Östergren, Olof; Lundberg, Olle; Martikainen, Pekka

2017-12-01

Prices of alcohol and income tend to influence how much people buy and consume alcohol. Price and income may be combined into one measure, affordability of alcohol. Research on the association between affordability of alcohol and alcohol-related harm is scarce. Furthermore, no research exists on how this association varies across different subpopulations. We estimated the effects of affordability of alcohol on alcohol-related mortality according to gender and education in Finland and Sweden. Vector-autoregressive time series modelling was applied to the quarter-annual aggregations of alcohol-related deaths and affordability of alcohol in Finland in 1988-2007 and in Sweden in 1991-2008. Alcohol-related mortality was defined using information on both underlying and contributory causes of death. We calculated affordability of alcohol index using information on personal taxable income and prices of various types of alcohol. Among Finnish men with secondary education, an increase of 1% in the affordability of total alcohol was associated with an increase of 0.028% (95% CI 0.004 to 0.053) in alcohol-related mortality. Similar associations were also found for affordability for various types of alcohol and for beer only in the lowest education group. We found few other significant positive associations for other subpopulations in Finland or Sweden. However, reverse associations were found among secondary-educated Swedish women. Overall, the associations between affordability of alcohol and alcohol-related mortality were relatively weak. Increased affordability of total alcoholic beverages was associated with higher rates of alcohol-related mortality only among Finnish men with secondary education. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effects of alcohol taxes on alcohol-related disease mortality in New York State from 1969 to 2006.

PubMed

Delcher, Chris; Maldonado-Molina, Mildred M; Wagenaar, Alexander C

2012-07-01

The relationship of increased alcohol taxes to reductions in alcohol-related harm is well established. Few studies, however, have examined the effects of sudden decreases in alcohol tax rates or effects of narrow tax changes limited to specific beverage types. In the current study, we: (1) examine whether tax increases on spirits have similar effects in reducing alcohol-related disease mortality as increasing taxes on all types of alcoholic beverages simultaneously, and (2) evaluate effects of beer-specific tax decreases in New York State on mortality. We used a time-series, quasi-experimental research design, including non-alcohol deaths within New York State and other states' rates of alcohol-related disease mortality for comparison. The dataset included 456 monthly observations of mortality in New York State over a 38-year period (1969-2006). We used a random-effects approach and included several other important covariates. Alcohol-related disease mortality declined by 7.0% after a 1990 tax increase for spirits and beer. A spirits-only tax increase (in 1972) was not significantly associated with mortality but a data anomaly increased error in this effect estimate. Small tax decreases on beer between 1996 and 2006 had no measurable effect on mortality. Doubling the beer tax from $0.11 to $0.22 per gallon, a return to New York State's 1990 levels, would decrease deaths by an estimated 250 deaths per year. Excise tax increases on beer and spirits were associated with reductions in alcohol-related disease mortality. Modifying tax rates on a single beverage type does not appear to be as effective as doing so on multiple alcoholic beverages simultaneously. In New York, small decreases in beer taxes were not significantly associated with alcohol-related disease mortality. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effects of alcohol taxes on alcohol-related disease mortality in New York State from 1969 to 2006

PubMed Central

Delcher, Chris; Maldonado-Molina, Mildred M.; Wagenaar, Alexander C.

2013-01-01

Objective The relationship of increased alcohol taxes to reductions in alcohol-related harm is well established. Few studies, however, have examined the effects of sudden decreases in alcohol tax rates or effects of narrow tax changes limited to specific beverage types. In the current study, we: (1) examine whether tax increases on spirits have similar effects in reducing alcohol-related disease mortality as increasing taxes on all types of alcoholic beverages simultaneously, and (2) evaluate effects of beer-specific tax decreases in New York State on mortality. Method We used a time-series, quasi-experimental research design, including non-alcohol deaths within New York State and other states’ rates of alcohol-related disease mortality for comparison. The dataset included 456 monthly observations of mortality in New York State over a 38-year period (1969–2006). We used a random-effects approach and included several other important covariates. Results Alcohol-related disease mortality declined by 7.0% after a 1990 tax increase for spirits and beer. A spirits-only tax increase (in 1972) was not significantly associated with mortality but a data anomaly increased error in this effect estimate. Small tax decreases on beer between 1996 and 2006 had no measurable effect on mortality. Doubling the beer tax from $0.11 to $0.22 per gallon, a return to New York State’s 1990 levels, would decrease deaths by an estimated 250 deaths per year. Conclusions Excise tax increases on beer and spirits were associated with reductions in alcohol-related disease mortality. Modifying tax rates on a single beverage type does not appear to be as effective as doing so on multiple alcoholic beverages simultaneously. In New York, small decreases in beer taxes were not significantly associated with alcohol-related disease mortality. PMID:22436591

Should I drink responsibly, safely or properly? Confusing messages about reducing alcohol-related harm.

PubMed

Jones, Sandra C; Hall, Sabine; Kypri, Kypros

2017-01-01

'Responsible drinking' campaigns emerged in the early 1970s as a means of addressing hazardous drinking and its related consequences. While these were initially the product of public health agencies and health-related NGOs, they are increasingly being developed and disseminated by the alcohol industry. There is considerable debate as to whether industry-generated campaigns are designed to reduce hazardous drinking and related problems (as argued by their developers) or are designed to avoid government regulation or even to increase sales. The aim of the present study was to explore the way that recent industry-developed responsible drinking campaigns are perceived and interpreted by the general public. That is, do they promote low-risk drinking, promote risky drinking, or just muddy the waters. Two sub-studies were conducted. The first, a mall intercept study with 180 adults in two Australian shopping districts, explored participants' understanding of slogans/taglines. The second, an online survey with 480 Australian adults, explored understandings and interpretations of television/online commercials. The results of the two studies revealed diversity in participants' interpretation of the 'responsible drinking' advertisements. Terminology utilised in industry-developed advertisements was found to be ambiguous; for example, what age group was being referred to in the tagline 'Kids and alcohol don't mix', and whether 'Drink Properly' meant not drinking to excess or drinking in a way that made you look more sophisticated. In Study Two, the government-developed campaign ('Know when to say when') was clearly interpreted as warning against risky consumption of alcohol; whereas the industry-developed campaigns ('How to drink properly', 'Kids absorb your drinking', 'Friends are waiting') were interpreted to have a range of different meanings, including some seemingly unrelated to alcohol. These findings are consistent with the literature evaluating anti-smoking campaigns

The Role of Alcohol Perceptions as Mediators Between Personality and Alcohol-Related Outcomes Among Incoming College-Student Drinkers

PubMed Central

Hustad, John T. P.; Pearson, Matthew R.; Neighbors, Clayton; Borsari, Brian

2014-01-01

After high school, college students escalate their drinking at a faster rate than their noncollege-attending peers, and alcohol use in high school is one of the strongest predictors of alcohol use in college. Therefore, an improved understanding of the role of predictors of alcohol use during the critical developmental period when individuals transition to college has direct clinical implications to reduce alcohol-related harms. We used path analysis in the present study to examine the predictive effects of personality (e.g., impulsivity, sensation seeking, hopelessness, and anxiety sensitivity) and three measures of alcohol perception: descriptive norms, injunctive norms, and perceptions regarding the perceived role of drinking in college on alcohol-related outcomes. Participants were 490 incoming freshmen college students. Results indicated that descriptive norms, injunctive norms, and the role of drinking largely mediated the effects of personality on alcohol outcomes. In contrast, both impulsivity and hopelessness exhibited direct effects on alcohol-related problems. The perceived role of drinking was a particularly robust predictor of outcomes and mediator of the effects of personality traits, including sensation seeking and impulsivity on alcohol outcomes. The intertwined relationships observed in this study between personality factors, descriptive norms, injunctive norms, and the role of drinking highlight the importance of investigating these predictors simultaneously. Findings support the implementation of interventions that target these specific perceptions about the role of drinking in college. PMID:24467197

Culture clash: alcohol marketing and public health aspirations.

PubMed

Munro, Geoffrey; de Wever, Johanna

2008-03-01

It is of no coincidence that a number of recent Harm Reduction Digests have addressed the issue of the reduction of alcohol-related harm. Despite the dominant focus on illicit drug use in the popular discourse, alcohol remains Australia's number one drug problem, as it is in many other developed countries. In this Digest Munro and de Wever use the 'four Ps' of marketing: product, price, place and promotion, to critique the two decades industry self-regulation of alcohol marketing. They conclude that if we are going to develop policies which effectively change Australian drinking culture to reduce alcohol-related harm, we need first to accept that the alcohol industry and the health field have separate and conflicting interests.

Weakening of one more alcohol control pillar: a review of the effects of the alcohol tax cuts in Finland in 2004.

PubMed

Mäkelä, Pia; Osterberg, Esa

2009-04-01

To review the consequences of the changes in Finnish alcohol policy in 2004, when quotas for travellers' tax-free imports of alcoholic beverages from other European Union (EU) countries were abolished, Estonia joined the EU and excise duties on alcoholic beverages were reduced in Finland by one-third, on average. A review of published research and routinely available data. Finland. Prices of alcoholic beverages, recorded and unrecorded alcohol consumption, data on criminality and other police statistics, alcohol-related deaths and hospitalizations, service use. Alcohol consumption increased 10% in 2004, clearly more than in the early 2000s. With few exceptions, alcohol-related harms increased. Alcohol-induced liver disease deaths increased the most, by 46% in 2004-06 compared to 2001-03, which indicates a strong effect on pre-2004 heavy drinkers. Consumption and harms increased most among middle-aged and older segments of the population, and harms in the worst-off parts of the population in particular. Alcohol taxation and alcohol prices affect consumption and related harms, and heavy drinkers are responsive to price. In Finland in 2004, the worst-off parts of the population paid the highest price in terms of health for cuts in alcohol prices. The removal of travellers' import quotas, which was an inherent part of creating the single European market, had serious public health consequences in Finland.

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

PubMed

Karriker-Jaffe, Katherine J; Greenfield, Thomas K

2014-05-01

To examine whether alcohol's harms to others are more prevalent in socioeconomically disadvantaged neighbourhoods and whether men or women are at differential risk in these neighbourhoods. Cross-sectional survey data from 2000 and 2005 National Alcohol Surveys were linked to geo-referenced indicators of neighbourhood disadvantage from the US 2000 Decennial Census. The pooled sample included 10,121 adults (54% female; average age 44.4 years; 69% White; 13% African-American; 13% Hispanic). A dichotomous indicator denoted neighbourhoods based on the top quartile on a five-item measure of disadvantage (alpha = 0.90). We examined past-year family problems due to someone else's drinking (marriage difficulties and/or financial trouble) and victimisation by someone who had been drinking (having property vandalised and/or being pushed, hit or assaulted). During the prior 12 months, 6% of women and 3% of men experienced family problems from someone else's drinking, and 4% of women and 7% of men reported being victimised by drinkers. Multivariate logistic regression models adjusting for individual-level socioeconomic status and other demographic characteristics showed the relationship between neighbourhood disadvantage and harms from someone else's drinking was moderated by gender, with significantly higher odds of family problems in disadvantaged neighbourhoods for men but not for women, as well as significantly higher odds of crime victimisation in disadvantaged neighbourhoods for women but not men. Experiences of harms from someone else's drinking in disadvantaged neighbourhoods vary for men and women. Targeted intervention strategies are needed to reduce alcohol's harm to others. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Family Based Prevention of Alcohol and Risky Sex for Older Teens

ClinicalTrials.gov

2018-05-08

Alcohol Drinking; Alcohol Intoxication; Alcohol Poison; Alcohol-Related Disorders; Alcohol Impairment; Alcohol Withdrawal; Alcohol Abstinence; Alcohol; Harmful Use; Sex Behavior; Sexual Aggression; Sexual Harassment; Relation, Interpersonal

Impact of alcohol harm reduction strategies in community sports clubs: pilot evaluation of the Good Sports program.

PubMed

Rowland, Bosco; Allen, Felicity; Toumbourou, John W

2012-05-01

Approximately 4.5 million Australians are involved in community sports clubs. A high level of alcohol consumption tends to be commonplace in this setting. The only program of its type in the world, the Good Sports program was designed to reduce harmful alcohol consumption in these Australian community sports clubs. The program offers a staged accreditation process to encourage the implementation of alcohol harm-reduction strategies. We conducted a postintervention adoption study to evaluate whether community sports club accreditation through the Good Sports program was associated with lower rates of alcohol consumption. We examined alcohol consumption rates in 113 clubs (N = 1,968 participants) and compared these to consumption rates in the general community. We hypothesized that members of clubs with more advanced implementation of the Good Sports accreditation program (Stage Two) would consume less alcohol than those with less advanced implementation (Stage One). Multilevel modeling (MLM) indicated that on days when teams competed, Stage Two club members consumed 19% less alcohol than Stage One club members. MLM also indicated that the length of time a club had been in the Good Sports program was associated with reduced rates of weekly drinking that exceeded Australian short-term risky drinking guidelines. However consumption rates for all clubs were still higher than the general community. Higher accreditation stage also predicted reduced long-term risky drinking by club members. Our findings suggest that community sports clubs show evidence of higher levels of alcohol consumption and higher rates of risky consumption than the general community. Implementation of the Good Sports accreditation strategy was associated with lower alcohol consumption in these settings.

Temporal Patterns of Alcohol Consumption and Alcohol-Related Road Accidents in Young Swiss Men: Seasonal, Weekday and Public Holiday Effects.

PubMed

Foster, Simon; Gmel, Gerhard; Estévez, Natalia; Bähler, Caroline; Mohler-Kuo, Meichun

2015-09-01

To assess seasonal, weekday, and public holiday effects on alcohol-related road accidents and drinking diaries among young Swiss men. Federal road accident data (35,485 accidents) from Switzerland and drinking diary data from a large cohort of young Swiss men (11,930 subjects) were analysed for temporal effects by calendar week, weekday and public holiday (Christmas, New Years, National Day). Alcohol-related accidents were analysed using rate ratios for observed versus expected numbers of accidents and proportions of alcohol-related accidents relative to the total number. Drinking diaries were analysed for the proportion of drinkers, median number of drinks consumed, and the 90th percentile's number of drinks consumed. Several parallel peaks were identified in alcohol-related accidents and drinking diaries. These included increases on Fridays and Saturdays, with Saturday drinking extending until early Sunday morning, an increase during the summer on workdays but not weekends, an increase at the end of the year, and increases on public holidays and the evening before. Our results suggest specific time-windows that are associated with increases in drinking and alcohol-related harm. Established prevention measures should be enforced during these time-windows to reduce associated peaks. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

The relationship between a less gender-stereotypical parenthood and alcohol-related care and death: A registry study of Swedish mothers and fathers

PubMed Central

Månsdotter, Anna; Backhans, Mona; Hallqvist, Johan

2008-01-01

Background In general men tend to drink more alcohol and experience more alcohol-related sickness, injuries and mortality than women. In this paper, the overall hypothesis was that increased gender similarity in the division of parental duties would lead to convergence in alcohol-related harm. The aim was to analyse whether the risk of alcohol harm differs between parents who fit a gender-stereotypical versus those with a less gender-stereotypical division of childcare and paid work. Methods The study sample was a retrospective registry-based cohort study of all Swedish couples who had their first child together in 1978 (N = 49,120). A less gender-stereotypical parenthood was indicated by paternity leave for fathers (1978–1979) and full-time work for mothers (1980). The outcome was inpatient care and/or death caused by alcohol psychosis, alcoholism, liver disease, or alcohol intoxication in the two decades following (1981–2001). Our main statistical method was multivariate logistic regression with odds ratios used to estimate relative risks. Results The main results show that fathers who took paternity leave had 18% lower risk of alcohol-related care and/or death than other fathers. Mothers who worked full-time about two years after having a child had 71% higher risk than mothers who were unemployed or worked part-time. Conclusion A less gender-stereotypical division of duties between parents in early parenthood may contribute to a long-term decreased gender disparity regarding risky alcohol consumption and alcohol-related harm. In order to know more about the causal direction however, future research has to consider subjects' drinking patterns in the years prior to parenthood. PMID:18793385

The relationship between a less gender-stereotypical parenthood and alcohol-related care and death: a registry study of Swedish mothers and fathers.

PubMed

Månsdotter, Anna; Backhans, Mona; Hallqvist, Johan

2008-09-15

In general men tend to drink more alcohol and experience more alcohol-related sickness, injuries and mortality than women. In this paper, the overall hypothesis was that increased gender similarity in the division of parental duties would lead to convergence in alcohol-related harm. The aim was to analyse whether the risk of alcohol harm differs between parents who fit a gender-stereotypical versus those with a less gender-stereotypical division of childcare and paid work. The study sample was a retrospective registry-based cohort study of all Swedish couples who had their first child together in 1978 (N = 49,120). A less gender-stereotypical parenthood was indicated by paternity leave for fathers (1978-1979) and full-time work for mothers (1980). The outcome was inpatient care and/or death caused by alcohol psychosis, alcoholism, liver disease, or alcohol intoxication in the two decades following (1981-2001). Our main statistical method was multivariate logistic regression with odds ratios used to estimate relative risks. The main results show that fathers who took paternity leave had 18% lower risk of alcohol-related care and/or death than other fathers. Mothers who worked full-time about two years after having a child had 71% higher risk than mothers who were unemployed or worked part-time. A less gender-stereotypical division of duties between parents in early parenthood may contribute to a long-term decreased gender disparity regarding risky alcohol consumption and alcohol-related harm. In order to know more about the causal direction however, future research has to consider subjects' drinking patterns in the years prior to parenthood.

Should I drink responsibly, safely or properly? Confusing messages about reducing alcohol-related harm

PubMed Central

Hall, Sabine; Kypri, Kypros

2017-01-01

‘Responsible drinking’ campaigns emerged in the early 1970s as a means of addressing hazardous drinking and its related consequences. While these were initially the product of public health agencies and health-related NGOs, they are increasingly being developed and disseminated by the alcohol industry. There is considerable debate as to whether industry-generated campaigns are designed to reduce hazardous drinking and related problems (as argued by their developers) or are designed to avoid government regulation or even to increase sales. The aim of the present study was to explore the way that recent industry-developed responsible drinking campaigns are perceived and interpreted by the general public. That is, do they promote low-risk drinking, promote risky drinking, or just muddy the waters. Two sub-studies were conducted. The first, a mall intercept study with 180 adults in two Australian shopping districts, explored participants’ understanding of slogans/taglines. The second, an online survey with 480 Australian adults, explored understandings and interpretations of television/online commercials. The results of the two studies revealed diversity in participants’ interpretation of the ‘responsible drinking’ advertisements. Terminology utilised in industry-developed advertisements was found to be ambiguous; for example, what age group was being referred to in the tagline ‘Kids and alcohol don’t mix’, and whether ‘Drink Properly’ meant not drinking to excess or drinking in a way that made you look more sophisticated. In Study Two, the government-developed campaign (‘Know when to say when’) was clearly interpreted as warning against risky consumption of alcohol; whereas the industry-developed campaigns (‘How to drink properly’, ‘Kids absorb your drinking’, ‘Friends are waiting’) were interpreted to have a range of different meanings, including some seemingly unrelated to alcohol. These findings are consistent with the

Intoxication with alcohol at the time of self-harm and pre-existing involvement with mental health services are associated with a pre-disposition to repetition of self-harming behavior in a large cohort of older New Zealanders presenting with an index episode of self-harm.

PubMed

Ames, David

2017-08-01

The paper on predictors of repeat self-harm and suicide by Cheung et al. (2017), which has been chosen by the editorial team as paper of the month for this issue of International Psychogeriatrics, makes a very useful contribution to the study of self-harm and suicide in late life. Of 339 individuals presenting with an index episode of self-harm to one of seven Emergency Departments (EDs) in New Zealand, close to 15% harmed themselves again within one year and for nearly one in six of these 50 people, the repeat episode was fatal. Having alcohol in the blood and already being engaged with mental health services at the time of the index episode both had some utility in predicting the occurrence of a further self-harm episode. While it is encouraging that mental health services look to have been focusing on those who turned out to be at highest risk, clinicians may need to be particularly vigilant when following up individuals who had been drinking alcohol at the time of an initial self-harm presentation. This study also emphasizes the high risk of recurrent self-harm and completed suicide in those older adults who harm themselves and survive the initial episode. It deserves to be widely cited and gives some direction for future research on interventions designed to diminish the recurrence of self-harm in those of our patients who have presented to an ED with an initial self-harm episode.

Screening and brief interventions for hazardous and harmful alcohol use among university students in South Africa: results from a randomized controlled trial.

PubMed

Pengpid, Supa; Peltzer, Karl; van der Heever, Hendry; Skaal, Linda

2013-05-21

The aim of this study was to assess the effectiveness of Screening and Brief Intervention (SBI) for alcohol problems among university students in South Africa. The study design for this efficacy study is a randomized controlled trial with 6- and 12-month follow-ups to examine the effects of a brief alcohol intervention to reduce alcohol use by hazardous and harmful drinkers in a university setting. The unit of randomization is the individual university student identified as a hazardous or harmful drinker attending public recruitment venues in a university campus. University students were screened for alcohol problems, and those identified as hazardous or harmful drinkers were randomized into an experimental or control group. The experimental group received one brief counseling session on alcohol risk reduction, while the control group received a health education leaflet. Results indicate that of the 722 screened for alcohol and who agreed to participate in the trial 152 (21.1%) tested positive for the Alcohol Use Disorder Identification Test (AUDIT) (score 8 or more). Among the 147 (96.7%) university students who also attended the 12-month follow-up session, the intervention effect on the AUDIT score was -1.5, which was statistically significant (P = 0.009). Further, the depression scores marginally significantly decreased over time across treatment groups, while other substance use (tobacco and cannabis use), self-rated health status and Posttraumatic Stress Disorder (PTSD) scores did not change over time across treatment groups. The study provides evidence of effective brief intervention by assistant nurses with hazardous and harmful drinkers in a university setting in South Africa. The short duration of the brief intervention makes it a realistic candidate for use in a university setting.

Self-harm and life problems: findings from the Multicentre Study of Self-harm in England.

PubMed

Townsend, Ellen; Ness, Jennifer; Waters, Keith; Kapur, Navneet; Turnbull, Pauline; Cooper, Jayne; Bergen, Helen; Hawton, Keith

2016-02-01

Self-harm is a major clinical problem and is strongly linked to suicide. It is important to understand the problems faced by those who self-harm to design effective clinical services and suicide prevention strategies. We investigated the life problems experienced by patients presenting to general hospitals for self-harm. Data for 2000-2010 from the Multicentre Study of Self-harm in England were used to investigate life problems associated with self-harm and their relationship to patient and clinical characteristics, including age, gender, repeat self-harm and employment status. Of 24,598 patients (36,431 assessed episodes), 57% were female and with a mean age of 33.1 years (SD 14.0 years), 92.6% were identified as having at least one contributing life problem. The most frequently reported problems at first episode of self-harm within the study period were relationship difficulties (especially with partners). Mental health issues and problems with alcohol were also very common (especially in those aged 35-54 years, and those who repeated self-harm). Those who repeated self-harm were more likely to report problems with housing, mental health and dealing with the consequences of abuse. Self-harm usually occurs in the context of multiple life problems. Clinical services for self-harm patients should have access to appropriate care for provision of help for relationship difficulties and problems concerning alcohol and mental health issues. Individualised clinical support (e.g. psychological therapy, interventions for alcohol problems and relationship counselling) for self-harm patients facing these life problems may play a crucial role in suicide prevention.

Tackling risky alcohol consumption in sport: a cluster randomised controlled trial of an alcohol management intervention with community football clubs

PubMed Central

Kingsland, Melanie; Wolfenden, Luke; Tindall, Jennifer; Rowland, Bosco C; Lecathelinais, Christophe; Gillham, Karen E; Dodds, Pennie; Sidey, Maree N; Rogerson, John C; McElduff, Patrick; Crundall, Ian; Wiggers, John H

2015-01-01

Background An increased prevalence of risky alcohol consumption and alcohol-related harm has been reported for members of sporting groups and at sporting venues compared with non-sporting populations. While sports clubs and venues represent opportune settings to implement strategies to reduce such risks, no controlled trials have been reported. The purpose of the study was to examine the effectiveness of an alcohol management intervention in reducing risky alcohol consumption and the risk of alcohol-related harm among community football club members. Method A cluster randomised controlled trial of an alcohol management intervention was undertaken with non-elite, community football clubs and their members in New South Wales, Australia. Risky alcohol consumption (5+ drinks) at the club and risk of alcohol-related harm using the Alcohol Use Disorders Identification Test (AUDIT) were measured at baseline and postintervention. Results Eighty-eight clubs participated in the trial (n=43, Intervention; n=45, Control) and separate cross-sectional samples of club members completed the baseline (N=1411) and postintervention (N=1143) surveys. Postintervention, a significantly lower proportion of intervention club members reported: risky alcohol consumption at the club (Intervention: 19%; Control: 24%; OR: 0.63 (95% CI 0.40 to 1.00); p=0.05); risk of alcohol-related harm (Intervention: 38%; Control: 45%; OR: 0.58 (95% CI 0.38 to 0.87); p<0.01); alcohol consumption risk (Intervention: 47%; Control: 55%; OR: 0.60 (95% CI 0.41 to 0.87); p<0.01) and possible alcohol dependence (Intervention: 1%; Control: 4%; OR: 0.20 (95% CI 0.06 to 0.65); p<0.01). Conclusions With large numbers of people worldwide playing, watching and sports officiating, enhancing club-based alcohol management interventions could make a substantial contribution to reducing the burden of alcohol misuse in communities. Trial registration number ACTRN12609000224224. PMID:26038252

Quantifying alcohol-related emergency admissions in a UK tertiary referral hospital: a cross-sectional study of chronic alcohol dependency and acute alcohol intoxication

PubMed Central

Vardy, J; Keliher, T; Fisher, J; Ritchie, F; Bell, C; Chekroud, M; Clarey, F; Blackwood, L; Barry, L; Paton, E; Clark, A; Connelly, R

2016-01-01

Objectives Alcohol is responsible for a proportion of emergency admissions to hospital, with acute alcohol intoxication and chronic alcohol dependency (CAD) implicated. This study aims to quantify the proportion of hospital admissions through our emergency department (ED) which were thought by the admitting doctor to be (largely or partially) a result of alcohol consumption. Setting ED of a UK tertiary referral hospital. Participants All ED admissions occurring over 14 weeks from 1 September to 8 December 2012. Data obtained for 5497 of 5746 admissions (95.67%). Primary outcome measures Proportion of emergency admissions related to alcohol as defined by the admitting ED clinician. Secondary outcome measures Proportion of emergency admissions due to alcohol diagnosed with acute alcohol intoxication or CAD according to ICD-10 criteria. Results 1152 (21.0%, 95% CI 19.9% to 22.0%) of emergency admissions were thought to be due to alcohol. 74.6% of patients admitted due to alcohol had CAD, and significantly greater than the 26.4% with ‘Severe’ or ‘Very Severe’ acute alcohol intoxication (p<0.001). Admissions due to alcohol differed to admissions not due to alcohol being on average younger (45 vs 56 years, p<0.001) more often male (73.4% vs 45.1% males, p<0.001) and more likely to have a diagnosis synonymous with alcohol or related to recreational drug use, pancreatitis, deliberate self-harm, head injury, gastritis, suicidal ideation, upper gastrointestinal bleeds or seizures (p<0.001). An increase in admissions due to alcohol on Saturdays reflects a surge in admissions with acute alcohol intoxication above the weekly average (p=0.003). Conclusions Alcohol was thought to be implicated in 21% of emergency admissions in this cohort. CAD is responsible for a significantly greater proportion of admissions due to alcohol than acute intoxication. Interventions designed to reduce alcohol-related admissions must incorporate measures to tackle CAD. PMID:27324707

Quantifying alcohol-related emergency admissions in a UK tertiary referral hospital: a cross-sectional study of chronic alcohol dependency and acute alcohol intoxication.

PubMed

Vardy, J; Keliher, T; Fisher, J; Ritchie, F; Bell, C; Chekroud, M; Clarey, F; Blackwood, L; Barry, L; Paton, E; Clark, A; Connelly, R

2016-06-20

Alcohol is responsible for a proportion of emergency admissions to hospital, with acute alcohol intoxication and chronic alcohol dependency (CAD) implicated. This study aims to quantify the proportion of hospital admissions through our emergency department (ED) which were thought by the admitting doctor to be (largely or partially) a result of alcohol consumption. ED of a UK tertiary referral hospital. All ED admissions occurring over 14 weeks from 1 September to 8 December 2012. Data obtained for 5497 of 5746 admissions (95.67%). Proportion of emergency admissions related to alcohol as defined by the admitting ED clinician. Proportion of emergency admissions due to alcohol diagnosed with acute alcohol intoxication or CAD according to ICD-10 criteria. 1152 (21.0%, 95% CI 19.9% to 22.0%) of emergency admissions were thought to be due to alcohol. 74.6% of patients admitted due to alcohol had CAD, and significantly greater than the 26.4% with 'Severe' or 'Very Severe' acute alcohol intoxication (p<0.001). Admissions due to alcohol differed to admissions not due to alcohol being on average younger (45 vs 56 years, p<0.001) more often male (73.4% vs 45.1% males, p<0.001) and more likely to have a diagnosis synonymous with alcohol or related to recreational drug use, pancreatitis, deliberate self-harm, head injury, gastritis, suicidal ideation, upper gastrointestinal bleeds or seizures (p<0.001). An increase in admissions due to alcohol on Saturdays reflects a surge in admissions with acute alcohol intoxication above the weekly average (p=0.003). Alcohol was thought to be implicated in 21% of emergency admissions in this cohort. CAD is responsible for a significantly greater proportion of admissions due to alcohol than acute intoxication. Interventions designed to reduce alcohol-related admissions must incorporate measures to tackle CAD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Distances to on- and off-premise alcohol outlets and experiences of alcohol-related amenity problems.

PubMed

Wilkinson, Claire; Livingston, Michael

2012-06-01

There are a number of studies in recent years that have examined the relationship of alcohol outlets to the incidence of alcohol-related problems. Only a small number of these studies examine the types of alcohol-related problems which may be considered amenity problems, such as neighbourhood disturbance, litter and noise. This paper examines the association between the proximity of someone's home to alcohol outlets and their experience of public amenity problems. Data came from an Australian general population survey: the Alcohol's Harm to Others Survey (2008). Two thousand six hundred and forty-nine Australians aged 18 years and over were asked about their experiences of a number of amenity-type problems and the distance they lived to the nearest on- and off-premise alcohol outlet. Bivariate results showed that respondents living closer to on- and off-premise outlets reported more problems, with minor differences by distance to on- and off-premise outlet. In multivariate logistic regression analyses, controlling for possible confounding effects of the respondent and neighbourhood characteristics, living closer to on-premise outlets was independently associated with reporting being kept awake or disturbed at night and living closer to an off-premise outlet was independently associated with reporting property damage. A possible interpretation of the results is that respondents living close to on- and off-premise outlets experience more amenity problems than those living further away, but that these experiences are concentrated among demographic groups who live in these areas. Direction of influence cannot be inferred from these cross-sectional findings. © 2011 Australasian Professional Society on Alcohol and other Drugs.

There has been little progress in implementing comprehensive alcohol control strategies in Africa.

PubMed

Peer, Nasheeta

2017-11-01

Alcohol is the most common substance of addiction and a threat not only to health but also to sustainable human development. Consequently, at least a 10% relative reduction in the harmful use of alcohol has been advocated by the World Health Organization (WHO). This perspective describes alcohol use in Africa, strategies to reduce harmful alcohol use, and the ability of African countries to meet this target. Although alcohol consumption in Africa was intermediate compared to other world regions, the total alcohol per capita among alcohol consumers was the second highest (19.5 liters); 19% of Sub-Saharan African men could be classified as binge drinkers. The alcohol industry is the key driver behind the uptake of alcohol use and misuse. The most cost-effective ways to reduce alcohol-related harm is to make alcohol less available and more expensive and to prohibit alcohol advertising. Most African countries have alcohol excise taxes, but these are not adjusted for inflation, meaning that the effectiveness of these taxes will likely decrease with time, leading to greater affordability. The majority of African countries do not have legally binding regulations for alcohol marketing. Alcohol misuse in Africa is not being addressed at a time when available strategies can efficiently and cost-effectively control alcohol-related harm.

Cost-effectiveness of interventions to prevent alcohol-related disease and injury in Australia.

PubMed

Cobiac, Linda; Vos, Theo; Doran, Christopher; Wallace, Angela

2009-10-01

To evaluate cost-effectiveness of eight interventions for reducing alcohol-attributable harm and determine the optimal intervention mix. Interventions include volumetric taxation, advertising bans, an increase in minimum legal drinking age, licensing controls on operating hours, brief intervention (with and without general practitioner telemarketing and support), drink driving campaigns, random breath testing and residential treatment for alcohol dependence (with and without naltrexone). Cost-effectiveness is modelled over the life-time of the Australian population in 2003, with all costs and health outcomes evaluated from an Australian health sector perspective. Each intervention is compared with current practice, and the most cost-effective options are then combined to determine the optimal intervention mix. Cost-effectiveness is measured in 2003 Australian dollars per disability adjusted life year averted. Although current alcohol intervention in Australia (random breath testing) is cost-effective, if the current spending of $71 million could be invested in a more cost-effective combination of interventions, more than 10 times the amount of health gain could be achieved. Taken as a package of interventions, all seven preventive interventions would be a cost-effective investment that could lead to substantial improvement in population health; only residential treatment is not cost-effective. Based on current evidence, interventions to reduce harm from alcohol are highly recommended. The potential reduction in costs of treating alcohol-related diseases and injuries mean that substantial improvements in population health can be achieved at a relatively low cost to the health sector. © 2009 The Authors. Journal compilation © 2009 Society for the Study of Addiction.

Effect of the Australian "Alcopops Tax" on Alcohol-Related Emergency Department Presentations for Injury in Two States.

PubMed

Lensvelt, Eveline; Liang, Wenbin; Gilmore, William; Gordon, Elise; Hobday, Michelle; Chikritzhs, Tanya

2016-09-01

The purpose of this study was to examine the impact of a specific tax increase on ready-to-drink beverages (the "alcopops" tax) on male injuries presenting to emergency departments during times likely to be highly alcohol related in two Australian states. Poisson regression was used to compare annual risk of Western Australian and Victorian male emergency department injuries occurring during high alcohol-related times before and after the implementation of the alcopops tax. A range of age groups was examined. Surrogate methodology was applied to identify numbers of emergency department injuries that occurred during high and low alcohol-related times. Risk of injury during high alcohol-related times (incident rate ratio [IRR]) was lower among Western Australian 12- to 15-year-olds beginning from the year of the tax increase and continued throughout. Lower IRRs were also apparent for 15- to 19-year-olds, although some delay was implicated. There was no change for 12- to 15-year-old Victorians, but immediate declines were evident for 15- to 19-year-olds. To a lesser extent, delayed effects were also indicated for 20- to 29-year-olds in both states. There was no evidence of a change in injury risk during high alcohol-related times among the oldest age group (35-39 years). Previous research on beverage-specific taxes has suggested that they may increase alcohol-related harms among the target group. This study found no evidence of increased injury during high alcohol-related times associated with the alcopops tax in two states. Evidence of reduced harm was apparent, however, and strongest for Western Australian males aged 19 years and younger. These outcomes are consistent with documented national reductions in alcopops sales.

Effects of Acute Alcohol Consumption on the Processing of Emotion in Faces: Implications for Understanding Alcohol-Related Aggression

PubMed Central

Attwood, Angela S.; Munafò, Marcus R.

2016-01-01

The negative consequences of chronic alcohol abuse are well known, but heavy episodic consumption ("binge drinking") is also associated with significant personal and societal harms. Aggressive tendencies are increased after alcohol but the mechanisms underlying these changes are not fully understood. While effects on behavioural control are likely to be important, other effects may be involved given the widespread action of alcohol. Altered processing of social signals is associated with changes in social behaviours, including aggression, but until recently there has been little research investigating the effects of acute alcohol consumption on these outcomes. Recent work investigating the effects of acute alcohol on emotional face processing has suggested reduced sensitivity to submissive signals (sad faces) and increased perceptual bias towards provocative signals (angry faces) after alcohol consumption, which may play a role in alcohol-related aggression. Here we discuss a putative mechanism that may explain how alcohol consumption influences emotional processing and subsequent aggressive responding, via disruption of OFC-amygdala connectivity. While the importance of emotional processing on social behaviours is well established, research into acute alcohol consumption and emotional processing is still in its infancy. Further research is needed and we outline a research agenda to address gaps in the literature. PMID:24920135

Combining energy drinks and alcohol - a recipe for trouble?

PubMed

Pennay, Amy; Lubman, Dan; Miller, Peter

2011-03-01

Combining energy drinks (such as 'Red Bull(®)') with alcohol is becoming increasingly popular, particularly among young people. However, as yet, limited research has been conducted examining the harms associated with this form of drinking. To review current evidence associated with combining energy drinks with alcohol and provide recommendations for addressing this issue within primary care. Combining alcohol with energy drinks can mask the signs of alcohol intoxication, resulting in greater levels of alcohol intake, dehydration, more severe and prolonged hangovers, and alcohol poisoning. It may also increase engagement in risky behaviours (such as drink driving) as well as alcohol related violence. General practitioners should be aware of the harms associated with this pattern of drinking, and provide screening and relevant harm reduction advice.

Economic Evaluation of Internet-Based Interventions for Harmful Alcohol Use Alongside a Pragmatic Randomized Controlled Trial

PubMed Central

Nabitz, Udo; Smit, Filip; Koeter, Maarten WJ; Schippers, Gerard M

2012-01-01

Background Internet interventions with and without therapist support have been found to be effective treatment options for harmful alcohol users. Internet-based therapy (IT) leads to larger and longer-lasting positive effects than Internet-based self-help (IS), but it is also more costly to provide. Objective To evaluate the cost effectiveness and cost utility of Internet-based interventions for harmful use of alcohol through the assessment of the incremental cost effectiveness of IT compared with IS. Methods This study was performed in a substance abuse treatment center in Amsterdam, the Netherlands. We collected data over the years 2008–2009. A total of 136 participants were included, 70 (51%) were female, and mean age was 41.5 (SD 9.83) years. Reported alcohol consumption and Alcohol Use Disorders Identification Test (AUDIT) scores indicated harmful drinking behavior at baseline. We collected self-reported outcome data prospectively at baseline and 6 months after randomization. Cost data were extracted from the treatment center’s cost records, and sex- and age-specific mean productivity cost data for the Netherlands. Results The median incremental cost-effectiveness ratio was estimated at €3683 per additional treatment responder and €14,710 per quality-adjusted life-year (QALY) gained. At a willingness to pay €20,000 for 1 additional QALY, IT had a 60% likelihood of being more cost effective than IS. Sensitivity analyses attested to the robustness of the findings. Conclusions IT offers better value for money than IS and might therefore be considered as a treatment option, either as first-line treatment in a matched-care approach or as a second-line treatment in the context of a stepped-care approach. Trial Registration Netherlands Trial Register NTR-TC1155; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1155 (Archived by WebCite at http://www.webcitation.org/6AqnV4eTU) PMID:23103771

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

PubMed

Bunker, Naomi; Woods, Cindy; Conway, Jane; Barker, Ruth; Usher, Kim

2017-01-01

This study aimed to establish the scale of alcohol-related injuries originating in the home. Despite recent media and public attention on alcohol-related injuries occurring at licensed venues, many occur in other locations including the home. A retrospective observational study. Emergency department surveillance data sourced from the Queensland Injury Surveillance Unit were interrogated for alcohol-related emergency department presentations from 2003-2012 (n = 12,296). Descriptive analysis was undertaken to assess alcohol involvement in injury, and analysis of variance was used to determine the differences among group means and their associated presentations. The relationship between demographic variables and injury location was assessed using p value of <0·05 as statistically significant. Of all injuries that were positively identified as being alcohol related, 41·07% occurred at the 'other' location, 36·14% 'at home', 13·00% on the street and 9·78% at licensed premises. Of these, males (n = 2635; 59%) represented a higher proportion than females (n = 1807; 41%). Of injuries identified as domestic violence by spouse or partner (n = 510), 59·5% occurred 'at home'. This is the first study to investigate alcohol-related injuries occurring at home. The home accounts for a greater proportion of injuries than the frequently assessed licensed premises location. Further research is required to validate these findings in a wider setting. A public health campaign is required to minimise harm associated with alcohol-related injuries in the home, and nurses are positioned to inform health policy makers around this issue. Furthermore, emergency department nurses are in a unique position to provide brief interventions around safe alcohol consumption and injury prevention. © 2016 John Wiley & Sons Ltd.

A Preliminary Investigation of Caffeinated Alcohol Use During Spring Break.

PubMed

Linden-Carmichael, Ashley N; Lau-Barraco, Cathy

2016-06-06

Caffeinated alcoholic beverages (e.g., Red Bull and vodka) are popular but associated with negative consequences. CABs may be particularly popular during Spring Break, a potentially risky social event. We aimed to identify the prevalence of Spring Break caffeinated alcohol use, determine how caffeinated alcohol use Spring Break drinking habits differ from usual, and examine the association between Spring Break caffeinated alcohol use and alcohol-related problems. Data were collected from 95 college students during March of 2013 and 2014. Students completed questionnaires of their alcohol and caffeinated alcohol use before and during Spring Break and Spring Break alcohol-related problems. Approximately 54% of students used caffeinated alcohol during Spring Break. Spring Break caffeinated alcohol use was associated with more alcohol-related problems, even after controlling for other alcohol consumed and Spring Break vacation status. Caffeinated alcoholic beverages are commonly consumed during Spring Break and their use uniquely predicted harms. Prevention efforts placed on caffeinated alcoholic beverage users may be helpful in reducing Spring Break-related harms.

Screening and brief interventions for hazardous and harmful alcohol use in primary care: a cluster randomised controlled trial protocol

PubMed Central

Kaner, Eileen; Bland, Martin; Cassidy, Paul; Coulton, Simon; Deluca, Paolo; Drummond, Colin; Gilvarry, Eilish; Godfrey, Christine; Heather, Nick; Myles, Judy; Newbury-Birch, Dorothy; Oyefeso, Adenekan; Parrott, Steve; Perryman, Katherine; Phillips, Tom; Shenker, Don; Shepherd, Jonathan

2009-01-01

Background There have been many randomized controlled trials of screening and brief alcohol intervention in primary care. Most trials have reported positive effects of brief intervention, in terms of reduced alcohol consumption in excessive drinkers. Despite this considerable evidence-base, key questions remain unanswered including: the applicability of the evidence to routine practice; the most efficient strategy for screening patients; and the required intensity of brief intervention in primary care. This pragmatic factorial trial, with cluster randomization of practices, will evaluate the effectiveness and cost-effectiveness of different models of screening to identify hazardous and harmful drinkers in primary care and different intensities of brief intervention to reduce excessive drinking in primary care patients. Methods and design GPs and nurses from 24 practices across the North East (n = 12), London and South East (n = 12) of England will be recruited. Practices will be randomly allocated to one of three intervention conditions: a leaflet-only control group (n = 8); brief structured advice (n = 8); and brief lifestyle counselling (n = 8). To test the relative effectiveness of different screening methods all practices will also be randomised to either a universal or targeted screening approach and to use either a modified single item (M-SASQ) or FAST screening tool. Screening randomisation will incorporate stratification by geographical area and intervention condition. During the intervention stage of the trial, practices in each of the three arms will recruit at least 31 hazardous or harmful drinkers who will receive a short baseline assessment followed by brief intervention. Thus there will be a minimum of 744 patients recruited into the trial. Discussion The trial will evaluate the impact of screening and brief alcohol intervention in routine practice; thus its findings will be highly relevant to clinicians working in primary care in the UK. There will

Perceived vulnerability moderates the relations between the use of protective behavioral strategies and alcohol use and consequences among high-risk young adults.

PubMed

Garcia, Tracey A; Fairlie, Anne M; Litt, Dana M; Waldron, Katja A; Lewis, Melissa A

2018-06-01

Drinking protective behavioral strategies (PBS) have been associated with reductions in alcohol use and alcohol-related consequences in young adults. PBS subscales, Limiting/Stopping (LS), Manner of Drinking (MOD), and Serious Harm Reduction (SHR), have been examined in the literature; LS, MOD, and SHR have mixed support as protective factors. Understanding moderators between PBS and alcohol use and related consequences is an important development in PBS research in order to delineate when and for whom PBS use is effective in reducing harm from alcohol use. Perceptions of vulnerability to negative consequences, included in health-risk models, may be one such moderator. The current study examined whether two types of perceived vulnerability (perceived vulnerability when drinking; perceived vulnerability in uncomfortable/unfamiliar situations) moderated the relations between LS, MOD, SHR strategies and alcohol use and related negative consequences. High-risk young adults (N = 400; 53.75% female) recruited nationally completed measures of PBS, alcohol use and related consequences, and measures of perceived vulnerability. Findings demonstrated that perceived vulnerability when drinking moderated the relations between MOD strategies and alcohol use. The interactions between perceived vulnerability when drinking and PBS did not predict alcohol-related consequences. Perceived vulnerability in unfamiliar/uncomfortable social situations moderated relations between MOD strategies and both alcohol use and related negative consequences; no other significant interactions emerged. Across both perceived vulnerability types and MOD strategies, those with the highest levels of perceived vulnerability and who used MOD strategies the most had the greatest decrements in alcohol use and related negative consequences. Prevention and intervention implications are discussed. Copyright © 2018. Published by Elsevier Ltd.

Western Australian students' alcohol consumption and expenditure intentions for Schoolies.

PubMed

Jongenelis, Michelle I; Pettigrew, Simone; Biagioni, Nicole; Hagger, Martin S

2017-07-01

In Australia, the immediate post-school period (known as 'Schoolies') is associated with heavy drinking and high levels of alcohol-related harm. This study investigated students' intended alcohol consumption during Schoolies to inform interventions to reduce alcohol-related harm among this group. An online survey was administered to students in their senior year of schooling. Included items related to intended daily alcohol consumption during Schoolies, amount of money intended to be spent on alcohol over the Schoolies period, and past drinking behaviour. On average, participants (n=187) anticipated that they would consume eight standard drinks per day, which is substantially higher than the recommended maximum of no more than four drinks on a single occasion. Participants intended to spend an average of A$131 on alcohol over the Schoolies period. Although higher than national guidelines, intended alcohol consumption was considerably lower than has been previously documented during Schoolies events. The substantial amounts of money expected to be spent during Schoolies suggest this group has adequate spending power to constitute an attractive target market for those offering alternative activities that are associated with lower levels of alcohol-related harm.

Alcohol use, alcohol-related aggression and intimate partner abuse: A cross-sectional survey of convicted versus general population men in Scotland.

PubMed

Gilchrist, Elizabeth Allison; Ireland, Lana; Forsyth, Alasdair; Godwin, Jon; Laxton, Tim

2017-01-01

Scotland has a particular problem with alcohol, and the links between intimate partner abuse (IPA) and alcohol appear stronger here than elsewhere across Europe. This study explored differences in alcohol use, related aggression and relationship conflict across a number of groups: men convicted for intimate partner abuse, men convicted of general offences and men recruited from community sports teams. Participants (n = 64) completed three questionnaires exploring their experiences of alcohol use (Alcohol Use Disorders Identification Test, AUDIT); alcohol and aggression (Alcohol Related Aggression Questionnaire, ARAQ-28), and relationship conflict (Revised Conflict Tactics Scale, CTS-2). There were significant differences across the groups in terms of AUDIT and ARAQ-28 scores, IPA and general offenders scored higher than the community sample. CTS-2 scores showed significant differences: both offender groups reported more use of negotiation and psychological abuse, than the community men, and IPA offenders reported causing more physical harm than either general offenders or the community sample. ARAQ-28 scores correlated with psychological abuse for general offenders. Alcohol use was very high across all groups, but the community group did not endorse an aggression-precipitating view of alcohol and did not report high IPA. Discussed is the need for cross-cultural research to explore putative mediators and moderators in the relationship between alcohol, aggressiveness and IPA. [Gilchrist EA, Ireland L, Forsyth A, Godwin J, Laxton T. Alcohol use, alcohol-related aggression and intimate partner abuse: A cross-sectional survey of convicted versus general population men in Scotland. Drug Alcohol Rev 2017;36:20-23]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Socioeconomic determinants of risk of harmful alcohol drinking among people aged 50 or over in England.

PubMed

Iparraguirre, José

2015-07-23

This paper looks into the socioeconomic determinants of risk of harmful alcohol drinking and of the transitions between risk categories over time among the population aged 50 or over in England. Community-dwellers across England. Respondents to the English Longitudinal Survey of Ageing, waves 4 and 5. (Confidence level at 95% or higher, except when stated): ▸ Higher risk drinking falls with age and there is a non-linear association between age and risk for men, peaking in their mid-60s. ▸ Retirement and income are positively associated with a higher risk for women but not for men. ▸ Education and smoking are positively associated for both sexes. ▸ Loneliness and depression are not associated. ▸ Caring responsibilities reduce risk among women. ▸ Single, separated or divorced men show a greater risk of harmful drinking (at 10% confidence level). ▸ For women, being younger and having a higher income at baseline increase the probability of becoming a higher risk alcohol drinker over time. ▸ For men, not eating healthily, being younger and having a higher income increase the probability of becoming a higher risk alcohol drinker. Furthermore, the presence of children living in the household, being lonely, being older and having a lower income are associated with ceasing to be a higher risk alcohol drinker over time. Several socioeconomic factors found to be associated with high-risk alcohol consumption behaviour among older people would align with those promoted by the 'successful ageing' policy framework. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Who Purchases Low-Cost Alcohol in Australia?

PubMed

Callinan, Sarah; Room, Robin; Livingston, Michael; Jiang, Heng

2015-11-01

Debates surrounding potential price-based polices aimed at reducing alcohol-related harms tend to focus on the debate concerning who would be most affected-harmful or low-income drinkers. This study will investigate the characteristics of people who purchase low-cost alcohol using data from the Australian arm of the International Alcohol Control study. 1681 Australians aged 16 and over who had consumed alcohol and purchased it in off-licence premises were asked detailed questions about both practices. Low-cost alcohol was defined using cut-points of 80¢, $1.00 or $1.25 per Australian standard drink. With a $1.00 cut-off low income (OR = 2.1) and heavy drinkers (OR = 1.7) were more likely to purchase any low-cost alcohol. Harmful drinkers purchased more, and low-income drinkers less, alcohol priced at less than $1.00 per drink than high income and moderate drinkers respectively. The relationship between the proportion of units purchased at low cost and both drinker category and income is less clear, with hazardous, but not harmful, drinkers purchasing a lower proportion of units at low cost than moderate drinkers. The impact of minimum pricing on low income and harmful drinkers will depend on whether the proportion or total quantity of all alcohol purchased at low cost is considered. Based on absolute units of alcohol, minimum unit pricing could be differentially effective for heavier drinkers compared to other drinkers, particularly for young males. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

How economic crises affect alcohol consumption and alcohol-related health problems: a realist systematic review.

PubMed

de Goeij, Moniek C M; Suhrcke, Marc; Toffolutti, Veronica; van de Mheen, Dike; Schoenmakers, Tim M; Kunst, Anton E

2015-04-01

Economic crises are complex events that affect behavioral patterns (including alcohol consumption) via opposing mechanisms. With this realist systematic review, we aimed to investigate evidence from studies of previous or ongoing crises on which mechanisms (How?) play a role among which individuals (Whom?). Such evidence would help understand and predict the potential impact of economic crises on alcohol consumption. Medical, psychological, social, and economic databases were used to search for peer-reviewed qualitative or quantitative empirical evidence (published January 1, 1990-May 1, 2014) linking economic crises or stressors with alcohol consumption and alcohol-related health problems. We included 35 papers, based on defined selection criteria. From these papers, we extracted evidence on mechanism(s), determinant, outcome, country-level context, and individual context. We found 16 studies that reported evidence completely covering two behavioral mechanisms by which economic crises can influence alcohol consumption and alcohol-related health problems. The first mechanism suggests that psychological distress triggered by unemployment and income reductions can increase drinking problems. The second mechanism suggests that due to tighter budget constraints, less money is spent on alcoholic beverages. Across many countries, the psychological distress mechanism was observed mainly in men. The tighter budget constraints mechanism seems to play a role in all population subgroups across all countries. For the other three mechanisms (i.e., deterioration in the social situation, fear of losing one's job, and increased non-working time), empirical evidence was scarce or absent, or had small to moderate coverage. This was also the case for important influential contextual factors described in our initial theoretical framework. This realist systematic review suggests that among men (but not among women), the net impact of economic crises will be an increase in harmful

[Connection between cancer- and alcohol-related mortality in a rural practice of a South-Hungarian village].

PubMed

Péter, Arpád

2013-05-05

The author, who is a sole general practitioner in a Hungarian village, has continuously followed mortality in his practice for a long period of time. He found connections between cancer- and alcohol-related mortality in the first observational period between 1987 and 1999. Among men, cancer mortality related to alcoholism reached 50% in men and 7.9% in women. The aim of the author was to obtain new data on the relation between cancer- and alcohol-related mortality during a 12-year period between 2000 and 2011, and compare them with findings in his earlier work. Data recorded in detailed death reports were analysed. For the main cause of death, long-term data from the medical history of patients were analysed thoroughly. Between 2000 and 2011 there were 326 cases of death (167 men and 159 women). Despite several changes in the structure of the cause of mortality (the frequency of alcohol-related deaths considerably decreased while the frequency of cancer-related deaths somewhat increased), the proportion of alcohol-related cancer mortality has increased to 60% in men and 9.1% in women. These data confirm earlier observation of the author showing that alcoholism is frequent in this Hungarian village and that it contributes to the high cancer mortality of the inhabitants, especially in men. Therefore, decreased alcohol consumption and alcohol-related harms would be an important step in cancer prevention.

Prescription opioid related misuse, harms, diversion and interventions in Canada: a review.

PubMed

Fischer, Benedikt; Argento, Elena

2012-07-01

) have increased considerably in Ontario where relevant data from the mid-1990s onward have been examined. In Canadian populations reporting NMPOU, sourcing of POs occurs through various diversion routes, including from family/friends, "double-doctoring," or street drug markets. In addition, losses and theft/robberies from pharmacies and licensed medications dealers appear to be on the rise. Finally, interventions (i.e., provincial PO guidelines, prescription monitoring programs, substance use treatment services) are fragmented and inconsistently applied throughout the country, and currently fail to effectively address the growing problem of NMPOU and PO-related harms across Canada. This review did not rely on systematic review methodologies. Corresponding to its increasing and high overall PO consumption levels, NMPOU and PO-related harms in Canada are high based on available data, and likely now constitute the third highest level of substance use burden of disease (after alcohol and tobacco). The data and monitoring situation in Canada regarding NMPOU and PO-related harms are fragmented, un-systematic, and insufficient. While major and concerted policy initiatives - primarily from the federal level - are absent to date, these urgently require vastly improved national data indicators and monitoring in order to allow for and evaluate evidence-based interventions on this urgent and extensive public health problem.

Suicide and Self-Harm Related Internet Use.

PubMed

Padmanathan, Prianka; Biddle, Lucy; Carroll, Robert; Derges, Jane; Potokar, John; Gunnell, David

2018-05-31

The rise in Internet use adds a new dimension to suicide prevention. We investigated suicide/self-harm (S/Sh)-related Internet use among patients presenting to hospital with self-harm. We asked 1,198 adult and 315 child and adolescent patients presenting to hospital following self-harm in a city in South West England about Internet use associated with their hospital presentation. Associations between Internet use and sociodemographic and clinical characteristics were investigated using multivariable logistic regression models. Focus groups with clinicians explored the acceptability and utility of asking about Internet use. The prevalence of S/Sh-related Internet use was 8.4% (95% CI: 6.8-10.1%) among adult hospital presentations and 26.0% (95% CI = 21.3-31.2%) among children's hospital presentations. In both samples, S/Sh-related Internet use was associated with higher levels of suicidal intent. Mostly, clinicians found it acceptable to ask about Internet use during psychosocial assessments and believed this could inform perceptions of risk and decision-making. It is unclear whether the findings in this study are applicable to the general self-harm patient population because only those who had psychosocial assessments were included. S/Sh-related Internet use is likely to become increasingly relevant as the Internet-native generation matures. Furthermore, Internet use may be a proxy marker for intent.

Combined alcohol and energy drink use: hedonistic motives, adenosine, and alcohol dependence.

PubMed

Marczinski, Cecile A

2014-07-01

Consumption of alcohol mixed with energy drinks (AmED) has been associated with both short- and long-term risks beyond those observed with alcohol alone. AmED use has been associated with heavy episodic (binge) drinking, risky behaviors, and risk of alcohol dependence. Laboratory research has demonstrated that AmED beverages lead to greater motivation to drink versus the same amount of alcohol consumed alone. However, the reason consumers find AmED beverages particularly appealing has been unclear. A recent report by Droste and colleagues (Alcohol Clin Exp Res 2014; 38:2087-2095) is the first study to investigate motivations related to AmED consumption and to determine which motives predict AmED consumption patterns, experience of drinking-related harms, and risk of alcohol dependence. The findings of this study significantly enhance our understanding of why AmED consumption is related to the risk of alcohol dependence and change our understanding of why consumers choose AmED beverages. The authors report that hedonistic motives strongly predicted AmED use and the harms associated with use. While intoxication-reduction motives predicted self-reported accidents and injuries, these motives did not predict AmED consumption patterns and risk of dependence. The risk of alcohol dependence may arise from repeated experiences when drinking alcohol is more pleasurable when energy drinks are consumed with the alcohol. This commentary will focus on why energy drinks might increase the rewarding properties of alcohol in social drinkers. In addition, discussion is provided explaining why more research on the neurotransmitter, adenosine, may actually inform us about the mechanisms contributing to the development of alcohol dependence. Copyright © 2014 by the Research Society on Alcoholism.

Personalised digital interventions for reducing hazardous and harmful alcohol consumption in community-dwelling populations.

PubMed

Kaner, Eileen Fs; Beyer, Fiona R; Garnett, Claire; Crane, David; Brown, Jamie; Muirhead, Colin; Redmore, James; O'Donnell, Amy; Newham, James J; de Vocht, Frank; Hickman, Matthew; Brown, Heather; Maniatopoulos, Gregory; Michie, Susan

2017-09-25

Excessive alcohol use contributes significantly to physical and psychological illness, injury and death, and a wide array of social harm in all age groups. A proven strategy for reducing excessive alcohol consumption levels is to offer a brief conversation-based intervention in primary care settings, but more recent technological innovations have enabled people to interact directly via computer, mobile device or smartphone with digital interventions designed to address problem alcohol consumption. To assess the effectiveness and cost-effectiveness of digital interventions for reducing hazardous and harmful alcohol consumption, alcohol-related problems, or both, in people living in the community, specifically: (i) Are digital interventions more effective and cost-effective than no intervention (or minimal input) controls? (ii) Are digital interventions at least equally effective as face-to-face brief alcohol interventions? (iii) What are the effective component behaviour change techniques (BCTs) of such interventions and their mechanisms of action? (iv) What theories or models have been used in the development and/or evaluation of the intervention? Secondary objectives were (i) to assess whether outcomes differ between trials where the digital intervention targets participants attending health, social care, education or other community-based settings and those where it is offered remotely via the internet or mobile phone platforms; (ii) to specify interventions according to their mode of delivery (e.g. functionality features) and assess the impact of mode of delivery on outcomes. We searched CENTRAL, MEDLINE, PsycINFO, CINAHL, ERIC, HTA and Web of Knowledge databases; ClinicalTrials.com and WHO ICTRP trials registers and relevant websites to April 2017. We also checked the reference lists of included trials and relevant systematic reviews. We included randomised controlled trials (RCTs) that evaluated the effectiveness of digital interventions compared with no

Tackling alcohol misuse: purchasing patterns affected by minimum pricing for alcohol.

PubMed

Ludbrook, Anne; Petrie, Dennis; McKenzie, Lynda; Farrar, Shelley

2012-01-01

Alcohol consumption is associated with a range of health and social harms that increase with the level of consumption. Policy makers are interested in effective and cost-effective interventions to reduce alcohol consumption and associated harms. Economic theory and research evidence demonstrate that increasing price is effective at the population level. Price interventions that target heavier consumers of alcohol may be more effective at reducing alcohol-related harms with less impact on moderate consumers. Minimum pricing per unit of alcohol has been proposed on this basis but concerns have been expressed that 'moderate drinkers of modest means' will be unfairly penalized. If those on low incomes are disproportionately affected by a policy that removes very cheap alcohol from the market, the policy could be regressive. The effect on households' budgets will depend on who currently purchases cheaper products and the extent to which the resulting changes in prices will impact on their demand for alcohol. This paper focuses on the first of these points. This paper aims to identify patterns of purchasing of cheap off-trade alcohol products, focusing on income and the level of all alcohol purchased. Three years (2006-08) of UK household survey data were used. The Expenditure and Food Survey provides comprehensive 2-week data on household expenditure. Regression analyses were used to investigate the relationships between the purchase of cheap off-trade alcohol, household income levels and whether the household level of alcohol purchasing is categorized as moderate, hazardous or harmful, while controlling for other household and non-household characteristics. Predicted probabilities and quantities for cheap alcohol purchasing patterns were generated for all households. The descriptive statistics and regression analyses indicate that low-income households are not the predominant purchasers of any alcohol or even of cheap alcohol. Of those who do purchase off-trade alcohol

Australian television news coverage of alcohol, health and related policies, 2005 to 2010: implications for alcohol policy advocates.

PubMed

Fogarty, Andrea S; Chapman, Simon

2012-12-01

To describe television news coverage between 2005 and 2010 of alcohol, health and relevant alcohol-control policies, with a view to informing policy advocacy. A content analysis of all alcohol stories archived by the Australian Health News Research Collaboration. We recorded what triggered a news item, the main topics covered, whether risks to health were communicated, whether alcohol-control policies were featured and which news-actors appeared. We identified 612 stories, where 69.2% were triggered by a particular newsworthy incident or the release of new findings. The most frequently reported alcohol stories were focused on associated harms (30.2%) and 'binge drinking' (19.0%). A majority (75.3%) reported a variety of positive and negative health effects, yet mainly focused on short-term consequences. Combined, 63% mentioned an alcohol-control policy, yet no one particular policy was featured in more than 10% of all stories. The most commonly featured news-actors included public-health professionals (50.0%), members of affected communities (28.4%) and government representatives (24.3%) Problems related to alcohol were well-established foci of news attention and reportage and covered a broad spectrum of issues related to public health goals, yet less coverage centred on long-term health consequences or effective policy solutions. Future policy advocacy could focus on moving the debate away from simple problem definition to better communication of long-term health risks, existing policies, and evidence of their effectiveness and arguments for their adoption. Future research might consider audience understanding of the information. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

Alcohol craving and demand mediate the relation between posttraumatic stress symptoms and alcohol-related consequences.

PubMed

Tripp, Jessica C; Meshesha, Lidia Z; Teeters, Jenni B; Pickover, Alison M; McDevitt-Murphy, Meghan E; Murphy, James G

2015-10-01

Posttraumatic stress (PTS) symptoms are associated with alcohol-related consequences, but there is a need to understand mediators that may help explain the reasons for this relationship. Individuals with PTS may experience elevated craving and alcohol reward value (demand), which may contribute to risk for alcohol-related consequences. We examined relationships between PTS status, craving, alcohol demand, and alcohol-related consequences in PTS-positive (n = 64) and PTS-negative (n = 200) college students (M age = 21.7; 77% women; 54% Caucasian; 34% African American) who endorsed past-month alcohol use. We tested craving and alcohol demand as mediators of the relation between PTS status and alcohol-related consequences. Craving (B = .04, SE = .02, 95% CI [.01, .10]), demand intensity (B = .02, SE = .02, 95% CI [.001, .07]), and demand elasticity (B = .05, SE = .03, 95% CI [.006, .12]) significantly mediated the association between PTS symptoms and alcohol-related consequences. Craving remained a significant mediator in a multiple mediators model (B = .08, SE = .04, 95% CI [.03, .19]). Craving and alcohol demand may partially explain the relation between PTS status and alcohol-related consequences. Craving may be especially salient for individuals with PTS symptoms, as it may lead to more severe alcohol-related consequences even in the absence of elevated alcohol consumption. (c) 2015 APA, all rights reserved).

Avoidance of alcohol-related stimuli in alcohol-dependent inpatients.

PubMed

Townshend, J M; Duka, T

2007-08-01

Previous research has shown an attentional bias toward drug-related stimuli in heavy social drinkers. Attentional orientation to drug-related cues may lead to increased craving and preoccupation with the drug and impaired ability to focus attention on nondrug-related activities, resulting in renewed drug taking or relapse from drug abstinence. The aim of this study was to investigate whether alcohol-dependent inpatients would differ in their selective attention toward alcohol-related stimuli in comparison with a group of social drinking controls. Thirty-five alcohol-dependent inpatients were compared with a group of 39 social drinking controls matched for age, sex, and verbal IQ. Attentional bias was assessed using alcohol-related pictures in a dot probe detection task. Questionnaires were used to examine outcome expectancies after alcohol consumption, anxiety, mood, and craving. The alcoholic inpatients showed a bias away from the alcohol-related stimuli, scored higher on alcohol outcome expectancies, and on anxiety measures (both state and trait). They also presented with more negative mood compared with the control group. Craving was higher in the alcoholic group for the factor "loss of control over drinking." Alcoholic inpatients undergoing treatment based on the 12-step treatment of Alcoholics Anonymous (Minnesota model), which includes counseling, and intensive group, individual, and family psychotherapy, show an avoidance for drug-related stimuli and a perception of loss of control over drinking. We suggest that their increased perception of loss of control over drinking produces the avoidance from the drug-related stimuli.

Alcohol-related presentations to the Royal Perth Hospital Emergency Department: A prospective study.

PubMed

McLay, Stuart Vb; MacDonald, Ellen; Fatovich, Daniel M

2017-10-01

To quantify and describe alcohol-related presentations to our ED, as part of the binational Alcohol Harm in Emergency Departments study. A prospective observational study at Royal Perth Hospital of every patient attending ED for the 168-h period commencing 08.00 hours Monday 1 December 2014. Patient presentations were classified as alcohol-related (alcohol-positive) using predefined criteria. These patients were compared to alcohol-negative patients on a range of demographic and clinical descriptors. Two hundred and thirteen (15.2%) of 1403 patients screened were alcohol-positive. Compared with alcohol-negative patients, alcohol-positive patients were more likely to be male (148/213, 69.5% vs 636/1190, 53.4%, P < 0.001) and younger (mean 38 years vs 48 years, P < 0.001). They were more likely to arrive in police custody (OR 3.7, 95% CI 1.3-9.5, P = 0.005), and be admitted to the State Adult Major Trauma Unit (OR 4.2, 95% CI 2.1-8.3, P < 0.001). Forty-two (19.7%) of 213 patients had injuries suspected to be caused by an alcohol-affected third party. The ED length of stay and admission rate were not significantly different between the groups. 15.2% of patient presentations over the study week were alcohol-related. These patients were more likely to present with injury; one in five having injuries suspected to be caused by a third party affected by alcohol. This is a significant public health problem. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

The effect of alcohol outlets, sales and trading hours on alcohol-related injuries presenting at emergency departments in Perth, Australia, from 2002 to 2010.

PubMed

Hobday, Michelle; Chikritzhs, Tanya; Liang, Wenbin; Meuleners, Lynn

2015-12-01

Few studies have investigated the combined effects of alcohol sales, outlet numbers and trading hours on alcohol-related harms. This study aimed to test whether associations: (i) exist between alcohol-related emergency department (ED) injuries and alcohol sales and counts of outlets; (ii) vary between on- and off-premises outlets; and (iii) vary by trading hours conditions [extended trading permits (ETP) versus standard hours]. Panel study using 117 postcodes over 8 years (2002-10): 936 data points. Perth, Australia. ED injury presentations, aggregated to postcode-level. Alcohol-related injuries were identified using time-based surrogate measures: night injuries (n=51,241) and weekend night injuries (n=30,682). Measures of alcohol availability included number of outlets with standard and extended trading hours and mean sales per postcode. Negative binomial regression modelling with random effects was used to examine associations between availability and alcohol-related injury, controlling for socio-demographic characteristics. (i) Night injuries were associated significantly with counts of on-premises outlets [incident rate ratio (IRR)=1.046; 95% confidence interval (CI)=1.014-1.078] and sales per off-premises outlet (IRR=1.019; 95% CI=1.004-1.035); (ii) counts of on-premises outlets were positively associated with alcohol-related injury while counts of off-premises outlets indicated a negative association; and (iii) weekend night injuries increased by about 5% per on-premises outlet with an ETP (IRR=1.049; 95% CI=1.015-1.084) and by less than 1% for outlets with standard trading hours (IRR=1.008; 95% CI=1.004-1.013). Regions of Perth, Australia with greater off-premises alcohol sales and counts of on-premises alcohol outlets, particularly those with extended trading hours, appear to have higher levels of alcohol-related injuries. © 2015 Society for the Study of Addiction.

Academic-Industry Partnerships in Alcohol and Gambling: a Continuum of Benefits and Harms.

PubMed

Stein, Dan J

2015-01-01

There are many reasons why collaboration between academic institutions and private industry should be encouraged. At the same time, such collaborations raise the potential for profound conflicts of interest. Furthermore, there may be different kinds of issues in different kinds of industry, as is reflected in the metaphors we employ to think about them. The pharmaceutical industry is at times viewed as a "good" industry that can go wrong, while the tobacco industry is analogously viewed as a "bad" industry that can do little right. The alcohol and gambling industries may be particularly useful to think through insofar as they arguably require a continuum of benefits and harms to be acknowledged. I consider a number of initiatives by the alcohol and gambling industry in South Africa, and argue that there are real opportunities for delineating and developing more robust models of academic-industry collaboration, which ensure that public health is maximized in that country and elsewhere.

Alcohol Craving and Demand Mediate the Relation between Posttraumatic Stress Symptoms and Alcohol-Related Consequences

PubMed Central

Tripp, Jessica C.; Meshesha, Lidia Z.; Teeters, Jenni B.; Pickover, Alison; McDevitt-Murphy, Meghan E.; Murphy, James G.

2015-01-01

Objective Posttraumatic stress (PTS) symptoms are associated with alcohol-related consequences, but there is a need to understand mediators that may help explain the reasons for this relationship. Individuals with PTS may experience elevated craving and alcohol reward value (demand), which may contribute to risk for alcohol-related consequences. Method We examined relationships between PTS status, craving, alcohol demand, and alcohol-related consequences in PTS-positive (n = 64) and PTS-negative (n = 200) college students (M age = 21.7; 77% women; 54% Caucasian; 34% African American) who endorsed past-month alcohol use. We tested craving and alcohol demand as mediators of the relation between PTS status and alcohol problems. Results Craving (B = .04, SE = .02, 95% CI = .01 – .10), demand intensity (B = .05, SE = .03, 95% CI = .0009 – .17), and demand elasticity (B = .05, SE = .03, 95% CI = .006 – .03) significantly mediated the association between PTS symptoms and alcohol problems. Craving remained a significant mediator in a multiple mediators model (B = .08, SE = .04, 95% CI = .03 – .19). Conclusions Craving and alcohol demand may partially explain the relation between PTS status and alcohol-related consequences. Craving may be especially salient for individuals with PTS symptoms, as it may lead to more severe alcohol-related consequences even in the absence of elevated alcohol consumption. PMID:26375513

Preliminary examination of spring break alcohol use and related consequences.

PubMed

Lee, Christine M; Lewis, Melissa A; Neighbors, Clayton

2009-12-01

The authors examined the extent to which college student drinkers are at risk for experiencing negative alcohol-related consequences during Spring Break. A sample of first-year college student drinkers (N = 726) participated by completing an online survey assessing typical drinking, as well as Spring Break drinking and related consequences. Findings suggest Spring Break drinking was positively associated with alcohol-related consequences during Spring Break, even after controlling for sex and typical drinking. Furthermore, results indicated that typical drinking moderated the relationship between Spring Break drinking and expected zero-values (i.e., not reporting any Spring Break consequences), such that the association between Spring Break drinking and the likelihood of being a zero-score was less evident for those who are typically lighter drinkers. Identifying and examining temporal and contextually relevant events and associated drinking is critical for understanding and ultimately preventing extreme drinking and associated consequences associated with specific events like Spring Break, which place many students at high risk for experiencing acute harm. Copyright 2009 APA

Feasibility of detection and intervention for alcohol-related liver disease in the community: the Alcohol and Liver Disease Detection study (ALDDeS).

PubMed

Sheron, Nick; Moore, Michael; O'Brien, Wendy; Harris, Scott; Roderick, Paul

2013-10-01

In the past 15 years mortality rates from liver disease have doubled in the UK. Brief alcohol advice is cost effective, but clinically meaningful reductions in alcohol consumption only occur in around 1 in 10 individuals. To provide evidence that detecting early liver disease in the community is feasible, practical, and that feedback of liver risk can increase the proportion of subjects reducing alcohol consumption. A community feasibility study in nine general practice sites in Hampshire. Hazardous and harmful drinkers were identified by WHO AUDIT questionnaire and offered screening for liver fibrosis. In total, 4630 individuals responded, of whom 1128 (24%) hazardous or harmful drinkers were offered a liver fibrosis check using the Southampton Traffic Light (STL) test; 393 (38%) attended and test results were returned by post. The STL has a low threshold for liver fibrosis with 45 (11%) red, 157 (40%) amber, and 191 (49%) green results. Follow-up AUDIT data was obtained for 303/393 (77%) and 76/153 (50%) subjects with evidence of liver damage reduced drinking by at least one AUDIT category (harmful to hazardous, or hazardous to low risk) compared with 52/150 (35%, P<0.011) subjects without this evidence; in the subset of harmful drinkers patterns (AUDIT >15), 22/34 (65%) of STL positives, reduced drinking compared with 10/29 (35%, P<0.017) STL negatives. Detection of liver disease in the community is feasible, and feedback of liver risk may reduce harmful drinking.

Safer-drinking Strategies Used by Chronically Homeless Individuals with Alcohol Dependence

PubMed Central

Grazioli, Véronique S.; Hicks, Jennifer; Kaese, Greta; Lenert, James; Collins, Susan E.

2015-01-01

Chronically homeless individuals with alcohol dependence experience severe alcohol-related consequences. It is therefore important to identify factors that might be associated with reduced alcohol-related harm, such as the use of safer-drinking strategies. Whereas effectiveness of safer-drinking strategies has been well-documented among young adults, no studies have explored this topic among more severely affected populations, such as chronically homeless individuals with alcohol dependence. The aims of this study were thus to qualitatively and quantitatively document safer-drinking strategies used in this population. Participants (N=31) were currently or formerly chronically homeless individuals with alcohol dependence participating in a pilot study of extended-release naltrexone and harm-reduction counseling. At weeks 0 and 8, research staff provided a list of safer-drinking strategies for participants to endorse. Implementation of endorsed safer-drinking strategies was recorded at the next appointment. At both time points, strategies to buffer the effects of alcohol on the body (e.g., eating prior to and during drinking) were most highly endorsed, followed by changing the manner in which one drinks (e.g., spacing drinks), and reducing alcohol consumption. Quantitative analyses indicated that all participants endorsed safer-drinking strategies, and nearly all strategies were implemented (80–90% at weeks 0 and 8, respectively). These preliminary findings indicate that chronically homeless people with alcohol dependence use strategies to reduce harm associated with their drinking. Larger randomized controlled trials are needed to test whether interventions that teach safer-drinking strategies may reduce overall alcohol-related harm in this population. PMID:25690515

Alcohol Drinking Among Kosovar Adolescents: An Examination of Gender-Specific Sociodemographic, Sport, and Familial Factors Associated With Harmful Drinking.

PubMed

Sajber, Dorica; Tahiraj, Enver; Zenic, Natasa; Peric, Mia; Sekulic, Damir

2016-01-01

Adolescent alcohol consumption is a significant public-health problem, although there is a lack of studies investigating this issue in Kosovo. The aim of this investigation was to examine the prevalence of alcohol drinking, and the factors associated with harmful drinking (HD) in Kosovar 17-18 years old adolescents. The sample comprised 636 girls and 366 boys (17-18 years old) from Pristina, Kosovo. The independent variables included sociodemographic factors, variables examining familial-monitoring and conflict (familial-variables), and sport-factors. Alcohol-drinking (dependent variable) was measured by means of the alcohol use disorders identification test scale. 39% of the girls and 43% of the boys reported HD (odds ratio (OR) = 1.17; 95% confidence interval = 0.90-1.55). A higher likelihood of HD is found for those girls whose mothers have an advanced education (OR = 1.59), who reported a higher level of conflict with their parents (OR = 1.95), whose parents are frequently absent from home (OR = 1.93), and who reported lower religiosity (OR = 0.90). HD is more frequent among boys who have participated longer in sports (OR = 1.49), whose fathers have an advanced education (OR = 1.80), and who reported higher level of familial conflict (OR = 2.87). The prevalence of HD is high. Knowing the problems related to alcohol drinking in girls (violence, trafficking, etc.), public-health authorities should urgently develop a specific preventive programme (SPP) to combat the misuse of alcohol. In preparing SPP, special attention should be paid to the varying influences of the studied factors on HD in boys and girls.

Investigation of the Association Between Alcohol Outlet Density and Alcohol-Related Hospital Admission Rates in England: Study Protocol

PubMed Central

Holmes, John; Green, Mark; Strong, Mark; Pearson, Tim; Meier, Petra

2016-01-01

Background Availability of alcohol is a major policy issue for governments, and one of the availability factors is the density of alcohol outlets within geographic areas. Objective The aim of this study is to investigate the association between alcohol outlet density and hospital admissions for alcohol-related conditions in a national (English) small area level ecological study. Methods This project will employ ecological correlation and cross-sectional time series study designs to examine spatial and temporal relationships between alcohol outlet density and hospital admissions. Census units to be used in the analysis will include all Lower and Middle Super-Output Areas (LSOAs and MSOAs) in England (53 million total population; 32,482 LSOAs and 6781 MSOAs). LSOAs (approximately 1500 people per LSOA) will support investigation at a fine spatial resolution. Spatio-temporal associations will be investigated using MSOAs (approximately 7500 people per MSOA). The project will use comprehensive coverage data on alcohol outlets in England (from 2003, 2007, 2010, and 2013) from a commercial source, which has estimated that the database includes 98% of all alcohol outlets in England. Alcohol outlets may be classified into two broad groups: on-trade outlets, comprising outlets from which alcohol can be purchased and consumed on the premises (eg, pubs); and off-trade outlets, in which alcohol can be purchased but not consumed on the premises (eg, off-licenses). In the 2010 dataset, there are 132,989 on-trade and 51,975 off-trade outlets. The longitudinal data series will allow us to examine associations between changes in outlet density and changes in hospital admission rates. The project will use anonymized data on alcohol-related hospital admissions in England from 2003 to 2013 and investigate associations with acute (eg, admissions for injuries) and chronic (eg, admissions for alcoholic liver disease) harms. The investigation will include the examination of conditions that

Dimensions of disinhibited personality and their relation with alcohol use and problems

PubMed Central

Gunn, Rachel L.; Finn, Peter R.; Endres, Michael J.; Gerst, Kyle R.; Spinola, Suzanne

2013-01-01

Although alcohol use disorders (AUDs) have been associated with different aspects of disinhibited personality and antisociality, less is known about the specific relationships among different domains of disinhibited personality, antisociality, alcohol use, and alcohol problems. The current study was designed to address three goals, (i) to provide evidence of a three-factor model of disinhibited personality (comprised of impulsivity [IMP], risk taking/ low harm avoidance [RTHA], excitement seeking [ES]), (ii) to test hypotheses regarding the association between each dimension and alcohol use and problems, and (iii) to test the hypothesis that antisociality (social deviance proneness [SDP]) accounts for the direct association between IMP and alcohol problems, while ES is directly related to alcohol use. Measures of disinhibited personality IMP, RTHA, ES and SDP and alcohol use and problems were assessed in a sample of young adults (N=474), which included a high proportion of individuals with AUDs. Confirmatory factor analyses supported a three-factor model of disinhibited personality reflecting IMP, RTHA, and ES. A structural equation model (SEM) showed that IMP was specifically associated with alcohol problems, while ES was specifically associated with alcohol use. In a second SEM, SDP accounted for the majority of the variance in alcohol problems associated with IMP. The results suggest aspects of IMP associated with SDP represent a direct vulnerability to alcohol problems. In addition, the results suggest that ES reflects a specific vulnerability to excessive alcohol use, which is then associated with alcohol problems, while RTHA is not specifically associated with alcohol use or problems when controlling for IMP and ES. PMID:23588138

Combining motivational and volitional approaches to reducing excessive alcohol consumption in pre-drinkers: a theory-based intervention protocol.

PubMed

Caudwell, Kim M; Mullan, Barbara A; Hagger, Martin S

2016-01-16

Pre-drinking refers to the consumption of alcohol at home or a private residence prior to attending a subsequent social event. We present the study protocol of an online theory-based intervention to reduce pre-drinking and related harm in pre-drinking undergraduates, using behavior change techniques targeting the motivational and volitional phases of behaviour. A fully randomized 2 (autonomy support: present vs. absent) x 2 (implementation intention: present vs. absent) between-participants design will be used to ascertain the effectiveness of the intervention in reducing pre-drinking alcohol consumption and alcohol-related harm. Participants will complete a range of theory-based measures prior to being allocated to one of the four experimental conditions. Four weeks later, participants will complete a follow-up questionnaire comprised of theoretical and behavioral measures. The main and interactive effects of the intervention components in reducing our primary dependent variables, namely, pre-drinking alcohol consumption and alcohol-related harm at four-week follow-up will be tested. Baseline alcohol consumption and demographic information will be included in the analysis as covariates. This online intervention is the first to be developed to reduce pre-drinking alcohol consumption, a behaviour linked to increased risk of alcohol-related harm. The intervention targets motivational and volitional components of the behaviour change process and is therefore likely to lead to greater reductions in pre-drinking alcohol consumption and experience of alcohol-related harm compared to either approach in isolation. If successful, the intervention can be implemented across various contexts and in populations where pre-drinking is prevalent. ACTRN12614001102662 . Registered 16 October 2014.

A Qualitative Exploration of the Effects of Increasing the Minimum Purchase Age of Alcohol in Thailand

PubMed Central

Srirojn, Bangorn; Lilleston, Pam; Aramrattana, Apinun; Thomson, Nicholas; Celentano, David D.; Sherman, Susan G.

2015-01-01

Introduction and Aims Although prevalence of alcohol consumption has been relatively stable among Thai youth, concerns over alcohol-related harms affecting youth influenced the passage of new laws in early 2008, which made it illegal to sell alcohol to anyone under the age of 20. This qualitative study explored the effects of the law on the purchasing patterns of underage Thai bar patrons, in order to understand the strategies employed by underage youth to circumvent the law. Design and Methods A total of 41 in-depth interviews were conducted with 18–19 year old bar patrons in Chiang Mai, Thailand. Results Underage Thai bar patrons frequented shops where enforcement was not strict and purchased alcohol, from familiar shopkeepers in their neighborhoods. Participants suggested that purchasing alcohol was relatively easy as long as shopkeepers were driven by the need to make a profit. Discussion and Conclusions To address alcohol-related harms, the control law must be enforced in a meaningful way to deter youth from purchasing alcohol. Otherwise, the law will have minimal effectiveness in reducing the harms associated with alcohol. PMID:22762793

The influence of alcohol-specific communication on adolescent alcohol use and alcohol-related consequences.

PubMed

Reimuller, Alison; Hussong, Andrea; Ennett, Susan T

2011-12-01

Alcohol-specific communication, a direct conversation between an adult and an adolescent regarding alcohol use, contains messages about alcohol relayed from the adult to the child. The current study examined the construct of alcohol-specific communication and the effect of messages on adolescent alcohol use and alcohol-related consequences. Parent-adolescent dyads were assessed biannually for 3 years (grades 9-11 at wave 6) to examine these relations in a large longitudinal study of adolescents initially in grades 6 through 8. An exploratory factor analysis identified two factors among alcohol-specific communication items, permissive messages and negative alcohol messages. Results showed previous level of adolescent alcohol use moderated the relation between permissive messages and alcohol use outcomes. Plotting of these interactions showed greater alcohol use and consequences with increasing permissive messages in adolescents with higher versus lower levels of previous alcohol use. Results suggest that parental messages regarding alcohol use may impact adolescent alcohol use beyond the effect of general parenting style and parental alcohol use.

The impact of an alcohol harm reduction intervention on interpersonal violence and engagement in sex work among female sex workers in Mombasa, Kenya: Results from a randomized controlled trial.

PubMed

Parcesepe, Angela M; L Engle, Kelly L; Martin, Sandra L; Green, Sherri; Sinkele, William; Suchindran, Chirayath; Speizer, Ilene S; Mwarogo, Peter; Kingola, Nzioki

2016-04-01

To evaluate whether an alcohol harm reduction intervention was associated with reduced interpersonal violence or engagement in sex work among female sex workers (FSWs) in Mombasa, Kenya. Randomized controlled trial. HIV prevention drop-in centers in Mombasa, Kenya. 818 women 18 or older in Mombasa who visited HIV prevention drop-in centers, were moderate-risk drinkers and engaged in transactional sex in past six months (410 and 408 in intervention and control arms, respectively). 6 session alcohol harm reduction intervention. 6 session non-alcohol related nutrition intervention. In-person interviews were conducted at enrollment, immediately post-intervention and 6-months post-intervention. General linear mixed models examined associations between intervention assignment and recent violence (physical violence, verbal abuse, and being robbed in the past 30 days) from paying and non-paying sex partners and engagement in sex work in the past 30 days. The alcohol intervention was associated with statistically significant decreases in physical violence from paying partners at 6 months post-intervention and verbal abuse from paying partners immediately post-intervention and 6-months post-intervention. Those assigned to the alcohol intervention had significantly reduced odds of engaging in sex work immediately post-intervention and 6-months post-intervention. The alcohol intervention was associated with reductions in some forms of violence and with reductions in engagement in sex work among FSWs in Mombasa, Kenya. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The impact of an alcohol harm reduction intervention on interpersonal violence and engagement in sex work among female sex workers in Mombasa, Kenya: Results from a randomized controlled trial*

PubMed Central

Parcesepe, Angela M.; L'Engle, Kelly L.; Martin, Sandra L.; Green, Sherri; Sinkele, William; Suchindran, Chirayath; Speizer, Ilene S.; Mwarogo, Peter; Kingola, Nzioki

2016-01-01

Aims To evaluate whether an alcohol harm reduction intervention was associated with reduced interpersonal violence or engagement in sex work among female sex workers (FSWs) in Mombasa, Kenya. Design Randomized controlled trial. Setting HIV prevention drop-in centers in Mombasa, Kenya. Participants 818 women 18 or older in Mombasa who visited HIV prevention drop-in centers, were moderate-risk drinkers and engaged in transactional sex in past six months (410 and 408 in intervention and control arms, respectively). Intervention 6 session alcohol harm reduction intervention. Comparator 6 session non-alcohol related nutrition intervention. Measurements In-person interviews were conducted at enrollment, immediately post-intervention and 6-months post-intervention. General linear mixed models examined associations between intervention assignment and recent violence (physical violence, verbal abuse, and being robbed in the past 30 days) from paying and non-paying sex partners and engagement in sex work in the past 30 days. Findings The alcohol intervention was associated with statistically significant decreases in physical violence from paying partners at 6 months post-intervention and verbal abuse from paying partners immediately post-intervention and 6-months post-intervention. Those assigned to the alcohol intervention had significantly reduced odds of engaging in sex work immediately post-intervention and 6-months post-intervention. Conclusions The alcohol intervention was associated with reductions in some forms of violence and with reductions in engagement in sex work among FSWs in Mombasa, Kenya. PMID:26872880

Potential consequences of replacing a retail alcohol monopoly with a private licence system: results from Sweden.

PubMed

Norström, Thor; Miller, Ted; Holder, Harold; Osterberg, Esa; Ramstedt, Mats; Rossow, Ingeborg; Stockwell, Tim

2010-12-01

To examine the potential effects of replacing the Swedish alcohol retail system with a private licensing system on alcohol consumption and alcohol-related harm. Two possible scenarios were analysed: (1) replacing the current alcohol retail monopoly with private licensed stores that specialize in alcohol sales or (2) making all alcohol available in grocery stores. We utilized a multiplicative model that projected effects of changes in a set of key factors including hours of sale, retail prices, promotion and advertising and outlet density. Next, we estimated the effect of the projected consumption increase on a set of harm indicators. Values for the model parameters were obtained from the research literature. Measures of alcohol-related harm included explicitly alcohol-related mortality, accident mortality, suicide, homicide, assaults, drinking driving and sickness absence. According to the projections, scenario 1 yields a consumption increase of 17% (1.4 litres/capita), which in turn would cause an additional 770 deaths, 8500 assaults, 2700 drinking driving offences and 4.5 million sick days per year. The corresponding figures for scenario 2 are a consumption increase of 37.4% (3.1 litres/capita) leading to an additional annual toll of 2000 deaths, 20 000 assaults, 6600 drinking driving offences and 11.1 million days of sick leave. Projections based on the research literature suggest that privatization of the Swedish alcohol retail market would significantly increase alcohol consumption and alcohol-related harm. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

Anticonvulsants for the treatment of alcohol withdrawal syndrome and alcohol use disorders.

PubMed

Hammond, Christopher J; Niciu, Mark J; Drew, Shannon; Arias, Albert J

2015-04-01

Alcoholic patients suffer from harmful allostatic neuroplastic changes in the brain causing an acute withdrawal syndrome upon cessation of drinking followed by a protracted abstinence syndrome and an increased risk of relapse to heavy drinking. Benzodiazepines have long been the treatment of choice for detoxifying patients and managing alcohol withdrawal syndrome (AWS). Non-benzodiazepine anticonvulsants (NBACs) are increasingly being used both for alcohol withdrawal management and for ongoing outpatient treatment of alcohol dependence, with the goal of either abstinence or harm reduction. This expert narrative review summarizes the scientific basis and clinical evidence supporting the use of NBACs in treating AWS and for reducing harmful drinking patterns. There is less evidence in support of NBAC therapy for AWS, with few placebo-controlled trials. Carbamazepine and gabapentin appear to be the most promising adjunctive treatments for AWS, and they may be useful as monotherapy in select cases, especially in outpatient settings and for the treatment of mild-to-moderate low-risk patients with the AWS. The body of evidence supporting the use of the NBACs for reducing harmful drinking in the outpatient setting is stronger. Topiramate appears to have a robust effect on reducing harmful drinking in alcoholics. Gabapentin is a potentially efficacious treatment for reducing the risk of relapse to harmful drinking patterns in outpatient management of alcoholism. Gabapentin's ease of use, rapid titration, good tolerability, and efficacy in both the withdrawal and chronic phases of treatment make it particularly appealing. In summary, several NBACs appear to be beneficial in treating AWS and alcohol use disorders.

Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

PubMed Central

Hammond, Christopher J.; Niciu, Mark J.; Drew, Shannon; Arias, Albert J.

2015-01-01

Alcoholic patients suffer from harmful allostatic neuroplastic changes in the brain causing an acute withdrawal syndrome upon cessation of drinking followed by a protracted abstinence syndrome and an increased risk of relapse to heavy drinking. Benzodiazepines have long been the treatment of choice for detoxifying patients and managing alcohol withdrawal syndrome (AWS). Non-benzodiazepine anticonvulsants (NBACs) are increasingly being used both for alcohol withdrawal management and for ongoing outpatient treatment of alcohol dependence, with the goal of either abstinence or harm reduction. This expert narrative review summarizes the scientific basis and clinical evidence supporting the use of NBACs in treating AWS and for reducing harmful drinking patterns. There is less evidence in support of NBAC therapy for AWS, with few placebo-controlled trials. Carbamazepine and gabapentin appear to be the most promising adjunctive treatments for AWS, and they may be useful as monotherapy in select cases, especially in outpatient settings and for the treatment of mild-to-moderate low-risk patients with the AWS. The body of evidence supporting the use of the NBACs for reducing harmful drinking in the outpatient setting is stronger. Topiramate appears to have a robust effect on reducing harmful drinking in alcoholics. Gabapentin is a potentially efficacious treatment for reducing the risk of relapse to harmful drinking patterns in outpatient management of alcoholism. Gabapentin's ease of use, rapid titration, good tolerability, and efficacy in both the withdrawal and chronic phases of treatment make it particularly appealing. In summary, several NBACs appear to be beneficial in treating AWS and alcohol use disorders. PMID:25895020

Alcohol consumption and sport: a cross-sectional study of alcohol management practices associated with at-risk alcohol consumption at community football clubs

PubMed Central

2013-01-01

Background Excessive alcohol consumption is responsible for considerable harm from chronic disease and injury. Within most developed countries, members of sporting clubs participate in at-risk alcohol consumption at levels above that of communities generally. There has been limited research investigating the predictors of at-risk alcohol consumption in sporting settings, particularly at the non-elite level. The purpose of this study was to examine the association between the alcohol management practices and characteristics of community football clubs and at-risk alcohol consumption by club members. Methods A cross sectional survey of community football club management representatives and members was conducted. Logistic regression analysis (adjusting for clustering by club) was used to determine the association between the alcohol management practices (including alcohol management policy, alcohol-related sponsorship, availability of low- and non-alcoholic drinks, and alcohol-related promotions, awards and prizes) and characteristics (football code, size and location) of sporting clubs and at-risk alcohol consumption by club members. Results Members of clubs that served alcohol to intoxicated people [OR: 2.23 (95% CI: 1.26-3.93)], conducted ‘happy hour’ promotions [OR: 2.84 (95% CI: 1.84-4.38)] or provided alcohol-only awards and prizes [OR: 1.80 (95% CI: 1.16-2.80)] were at significantly greater odds of consuming alcohol at risky levels than members of clubs that did not have such alcohol management practices. At-risk alcohol consumption was also more likely among members of clubs with less than 150 players compared with larger clubs [OR:1.45 (95% CI: 1.02-2.05)] and amongst members of particular football codes. Conclusions The findings of this study suggest a need and opportunity for the implementation of alcohol harm reduction strategies targeting specific alcohol management practices at community football clubs. PMID:23947601

Feasibility of detection and intervention for alcohol-related liver disease in the community: the Alcohol and Liver Disease Detection study (ALDDeS)

PubMed Central

Sheron, Nick; Moore, Michael; O’Brien, Wendy; Harris, Scott; Roderick, Paul

2013-01-01

Background In the past 15 years mortality rates from liver disease have doubled in the UK. Brief alcohol advice is cost effective, but clinically meaningful reductions in alcohol consumption only occur in around 1 in 10 individuals. Aim To provide evidence that detecting early liver disease in the community is feasible, practical, and that feedback of liver risk can increase the proportion of subjects reducing alcohol consumption. Design and setting A community feasibility study in nine general practice sites in Hampshire. Method Hazardous and harmful drinkers were identified by WHO AUDIT questionnaire and offered screening for liver fibrosis. Results In total, 4630 individuals responded, of whom 1128 (24%) hazardous or harmful drinkers were offered a liver fibrosis check using the Southampton Traffic Light (STL) test; 393 (38%) attended and test results were returned by post. The STL has a low threshold for liver fibrosis with 45 (11%) red, 157 (40%) amber, and 191 (49%) green results. Follow-up AUDIT data was obtained for 303/393 (77%) and 76/153 (50%) subjects with evidence of liver damage reduced drinking by at least one AUDIT category (harmful to hazardous, or hazardous to low risk) compared with 52/150 (35%, P<0.011) subjects without this evidence; in the subset of harmful drinkers patterns (AUDIT >15), 22/34 (65%) of STL positives, reduced drinking compared with 10/29 (35%, P<0.017) STL negatives. Conclusion Detection of liver disease in the community is feasible, and feedback of liver risk may reduce harmful drinking. PMID:24152485

Public support for alcohol policies associated with knowledge of cancer risk.

PubMed

Buykx, Penny; Gilligan, Conor; Ward, Bernadette; Kippen, Rebecca; Chapman, Kathy

2015-04-01

Several options are advocated by policy experts to mitigate alcohol-related harms, although the most effective strategies often have the least public support. While knowledge of tobacco-related health risks predicts support for relevant public health measures, it is not known whether knowledge of alcohol health risks is similarly associated with the acceptability of policies intended to reduce alcohol consumption and related harms. This study aims to gauge public support for a range of alcohol policies and to determine whether or not support is associated with knowledge of a long-term health risk of alcohol consumption, specifically cancer. 2482 adults in New South Wales (NSW), Australia, participated in an online survey. Logistic regression analysis was used to examine the association between demographic data, alcohol consumption, smoking status, knowledge of alcohol as a risk factor for cancer and support for alcohol-related policies. Most participants were supportive of health warnings, restricting access to internet alcohol advertising to young people, and requiring information on national drinking guidelines on alcohol containers. Almost half of participants supported a ban on sport sponsorship, while less than 41% supported price increases, volumetric taxation, or reducing the number of retail outlets. Only 47% of participants identified drinking too much alcohol as a risk factor for cancer. Knowledge of alcohol as a risk factor for cancer was a significant predictor of support for all policies, while level of alcohol consumption had a significant inverse relationship with policy support. The finding that support for alcohol management policies is associated with awareness that drinking too much alcohol may contribute to cancer could assist in the planning of future public health interventions. Improving awareness of the long term health risks of alcohol consumption may be one avenue to increasing public support for effective alcohol harm-reduction policies

What Research Is Being Done on Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorders in the Russian Research Community?

PubMed Central

Popova, Svetlana; Yaltonskaya, Aleksandra; Yaltonsky, Vladimir; Kolpakov, Yaroslav; Abrosimov, Ilya; Pervakov, Kristina; Tanner, Valeria; Rehm, Jürgen

2014-01-01

Aims: Although Russia has one of the highest rates of alcohol consumption and alcohol-attributable burden of disease, little is known about the existing research on prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorders (FASDs) in this country. The objective of this study was to locate and review published and unpublished studies related to any aspect of PAE and FASD conducted in or using study populations from Russia. Methods: A systematic literature search was conducted in multiple English and Russian electronic bibliographic databases. In addition, a manual search was conducted in several major libraries in Moscow. Results: The search revealed a small pool of existing research studies related to PAE and/or FASD in Russia (126: 22 in English and 104 in Russian). Existing epidemiological data indicate a high prevalence of PAE and FASD, which underlines the strong negative impact that alcohol has on mortality, morbidity and disability in Russia. High levels of alcohol consumption by women of childbearing age, low levels of contraception use, and low levels of knowledge by health and other professionals regarding the harmful effects of PAE put this country at great risk of further alcohol-affected pregnancies. Conclusions: Alcohol preventive measures in Russia warrant immediate attention. More research focused on alcohol prevention and policy is needed in order to reduce alcohol-related harm, especially in the field of FASD. PMID:24158024

Does Increasing Community and Liquor Licensees’ Awareness, Police Activity, and Feedback Reduce Alcohol-Related Violent Crime? A Benefit-Cost Analysis

PubMed Central

Navarro, Héctor José; Shakeshaft, Anthony; Doran, Christopher M.; Petrie, Dennis J.

2013-01-01

Approximately half of all alcohol-related crime is violent crime associated with heavy episodic drinking. Multi-component interventions are highly acceptable to communities and may be effective in reducing alcohol-related crime generally, but their impact on alcohol-related violent crime has not been examined. This study evaluated the impact and benefit-cost of a multi-component intervention (increasing community and liquor licensees’ awareness, police activity, and feedback) on crimes typically associated with alcohol-related violence. The intervention was tailored to weekends identified as historically problematic in 10 experimental communities in NSW, Australia, relative to 10 control ones. There was no effect on alcohol-related assaults and a small, but statistically significant and cost-beneficial, effect on alcohol-related sexual assaults: a 64% reduction in in the experimental relative to control communities, equivalent to five fewer alcohol-related sexual assaults, with a net social benefit estimated as AUD$3,938,218. The positive benefit-cost ratio was primarily a function of the value that communities placed on reducing alcohol-related harm: the intervention would need to be more than twice as effective for its economic benefits to be comparable to its costs. It is most likely that greater reductions in crimes associated with alcohol-related violence would be achieved by a combination of complementary legislative and community-based interventions. PMID:24169411

Does increasing community and liquor licensees' awareness, police activity, and feedback reduce alcohol-related violent crime? A benefit-cost analysis.

PubMed

Navarro, Héctor José; Shakeshaft, Anthony; Doran, Christopher M; Petrie, Dennis J

2013-10-28

Approximately half of all alcohol-related crime is violent crime associated with heavy episodic drinking. Multi-component interventions are highly acceptable to communities and may be effective in reducing alcohol-related crime generally, but their impact on alcohol-related violent crime has not been examined. This study evaluated the impact and benefit-cost of a multi-component intervention (increasing community and liquor licensees' awareness, police activity, and feedback) on crimes typically associated with alcohol-related violence. The intervention was tailored to weekends identified as historically problematic in 10 experimental communities in NSW, Australia, relative to 10 control ones. There was no effect on alcohol-related assaults and a small, but statistically significant and cost-beneficial, effect on alcohol-related sexual assaults: a 64% reduction in in the experimental relative to control communities, equivalent to five fewer alcohol-related sexual assaults, with a net social benefit estimated as AUD$3,938,218. The positive benefit-cost ratio was primarily a function of the value that communities placed on reducing alcohol-related harm: the intervention would need to be more than twice as effective for its economic benefits to be comparable to its costs. It is most likely that greater reductions in crimes associated with alcohol-related violence would be achieved by a combination of complementary legislative and community-based interventions.

The Influence of Alcohol-specific Communication on Adolescent Alcohol Use and Alcohol-related Consequences

PubMed Central

Reimuller, Alison; Hussong, Andrea; Ennett, Susan T.

2013-01-01

Alcohol-specific communication, a direct conversation between an adult and an adolescent regarding alcohol use, contains messages about alcohol relayed from the adult to the child. The current study examined the construct of alcohol-specific communication and the effect of messages on adolescent alcohol use and alcohol-related consequences. Parent-adolescent dyads were assessed biannually for 3 years (grades 9-11 at wave 6) to examine these relations in a large longitudinal study of adolescents initially in grades 6 through 8. An exploratory factor analysis identified two factors among alcohol-specific communication items, permissive messages and negative alcohol messages. Results showed previous level of adolescent alcohol use moderated the relation between permissive messages and alcohol use outcomes. Plotting of these interactions showed greater alcohol use and consequences with increasing permissive messages in adolescents with higher versus lower levels of previous alcohol use. Results suggest that parental messages regarding alcohol use may impact adolescent alcohol use beyond the effect of general parenting style and parental alcohol use. PMID:21667141

Prevention of deaths from harmful drinking in the United States: the potential effects of tax increases and advertising bans on young drinkers.

PubMed

Hollingworth, William; Ebel, Beth E; McCarty, Carolyn A; Garrison, Michelle M; Christakis, Dimitri A; Rivara, Frederick P

2006-03-01

Harmful alcohol consumption is a leading cause of death in the United States. The majority of people who die from alcohol use begin drinking in their youth. In this study, we estimate the impact of interventions to reduce the prevalence of drinking among youth on subsequent drinking patterns and alcohol-attributable mortality. We first estimated the effect of public health interventions to decrease harmful drinking among youth from literature reviews and used life table methods to estimate alcohol-attributable years of life lost by age 80 years among the cohort of approximately 4 million U.S. residents aged 20 in the year 2000. Then, from national survey data on transitions in drinking habits by age, we modeled the impact of interventions on alcohol-attributable mortality. A tax increase and an advertising ban were the most effective interventions identified. In the absence of intervention, there would be 55,259 alcohol-attributable deaths over the lifetime of the cohort. A tax-based 17% increase in the price of alcohol of dollar 1 per six pack of beer could reduce deaths from harmful drinking by 1,490, equivalent to 31,130 discounted years of potential life saved or 3.3% of current alcohol-attributable mortality. A complete ban on alcohol advertising would reduce deaths from harmful drinking by 7,609 and result in a 16.4% decrease in alcohol-related life-years lost. A partial advertising ban would result in a 4% reduction in alcohol-related life-years lost. Interventions to prevent harmful drinking by youth can result in reductions in adult mortality. Among interventions shown to be successful in reducing youthful drinking prevalence, advertising bans appear to have the greatest potential for premature mortality reduction.

Precise estimates of gaming-related harm should guide regulation of gaming.

PubMed

Starcevic, Vladan; Billieux, Joël

2018-06-13

Regulation of gaming is largely based on the perception of gaming-related harm. This perception varies from one country to another and does not necessarily correspond to the real gaming-related harm. It is argued that there is a crucial need to define and assess domains of this harm in order to introduce policies that regulate gaming. Such policies would ideally be targeted at individuals at risk for problematic gaming and would be based more on educational efforts than on restrictive measures. The role of gaming industry in the regulation of gaming would depend on the more precise estimates of gaming-related harm.

Human alcohol-related neuropathology

PubMed Central

Kril, Jillian J.

2015-01-01

Alcohol-related diseases of the nervous system are caused by excessive exposures to alcohol, with or without co-existing nutritional or vitamin deficiencies. Toxic and metabolic effects of alcohol (ethanol) vary with brain region, age/developmental stage, dose, and duration of exposures. In the mature brain, heavy chronic or binge alcohol exposures can cause severe debilitating diseases of the central and peripheral nervous systems, and skeletal muscle. Most commonly, long-standing heavy alcohol abuse leads to disproportionate loss of cerebral white matter and impairments in executive function. The cerebellum (especially the vermis), cortical-limbic circuits, skeletal muscle, and peripheral nerves are also important targets of chronic alcohol-related metabolic injury and degeneration. Although all cell types within the nervous system are vulnerable to the toxic, metabolic, and degenerative effects of alcohol, astrocytes, oligodendrocytes, and synaptic terminals are major targets, accounting for the white matter atrophy, neural inflammation and toxicity, and impairments in synaptogenesis. Besides chronic degenerative neuropathology, alcoholics are predisposed to develop severe potentially life-threatening acute or subacute symmetrical hemorrhagic injury in the diencephalon and brainstem due to thiamine deficiency, which exerts toxic/metabolic effects on glia, myelin, and the microvasculature. Alcohol also has devastating neurotoxic and teratogenic effects on the developing brain in association with fetal alcohol spectrum disorder/fetal alcohol syndrome. Alcohol impairs function of neurons and glia, disrupting a broad array of functions including neuronal survival, cell migration, and glial cell (astrocytes and oligodendrocytes) differentiation. Further progress is needed to better understand the pathophysiology of this exposure-related constellation of nervous system diseases and better correlate the underlying pathology with in vivo imaging and biochemical lesions

Screening and brief interventions for hazardous and harmful alcohol use in probation services: a cluster randomised controlled trial protocol

PubMed Central

2009-01-01

Background A large number of randomised controlled trials in health settings have consistently reported positive effects of brief intervention in terms of reductions in alcohol use. However, although alcohol misuse is common amongst offenders, there is limited evidence of alcohol brief interventions in the criminal justice field. This factorial pragmatic cluster randomised controlled trial with Offender Managers (OMs) as the unit of randomisation will evaluate the effectiveness and cost-effectiveness of different models of screening to identify hazardous and harmful drinkers in probation and different intensities of brief intervention to reduce excessive drinking in probation clients. Methods and design Ninety-six OMs from 9 probation areas across 3 English regions (the North East Region (n = 4) and London and the South East Regions (n = 5)) will be recruited. OMs will be randomly allocated to one of three intervention conditions: a client information leaflet control condition (n = 32 OMs); 5-minute simple structured advice (n = 32 OMs) and 20-minute brief lifestyle counselling delivered by an Alcohol Health Worker (n = 32 OMs). Randomisation will be stratified by probation area. To test the relative effectiveness of different screening methods all OMs will be randomised to either the Modified Single Item Screening Questionnaire (M-SASQ) or the Fast Alcohol Screening Test (FAST). There will be a minimum of 480 clients recruited into the trial. There will be an intention to treat analysis of study outcomes at 6 and 12 months post intervention. Analysis will include client measures (screening result, weekly alcohol consumption, alcohol-related problems, re-offending, public service use and quality of life) and implementation measures from OMs (the extent of screening and brief intervention beyond the minimum recruitment threshold will provide data on acceptability and feasibility of different models of brief intervention). We will also examine the practitioner and

Screening and brief interventions for hazardous and harmful alcohol use in probation services: a cluster randomised controlled trial protocol.

PubMed

Newbury-Birch, Dorothy; Bland, Martin; Cassidy, Paul; Coulton, Simon; Deluca, Paolo; Drummond, Colin; Gilvarry, Eilish; Godfrey, Christine; Heather, Nick; Kaner, Eileen; Myles, Judy; Oyefeso, Adenekan; Parrott, Steve; Perryman, Katherine; Phillips, Tom; Shenker, Don; Shepherd, Jonathan

2009-11-18

A large number of randomised controlled trials in health settings have consistently reported positive effects of brief intervention in terms of reductions in alcohol use. However, although alcohol misuse is common amongst offenders, there is limited evidence of alcohol brief interventions in the criminal justice field. This factorial pragmatic cluster randomised controlled trial with Offender Managers (OMs) as the unit of randomisation will evaluate the effectiveness and cost-effectiveness of different models of screening to identify hazardous and harmful drinkers in probation and different intensities of brief intervention to reduce excessive drinking in probation clients. Ninety-six OMs from 9 probation areas across 3 English regions (the North East Region (n = 4) and London and the South East Regions (n = 5)) will be recruited. OMs will be randomly allocated to one of three intervention conditions: a client information leaflet control condition (n = 32 OMs); 5-minute simple structured advice (n = 32 OMs) and 20-minute brief lifestyle counselling delivered by an Alcohol Health Worker (n = 32 OMs). Randomisation will be stratified by probation area. To test the relative effectiveness of different screening methods all OMs will be randomised to either the Modified Single Item Screening Questionnaire (M-SASQ) or the Fast Alcohol Screening Test (FAST). There will be a minimum of 480 clients recruited into the trial. There will be an intention to treat analysis of study outcomes at 6 and 12 months post intervention. Analysis will include client measures (screening result, weekly alcohol consumption, alcohol-related problems, re-offending, public service use and quality of life) and implementation measures from OMs (the extent of screening and brief intervention beyond the minimum recruitment threshold will provide data on acceptability and feasibility of different models of brief intervention). We will also examine the practitioner and organisational factors

Marijuana usage in relation to harmfulness ratings, perceived likelihood of negative consequences, and defense mechanisms in high school students.

PubMed

Como-Lesko, N; Primavera, L H; Szeszko, P R

1994-08-01

This study investigated high school students' marijuana usage patterns in relation to their harmfulness ratings of 15 licit and illicit drugs, perceived negative consequences from using marijuana, and types of defense mechanisms employed. Subjects were classified into one of five pattern-of-use groups based on marijuana usage: principled nonusers, nonusers, light users, moderate users, and heavy users. Principled nonusers (individuals who have never used marijuana and would not do so if it was legalized) rated marijuana, hashish, cocaine, and alcohol as significantly more harmful than heavy users. A cluster analysis of the drugs' harmfulness ratings best fit a three cluster solution and were named medicinal drugs, recreational drugs, and hard drugs. In general, principled nonusers rated negative consequences from using marijuana as significantly more likely to occur than other groups. Principled nonusers and heavy users utilized reversal from the Defense Mechanism Inventory, which includes repression and denial, significantly more than nonusers, indicating some trait common to the two extreme pattern-of-use groups.

Exposure to alcohol advertisements and teenage alcohol-related problems.

PubMed

Grenard, Jerry L; Dent, Clyde W; Stacy, Alan W

2013-02-01

This study used prospective data to test the hypothesis that exposure to alcohol advertising contributes to an increase in underage drinking and that an increase in underage drinking then leads to problems associated with drinking alcohol. A total of 3890 students were surveyed once per year across 4 years from the 7th through the 10th grades. Assessments included several measures of exposure to alcohol advertising, alcohol use, problems related to alcohol use, and a range of covariates, such as age, drinking by peers, drinking by close adults, playing sports, general TV watching, acculturation, parents' jobs, and parents' education. Structural equation modeling of alcohol consumption showed that exposure to alcohol ads and/or liking of those ads in seventh grade were predictive of the latent growth factors for alcohol use (past 30 days and past 6 months) after controlling for covariates. In addition, there was a significant total effect for boys and a significant mediated effect for girls of exposure to alcohol ads and liking of those ads in 7th grade through latent growth factors for alcohol use on alcohol-related problems in 10th grade. Younger adolescents appear to be susceptible to the persuasive messages contained in alcohol commercials broadcast on TV, which sometimes results in a positive affective reaction to the ads. Alcohol ad exposure and the affective reaction to those ads influence some youth to drink more and experience drinking-related problems later in adolescence.

Exposure to Alcohol Advertisements and Teenage Alcohol-Related Problems

PubMed Central

Dent, Clyde W.; Stacy, Alan W.

2013-01-01

OBJECTIVE: This study used prospective data to test the hypothesis that exposure to alcohol advertising contributes to an increase in underage drinking and that an increase in underage drinking then leads to problems associated with drinking alcohol. METHODS: A total of 3890 students were surveyed once per year across 4 years from the 7th through the 10th grades. Assessments included several measures of exposure to alcohol advertising, alcohol use, problems related to alcohol use, and a range of covariates, such as age, drinking by peers, drinking by close adults, playing sports, general TV watching, acculturation, parents’ jobs, and parents’ education. RESULTS: Structural equation modeling of alcohol consumption showed that exposure to alcohol ads and/or liking of those ads in seventh grade were predictive of the latent growth factors for alcohol use (past 30 days and past 6 months) after controlling for covariates. In addition, there was a significant total effect for boys and a significant mediated effect for girls of exposure to alcohol ads and liking of those ads in 7th grade through latent growth factors for alcohol use on alcohol-related problems in 10th grade. CONCLUSIONS: Younger adolescents appear to be susceptible to the persuasive messages contained in alcohol commercials broadcast on TV, which sometimes results in a positive affective reaction to the ads. Alcohol ad exposure and the affective reaction to those ads influence some youth to drink more and experience drinking-related problems later in adolescence. PMID:23359585

Alcohol on campus: alcohol-related emergencies in undergraduate college students.

PubMed

Wright, S W; Norton, V C; Dake, A D; Pinkston, J R; Slovis, C M

1998-10-01

We reviewed demographic factors associated with alcohol-related disorders in undergraduates seen in the emergency department (ED) and determined the incidence of alcohol-related ED visits among undergraduates. This prospective, observational study was done in a university-affiliated emergency department. Demographic variables and incidence of students with alcohol-related disorders were analyzed. Of the 616 students seen in the ED during 1 academic year, 101 (16%) had an alcohol-related disorder. White students and freshmen were overrepresented. There were equal numbers of male and female students. The overall annual incidence for an alcohol-related visit among undergraduates was 1.7% per academic year. The incidence for freshmen was 2.9%. Four students were admitted; one died of a severe head injury. We estimate that 1 of every 15 undergraduates at our college comes to our ED with an alcohol-related problem during their 4-year college career. Younger and nonminority students were more commonly seen; there was no difference by sex. Serious outcomes included one death. This study probably underestimates the true incidence of alcohol-related disorders among students on campus.

Demographic and Substance Use Factors Associated with Non-Violent Alcohol-Related Injuries among Patrons of Australian Night-Time Entertainment Districts

PubMed Central

Coomber, Kerri; Mayshak, Richelle; Hyder, Shannon; Droste, Nicolas; Curtis, Ashlee; Pennay, Amy; Gilmore, William; Lam, Tina; Chikritzhs, Tanya; Miller, Peter G.

2017-01-01

This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries. PMID:28085105

Demographic and Substance Use Factors Associated with Non-Violent Alcohol-Related Injuries among Patrons of Australian Night-Time Entertainment Districts.

PubMed

Coomber, Kerri; Mayshak, Richelle; Hyder, Shannon; Droste, Nicolas; Curtis, Ashlee; Pennay, Amy; Gilmore, William; Lam, Tina; Chikritzhs, Tanya; Miller, Peter G

2017-01-12

This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews ( n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries.

Meta-Analysis of the Association of Alcohol-Related Social Media Use with Alcohol Consumption and Alcohol-Related Problems in Adolescents and Young Adults.

PubMed

Curtis, Brenda L; Lookatch, Samantha J; Ramo, Danielle E; McKay, James R; Feinn, Richard S; Kranzler, Henry R

2018-06-01

Despite the pervasive use of social media by young adults, there is comparatively little known about whether, and how, engagement in social media influences this group's drinking patterns and risk of alcohol-related problems. We examined the relations between young adults' alcohol-related social media engagement (defined as the posting, liking, commenting, and viewing of alcohol-related social media content) and their drinking behavior and problems. We conducted a systematic review and meta-analysis of studies evaluating the association of alcohol consumption and alcohol-related problems with alcohol-related social media engagement. Summary baseline variables regarding the social media platform used (e.g., Facebook and Twitter), social media measures assessed (e.g., number of alcohol photographs posted), alcohol measures (e.g., Alcohol Use Disorders Identification Test and Timeline Follow back Interview), and the number of time points at which data were collected were extracted from each published study. We used the Q statistic to examine heterogeneity in the correlations between alcohol-related social media engagement and both drinking behavior and alcohol-related problems. Because there was significant heterogeneity, we used a random-effects model to evaluate the difference from zero of the weighted aggregate correlations. We used metaregression with study characteristics as moderators to test for moderators of the observed heterogeneity. Following screening, 19 articles met inclusion criteria for the meta-analysis. The primary findings indicated a statistically significant relationship and moderate effect sizes between alcohol-related social media engagement and both alcohol consumption (r = 0.36, 95% CI: 0.29 to 0.44, p < 0.001) and alcohol-related problems (r = 0.37, 95% CI: 0.21 to 0.51, p < 0.001). There was significant heterogeneity among studies. Two significant predictors of heterogeneity were (i) whether there was joint measurement of alcohol-related

Alcohol and energy drinks: a pilot study exploring patterns of consumption, social contexts, benefits and harms

PubMed Central

2012-01-01

Background Young people around the world are increasingly combining alcohol with energy drinks (AEDs). However, as yet, limited research has been conducted examining this issue, particularly in terms of exploring patterns of consumption, social practices and the cultural contexts of AED consumption. We sought to understand how AEDs are used and socially constructed among young people. Methods We conducted 25 hours of observation in a variety of pubs, bars and nightclubs, as well as in-depth interviews with ten young people who regularly consumed AEDs during a session of alcohol use. Results In this pilot study, participants were highly organised in their AED consumption practices and reported rarely altering this routine. Some young people consumed upwards of eight AEDs on a typical night, and others limited their use to between three and five AEDs to avoid unpleasant consequences, such as sleep disturbances, severe hangovers, heart palpitations and agitation. Wakefulness and increased energy were identified as the primary benefits of AEDs, with taste, reduced and increased intoxication, and sociability reported as additional benefits. Young AED users were brand sensitive and responded strongly to Red Bull imagery, as well as discounted AEDs. Finally, some young people reported substituting illicit stimulants with energy drinks. Conclusions Combining energy drinks with alcohol is now a normalised phenomenon and an integral and ingrained feature of the night-time economy. Despite this, many young people are unaware of recommended daily limits or related harms. While some young people consume AEDs to feel less drunk (consistent with motivations for combining alcohol with illicit stimulants), others report using AEDs to facilitate intoxication. While preliminary, our findings have relevance for potential policy and regulatory approaches, as well as directions for future research. PMID:22824297

Factors associated with drug-related harms related to policing in Tijuana, Mexico

PubMed Central

2011-01-01

Objective To assess factors associated with drug-related harms related to policing among injection drug users (IDUs) in Tijuana, Mexico. Methods IDUs who were over 18 years old and had injected drugs within the last six months were recruited via respondent-driven sampling and underwent questionnaires and testing for HIV (human immunodeficiency virus), syphilis and TB (tuberculosis). Random effects logistic regression was used to simultaneously model factors associated with five drug-related harms related to policing practices in the prior six months (i.e., police led them to rush injections; affected where they bought drugs; affected locations where they used drugs; feared that police will interfere with their drug use; receptive syringe sharing). Results Of 727 IDUs, 85% were male; median age was 38 years. Within the last 6 months, 231 (32%) of IDUs reported that police had led them to rush injections, affected where they bought or used drugs or were very afraid police would interfere with their drug use, or shared syringes. Factors independently associated with drug-related harms related to policing within the last six months included: recent arrest, homelessness, higher frequencies of drug injection, use of methamphetamine, using the local needle exchange program and perceiving a decrease in the purity of at least one drug. Conclusions IDUs who experienced drug-related harms related to policing were those who were most affected by other micro and macro influences in the physical risk environment. Police education programs are needed to ensure that policing practices do not exacerbate risky behaviors or discourage protective behaviors such as needle exchange program use, which undermines the right to health for people who inject drugs. PMID:21477299

Improving adherence to ante-retroviral treatment for people with harmful alcohol use in Kariobangi, Kenya through participatory research and action

PubMed Central

2012-01-01

Background Harmful alcohol use has been linked to the spread of HIV in Kenya. It also adversely affects those on antiretroviral (ARV) treatment through poor compliance. This study using participatory research and action (PRA) methods sought to understand factors related to alcohol abuse and non-adherence and to formulate appropriate interventions in a sample of people living with HIV and AIDS (PLWHA) who were also abusing alcohol, at Kariobangi in Nairobi, Kenya. Methods Entry into the community was gained through previous PRA work in that community and PLWHA were recruited through snowballing. Working together with the community members, the researchers explored the participants’ understanding of alcohol use problem, its effects on compliance to ARV treatment and discussed possible action areas through PRA techniques that included focus group and market place discussions; visual aids such as spider diagrams, community mapping and ranking. Follow-up meetings were held to discuss the progress. Results By the final meeting, 67 PLWHA and 19 community members had been recruited. Through discussions, misconceptions regarding alcohol use were identified. It emerged that alcohol abuse was poorly recognised among both the community and health workers. Screening for alcohol use was not routinely done and protocols for managing alcohol related disorders were not available at the local health centres providing ARVs. The study participants identified improving communication, psychoeducation and screening for alcohol use as possible action areas. Poverty was identified as a major problem but the interventions to mitigate this were not easy to implement. Conclusion We propose that PRA could be useful in improving communication between the health workers and the clients attending primary health care (PHC) facilities and can be applied to strengthen involvement of support groups and community health workers in follow up and counselling. Integrating these features into primary

The Alcohol Environment Protocol: A new tool for alcohol policy.

PubMed

Casswell, Sally; Morojele, Neo; Williams, Petal Petersen; Chaiyasong, Surasak; Gordon, Ross; Gray-Philip, Gaile; Viet Cuong, Pham; MacKintosh, Anne-Marie; Halliday, Sharon; Railton, Renee; Randerson, Steve; Parry, Charles D H

2018-01-04

To report data on the implementation of alcohol policies regarding availability and marketing, and drink driving, along with ratings of enforcement from two small high-income to three high-middle income countries, and one low-middle income country. This study uses the Alcohol Environment Protocol, an International Alcohol Control study research tool, which documents the alcohol policy environment by standardised collection of data from administrative sources, observational studies and interviews with key informants to allow for cross-country comparison and change over time. All countries showed adoption to varying extents of key effective policy approaches outlined in the World Health Organization Global Strategy to Reduce the Harmful Use of Alcohol (2010). High-income countries were more likely to allocate resources to enforcement. However, where enforcement and implementation were high, policy on availability was fairly liberal. Key Informants judged alcohol to be very available in both high- and middle-income countries, reflecting liberal policy in the former and less implementation and enforcement and informal (unlicensed) sale of alcohol in the latter. Marketing was largely unrestricted in all countries and while drink-driving legislation was in place, it was less well enforced in middle-income countries. In countries with fewer resources, alcohol policies are less effective because of lack of implementation and enforcement and, in the case of marketing, lack of regulation. This has implications for the increase in consumption taking place as a result of the expanding distribution and marketing of commercial alcohol and consequent increases in alcohol-related harm. © 2018 The Authors Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

The paradox of public holidays: Hospital-treated self-harm and associated factors.

PubMed

Griffin, Eve; Dillon, Christina B; O'Regan, Grace; Corcoran, Paul; Perry, Ivan J; Arensman, Ella

2017-08-15

Recent research on the patterns of self-harm around public holidays is lacking. This study used national data to examine the patterns of hospital-treated self-harm during public holidays, and to examine associated factors. Data on self-harm presentations to all emergency departments were obtained from the National Self-Harm Registry Ireland. The association between self-harm presentations and public holidays was examined using univariate and multivariate Poisson regression analyses. A total of 104,371 presentations of self-harm were recorded between 2007 and 2015. The mean number of self-harm presentations was 32 on public holidays. St. Patrick's Day had the highest number of presentations compared to all other public holidays, with a daily mean of 44 presentations. Across all years, self-harm presentations during public holidays had a 24% increased risk of involving alcohol consumption compared to all other days and this effect was most pronounced during the Christmas period. The association with alcohol remained significant at a multivariate level. Presentations on public holidays were more likely to attend out of normal working hours. An increase in male presentations involving self-cutting was observed on public holidays and there was an over-representation of males presenting for the first time. It is likely that extent of alcohol involvement in self-harm presentations reported here is an underestimate, as it was dependent on the information being recorded by the attending clinician. Public holidays are associated with an elevated number of self-harm presentations to hospital, with presentations to hospital involving alcohol significantly increased on these days. Hospital resources should be targeted to address increases during public holidays, including during out-of-hours. Involvement of alcohol may delay delivery of care to these patients in emergency settings. Copyright © 2017 Elsevier B.V. All rights reserved.

Predictors for repeat self-harm and suicide among older people within 12 months of a self-harm presentation.

PubMed

Cheung, Gary; Foster, Gisele; de Beer, Wayne; Gee, Susan; Hawkes, Tracey; Rimkeit, Sally; Tan, Yu Mwee; Merry, Sally; Sundram, Frederick

2017-08-01

A past history of self-harm is a significant risk factor for suicide in older people. The aims of this study are to (i) characterize older people who present with self-harm to emergency departments (EDs); and (ii) determine the predictors for repeat self-harm and suicide. Demographic and clinical data were retrospectively collected on older people (age 65+ years), who presented to seven EDs in New Zealand following an episode of self-harm between 1st July 2010 and 30th June 2013. In addition, 12-month follow-up information on repeat self-harm and suicide was collected. The sample included 339 older people (55.2% female) with an age range of 65-96 years (mean age = 75.0; SD = 7.6). Overdose (68.7%) was the most common method of self-harm. 76.4% of the self-harm cases were classified as suicide attempts. Perceived physical illness (47.8%) and family discord (34.5%) were the most common stressors. 12.7% of older people repeated self-harm and 2.1% died by suicide within 12 months. Older people who had a positive blood alcohol reading (OR = 3.87, 95% Cl = 1.35-11.12, p = 0.012) and were already with mental health services at the index self-harm (OR = 2.73, 95% Cl = 1.20-6.25, p = 0.047) were more likely to repeat self-harm/suicide within 12 months. Older people who self-harm are at very high risk of repeat self-harm and suicide. Screening and assessment for alcohol use disorders should be routinely performed following a self-harm presentation, along with providing structured psychological treatment as an adjunct to pharmacological treatment for depression and interventions to improve the person's resilience resources.

Alcohol promotions in Australian supermarket catalogues.

PubMed

Johnston, Robyn; Stafford, Julia; Pierce, Hannah; Daube, Mike

2017-07-01

In Australia, most alcohol is sold as packaged liquor from off-premises retailers, a market increasingly dominated by supermarket chains. Competition between retailers may encourage marketing approaches, for example, discounting, that evidence indicates contribute to alcohol-related harms. This research documented the nature and variety of promotional methods used by two major supermarket retailers to promote alcohol products in their supermarket catalogues. Weekly catalogues from the two largest Australian supermarket chains were reviewed for alcohol-related content over 12 months. Alcohol promotions were assessed for promotion type, product type, number of standard drinks, purchase price and price/standard drink. Each store catalogue included, on average, 13 alcohol promotions/week, with price-based promotions most common. Forty-five percent of promotions required the purchase of multiple alcohol items. Wine was the most frequently promoted product (44%), followed by beer (24%) and spirits (18%). Most (99%) wine cask (2-5 L container) promotions required multiple (two to three) casks to be purchased. The average number of standard drinks required to be purchased to participate in catalogue promotions was 31.7 (SD = 24.9; median = 23.1). The median price per standard drink was $1.49 (range $0.19-$9.81). Cask wines had the lowest cost per standard drink across all product types. Supermarket catalogues' emphasis on low prices/high volumes of alcohol reflects that retailers are taking advantage of limited restrictions on off-premise sales and promotion, which allow them to approach market competition in ways that may increase alcohol-related harms in consumers. Regulation of alcohol marketing should address retailer catalogue promotions. [Johnston R, Stafford J, Pierce H, Daube M. Alcohol promotions in Australian supermarket catalogues. Drug Alcohol Rev 2017;36:456-463]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

[Hospital emergency events related with alcohol consumption in young. Castile and Leon, Spain].

PubMed

Sánchez Sánchez, Ana; Redondo Martín, Susana; García Vicario, Ma Isabel; Velázquez Miranda, Alexander

2012-01-01

Excessive alcohol consumption (regular or binge drinking) in adolescents produces physical and psychological alterations. The objective is to know its size, timing, distribution, profile and main category diagnostic of emergency department related to the consumption of alcohol in youngster people. It´s an observational analytic study of hospital emergency related to alcohol consumption in young (10-30 years), in Castile and León hospitals, between 2003 and 2010. It is used the χ2 for comparison of proportions (significance p<0.05). 4.429 emergency hospital episodes related with consumption of alcohol have been analyced. The 59.5% of episodes have been registered in men and the 68.1% in the group of 18-30 years (p=0.000). There are 3.424 episodes at the weekend, and 1.005 during the week, no differences by sexes (p<0.05). The weekend raises more cases in youngster under 18 years (85,3%) than in 18-30 years (73,6%) (p=0.000). Acute alcohol intoxication is more common in <18 years (94,2%) than in 18-30 years (84,8%) (p=0.000), although between 18-30 years more harmful use (10,7%) and dependence (3,5%) is detected (p=0.000). The medical discharge is more common in women (89,9%) (p=0.000) and <18 years (p=0.000). The largest number of cases is detected in men of 18-30 years; besides, it is more severe than in under eighteen people. An increase in women emergency is detected with respect to men in under eighteen people. The most important diagnostic is acute alcohol intoxication, and more of them don´t need admission.

The impact of alcohol-related presentations on a New Zealand hospital emergency department.

PubMed

Stewart, Rebecca; Das, Manidipa; Ardagh, Michael; Deely, Joanne M; Dodd, Stuart; Bartholomew, Nadia; Pearson, Scott; Spearing, Ruth; Williams, Tracey; Than, Martin

2014-08-29

To determine the impact of alcohol-related presentations on the Christchurch Hospital Emergency Department (ED). Over 42 8-hour shifts (2 weeks) between 15 November 2013 and 9 December 2013, patients attending the ED with recent alcohol consumption were classified as screen-positive (consumed alcohol in the 4 hours prior to presentation) or not. A subset of screen-positive patients was classified as impact-positive (alcohol consumption clearly contributed to the reason for presenting). Data were analysed in relation to days/shifts for gender, age, disruptive behaviour, medical reasons for presenting, and completeness of ED records. Of the 3619 patients screened in the study, 268 (7.4%) and 182 (5%) were screen-positive and impact-positive, respectively. Most patients attended the ED on the weekends (58%: 105/182), particularly on Saturday night (31%; 56/182). More males (118) than females (64) were impact-positive. Of the impact-positive males, most were 16-25 years old (37%; 44/118) or 41-61 years old (32%; 38/118), attended the ED on weekend night shifts (24%; 28/118), and sought treatment for non- interpersonal trauma (38%; 45/118) or interpersonal trauma due to violence (17%; 20/118). Of the female impact-positive patients, most were 16-25 years old (41%; 26/64) or 41-60 years old (33%; 21/64), and presented for deliberate self-harm (36%; 23/64) or non-interpersonal trauma (27%; 17/64). Of the 182 impact-positive patients, 86% (156) were recorded in the ED computer system. Alcohol-related presentations had a significant impact on the ED, particularly on weekends. Teenagers, young adults and middle-aged adults contributed to the alcohol-related patient impact on weekends. Male patients were a significant burden on Saturday evening and night shifts.

Worries about others' substance use-Differences between alcohol, cigarettes and illegal drugs?

PubMed

Moan, Inger Synnøve; Storvoll, Elisabet E; Lund, Ingunn Olea

2017-10-01

While it is well documented that many experience harm from others' substance use, little is known about the psychological strain associated with others' use. The aims were: (1) to describe the prevalence of worries about others' alcohol, cigarette and illegal drug use, (2) whose substance use people worry about, (3) the overlap in worries, and (4) to examine how worries about others' use of each substance vary according to demographics, own substance use and experience of harm from others' use. A population survey was conducted among 16-64year old Norwegians (N=1667). Respondents' reported on worries about others' alcohol, cigarette and illegal drug use, measures of experiences of harm from others' use of the three substances, and own substance use. Worries about others' drinking were most prevalent. Among those who worried, others' cigarette and illegal drug use caused more frequent worry. While worry about cigarette use was mostly associated with family members' use, worry about others' alcohol and illegal drug use more often concerned friends'/acquaintances' use. About half worried about others' use of at least one substance. Across all three substances, experience of harm from others' substance use was most strongly related to worries. Worries about others' substance use are common and reflect the prevalence of use of the substances in the population. In sum, the findings suggest that worry about others' alcohol and illegal drug use is primarily related to acute harm while worry about others' cigarette smoking is more related to chronic harm. Copyright © 2017 Elsevier B.V. All rights reserved.

Alcohol consumption and mortality in Russia since 2000: are there any changes following the alcohol policy changes starting in 2006?

PubMed

Neufeld, Maria; Rehm, Jürgen

2013-01-01

To elucidate the possible effects of Russian alcohol control policy on alcohol consumption and alcohol-related mortality for the period 2000-2010. Narrative review including statistical analysis. Trends before and after 2006 are compared, 2006 being the date of implementation of the Russian government's long-term strategy to reduce alcohol-related harms. Mortality data were taken from the World Health Organization (WHO) database 'Health for All'. Data on recorded alcohol consumption were taken from the WHO, based on the Russian Statistical Service (Rosstat). For unrecorded consumption, the calculations of Alexandr Nemtsov were used. Russian public opinion surveys on drinking habits were utilized. Treatment data on alcohol dependence were obtained from the Moscow National Research Centre on Addictions. Information on alcohol policy was obtained from official reports. Marked fluctuations in all-cause and alcohol-associated mortality in the working-age population were observed during the reviewed period. A decrease in total consumption and mortality was noted since the end of 2005, when the Russian government initially adopted the regulation of alcohol production and sale. The consumption changes were driven by decreases in recorded and unrecorded spirit consumption, only partly compensated for by increases in beer and wine consumption. Alcohol is a strong contributor to premature deaths in Russia, with both the volume and the pattern of consumption being detrimental to health. The regulations introduced since 2006 seem to have positive effects on both drinking behavior and health outcomes. However, there is an urgent need for further alcohol-control strategies to reduce alcohol-related harm.

Reported Theory Use by Digital Interventions for Hazardous and Harmful Alcohol Consumption, and Association With Effectiveness: Meta-Regression

PubMed Central

Crane, David; Brown, Jamie; Kaner, Eileen; Beyer, Fiona; Muirhead, Colin; Hickman, Matthew; Redmore, James; de Vocht, Frank; Beard, Emma; Michie, Susan

2018-01-01

Background Applying theory to the design and evaluation of interventions is likely to increase effectiveness and improve the evidence base from which future interventions are developed, though few interventions report this. Objective The aim of this paper was to assess how digital interventions to reduce hazardous and harmful alcohol consumption report the use of theory in their development and evaluation, and whether reporting of theory use is associated with intervention effectiveness. Methods Randomized controlled trials were extracted from a Cochrane review on digital interventions for reducing hazardous and harmful alcohol consumption. Reporting of theory use within these digital interventions was investigated using the theory coding scheme (TCS). Reported theory use was analyzed by frequency counts and descriptive statistics. Associations were analyzed with meta-regression models. Results Of 41 trials involving 42 comparisons, half did not mention theory (50% [21/42]), and only 38% (16/42) used theory to select or develop the intervention techniques. Significant heterogeneity existed between studies in the effect of interventions on alcohol reduction (I2=77.6%, P<.001). No significant associations were detected between reporting of theory use and intervention effectiveness in unadjusted models, though the meta-regression was underpowered to detect modest associations. Conclusions Digital interventions offer a unique opportunity to refine and develop new dynamic, temporally sensitive theories, yet none of the studies reported refining or developing theory. Clearer selection, application, and reporting of theory use is needed to accurately assess how useful theory is in this field and to advance the field of behavior change theories. PMID:29490895

Contextual determinants and alcohol control policies in the United Kingdom.

PubMed

Plant, Moira; Allamani, Allaman; Massini, Giulia; Pepe, Pasquale

2014-10-01

In the United Kingdom, between 1960 and the 2000s, there were many sociodemographic and economic factors that played a part in the changing picture of alcohol consumption and its related harm. This paper describes some of these variables along with the political measures that were identified as correlated with changes in consumption and harm. The resulting picture is unclear. No consistent pattern was identified among the variables analyzed. Beverage choice changed over time with a reduction in beer consumption and an increase in wines and spirits. Nevertheless, the overall picture showed an increase in total alcohol consumption and resulting harm.

Age-related differences in self-harm presentations and subsequent management of adolescents and young adults at the emergency department.

PubMed

Diggins, Emma; Kelley, Rachael; Cottrell, David; House, Allan; Owens, David

2017-01-15

Characteristics of self-harm differ across ages, but there is little work identifying age-related differences in younger people. Young people entering adolescence face emotionally and developmentally different challenges to those entering adulthood. This study investigates how Emergency Department (ED) presentations and management of self-harm differ through adolescence and early adulthood. 3782 consecutive self-harm episodes involving 2559 people aged 12-25 years were identified from an existing database of Leeds ED attendances from 2004 to 2007. Odds ratios for each of four age bands were compared to the remaining young people. The female to male ratio was 6.3:1 at 12-14 years old, decreasing with successive age groups to 1.2:1 at 22-25 years old. Self-poisoning was commoner in those under 18 years old. 18-25 year olds were more likely to self-poison with prescribed medications, mixed overdoses, alcohol or recreational drugs. 18-25 year olds more often required medical treatment for the effects of the self-harm. 12-14 year olds were more often seen urgently by ED medical staff and offered high intensity mental health aftercare. Repetition of self-harm was commonest in 12-14 year olds, although multiple repetition of self-harm was commonest in 22-25 year olds. Data were not collected on whether the aftercare offered was received. The study sample included hospital attenders only. The large excess of females over males in young people's self-harm is only true at the younger age range. Older adolescents present with more severe acts of self-harm, yet receive the lowest intensity of assessment and after care. Copyright © 2016 Elsevier B.V. All rights reserved.

Partners in treatment: relational psychoanalysis and harm reduction therapy.

PubMed

Rothschild, Debra

2010-02-01

A relational psychoanalytic harm reduction orientation to the treatment of substance misusers is presented and illustrated with a clinical example. Both harm reduction therapy and relational psychoanalysis rely on a two-person model in which the therapist and client are collaborators in the treatment. In both, substance use is seen in the context of the user's internal psychodynamics and external environment, and there is an emphasis on treating the person as a whole individual whose substance use is one aspect of life, rather than focusing on the substance use itself as was often done in the past. Historically, psychoanalysis and substance abuse treatment were so different from each other that their paths rarely crossed. The introduction of harm reduction therapy to substance abuse and the relational orientation in psychoanalysis have brought the fields closer together such that the valuable contributions that each can make to the other can now be appreciated. (c) 2010 Wiley Periodicals, Inc.

When the cats are away: the impact of sporting events on assault- and alcohol-related emergency department attendances.

PubMed

Miller, Peter; McDonald, Louise; McKenzie, Stephen; O'Brien, Kerry; Staiger, Petra

2013-01-01

Despite the attention given to the broad topic of alcohol and violence, there are few studies of this relationship in the context of sporting events and their impact on alcohol-related hospital emergency department (ED) attendances, none of which are Australian. De-identified patient records from Barwon Health's Geelong Hospital ED were analysed from 1 July 2005 to 16 February 2010. Information contained in these records included age, gender, suburb of residence, attendance date and time, arrival mode and reason for attendance. The ED triage database was searched for attendances relating to alcohol, drugs and assault of which 16,940 cases were returned. There was a substantial increase in annual alcohol-related ED attendances from 2006 to 2009. Hierarchical binary logistic regression analyses showed that having a game on a particular day did not contribute to the model, but there were significantly more ED attendances for assaults on days when the Geelong Cats won. There were no significant predictors of ED attendance for alcohol-related harm in the variables studied. The findings of the study suggest that there are significantly more assault-related attendances at the ED in Geelong when the local national football team, the Geelong Cats, won. None of the variables under investigation appears to have impacted on alcohol-related attendances which were not assaults (i.e. injuries or intoxication). It appears that increases in ED attendances associated with the success of a local sporting team are not significantly associated with alcohol use and are more influenced by other factors. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Depression, alcohol use, and stigma in younger versus older HIV-infected pregnant women initiating antiretroviral therapy in Cape Town, South Africa

PubMed Central

Wong, Marcia; Myer, Landon; Zerbe, Allison; Phillips, Tamsin; Petro, Greg; Mellins, Claude A.; Remien, Robert H.; Shiau, Stephanie; Brittain, Kirsty; Abrams, Elaine J.

2017-01-01

Purpose HIV-infected pregnant women in sub-Saharan Africa are at risk for depression and alcohol abuse. Young women may be more vulnerable, but little is known about the psychosocial functioning of this population. Methods We compared younger (18–24 year-olds) and older (≥25 year-olds) HIV-infected pregnant women initiating antiretroviral therapy (ART) in Cape Town, South Africa. Women were assessed on a range of psychosocial measures, including the Alcohol Use Disorders Identification Test, and the Edinburgh Postnatal Depression Scale (EPDS). Results Among 625 women initiating ART, 16% reported risky alcohol use, and 21% alcohol-related harm; these percentages were similar across age groups. When younger women were stratified by age, 37% of 18–21 year-olds vs. 20% of 22–24 year-olds reported alcohol-related harm (p=0.02). Overall, 11% of women had EPDS scores suggesting probable depression, and 6% reported self-harming thoughts. Younger women reported more depressive symptoms. Report of self-harming thoughts was 11% in younger and 4% in older women (p=0.003). In multivariable analysis, age remained significantly associated with depressive symptoms and report of self-harming thoughts. Level of HIV-related stigma and report of intimate partner violence modified the association between age and depressive symptoms. Conclusions Young HIV-infected pregnant women in South Africa were more likely to report depressive symptoms and self-harming thoughts compared to older women and the youngest women reported the highest levels of alcohol-related harm. HIV-related stigma may be a moderating factor. These findings have implications for maternal and infant health, underscoring the urgent need for effective targeted interventions in this vulnerable population. PMID:27815628

Personality and Alcohol-Related Outcomes among Mandated College Students: Descriptive Norms, Injunctive Norms, and College-Related Alcohol Beliefs as Mediators

PubMed Central

Pearson, Matthew R.; Hustad, John T. P.

2014-01-01

The present study examined three alcohol-perception variables (descriptive norms, injunctive norms, and college-related alcohol beliefs) as mediators of the predictive effects of four personality traits (impulsivity, sensation seeking, anxiety sensitivity, and hopelessness) on alcohol use and alcohol-related consequences in a sample of mandated college students (n = 875). Our findings replicated several findings of a previous study of incoming freshman college students (Hustad et al., in press) in that impulsivity and hopelessness had direct effects on alcohol-related problems, sensation seeking and impulsivity had indirect effects on alcohol-related outcomes via college-related alcohol beliefs, and college-related alcohol beliefs predicted both alcohol use and alcohol-related problems. We discuss the implications of our findings for global college student interventions as well as personality-targeted interventions. PMID:24589869

Problems Related to Alcohol Consumption among Youth in Jujuy Province, Argentina

PubMed Central

Alderete, Ethel; Kaplan, Celia P; Nah, Gregory; Pérez-Stable, Eliseo J

2014-01-01

Objective To examine drinking patterns and alcohol-related problems among youth in Jujuy, Argentina. Material and Methods A survey was conducted in 2005 with a representative sample of 9th grade youth (12 to 17 years old) including sociodemographic and consumption data, and the AUDIT-C test. Results Nine percent of girls and 11% of boys reported hazardous drinking; 12% of girls and 19% of boys reported dependence symptoms. The odds ratio for dependence symptoms (adjusted OR 0.7; 95%CI: 0.6-0.8) and for hazardous drinking (adjusted OR 0.7; 95%CI: 0.6-0.8) was significantly lower for girls compared with boys. Older age, working, and attending night school were risk factors for hazardous drinking, dependence symptoms, and harmful drinking. Conclusions A significant proportion of youth reported problematic patterns of alcohol drinking, highlighting the need to implement prevention and treatment interventions tailored to the adolescent population. PMID:18670721

Living under the influence: normalisation of alcohol consumption in our cities.

PubMed

Sureda, Xisca; Villalbí, Joan R; Espelt, Albert; Franco, Manuel

Harmful use of alcohol is one of the world's leading health risks. A positive association between certain characteristics of the urban environment and individual alcohol consumption has been documented in previous research. When developing a tool characterising the urban environment of alcohol in the cities of Barcelona and Madrid we observed that alcohol is ever present in our cities. Urban residents are constantly exposed to a wide variety of alcohol products, marketing and promotion and signs of alcohol consumption. In this field note, we reflect the normalisation of alcohol in urban environments. We highlight the need for further research to better understand attitudes and practices in relation to alcohol consumption. This type of urban studies is necessary to support policy interventions to prevent and control harmful alcohol use. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Alcohol prevention strategies on college campuses and student alcohol abuse and related problems.

PubMed

Ringwalt, Christopher L; Paschall, Mallie J; Gitelman, Amy M

2011-01-01

This study examined the relationship between colleges' alcohol abuse prevention strategies and students' alcohol abuse and related problems. Alcohol prevention coordinators and first year students in 22 colleges reported whether their schools were implementing 48 strategies in six domains, and students (N = 2041) completed another survey concerning their use of alcohol and related consequences. Colleges were most likely to prevent alcohol use in public places on campus and the delivery and use of kegs. Four alcohol prevention domains were inversely associated with at least one of five outcomes related to student alcohol abuse or related consequences, and the alcohol policy and enforcement domain was inversely associated with all outcomes. Colleges should pay particular attention to strategies related to policy and enforcement.

Parental History of Anxiety and Alcohol-Use Disorders and Alcohol Expectancies as Predictors of Alcohol-Related Problems*

PubMed Central

Morean, Meghan E.; Corbin, William R.; Sinha, Rajita; O'Malley, Stephanie S.

2009-01-01

Objective: Research has consistently identified a family history of alcoholism as a risk factor for alcohol-related problems, and global positive expectancies have been found to moderate this association. High rates of comorbidity between alcohol use and anxiety disorders suggest that a family history of anxiety disorders may also increase risk. Further, expectations of negative reinforcement (e.g., tension reduction) have been found to moderate the influence of anxiety-related traits. The current study sought to extend previous research by examining the influence of parental history of alcoholism, anxiety disorders, and the combination, as predictors of alcohol-related problems. Expectancies of global positive changes and tension reduction were hypothesized to moderate the influence of parental history of alcoholism and anxiety, respectively. Method: Direct interviews with parents assessed their history of alcoholism and anxiety for 144 offspring (ages 18-32; 53.5% male) creating four groups: those with a parental history of alcoholism (27.80%), anxiety (22.20%), both alcoholism and anxiety (33.30%), and no history of psychopathology (16.70%). Established measures assessed the offsprings'alcohol expectancies, alcohol use, and alcohol-related problems. Results: Although expected interactions between parental alcoholism and global positive expectancies and between parental anxiety and tension-reduction expectancies were not found, global positive expectancies were associated with alcohol-related problems among the group with parental history of both alcoholism and anxiety. Conclusions: The results suggest that the relation between parental history of alcoholism and global positive expectancies observed in previous studies may be strongest among individuals with a comorbid parental history of alcohol and anxiety disorders. Incorporating expectancies into interventions targeting individuals with a comorbid parental history of alcohol and anxiety disorders may have

DIgital Alcohol Management ON Demand (DIAMOND) feasibility randomised controlled trial of a web-based intervention to reduce alcohol consumption in people with hazardous and harmful use versus a face-to-face intervention: protocol.

PubMed

Hamilton, Fiona L; Hornby, Jo; Sheringham, Jessica; Kerry, Sally; Linke, Stuart; Solmi, Francesca; Ashton, Charlotte; Moore, Kevin; Murray, Elizabeth

2015-01-01

"Hazardous and harmful" drinkers make up approximately 23 % of the adult population in England. However, only around 10 % of these people access specialist care, such as face-to-face extended brief treatment in community alcohol services. This may be due to stigma, difficulty accessing services during working hours, a shortage of trained counsellors and limited provision of services in many places. Web-based alcohol treatment programmes may overcome these barriers and may better suit people who are reluctant or unable to attend face-to-face services, but there is a gap in the evidence base for the acceptability, effectiveness and cost-effectiveness of these programmes compared with treatment as usual (TAU) in community alcohol services. This study aims investigate the feasibility of all parts of a randomised controlled trial (RCT) of a psychologically informed web-based alcohol treatment programme called Healthy Living for People who use Alcohol (HeLP-Alcohol) versus TAU in community alcohol services, e.g. recruitment and retention, online data collection methods, and the use and acceptability of the intervention to participants. A feasibility RCT delivered in north London community alcohol services, comparing HeLP-Alcohol with TAU. Potential participants are aged ≥18 years referred or self-referred for hazardous and harmful use of alcohol, without co-morbidities or other complex problems. The main purpose of this study is to demonstrate the feasibility of recruiting participants to the study and will test online methods for collecting baseline demographic and outcome questionnaire data, randomising participants and collecting 3-month follow-up data. The acceptability of this intervention will be measured by recruitment and retention rates, automated log-in data collection and an online service satisfaction questionnaire. The feasibility of using tailored text message, email or phone prompt to maintain engagement with the intervention will also be explored

Exploring college students' use of general and alcohol-related social media and their associations with alcohol-related behaviors.

PubMed

Hoffman, Eric W; Pinkleton, Bruce E; Weintraub Austin, Erica; Reyes-Velázquez, Wanda

2014-01-01

Alcohol marketers have increasingly moved their advertising efforts into digital and social media venues. As a result, the purpose of this study is to investigate associations between students' use of social media, their exposure to alcohol marketing messages through social media, and their alcohol-related beliefs and behaviors. Public and private university students (N = 637) participated November and December 2011 and April 2012. College students completed online surveys to measure their exposure to social and online media generally, as well as their alcohol-related digital media use and alcohol use. Use of social media related to alcohol marketing predicted alcohol consumption and engaging in risky behaviors, whereas the use of social media more generally did not. Students' use of alcohol-related social media-marketing content associates with their problem drinking. Results have implications for alcohol abuse reduction efforts targeted at college students and suggest the importance of considering social, cultural, and cognitive factors in campaign planning and design.

Spatial relationships between alcohol-related road crashes and retail alcohol availability.

PubMed

Morrison, Christopher; Ponicki, William R; Gruenewald, Paul J; Wiebe, Douglas J; Smith, Karen

2016-05-01

This study examines spatial relationships between alcohol outlet density and the incidence of alcohol-related crashes. The few prior studies conducted in this area used relatively large spatial units; here we use highly resolved units from Melbourne, Australia (Statistical Area level 1 [SA1] units: mean land area=0.5 km(2); SD=2.2 km(2)), in order to assess different micro-scale spatial relationships for on- and off-premise outlets. Bayesian conditional autoregressive Poisson models were used to assess cross-sectional relationships of three-year counts of alcohol-related crashes (2010-2012) attended by Ambulance Victoria paramedics to densities of bars, restaurants, and off-premise outlets controlling for other land use, demographic and roadway characteristics. Alcohol-related crashes were not related to bar density within local SA1 units, but were positively related to bar density in adjacent SA1 units. Alcohol-related crashes were negatively related to off-premise outlet density in local SA1 units. Examined in one metropolitan area using small spatial units, bar density is related to greater crash risk in surrounding areas. Observed negative relationships for off-premise outlets may be because the origins and destinations of alcohol-affected journeys are in distal locations relative to outlets. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Characterizing use patterns and perceptions of relative harm in dual users of electronic and tobacco cigarettes

PubMed Central

Rass, Olga; Pacek, Lauren R.; Johnson, Patrick S.; Johnson, Matthew W.

2015-01-01

Awareness and use of electronic cigarettes (e-cigarettes) is increasing. Questions regarding positive (e.g., smoking reduction/cessation) and negative (e.g., delay of cessation) potential public health consequences of e-cigarettes may be informed by studying dual users of e-cigarettes and tobacco cigarettes. A cross-sectional online survey assessed demographics, product use patterns, and beliefs about relative product benefits and harms among dual users (n = 350) in the United States using the website Amazon Mechanical Turk (MTurk). Compared to tobacco cigarettes, e-cigarettes were used less often and were associated with lower dependence. Participants reported a 30% reduction in self-reported tobacco cigarette smoking since beginning to use e-cigarettes. Reported primary reasons for e-cigarette use were harm reduction and smoking cessation. E-cigarette use was reported as more likely in settings with smoking restrictions and when others’ health could be adversely affected. Conversely, participants reported having used tobacco cigarettes more often than e-cigarettes in hedonic situations (e.g., after eating, drinking coffee or alcohol, or having sex), outdoors, or when stressed. Participants were twice as likely to report wanting to quit tobacco cigarettes compared to e-cigarettes in the next year and intended to quit tobacco cigarettes sooner. Tobacco cigarettes were described as more harmful and addictive, but also more enjoyable than e-cigarettes. Participants provided evidence consistent with both positive and negative public health consequences of e-cigarettes, highlighting the need for experimental research, including laboratory studies and clinical trials. Policies should consider potential public health benefits of e-cigarettes, in addition to potential harms. PMID:26389638

Prevalence of gambling-related harm provides evidence for the prevention paradox.

PubMed

Browne, Matthew; Rockloff, Matthew J

2018-05-23

Background The prevention paradox (PP) describes a situation in which a greater number of cases of a disease-state come from low-risk members of a population, because they are more prevalent than high-risk members. Past research has provided only tangential and disputed evidence to support the application of the PP to gambling-related harm. Aims To assess whether the PP applies to gambling, the prevalence of a large set (72) of diverse harmful consequences from gambling was examined across four risk categories for problem gambling, including no-risk, low-risk, moderate-risk, and problem-gambling. Methods Respondents who had gambled on non-lottery forms in the past 6 months completed an online survey (N = 1,524, 49.4% male). The data were weighted to the known prevalence of gambling problems in the Victorian community. Results The prevalence of gambling harms, including severe harms, was generally higher in the combined categories of lower risk categories compared to the high-risk problem-gambling category. There were some notable exceptions, however, for some severe and rare harms. Nevertheless, the majority of harms in the 72-item list, including serious harms such as needing temporary accommodation, emergency welfare assistance, experiencing separation or end of a relationship, loss of a job, needing to sell personal items, and experiencing domestic violence from gambling, were more commonly associated with lower risk gamblers. Conclusion Many significant harms are concentrated outside the ranks of gamblers with a severe mental health condition, which supports a public-health approach to ameliorating gambling-related harm.

Local government alcohol policy development: case studies in three New Zealand communities

PubMed Central

Maclennan, Brett; Kypri, Kypros; Room, Robin; Langley, John

2013-01-01

Aims Local alcohol policies can be effective in reducing alcohol-related harm. The aim of this study was to examine local government responses to alcohol-related problems and identify factors influencing their development and adoption of alcohol policy. Designsettings and participants Case studies were used to examine local government responses to alcohol problems in three New Zealand communities: a rural town, a provincial city and a metropolitan city. Newspaper reports, local government documents and key informant interviews were used to collect data which were analysed using two conceptual frameworks: Kingdon's Streams model and the Stakeholder model of policy development. Measurements Key informant narratives were categorized according to the concepts of the Streams and Stakeholder models. Findings Kingdon's theoretical concepts associated with increased likelihood of policy change seemed to apply in the rural and metropolitan communities. The political environment in the provincial city, however, was not favourable to the adoption of alcohol restrictions. The Stakeholder model highlighted differences between the communities in terms of power over agenda-setting and conflict between politicians and bureaucrats over policy solutions to alcohol-related harm. These differences were reflected in the ratio of policies considered versus adopted in each location. Decisions on local alcohol policies lie ultimately with local politicians, although the policies that can be adopted by local government are restricted by central government legislation. Conclusions The adoption of policies and strategies to reduce alcohol-related harm may be better facilitated by an agenda-setting process where no ‘gate-keepers’ determine what is included into the agenda, and community mobilization efforts to create competitive local government elections around alcohol issues. Policy adoption would also be facilitated by more enabling central government legislation. PMID:23130762

An investigation of strategies used in alcohol brand marketing and alcohol-related health promotion on Facebook.

PubMed

Lim, Megan Sc; Hare, James D; Carrotte, Elise R; Dietze, Paul M

2016-01-01

Alcohol brands are incorporating social networking sites (SNS) into their marketing programmes. SNS are also being used to reduce alcohol consumption and harms by health promotion organisations. Marketing via SNS can attempt to influence consumers using a range of strategies from traditional marketing, social media, and behaviour change theory. This study systematically quantifies marketing strategies used by alcohol brands and health promoters on Facebook. We identified the 10 most popular alcohol brands and health promotion organisations in Australia on Facebook and extracted all posts from April 2014. A framework was developed, listing 33 SNS marketing strategies. The frequency of use of each strategy in posts was counted for all profiles. The median number of fans of alcohol brands was 189,290 compared with 7562 for health promotion pages. A total of 210 Facebook posts were analysed. Popular marketing strategies included visual attraction, connecting with other organisations, and links to culture and events. Time-specific and day-specific posts and tweets were used more regularly by alcohol brands than health promotion agencies. Alcohol brands remain substantially more popular than health promotion organisations, and this difference is likely driven by offline factors rather than specific use of marketing strategies. However, health promotion organisations can learn from the strategies used by popular brands, particularly in the use of time and day-specific content.

Temporal distribution of alcohol related facial fractures.

PubMed

Lee, Kai H; Qiu, Michael; Sun, Jiandong

2017-11-01

This study aimed to address 2 important aspects of temporal pattern in alcohol-related facial fractures: (1) comparison of temporal pattern of alcohol-related facial fracture (alcohol group) presentation with non-alcohol-related fracture (non-alcohol group) presentation; (2) temporal pattern of patient demographic characteristics, injury characteristics, and surgical management in the alcohol group presentation. This study retrospectively examined the Victorian admitted episodes data set (VAED) for the years 2010 to 2013. VAED is a standardized set of data collected during all hospital presentations in Victoria. The study found higher incidence of alcohol-related facial fracture presentations during weekends and during the summer and spring months compared with non-alcohol-related fractures (statistically significant). Alcohol-related facial fractures are more likely to involve male patients in the 20- to 29-year age group, occur as a result of interpersonal violence, and require shorter hospital stays during weekend admissions (statistically significant). No statistically significant relationship has been observed in seasonal variation across all variables. This study found distinct characteristics in temporal distribution of alcohol-related facial fractures. These characteristics are, in particular, significant in weekend trauma admissions. Such information is important in workforce planning, resource distribution, and implementation of injury prevention programs. Copyright © 2017 Elsevier Inc. All rights reserved.

Inequalities in the distribution of the costs of alcohol misuse in Scotland: a cost of illness study.

PubMed

Johnston, Marjorie C; Ludbrook, Anne; Jaffray, Mariesha A

2012-01-01

To examine the distribution of the costs of alcohol misuse across Scotland in 2009/2010, in relation to deprivation. A cost of illness approach was used. Alcohol-related harmful effects were assessed for inclusion using a literature review. This was based upon the following categories: direct healthcare costs, intangible health costs, social care costs, crime costs and labour and productivity costs. An analysis of secondary data supplemented by a literature review was carried out to quantify each harmful effect, determine its value and provide an estimate of the distribution by deprivation. The deprivation distributions used were area measures (primarily the Scottish Index of Multiple Deprivation). The overall cost was £7457 million. Two alcohol harmful effects were not included in the overall cost by deprivation due to a lack of data. These were 'children's social work and hearing system' and the criminal justice system costs from 'alcohol-specific offences'. The included alcohol harmful effects demonstrated that 40.41% of the total cost arose from the 20% most deprived areas. The intangible cost category was the largest category (78.65%). The study found that the burden of alcohol harmful effects is greater in deprived groups and these burdens do not simply arise from deprived groups but are also experienced more by these groups. The study was limited by a lack of data availability in certain areas, leading to less-precise cost estimates.

Trade and health: how World Trade Organization (WTO) law affects alcohol and public health.

PubMed

Baumberg, Ben; Anderson, Peter

2008-12-01

The alcohol field is becoming more aware of the consequences of world trade law for alcohol policies. However, there is a need for greater clarity about the different effects of trade on alcohol-related harm. A comprehensive review of all literature on alcohol and world trade [including World Trade Organization (WTO) disputes on alcohol], supported by a more selective review of other relevant cases, academic reports and the grey literature on trade and health. The burden of WTO law on alcohol policies depends upon the type of policy in question. Purely protectionist policies are likely to be struck down, which may lead to increases in alcohol-related harm. Partly protectionist and partly health-motivated policies are also at risk of being struck down. However, purely health-motivated policies are likely to be defended by the WTO-and to the extent that policy makers misunderstand this, they are needlessly avoiding effective ways of reducing alcohol-related harm. WTO agreements contain genuine and substantial risks to alcohol policies, and various ways of minimizing future risks are suggested. However, the 'chilling effect' of mistakenly overestimating these constraints should be avoided. Health policy makers should decide on which policies to pursue based primarily on considerations of effectiveness, ethics and politics rather than legality. As long as any effect of these policies on trade is minimized, they are overwhelmingly likely to win any challenges at the WTO.

Depression, alcohol use, and stigma in younger versus older HIV-infected pregnant women initiating antiretroviral therapy in Cape Town, South Africa.

PubMed

Wong, Marcia; Myer, Landon; Zerbe, Allison; Phillips, Tamsin; Petro, Greg; Mellins, Claude A; Remien, Robert H; Shiau, Stephanie; Brittain, Kirsty; Abrams, Elaine J

2017-02-01

HIV-infected pregnant women in sub-Saharan Africa are at risk for depression and alcohol abuse. Young women may be more vulnerable, but little is known about the psychosocial functioning of this population. We compared younger (18-24 years old) and older (≥25 years old) HIV-infected pregnant women initiating antiretroviral therapy (ART) in Cape Town, South Africa. Women were assessed on a range of psychosocial measures, including the Alcohol Use Disorders Identification Test and the Edinburgh Postnatal Depression Scale (EPDS). Among 625 women initiating ART, 16 % reported risky alcohol use and 21 % alcohol-related harm; these percentages were similar across age groups. When younger women were stratified by age, 37 % of 18-21 years old versus 20 % of 22-24 years old reported alcohol-related harm (p = 0.02). Overall, 11 % of women had EPDS scores suggesting probable depression, and 6 % reported self-harming thoughts. Younger women reported more depressive symptoms. Report of self-harming thoughts was 11 % in younger and 4 % in older women (p = 0.002). In multivariable analysis, age remained significantly associated with depressive symptoms and report of self-harming thoughts. Level of HIV-related stigma and report of intimate partner violence modified the association between age and depressive symptoms. Young HIV-infected pregnant women in South Africa were more likely to report depressive symptoms and self-harming thoughts compared to older women, and the youngest women reported the highest levels of alcohol-related harm. HIV-related stigma and intimate partner violence may be moderating factors. These findings have implications for maternal and infant health, underscoring the urgent need for effective targeted interventions in this vulnerable population.

[Self-harm vs. harming others: the lived experiences of a dysfunctional family].

PubMed

Wu, Hsiu-Chin; Lin, Mei-Feng; Yu, Shu-Hua

2007-10-01

The purpose of this study was to explore the lived experiences of self-harm and harm to others from the perspective of two adult offspring and a father, the latter of whom was prone to alcohol abuse and domestic violence and had attempted suicide. Written informed consents were obtained from the subjects after a detailed explanation of the research aims and procedures. A qualitative, phenomenological method was applied for the study. Three subjects were interviewed using a semi-structured interview guide designed by the researchers and based on the aims of the study over a six-month period of home care. A qualitative content analysis based on a phenomenological method was used to identify themes in the data. Two main categories emerged: (1) the mutual harm to the couple subsystem, (2) the misplaced parental-child subsystem. Subsequently, two to four themes were identified from each category. These results provide a better analysis and understanding of the perceived experiences of the harm to the spouse, parental, and sibling subsystems. They should also help health professionals to improve awareness of the lived experiences associated with the issues of self-harm and threats of harm to others. This study could serve as a valuable reference in promoting possible prevention strategies aiming at the reduction of self-harm and harm to others in dysfunctional families within the community.

Alcohol consumption, masculinity, and alcohol-related violence and anti-social behaviour in sportspeople.

PubMed

O'Brien, Kerry S; Forrest, Walter; Greenlees, Iain; Rhind, Daniel; Jowett, Sophia; Pinsky, Ilana; Espelt, Albert; Bosque-Prous, Marina; Sonderlund, Anders Larrabee; Vergani, Matteo; Iqbal, Muhammad

2018-04-01

There is no research examining alcohol-related aggression and anti-social behaviour in UK or European sportspeople (athletes), and no research has examined relationships between masculinity, alcohol consumption, and alcohol-related aggression and antisocial behaviour in sportspeople (athletes). This study addresses this gap. Cross-sectional. A sample (N=2048; women=892, 44%) of in season sportspeople enrolled at UK universities (response 83%), completed measures of masculinity, alcohol consumption, within-sport (on-field) violence, and having been the perpetrator and/or victim of alcohol-related violent/aggressive and antisocial behaviour (e.g., hit/assaulted, vandalism, sexual assault). Logistic regressions examined predictors of alcohol-related violence/aggression and anti-social behaviours. Significant bivariate relationships between masculinity, within-sport violence, alcohol consumption, and alcohol-related aggression and anti-social behaviour were found for both men and women (p's<.001). Logistic regression adjusting for all variables showed that higher levels of masculinity and alcohol consumption in men and women were related to an increased odds of having conducted an aggressive, violent and/or anti-social act in the past 12 months when intoxicated. Odds ratios were largest for relationships between masculinity, alcohol consumption, within-sport violence, and interpersonal violence/aggression (p's<.001). A similar pattern of results was found for having been the victim of aggression and anti-social behaviour. Alcohol-related aggression and anti-social behaviour appear to be problematic in UK university sportspeople, and is related to masculinity and excessive drinking. Interventions that reduce excessive alcohol consumption, masculine norms and associated within-sport violence, could be effective in reducing alcohol-related aggression and antisocial behaviour in UK sportspeople. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All

Association between alcohol-impaired driving enforcement-related strategies and alcohol-impaired driving.

PubMed

Sanem, Julia R; Erickson, Darin J; Rutledge, Patricia C; Lenk, Kathleen M; Nelson, Toben F; Jones-Webb, Rhonda; Toomey, Traci L

2015-05-01

All states in the U.S. prohibit alcohol-impaired driving but active law enforcement is necessary for effectively reducing this behavior. Sobriety checkpoints, saturation patrols, open container laws, and media campaigns related to enforcement efforts are all enforcement-related strategies for reducing alcohol-impaired driving. We conducted surveys of all state patrol agencies and a representative sample of local law enforcement agencies to assess their use of alcohol-impaired driving enforcement-related strategies and to determine the relationship between these enforcement-related strategies and self-reported alcohol-impaired driving behavior obtained from the Behavioral Risk Factor Surveillance System. We found that sobriety checkpoints, saturation patrols, and enforcement of open container laws were associated with a lower prevalence of alcohol-impaired driving but, more importantly, a combination of enforcement-related strategies was associated with a greater decrease in alcohol-impaired driving than any individual enforcement-related activity. In addition, alcohol-impaired driving enforcement-related strategies were associated with decreased alcohol-impaired driving above and beyond their association with decreased binge drinking. Results suggest law enforcement agencies should give greater priority to using a combination of strategies rather than relying on any one individual enforcement activity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Alcohol Electronic Screening and Brief Intervention: A Community Guide Systematic Review.

PubMed

Tansil, Kristin A; Esser, Marissa B; Sandhu, Paramjit; Reynolds, Jeffrey A; Elder, Randy W; Williamson, Rebecca S; Chattopadhyay, Sajal K; Bohm, Michele K; Brewer, Robert D; McKnight-Eily, Lela R; Hungerford, Daniel W; Toomey, Traci L; Hingson, Ralph W; Fielding, Jonathan E

2016-11-01

Excessive drinking is responsible for one in ten deaths among working-age adults in the U.S. annually. Alcohol screening and brief intervention is an effective but underutilized intervention for reducing excessive drinking among adults. Electronic screening and brief intervention (e-SBI) uses electronic devices to deliver key elements of alcohol screening and brief intervention, with the potential to expand population reach. Using Community Guide methods, a systematic review of the scientific literature on the effectiveness of e-SBI for reducing excessive alcohol consumption and related harms was conducted. The search covered studies published from 1967 to October 2011. A total of 31 studies with 36 study arms met quality criteria and were included in the review. Analyses were conducted in 2012. Twenty-four studies (28 study arms) provided results for excessive drinkers only and seven studies (eight study arms) reported results for all drinkers. Nearly all studies found that e-SBI reduced excessive alcohol consumption and related harms: nine study arms reported a median 23.9% reduction in binge-drinking intensity (maximum drinks/binge episode) and nine study arms reported a median 16.5% reduction in binge-drinking frequency. Reductions in drinking measures were sustained for up to 12 months. According to Community Guide rules of evidence, e-SBI is an effective method for reducing excessive alcohol consumption and related harms among intervention participants. Implementation of e-SBI could complement population-level strategies previously recommended by the Community Preventive Services Task Force for reducing excessive drinking (e.g., increasing alcohol taxes and regulating alcohol outlet density). Published by Elsevier Inc.

Randomized pilot trial of a cognitive-behavioral alcohol, self-harm, and HIV prevention program for teens in mental health treatment.

PubMed

Esposito-Smythers, Christianne; Hadley, Wendy; Curby, Timothy W; Brown, Larry K

2017-02-01

Adolescents with mental health conditions represent a high-risk group for substance use, deliberate self-harm (DSH), and risky sexual behavior. Mental health treatment does not uniformly decrease these risks. Effective prevention efforts are needed to offset the developmental trajectory from mental health problems to these behaviors. This study tested an adjunctive cognitive-behavioral family-based alcohol, DSH, and HIV prevention program (ASH-P) for adolescents in mental healthcare. A two group randomized design was used to compare ASH-P to an assessment only control (AO-C). Participants included 81 adolescents and a parent. Assessments were completed at pre-intervention as well as 1, 6, and 12-months post-enrollment, and included measures of family-based mechanisms and high-risk behaviors. ASH-P relative to AO-C was associated with greater improvements in most family process variables (perceptions of communication and parental disapproval of alcohol use and sexual behavior) as well as less DSH and greater refusal of sex to avoid a sexually transmitted infection. It also had a moderate (but non-significant) effect on odds of binge drinking. No differences were found in suicidal ideation, alcohol use, or sexual intercourse. ASH-P showed initial promise in preventing multiple high-risk behaviors. Further testing of prevention protocols that target multiple high-risk behaviors in clinical samples is warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of caffeine on alcohol-related changes in behavioural control and perceived intoxication in light caffeine consumers.

PubMed

Attwood, Angela S; Rogers, Peter J; Ataya, Alia F; Adams, Sally; Munafò, Marcus R

2012-06-01

Caffeinated alcoholic beverages have been associated with increased risk of alcohol-related harms. However, few studies have examined these combined effects on behavioural control, which is believed to underlie many of the negative effects of alcohol consumption. In addition, studies have often omitted subjective measures, and none have directly assessed the role of caffeine consumer history. To examine the combined effects of alcohol and caffeine on measures of behavioural control and perceived intoxication in abstinent, light caffeine consumers. Participants (n = 28; 50% male) attended four sessions at which they consumed one of the following beverages in a randomised order: placebo, alcohol alone (0.6 g/kg), caffeine alone (2.0 mg/kg), and alcohol/caffeine. They completed measures of mood, intoxication, anxiety and alcohol craving before and after a task battery comprising measures of behavioural control and reaction time performance. Caffeine attenuated alcohol-related performance deficits on stop-signal accuracy, had no effect on go-no-go performance deficits, and worsened accuracy on the Stroop task. Caffeine did not influence absolute changes in perceived intoxication but there was suggestion that caffeine may have changed the nature of intoxication with increases in stimulation. Caffeine appears to have mixed effects on alcohol intoxication that are task-dependent. We found increased stimulation in the alcohol/caffeine condition, supporting the contention that caffeinated alcoholic beverages enable an individual to drink for longer. Future research should model real world drinking behaviour by examining how these effects change across multiple drink administrations.

Is alcohol more dangerous than heroin? The physical, social and financial costs of alcohol.

PubMed

Lee, Geraldine A; Forsythe, Marcus

2011-07-01

A recent paper claimed in its classification of harmful substances, that alcohol is more dangerous than heroin. This paper aims to weigh up some of the evidence in the literature on the physical, social and financial effects of alcohol and the associated disease burden. We will also explore alcohol within the context of emergency department (ED) presentations. Reasons for ED attendance can be overtly and directly alcohol related such as alcohol intoxication, assaults, injuries and falls and indirectly such as child neglect, psychological problems and chronic diseases. Alcohol is often viewed as an isolated incident or factor for ED presentations but there are data that refute this perception. In ED, the priority is to treat the patient and their primary complaint, however it may be appropriate to screen for alcohol use, give advice and potentially offer an intervention to the patient. With the recent UK and Australian guidelines on reducing health risks from drinking alcohol, the ED has the ability to play an active role in reducing the harmful effects of alcohol through screening, advising and undertaking intervention as appropriate. However this cannot be achieved in isolation but within the broader political and health policy framework. There is now a growing body of literature supporting the need to make alcohol less affordable, less easy to buy and reducing alcohol advertising. Although alcohol is a legal substance, this paper concludes that examining the wider effects in physical, social and financial terms, alcohol is more dangerous than heroin. It has become an endemic problem in society affecting the individual and the whole community. Copyright © 2011 Elsevier Ltd. All rights reserved.

Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis.

PubMed

McNeil, Ryan; Guirguis-Younger, Manal; Dilley, Laura B; Aubry, Tim D; Turnbull, Jeffrey; Hwang, Stephen W

2012-05-17

Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.

Assessing the impacts of Saskatchewan's minimum alcohol pricing regulations on alcohol-related crime.

PubMed

Stockwell, Tim; Zhao, Jinhui; Sherk, Adam; Callaghan, Russell C; Macdonald, Scott; Gatley, Jodi

2017-07-01

Saskatchewan's introduction in April 2010 of minimum prices graded by alcohol strength led to an average minimum price increase of 9.1% per Canadian standard drink (=13.45 g ethanol). This increase was shown to be associated with reduced consumption and switching to lower alcohol content beverages. Police also informally reported marked reductions in night-time alcohol-related crime. This study aims to assess the impacts of changes to Saskatchewan's minimum alcohol-pricing regulations between 2008 and 2012 on selected crime events often related to alcohol use. Data were obtained from Canada's Uniform Crime Reporting Survey. Auto-regressive integrated moving average time series models were used to test immediate and lagged associations between minimum price increases and rates of night-time and police identified alcohol-related crimes. Controls were included for simultaneous crime rates in the neighbouring province of Alberta, economic variables, linear trend, seasonality and autoregressive and/or moving-average effects. The introduction of increased minimum-alcohol prices was associated with an abrupt decrease in night-time alcohol-related traffic offences for men (-8.0%, P < 0.001), but not women. No significant immediate changes were observed for non-alcohol-related driving offences, disorderly conduct or violence. Significant monthly lagged effects were observed for violent offences (-19.7% at month 4 to -18.2% at month 6), which broadly corresponded to lagged effects in on-premise alcohol sales. Increased minimum alcohol prices may contribute to reductions in alcohol-related traffic-related and violent crimes perpetrated by men. Observed lagged effects for violent incidents may be due to a delay in bars passing on increased prices to their customers, perhaps because of inventory stockpiling. [Stockwell T, Zhao J, Sherk A, Callaghan RC, Macdonald S, Gatley J. Assessing the impacts of Saskatchewan's minimum alcohol pricing regulations on alcohol-related

User characteristics of a smartphone app to reduce alcohol consumption.

PubMed

Garnett, Claire; Crane, David; West, Robert; Michie, Susan; Brown, Jamie; Winstock, Adam

2017-12-01

Digital interventions are available to help people reduce their alcohol consumption, but it is not known who uses these interventions and how this treatment-seeking group compares with the general population of drinkers. The study objective was to compare the socio-demographic and drinking characteristics of users of the 'Drinks Meter' smartphone app with the general population of drinkers in England and website users of the same intervention. Data were used from the Drinks Meter app and website, and a nationally representative cross-sectional survey in England (Alcohol Toolkit Study). Participants were drinkers aged 16+ in England. Data were collected on participants' age, gender, region, sexual orientation, social grade and AUDIT score. Regression analyses were conducted to assess differences in socio-demographic and drinking characteristics between samples. Drinks Meter app users, compared with drinkers of the general population, were younger, more likely to be from the South, not heterosexual, less likely to be of a lower social grade and had a higher mean AUDIT score. Drinks Meter app users were younger than website users and reported greater alcohol consumption and related harms. Drinkers using the Drinks Meter app are more likely to be younger and report greater alcohol consumption and related harms compared with the general population of drinkers in England and website users of the same intervention. Apps that provide feedback on drinking appear to be reaching those who report greater alcohol consumption and related harms.

The moderating role of implicit alcohol-related cognitions in hazardous alcohol use

PubMed Central

Cavanagh, Lucia; Obasi, Ezemenari M.

2015-01-01

The present study applied the Go/No-Go Association Test (GNAT; Nosek & Banaji, 2001) to measure alcohol-related implicit cognitions. Additionally, it assessed the role of implicit cognitions as a potential moderator in the relationship between explicit predictors of alcohol use and hazardous drinking behavior. University undergraduate students (N = 214) completed self-report questionnaires assessing reasons for drinking and reported alcohol use. Participants also completed two GNATs assessing implicit-alcohol-related cognitions associated with attitude (good-bad) and perceived safety (safe-dangerous). As expected, participants held implicit appraisals of alcohol as ‘‘bad’’ and ‘‘dangerous’’ in the context of nonalcoholic drinks, and as ‘‘good’’ and ‘‘safe’’ in the context of licit and illicit drugs. Implicit alcohol-related cognitions moderated the relationship between drinking to cope with negative affect and hazardous drinking and drinking due to cues or craving and hazardous drinking. These findings highlight the multidimensional nature of implicit cognitions and the role of negative implicit alcohol-related associations in moderating relationships between explicit processes and subsequent alcohol use behaviors. PMID:26989352

A Commentary on the Limits of Alcoholic Beverage Policies.

PubMed

Allamani, Allaman; Beccaria, Franca; Einstein, S

2017-11-01

Providing one set of policy measures for all countries as if they were a single, homogeneous entity does not appear to be evidence-based, according to recent research on the effectiveness of alcoholic beverage control policies. Contextual and cultural determinants-social, economic, demographic, cultural and political-appear to be major factors of influencing change in drinking trends, drinking patterns and drinking-related harms. The variable interplay between contextual determinants and alcohol control policy measures implies diverse impacts on consumption and harm according to time, and to the different countries and groups of countries. In addition, epidemiology research manifests some limitations when applied to alcohol drinking and results are transferred from one culture to another. The conditions of individual cultures and countries should be considered when planning and evaluating alcohol control policies. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Impact of Alcohol Tax Increase on Maryland College Students' Alcohol-Related Outcomes.

PubMed

Smart, Mieka J; Yearwood, Safiya S; Hwang, Seungyoung; Thorpe, Roland J; Furr-Holden, C Debra

2018-05-12

This study A) assessed whether levels of alcohol-related disciplinary actions on college campuses changed among MD college students after the 2011 Maryland (MD) state alcohol tax increase from 6% to 9%, and B) determined which school-level factors impacted the magnitude of changes detected. A quasi-experimental interrupted time series (ITS) analysis of panel data containing alcohol-related disciplinary actions on 33 MD college campuses in years 2006-2013. Negative binomial regression models were used to examine whether there was a statistically significant difference in counts of alcohol-related disciplinary actions comparing time before and after the tax increase. The ITS anaysis showed an insignificant relationship between alcohol-related disciplinary actions and tax implementation (β = -.27; p =.257) but indicated that alcohol-related disciplinary actions decreased significantly over the time under study (β = -.05; p =.022). Alcohol related disciplinary actions did decrease over time in the years of study, and this relationship was correlated with several school-level characteristics, including school price, school funding type, types of degrees awarded, and specialty. School price may serve as a proxy mediator or confounder of the effect of time on disciplinary actions.

Predictive Effects of Good Self-Control and Poor Regulation on Alcohol-Related Outcomes: Do Protective Behavioral Strategies Mediate?

PubMed Central

Pearson, Matthew R.; Kite, Benjamin A.; Henson, James M.

2016-01-01

In the present study, we examined whether use of protective behavioral strategies mediated the relationship between self-control constructs and alcohol-related outcomes. According to the two-mode model of self-control, good self-control (planfulness; measured with Future Time Perspective, Problem Solving, and Self-Reinforcement) and poor regulation (impulsivity; measured with Present Time Perspective, Poor Delay of Gratification, Distractibility) are theorized to be relatively independent constructs rather than opposite ends of a single continuum. The analytic sample consisted of 278 college student drinkers (68% women) who responded to a battery of surveys at a single time point. Using a structural equation model based on the two-mode model of self-control, we found that good self-control predicted increased use of three types of protective behavioral strategies (Manner of Drinking, Limiting/Stopping Drinking, and Serious Harm Reduction). Poor regulation was unrelated to use of protective behavioral strategies, but had direct effects on alcohol use and alcohol problems. Further, protective behavioral strategies mediated the relationship between good self-control and alcohol use. The clinical implications of these findings are discussed. PMID:22663345

Alcohol education and training in pre-registration nursing: a national survey to determine curriculum content in the United Kingdom (UK).

PubMed

Holloway, Aisha S; Webster, Brian J

2013-09-01

Alcohol-related harm impacts significantly on the health of the population. Nurses are often among the first health professionals that many patients with alcohol-related problems come into contact with and have been identified as playing a key role but may be ill-prepared to respond. Future nurses need to have the skills, knowledge and clinical confidence to respond to patients suffering from alcohol-related harm. A pre-registration curriculum that ensures a nursing workforce fit for practice in responding to alcohol-related harm is necessary. To determine the level of alcohol education and training content in the pre-registration curriculum for nursing in the United Kingdom (UK). To establish whether there are variations in the pre-registration curriculum content across the UK. A descriptive study. All 68 UK Higher Education Institutions offering a total of 111 pre-registration courses for nurses were invited to participate in the study. Twenty nine completed questionnaires were returned, a response rate of 26%. The largest number of identified responders were from England (n=15), with 3 from Scotland and 1 each from Wales and Northern Ireland. Nine Universities chose not to identify themselves. An online semi-structured questionnaire survey was used to collect the study data. Teaching of alcohol and alcohol related harm was mainly delivered during the second year of a pre-registration nursing programme provided mainly to adult and mental health students. Overall, the majority of alcohol related content that is provided within the responding pre-registration nursing courses relates to biophysiology, aetiology, and pharmacological and non-pharmacological interventions. This study highlights the need for a greater and more relevant focus of alcohol education to pre-registration nursing students of all fields of practice incorporating an integrated approach across all years of study. Copyright © 2012 Elsevier Ltd. All rights reserved.

Motives to drink or not to drink: longitudinal relations among personality, motives, and alcohol use across adolescence and early adulthood.

PubMed

Anderson, Kristen G; Briggs, Kristen E L; White, Helene R

2013-05-01

Adolescent selective intervention programs for alcohol have focused on the identification of youth at risk as a function of personality and associated alcohol-related cognitions. Research into the role of personality, drinking motivations, and alcohol-related outcomes has generally focused exclusively on motives to drink. We expand on this literature by focusing on both motives to drink and motives not to drink across time from adolescence to early adulthood in a community sample. Using 3 waves of data from 3 cohorts from the Rutgers Health and Human Development Project (n = 1,380; 49.4% women), we modeled the influence of baseline alcohol consumption, disinhibition (DIS), and harm avoidance (ages 15, 18, and 21 years) on drinking motives and motives not to drink 3 years later (ages 18, 21, and 24 years) and alcohol use and drinking-related problems 7 years subsequently (ages 25, 28, and 31 years). Path analytic models were relatively invariant across cohort. Across cohorts, DIS and baseline alcohol consumption related to later positive reinforcement drinking motives, but less consistency was found for the prediction of negative reinforcement motives to drink. While positive reinforcement motives were associated with greater alcohol consumption and problems 7 years later, negative reinforcement motives were generally associated with problems alone. Positive reinforcement motives for drinking mediated relations between baseline consumption and later consumption. However, results were mixed when considering DIS as a predictor and drinking problems as an outcome. Similarly, personality and baseline consumption related to later motives not to drink and such motives predicted subsequent alcohol-related problems. However, mediation was not generally supported for pathways through motives to abstain. The results of this study replicate and extend previous longitudinal findings with youth and add to the growing literature on motivations not to engage in alcohol use

Reported Theory Use by Digital Interventions for Hazardous and Harmful Alcohol Consumption, and Association With Effectiveness: Meta-Regression.

PubMed

Garnett, Claire; Crane, David; Brown, Jamie; Kaner, Eileen; Beyer, Fiona; Muirhead, Colin; Hickman, Matthew; Redmore, James; de Vocht, Frank; Beard, Emma; Michie, Susan

2018-02-28

Applying theory to the design and evaluation of interventions is likely to increase effectiveness and improve the evidence base from which future interventions are developed, though few interventions report this. The aim of this paper was to assess how digital interventions to reduce hazardous and harmful alcohol consumption report the use of theory in their development and evaluation, and whether reporting of theory use is associated with intervention effectiveness. Randomized controlled trials were extracted from a Cochrane review on digital interventions for reducing hazardous and harmful alcohol consumption. Reporting of theory use within these digital interventions was investigated using the theory coding scheme (TCS). Reported theory use was analyzed by frequency counts and descriptive statistics. Associations were analyzed with meta-regression models. Of 41 trials involving 42 comparisons, half did not mention theory (50% [21/42]), and only 38% (16/42) used theory to select or develop the intervention techniques. Significant heterogeneity existed between studies in the effect of interventions on alcohol reduction (I 2 =77.6%, P<.001). No significant associations were detected between reporting of theory use and intervention effectiveness in unadjusted models, though the meta-regression was underpowered to detect modest associations. Digital interventions offer a unique opportunity to refine and develop new dynamic, temporally sensitive theories, yet none of the studies reported refining or developing theory. Clearer selection, application, and reporting of theory use is needed to accurately assess how useful theory is in this field and to advance the field of behavior change theories. ©Claire Garnett, David Crane, Jamie Brown, Eileen Kaner, Fiona Beyer, Colin Muirhead, Matthew Hickman, James Redmore, Frank de Vocht, Emma Beard, Susan Michie. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.02.2018.

Driving under the influence of alcohol: examining ethno-specific rates and the mediating effects of psychological distress and harmful and problematic drinking.

PubMed

Asbridge, Mark; Payne, Elspeth; Cartwright, Jennifer; Mann, Robert

2010-07-01

This paper examines ethnic disparities in rates of driving under the influence of alcohol (DUIA) in a representative sample of Ontario adults. Data were drawn from the Centre for Addiction and Mental Health (CAMH) Monitor, a survey of 8276 Ontario adults aged 18 and older. We considered 19 distinct ethnic groups based on participants' self-identification of ethno-cultural heritage. Differences in the prevalence of DUIA across ethnic groups were limited. Relative to other ethnic groups, those adults who identified as Irish had a significantly higher rate of DUIA, while those of Italian and Chinese ethnicity had significantly lower rates of DUIA. The mediating effects of psychological distress (General Health Questionnaire) and harmful and problematic drinking (Alcohol Use Disorders Identification Test [AUDIT] consumption, dependence and problems) on the direct relationship between ethnic identity and impaired driving were also considered. Mediation was observed as remaining ethnic differences in DUIA disappeared when AUDIT subscales were introduced. These findings are interpreted in the context of patterns of alcohol consumption among ethnic populations and their impact on DUIA. Implications of study findings are considered with respect to the role of ethnicity in impaired driving research and its impact on programs and policies directed at reducing impaired driving. Copyright 2010 Elsevier Ltd. All rights reserved.

Institutional trust and alcohol consumption in Sweden: the Swedish National Public Health Survey 2006.

PubMed

Ahnquist, Johanna; Lindström, Martin; Wamala, Sarah P

2008-08-13

Trust as a measure of social capital has been documented to be associated with health. Mediating factors for this association are not well investigated. Harmful alcohol consumption is believed to be one of the mediating factors. We hypothesized that low social capital defined as low institutional trust is associated with harmful alcohol consumption. Data from the 2006 Swedish National Survey of Public Health were used for analyses. The total study population comprised a randomly selected representative sample of 26.305 men and 30.584 women aged 16-84 years. Harmful alcohol consumption was measured using a short version the Alcohol Use Disorders Identification Test (AUDIT), developed and recommended by the World Health Organisation. Low institutional trust was defined based on trust in ten main welfare institutions in Sweden. Independent of age, country of birth and socioeconomic circumstances, low institutional trust was associated with increased likelihood of harmful alcohol consumption (OR (men) = 1.52, 95% CI 1.34-1.70) and (OR (women) = 1.50, 95% CI 1.35-1.66). This association was marginally altered after adjustment for interpersonal trust. Findings of the present study show that lack of trust in institutions is associated with increased likelihood of harmful alcohol consumption. We hope that findings in the present study will inspire similar studies in other contexts and contribute to more knowledge on the association between institutional trust and lifestyle patterns. This evidence may contribute to policies and strategies related to alcohol consumption.

Characterizing use patterns and perceptions of relative harm in dual users of electronic and tobacco cigarettes.

PubMed

Rass, Olga; Pacek, Lauren R; Johnson, Patrick S; Johnson, Matthew W

2015-12-01

Awareness and use of electronic cigarettes (e-cigarettes) is increasing. Questions regarding positive (e.g., smoking reduction/cessation) and negative (e.g., delay of cessation) potential public health consequences of e-cigarettes may be informed by studying dual users of e-cigarettes and tobacco cigarettes. A cross-sectional online survey assessed demographics, product use patterns, and beliefs about relative product benefits and harms among dual users (n = 350) in the United States using the website Amazon Mechanical Turk. Compared to tobacco cigarettes, e-cigarettes were used less often and were associated with lower dependence. Participants reported a 30% reduction in self-reported tobacco cigarette smoking since beginning to use e-cigarettes. Reported primary reasons for e-cigarette use were harm reduction and smoking cessation. E-cigarette use was reported as more likely in settings with smoking restrictions and when others' health could be adversely affected. Conversely, participants reported having used tobacco cigarettes more often than e-cigarettes in hedonic situations (e.g., after eating, drinking coffee or alcohol, or having sex), outdoors, or when stressed. Participants were twice as likely to report wanting to quit tobacco cigarettes compared to e-cigarettes in the next year and intended to quit tobacco cigarettes sooner. Tobacco cigarettes were described as more harmful and addictive, but also as more enjoyable than e-cigarettes. Participants provided evidence consistent with both positive and negative public health consequences of e-cigarettes, highlighting the need for experimental research, including laboratory studies and clinical trials. Policies should consider potential public health benefits of e-cigarettes, in addition to potential harms. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Alcohol Electronic Screening and Brief Intervention: A Community Guide Systematic Review

PubMed Central

Tansil, Kristin A.; Esser, Marissa B.; Sandhu, Paramjit; Reynolds, Jeffrey A.; Elder, Randy W.; Williamson, Rebecca S.; Chattopadhyay, Sajal K.; Bohm, Michele K.; Brewer, Robert D.; McKnight-Eily, Lela R.; Hungerford, Daniel W.; Toomey, Traci L.; Hingson, Ralph W.; Fielding, Jonathan E.

2016-01-01

Context Excessive drinking is responsible for 1 in 10 deaths among working-age adults in the U.S. annually. Alcohol screening and brief intervention (ASBI) is an effective, but underutilized, intervention for reducing excessive drinking among adults. Electronic screening and brief intervention (e-SBI) uses electronic devices to deliver key elements of ASBI, and has the potential to expand population reach. Evidence acquisition Using Community Guide methods, a systematic review of the scientific literature on the effectiveness of e-SBI for reducing excessive alcohol consumption and related harms was conducted. The search covered studies published from 1967 to October 2011. A total of 31 studies with 36 study arms met quality criteria, and were included in the review. Analyses were conducted in 2012. Evidence synthesis Twenty-four studies (28 study arms) provided results for excessive drinkers only and seven studies (eight study arms) reported results for all drinkers. Nearly all studies found that e-SBI reduced excessive alcohol consumption and related harms: nine study arms reported a median 23.9% reduction in binge drinking intensity (maximum drinks/binge episode) and nine study arms reported a median 16.5% reduction in binge drinking frequency. Reductions in drinking measures were sustained for up to 12 months. Conclusion According to Community Guide rules of evidence, e-SBI is an effective method for reducing excessive alcohol consumption and related harms among intervention participants. Implementation of e-SBI could complement population-level strategies previously recommended by the Community Preventive Services Task Force for reducing excessive drinking (e.g., increasing alcohol taxes and regulating alcohol outlet density). PMID:27745678

Explaining trends in alcohol-related harms in Scotland, 1991-2011 (I): the role of incomes, effects of socio-economic and political adversity and demographic change.

PubMed

McCartney, G; Bouttell, J; Craig, N; Craig, P; Graham, L; Lakha, F; Lewsey, J; McAdams, R; MacPherson, M; Minton, J; Parkinson, J; Robinson, M; Shipton, D; Taulbut, M; Walsh, D; Beeston, C

2016-03-01

This paper tests the extent to which differing trends in income, demographic change and the consequences of an earlier period of social, economic and political change might explain differences in the magnitude and trends in alcohol-related mortality between 1991 and 2011 in Scotland compared to England & Wales (E&W). Comparative time trend analyses and arithmetic modelling. Three approaches were utilised to compare Scotland with E&W: 1. We modelled the impact of changes in income on alcohol-related deaths between 1991-2001 and 2001-2011 by applying plausible assumptions of the effect size through an arithmetic model. 2. We used contour plots, graphical exploration of age-period-cohort interactions and calculation of Intrinsic Estimator coefficients to investigate the effect of earlier exposure to social, economic and political adversity on alcohol-related mortality. 3. We recalculated the trends in alcohol-related deaths using the white population only to make a crude approximation of the maximal impact of changes in ethnic diversity. Real incomes increased during the 1990s but declined from around 2004 in the poorest 30% of the population of Great Britain. The decline in incomes for the poorest decile, the proportion of the population in the most deprived decile, and the inequality in alcohol-related deaths, were all greater in Scotland than in E&W. The model predicted less of the observed rise in Scotland (18% of the rise in men and 29% of the rise in women) than that in E&W (where 60% and 68% of the rise in men and women respectively was explained). One-third of the decline observed in alcohol-related mortality in Scottish men between 2001 and 2011 was predicted by the model, and the model was broadly consistent with the observed trends in E&W and amongst women in Scotland. An age-period interaction in alcohol-related mortality was evident for men and women during the 1990s and 2000s who were aged 40-70 years and who experienced rapidly increasing alcohol-related

Typology of alcohol consumers in five Australian nighttime entertainment districts.

PubMed

Peacock, Amy; Norman, Thomas; Bruno, Raimondo; Pennay, Amy; Droste, Nicolas; Jenkinson, Rebecca; Quinn, Brendan; Lubman, Dan I; Miller, Peter

2016-09-01

Understanding how types of alcohol consumers differ is important for public policy targeted at reducing adverse events. The aims of the present study were to identify typologies of alcohol consumers in Australian nighttime entertainment districts based on risk factors for harm and to examine variation between the identified groups in drinking setting and harms. Street-intercept surveys were conducted with 5556 alcohol consumers in and around licensed venues in five Australian cities between November 2011 and June 2012. Latent class analysis identified groups based on age and sex, and blood alcohol concentration, pre-drinking, energy drink use and illicit drug use during that night. Four classes were identified: general patron group (33%), young pre-drinker group (27%), intoxicated male pre-drinker group (31%) and intoxicated illicit drug male group (9%). The proportion of the general patron group interviewed decreased over the night, while the other groups increased (particularly in regional cities). As compared with the general patron group, the remaining three groups reported increased odds of being involved in aggression and any alcohol-related injuries in the past 3 months, with highest rates of harm amongst the intoxicated illicit drug male group. Alcohol consumers in nighttime entertainment districts are not a homogeneous group. One-third have a low likelihood of risky consumption practices; however, representation of this consumer class diminishes throughout the night. Elevated harms amongst groups characterised by certain risk factors (e.g. pre-drinking and illicit drug use) emphasise the importance of addressing these behaviours in public policy. [Peacock A, Norman T, Bruno B, Pennay, Droste N, Jenkinson R, Quinn B, Lubman DI, Miller P. Typology of alcohol consumers in five Australian nighttime entertainment districts. Drug Alcohol Rev 2016;35:539-548]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

A total ban on alcohol advertising: presenting the public health case.

PubMed

Parry, Charles; Burnhams, Nadine Harker; London, Leslie

2012-05-28

Evidence from burden of disease and economic costing studies amply indicate that the public health burden from hazardous and harmful use of alcohol in South Africa warrants drastic action. Evidence that banning alcohol advertising is likely to be an effective intervention is reflected in WHO strategy documents on non-communicable diseases and harmful use of alcohol. Studies on young people furthermore support arguments refuting the claim that advertising only influences brand choice. Given the weakness of relying on industry self-regulation, the government is considering legislation to ban alcohol advertising, resulting in heated debate. Tobacco control and studies investigating the effect of alcohol advertising bans on consumption and alcohol-related deaths point to the effectiveness of such action - ideally supplemented by other policy interventions. Arguments against an advertising ban include possible communication sector job losses, but these are likely to have been exaggerated. Banning alcohol advertising will necessitate greater scrutiny of digital media, satellite television and merchandising to reduce the likelihood of subverting the ban.

The Mechanisms of Alcohol Control

PubMed Central

Carpenter, Christopher S.; Dobkin, Carlos; Warman, Casey

2015-01-01

A substantial economics literature documents that tighter alcohol controls reduce alcohol-related harms, but far less is known about mechanisms. We use the universe of Canadian mortality records to document that Canada’s Minimum Legal Drinking Age (MLDA) significantly reduces mortality rates of young men but has much smaller effects on women. Using drinking data that are far more detailed than in prior work, we document that the MLDA substantially reduces ‘extreme’ drinking among men but not women. Our results suggest that alcohol control efforts targeting young adults should focus on reducing extreme drinking behavior. PMID:27127308

Understanding resolution of deliberate self harm: qualitative interview study of patients' experiences

PubMed Central

Sinclair, Julia; Green, Judith

2005-01-01

Objective To explore the accounts of those with a history of deliberate self harm but who no longer do so, to understand how they perceive this resolution and to identify potential implications for provision of health services. Design Qualitative in-depth interview study. Setting Interviews in a community setting. Participants 20 participants selected from a representative cohort identified in 1997 after an episode of deliberate self poisoning that resulted in hospital treatment. Participants were included if they had no further episodes for at least two years before interview. Results We identified three recurrent themes: the resolution of adolescent distress; the recognition of the role of alcohol as a precipitating and maintaining factor in self harm; and the understanding of deliberate self harm as a symptom of untreated or unrecognised illness. Conclusion Patients with a history of deliberate self harm who no longer harm themselves talk about their experiences in terms of lack of control over their lives, either through alcohol dependence, untreated depression, or, in adolescents, uncertainty within their family relationships. Hospital management of deliberate self harm has a role in the identification and treatment of depression and alcohol misuse, although in adolescents such interventions may be less appropriate. PMID:15843425

Motives to drink or not to drink: Longitudinal relations among personality, motives and alcohol use across adolescence and early adulthood

PubMed Central

Anderson, Kristen G.; Briggs, Kristen E.L.; White, Helene R.

2012-01-01

Background Adolescent selective intervention programs for alcohol have focused on the identification of youth at risk as a function of personality and associated alcohol-related cognitions. Research into the role of personality, drinking motivations, and alcohol-related outcomes has generally focused exclusively on motives to drink. We expand on this literature by focusing on both motives to drink and motives not drink across time from adolescence to early adulthood in a community sample. Methods Using three waves of data from three cohorts from the Rutgers Health and Human Development Project (n = 1380; 49.4% women), we modeled the influence of baseline alcohol consumption, disinhibition and harm avoidance (ages 15, 18 and 21 years) on drinking motives and motives not to drink three years later (ages 18, 21 and 24 years) and alcohol use and drinking-related problems seven years subsequently (ages 25, 28, 31 years). Results Path analytic models were relatively invariant across cohort. Across cohorts, disinhibition and baseline alcohol consumption related to later positive reinforcement drinking motives, but less consistency was found for the prediction of negative reinforcement motives to drink. While positive reinforcement motives were associated with greater alcohol consumption and problems seven years later, negative reinforcement motives were generally associated with problems alone. Positive reinforcement motives for drinking mediated relations between baseline consumption and later consumption. However, results were mixed when considering disinhibition as a predictor and drinking problems as an outcome. Similarly, personality and baseline consumption related to later motives not to drink and such motives predicted subsequent alcohol-related problems. However, mediation was not generally supported for pathways through motives to abstain. Conclusions The results of this study replicate and extend previous longitudinal findings with youth and add to the growing

The Impact of Alcohol Outlet Density on the Geographic Clustering of Underage Drinking Behaviors within Census Tracts

PubMed Central

Reboussin, Beth A.; Song, Eun-Young; Wolfson, Mark

2011-01-01

Background The regulation of alcohol outlet density has been considered as a potential means of reducing alcohol consumption and related harms among underage youth. Whereas prior studies have examined whether alcohol outlet density was associated with an individual’s alcohol consumption and related harms, this study examines whether it is related to the co-occurrence, or clustering, of these behaviors within geographic areas, specifically census tracts. Methods The Enforcing Underage Drinking Laws Randomized Community Trial provided cross-sectional telephone survey data in 2006 and 2007 from 10,754 youth aged 14–20 from 5 states residing in 1556 census tracts. The alternating logistic regression approach was used to estimate pairwise odds ratios between responses from youth residing in the same census tract and to model them as a function of alcohol outlet density. Results Riding with a drinking driver, making an alcohol purchase attempt and making a successful alcohol purchase attempt clustered significantly within census tracts with the highest off-premise alcohol outlet density while frequent drinking clustered within census tracts with the greatest on-premise density. Driving after drinking and experiencing non-violent alcohol-related consequences clustered marginally within census tracts with the greatest on-premise and off-premise alcohol outlet density, respectively. Conclusions Although youth primarily receive alcohol from social sources, commercial alcohol access is geographically concentrated within census tracts with the greatest off-premise outlet density. A potentially greater concern is the clustering of more frequent drinking and drinking and driving within census tracts with the greatest on-premise outlet density which may necessitate alternative census tract level initiatives to reduce these potentially harmful behaviors. PMID:21463343

The Quik Fix study: a randomised controlled trial of brief interventions for young people with alcohol-related injuries and illnesses accessing emergency department and crisis support care

PubMed Central

2014-01-01

Background Alcohol is a major preventable cause of injury, disability and death in young people. Large numbers of young people with alcohol-related injuries and medical conditions present to hospital emergency departments (EDs). Access to brief, efficacious, accessible and cost effective treatment is an international health priority within this age group. While there is growing evidence for the efficacy of brief motivational interviewing (MI) for reducing alcohol use in young people, there is significant scope to increase its impact, and determine if it is the most efficacious and cost effective type of brief intervention available. The efficacy of personality-targeted interventions (PIs) for alcohol misuse delivered individually to young people is yet to be determined or compared to MI, despite growing evidence for school-based PIs. This study protocol describes a randomized controlled trial comparing the efficacy and cost-effectiveness of telephone-delivered MI, PI and an Assessment Feedback/Information (AF/I) only control for reducing alcohol use and related harm in young people. Methods/design Participants will be 390 young people aged 16 to 25 years presenting to a crisis support service or ED with alcohol-related injuries and illnesses (including severe alcohol intoxication). This single blinded superiority trial randomized young people to (i) 2 sessions of MI; (ii) 2 sessions of a new PI or (iii) a 1 session AF/I only control. Participants are reassessed at 1, 3, 6 and 12 months on the primary outcomes of alcohol use and related problems and secondary outcomes of mental health symptoms, functioning, severity of problematic alcohol use, alcohol injuries, alcohol-related knowledge, coping self-efficacy to resist using alcohol, and cost effectiveness. Discussion This study will identify the most efficacious and cost-effective telephone-delivered brief intervention for reducing alcohol misuse and related problems in young people presenting to crisis support

The Quik Fix study: a randomised controlled trial of brief interventions for young people with alcohol-related injuries and illnesses accessing emergency department and crisis support care.

PubMed

Hides, Leanne; Kavanagh, David J; Daglish, Mark; Cotton, Susan; Connor, Jason P; Barendregt, Jan J; Young, Ross McD; Sanders, Davina; White, Angela; Mergard, Lance

2014-08-08

Alcohol is a major preventable cause of injury, disability and death in young people. Large numbers of young people with alcohol-related injuries and medical conditions present to hospital emergency departments (EDs). Access to brief, efficacious, accessible and cost effective treatment is an international health priority within this age group. While there is growing evidence for the efficacy of brief motivational interviewing (MI) for reducing alcohol use in young people, there is significant scope to increase its impact, and determine if it is the most efficacious and cost effective type of brief intervention available. The efficacy of personality-targeted interventions (PIs) for alcohol misuse delivered individually to young people is yet to be determined or compared to MI, despite growing evidence for school-based PIs. This study protocol describes a randomized controlled trial comparing the efficacy and cost-effectiveness of telephone-delivered MI, PI and an Assessment Feedback/Information (AF/I) only control for reducing alcohol use and related harm in young people. Participants will be 390 young people aged 16 to 25 years presenting to a crisis support service or ED with alcohol-related injuries and illnesses (including severe alcohol intoxication). This single blinded superiority trial randomized young people to (i) 2 sessions of MI; (ii) 2 sessions of a new PI or (iii) a 1 session AF/I only control. Participants are reassessed at 1, 3, 6 and 12 months on the primary outcomes of alcohol use and related problems and secondary outcomes of mental health symptoms, functioning, severity of problematic alcohol use, alcohol injuries, alcohol-related knowledge, coping self-efficacy to resist using alcohol, and cost effectiveness. This study will identify the most efficacious and cost-effective telephone-delivered brief intervention for reducing alcohol misuse and related problems in young people presenting to crisis support services or EDs. We expect efficacy will

Alcohol and Primary Health Care. WHO Regional Publications, European Series No. 64.

ERIC Educational Resources Information Center

Anderson, Peter

The European Alcohol Action Plan stresses that health care systems, traditionally involved in the management of alcohol problems, must play a greater role in the detection and prevention of alcohol-related harm. Primary health care is seen as an important setting for identifying individuals at risk from heavy drinking and helping them to reduce…

The price of a drink: the potential of alcohol minimum unit pricing as a public health measure in the UK.

PubMed

Rice, Peter; Drummond, Colin

2012-09-01

The UK has seen a dramatic increase in alcohol consumption and alcohol-related harm over the past 30 years. Alcohol taxation has long been considered a key method of controlling alcohol-related harm but a combination of factors has recently led to consideration of methods which affect the price of the cheapest alcohol as a means of improved targeting of alcohol control measures to curb the consumption of the heaviest drinkers. Although much of the evidence in favour of setting a minimum price of a unit of alcohol is based on complex econometric models rather than empirical data, all jurisdictions within the UK now intend to make selling alcohol below a set price illegal, which will provide a naturalistic experiment allowing assessment of the impact of minimum pricing.

Prevalence and predictors of problematic alcohol use, risky sexual practices and other negative consequences associated with alcohol use among safety and security employees in the Western Cape, South Africa.

PubMed

Harker Burnhams, Nadine; Parry, Charles; Laubscher, Ria; London, Leslie

2014-03-04

Harmful alcohol use can compromise worker health and productivity. Persons employed in safety-sensitive occupations are particularly vulnerable to hazardous alcohol use and its associated risks. This study describes the patterns of harmful alcohol use, related HIV risks and risk factors for the harmful use of alcohol among a sample of employees in South Africa working in the safety and security sector. A cross-sectional study that formed the baseline for a clustered randomized control trial was undertaken in 2011. A random sample of 325 employees employed within a safety and security sector of a local municipality in the Western Cape Province of South Africa participated in the study. Data were collected by means of an 18-page self-administered structured questionnaire and analyzed using SAS/STAT software version 9.2. For all significance testing, the F-statistic and p-values are reported. Three hundred and twenty-five employees were surveyed. Findings suggest that more than half (76.1%) of the 78.9% of participants who consumed alcohol engaged in binge drinking, with close to a quarter reporting a CAGE score greater than the cut-off of 2, indicating potentially hazardous drinking patterns. The study further found that employees who use alcohol are more likely to engage in risky sexual practices when under the influence. A favorable drinking climate (p < 0.001) and poor levels of group cohesion (p = 0.009) were significantly correlated to binge drinking. This study identifies alcohol-related behaviors and associated risks in the context of safety-sensitive occupations at the workplace. It suggests that persons employed within such positions are at high risk for developing alcohol-related disorders and for contracting HIV. This study highlights the need for testing a comprehensive package of services designed to prevent hazardous alcohol use among safety and security employees.

Strengthening the Canadian alcohol advertising regulatory system.

PubMed

Heung, Carly M; Rempel, Benjamin; Krank, Marvin

2012-05-24

Research evidence points to harmful effects from alcohol advertising among children and youth. In particular, exposure to alcohol advertising has been associated with adolescents drinking both earlier and heavier. Although current federal and provincial guidelines have addressed advertising practices to prevent underage drinking, practice has not been supported by existing policy. While protective measures such as social marketing campaigns have the potential for counteracting the effects from alcohol advertising, the effectiveness of such measures can be easily drowned out with increasing advertising activities from the alcohol industry, especially without effective regulation. Research reviewed by the European Focus on Alcohol Safe Environment (FASE) Project has identified a set of key elements that are necessary to make alcohol advertising policy measures effective at protecting children and youth from the harmful effects of alcohol marketing. Using these key elements as an evaluation framework, there are critical components in the Canadian alcohol advertising regulatory system that clearly require strengthening. To protect impressionable children and youth against the harmful effects of alcohol advertising, 13 recommendations to strengthen current alcohol advertising regulations in Canada are provided for Canadian policy-makers, advertising standard agencies, and public health groups.

Alcohol policy reform in Australia: what can we learn from the evidence?

PubMed

Doran, Christopher M; Hall, Wayne D; Shakeshaft, Anthony P; Vos, Theo; Cobiac, Linda J

2010-04-19

Alcohol consumption is a major risk factor contributing to the burden of disease in Australia. The National Preventative Health Taskforce recommends the long-term goal of reshaping Australia's drinking culture to produce healthier and safer outcomes. A study of the cost-effectiveness of interventions to reduce alcohol-related harm in Australia suggests that policymakers could achieve over 10 times the health gain if they reallocated the current level of investment. The optimal package of interventions identified in the study comprises, in order of cost-effectiveness, volumetric taxation, advertising bans, an increase in the minimum legal drinking age to 21 years, brief intervention by primary care practitioners, licensing controls, a drink-driving mass media campaign, and random breath testing. Australia has a window of opportunity to significantly expand activities to reduce alcohol-related harm. It is important that federal and state governments take this opportunity to reform alcohol policy in Australia.

Potential Impact of Minimum Unit Pricing for Alcohol in Ireland: Evidence from the National Alcohol Diary Survey.

PubMed

Cousins, Gráinne; Mongan, Deirdre; Barry, Joe; Smyth, Bobby; Rackard, Marion; Long, Jean

2016-11-01

One of the main provisions of the Irish Public Health (Alcohol) Bill is the introduction of a minimum unit price (MUP) for alcohol in Ireland, set at €1.00/standard drink. We sought to identify who will be most affected by the introduction of a MUP, examining the relationship between harmful alcohol consumption, personal income, place of purchase and price paid for alcohol. A nationally representative survey of 3187 respondents aged 18-75 years, completing a diary of their previous week's alcohol consumption. The primary outcome was purchasing alcohol at <€1.00/standard drink; secondary outcome was purchasing alcohol at <€1.00/standard drink off-sales. Primary exposures were harmful alcohol consumption (AUDIT-C > 5), low personal annual income (<€20,000) and place of purchase (off- or- on-sales). One in seven respondents (14%) spent <€1.00/standard drink, with a median spend of 0.78/standard drink. High-risk drinkers (OR 1.56, 95% CI 1.09-2.23), men (OR 1.95, 95% CI 1.43-2.66), people on low income (OR 1.64, 95% CI 1.20-2.23) and those purchasing alcohol off-sales (OR 21.9, 95% CI 12.5-38.1) were most likely to report purchasing alcohol at <€1.00/standard drink. Forty-four per cent of alcohol consumed was purchased off-sales. Of those purchasing off-sales, 30% bought cheap alcohol. High-risk drinkers, men and those on low income were most likely to report paying < €1.00/standard drink off-sales. Heavy drinkers, men and those on low income seek out the cheapest alcohol. The introduction of a MUP in Ireland is likely to target those suffering the greatest harm, and reduce alcohol-attributable mortality in Ireland. Further prospective studies are needed to monitor consumption trends and associated harms following the introduction of minimum unit pricing of alcohol. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Predicting and measuring premises-level harm in the night-time economy.

PubMed

Moore, Simon C; Brennan, Iain; Murphy, Simon

2011-01-01

To assess associations between measures of premises-level alcohol-related harm and risk factors for harm. Thirty-two licensed premises with a history of on-premises violent assault were recruited. An environmental survey of the drinking context of each premises was undertaken. Levels of patron intoxication were assessed using a breathalyser and a visual assessment of customers at each premises. Premise-level violence was identified via routine police and hospital emergency department data. Analyses examined associations between hospital and police data, surveyor and objective ratings of intoxication and the relationship between intoxication, drinking context and violence at the premises level. Hospital and police data were associated. Aggregate levels of surveyor-rated intoxication were associated with aggregate alcometer breath alcohol levels. Analyses further suggest that premises with the highest levels of violence also had customers whose entry-exit change in intoxication was greatest, were open for longer hours, had alcohol promotions and had visible security staff present. Police and hospital data can be used to identify violent premises and to assess outcomes from premises-level interventions to reduce violence. Relatively low-cost observational survey methods can be used to identify high-risk premises, and can be used as outcomes for premises-level interventions. Features of premises that promote intoxication are associated with violence, suggesting that targeting resources at risky premises will likely address two public health concerns: excessive intoxication and assault-related injury.

Australia's double standard on Thailand's alcohol warning labels.

PubMed

O'Brien, Paula

2013-01-01

Since 2010, members of the World Trade Organization (WTO), including Australia, have opposed Thailand's proposal for graphic warnings on alcohol containers. This paper aims to provide an account of the arguments for/against Thailand and to examine the arguments' legal and political validity. This paper reviews primary WTO records in relation to Thailand's proposal to reveal the arguments for/against Thailand's proposal. The paper analyses these arguments in light of WTO cases to identify the legal strengths and weaknesses of Thailand's position. The paper then considers whether the attacks on Thailand by Australia are justified in light of the Australian Government's position on (i) alcohol warning labels in Australia and (ii) tobacco plain packaging. The legal arguments against Thailand are: only harmful alcohol consumption should be prevented; there is no evidence that graphic warning labels can reduce alcohol-related harm; the labels unnecessarily restrict international trade. There are some legal weaknesses in Thailand's proposal. Yet, Australia's opposition to Thailand cannot be justified whilst Australia is (i) mandating pregnancy-related alcohol warnings in Australia and (ii) defending its plain packaging law against similar WTO attacks. No WTO member is obliged to challenge another member for being non-compliant. The case tests the willingness of WTO members like Australia to respect the autonomy of other countries to pursue their public health goals and trial novel interventions. Australia's actions suggest it is willing to protect its alcohol industry at the expense of public health in Thailand. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Reducing Alcohol Harm. International Benchmark

DTIC Science & Technology

2008-01-01

consume alcohol.30 Binge drinking among young people is reported in Table 4. Similar to the data for adults in previous tables, the data should be...more-targeted awareness raising and education.145 In addition, the campaigns seem mostly beneficial in increasing knowledge among adults and young ...effective in reducing consumption amongst teenagers and young adults .204 The policy implications of this have been succinctly stated by one researcher

Alcohol Mixed with Energy Drinks: Daily Context of Use.

PubMed

Linden-Carmichael, Ashley N; Lau-Barraco, Cathy

2017-04-01

The link between use of alcohol mixed with energy drinks (AmEDs) and alcohol-related harms is well established, but limited research has examined the context in which AmEDs are consumed. Identifying the social and environmental characteristics of use may illuminate whether AmEDs are used in settings that could increase the likelihood of engaging in risky behaviors or experiencing harms. This study used a 2-week daily diary assessment to compare days in which AmEDs were consumed ("AmED days") and days where other types of alcohol were used ("non-AmED days") on where, when, and with whom drinking occurred. Participants were 122 (90 women) heavy drinking college students who reported mixing caffeine with alcohol at least once in the past week. Data were collected across 389 drinking days; 40 of these days involved AmED use. Multilevel modeling findings revealed that odds of drinking AmEDs were higher on days where individuals drank at a bar or club and drank at home relative to other locations. In addition, odds of pregaming were higher on AmED days as compared to non-AmED days. AmED use was linked with lower odds of drinking game behavior. Overall, AmEDs appear to be consumed in potentially risky contexts. In combination with prior findings that AmED days are linked with heavier alcohol use and more harms experienced, these findings support the unique nature of AmED consumption in terms of the factors that may predict or maintain potentially hazardous drinking patterns. Copyright © 2017 by the Research Society on Alcoholism.

Evidencing Protective and Risk Factors for Harmful Alcohol Drinking in Adolescence: A Prospective Analysis of Sport-Participation and Scholastic-Achievement in Older Adolescents from Croatia.

PubMed

Devcic, Sime; Sekulic, Damir; Ban, Divo; Kutlesa, Zvonimir; Rodek, Jelena; Sajber, Dorica

2018-05-14

Background : The prevalence of alcohol drinking (AD) in Croatian adolescents is alarming, but there is an evident lack of prospective analyses of the protective/risk factors of AD. This study aimed to prospectively investigate the relationships between scholastic and sport factors and harmful alcohol drinking (HD) in older adolescents. Methods : The participants (n = 644, 53.7% females) were 16 years of age at study baseline and were tested at baseline and again 20 months later (follow-up). The predictors included four variables of scholastic achievement and four factors evidencing involvement in sport. Criterion was AD observed on the Alcohol Use Disorders Identification Test (AUDIT), and results were later categorized into harmful drinking (HD) and non-harmful drinking (NHD). The HD at baseline, HD at follow-up and HD initiation during the study course were observed as criteria in logistic regression analyses, which were additionally controlled for confounders (age, gender, socioeconomic status, and conflict with parents). Results: With 22% and 29% adolescents who reported HD at baseline and follow-up, respectively, the prevalence of HD remains among the highest in Europe. Scholastic failure was systematically related to HD at baseline and follow-up, but scholastic variables did not predict HD initiation during the course of the study. The higher odds for HD at baseline were evidenced for current and former team sport athletes. Those who quit individual sport were more likely to engage in HD at follow-up. Longer involvement in sport (OR: 2.10, 95% CI: 1.18⁻3.72), higher sport result (OR: 3.15, 95% CI: 1.19⁻8.34), and quitting individual sport (OR: 13.13, 95% CI: 2.67⁻64.62) were predictive of HD initiation. Conclusions : The results indicated specific associations between sport factors with HD initiation, which is understandable knowing the high stress placed on young athletes in this period of life, mainly because of the forthcoming selection between

Partnership Working in Community Alcohol Prevention Programmes

ERIC Educational Resources Information Center

Mastache, Claudia; Mistral, Willm; Velleman, Richard; Templeton, Lorna

2008-01-01

The National Alcohol Harm Reduction Strategy for England places much emphasis on creating partnerships at both national and local levels between government, the drinks industry, health services, police, individuals and communities to tackle alcohol misuse and associated harm and disorder. This article describes the characteristic structures and…

Gender, intoxication and the developing brain: Problematisations of drinking among young adults in Australian alcohol policy.

PubMed

Manton, Elizabeth; Moore, David

2016-05-01

In this article, we draw on recent scholarly work in the poststructuralist analysis of policy to consider how policy itself functions as a key site in the constitution of alcohol 'problems', and the political implications of these problematisations. We do this by examining Australian alcohol policy as it relates to young adults (18-24 years old). Our critical analysis focuses on three national alcohol policies (1990, 2001 and 2006) and two Victorian state alcohol policies (2008 and 2013), which together span a 25-year period. We argue that Australian alcohol policies have conspicuously ignored young adult men, despite their ongoing over-representation in the statistical 'evidence base' on alcohol-related harm, while increasingly problematising alcohol consumption amongst other population subgroups. We also identify the development of a new problem representation in Australian alcohol policy, that of 'intoxication' as the leading cause of alcohol-related harm and rising hospital admissions, and argue that changes in the classification and diagnosis of intoxication may have contributed to its prioritisation and problematisation in alcohol policy at the expense of other forms of harm. Finally, we draw attention to how preliminary and inconclusive research on the purported association between binge drinking and brain development in those under 25 years old has been mobilised prematurely to support calls to increase the legal purchasing age from 18 to 21 years. Our critical analysis of the treatment of these three issues - gender, intoxication, and brain development - is intended to highlight the ways in which policy functions as a key site in the constitution of alcohol 'problems'. Copyright © 2015 Elsevier B.V. All rights reserved.

Alcohol-related morbidity and mortality within siblings.

PubMed

Søndergaard, Grethe; Osler, Merete; Andersen, Anne-Marie Nybo; Andersen, Per Kragh; Dalton, Susanne Oksbjerg; Mortensen, Laust H

2015-03-01

To estimate the association between educational status and alcohol-related somatic and non-somatic morbidity and mortality among full siblings in comparison with non-related individuals. Cohort study. Denmark. Approximately 1.4 million full siblings born in Denmark between 1950 and 1979 were followed from age 28-58 years or censoring due to alcohol-related hospitalization and mortality. Cox regression analyses were used to estimate associations of educational status with alcohol-related outcomes. Results from cohort analyses based on non-related individuals and inter-sibling analyses were compared. A lower educational status was associated with a higher rate of alcohol-related outcomes, especially among the youngest (aged 28-37 years) and individuals born 1970-79. Compared with the cohort analyses, the associations attenuated slightly in the inter-sibling analysis. For example, in the cohort analysis, females with a basic school education born 1970-79 had an increased rate of alcohol-related non-somatic morbidity and mortality [hazard rate ratio (HR) = 4.05, 95% confidence interval (CI) = 3.27-5.02] compared to those with a vocational education. In the inter-sibling analysis, the HR attenuated (HR = 2.66, 95% CI = 1.95-3.63). For alcohol-related somatic outcomes the corresponding figures were HR = 3.47 (95% CI = 2.63-4.58) and HR = 3.36 (95% CI = 2.10-5.38), respectively. In general, the associations were stronger among females than males (aged 28-37) in the analyses of alcohol-related non-somatic outcomes. Health conditions earlier in life explained only a minor part of the associations. The association between educational status and alcohol-related somatic and non-somatic morbidity and mortality is only driven by familial factors to a small degree. © 2014 Society for the Study of Addiction.

Influence of Early Onset of Alcohol Use on the Development of Adolescent Alcohol Problems: A Longitudinal Binational Study

PubMed Central

Kim, Min Jung; Mason, W. Alex; Herrenkohl, Todd I.; Catalano, Richard F.; Toumbourou, John W.; Hemphill, Sheryl A.

2016-01-01

This study examined cross-national similarities in a developmental model linking early age of alcohol use onset to frequent drinking and heavy drinking and alcohol problems 1 and 2 years later in a binational sample of 13-year-old students from 2 states: Washington State, United States, and Victoria, Australia (N = 1,833). A range of individual, family, school, and peer influences were included in analyses to investigate their unique and shared contribution to development of early and more serious forms of alcohol use and harms from misuse. Data were collected annually over a 3-year period from ages 13 to 15. Analyses were conducted using multiple-group structural equation modeling. For both states, early use of alcohol predicted frequent drinking, which predicted alcohol problems. Family protective influences had no direct effects on heavy drinking, nor effects on alcohol harm in either state, whereas school protection directly reduced the risk of heavy drinking in both states. Exposure to antisocial peers and siblings predicted a higher likelihood of heavy drinking and alcohol harm for students in both Washington and Victoria. Implications for the prevention of adolescent alcohol problems are discussed. PMID:27699620

Alcohol Expectancies Mediate and Moderate the Associations between Big Five Personality Traits and Adolescent Alcohol Consumption and Alcohol-Related Problems.

PubMed

Ibáñez, Manuel I; Camacho, Laura; Mezquita, Laura; Villa, Helena; Moya-Higueras, Jorge; Ortet, Generós

2015-01-01

Personality and expectancies are relevant psychological factors for the development of adolescent alcohol use and misuse. The present study examined their direct, mediated and moderated effects on different drinking behaviors in adolescence. Personality domains of the five-factor model, positive and negative alcohol expectancies (AEs), alcohol use during the week and the weekend, and alcohol-related problems were assessed in a sample of 361 adolescents. Different personality dimensions were directly associated with specific alcohol outcomes: Extraversion, low Conscientiousness and low Openness were associated with weekend alcohol use; low Agreeableness was related to weekday use; whereas low Agreeableness, low Conscientiousness and Extraversion were associated with alcohol-related problems. In addition, positive AEs mediated the relationship between Extraversion and alcohol use, whereas both positive and negative expectancies mediated the association between Neuroticism and alcohol consumption and alcohol-related problems. Finally, both types of expectancies interacted with Extraversion to predict alcohol problems. Our results highlight the importance of examining the complex interplay of comprehensive personality models and AEs to gain a better understanding of the development of different alcohol use and misuse patterns in adolescence.

Australian governments' spending on preventing and responding to drug abuse should target the main sources of drug-related harm and the most cost-effective interventions.

PubMed

McDonald, David

2011-01-01

A notable feature of Australian drug policy is the limited public and professional attention given to the financial costs of drug abuse and to the levels and patterns of government expenditures incurred in preventing and responding to this. Since 1991, Collins and Lapsley have published scholarly reports documenting the social costs of drug abuse in Australia and their reports also contain estimates of governments' drug budgets: revenue and expenditures. They show that, in 2004-2005, Australian governments expended at least $5288 million on drug abuse, with 50% of the expenditure directed to preventing and dealing with alcohol-related problems, 45% to illicit drugs and just 5% to tobacco. Some 60% of the expenditure was directed at drug crime and 37% at health interventions. This pattern of resource allocation does not adequately reflect an evidence-informed policy orientation in that it largely fails to focus on the drug types that are the sources of the most harm (tobacco and alcohol rather than illicit drugs), and the sectors for which we have the strongest evidence of the cost-effectiveness of the available interventions (treatment and harm reduction rather than legislation and law enforcement). The 2010-2014 phase of Australia's National Drug Strategy should include incremental changes to the resource allocation mix, and not simply maintain the historical resource allocation formulae. © 2010 Australasian Professional Society on Alcohol and other Drugs.

TPH2 polymorphisms and alcohol-related suicide.

PubMed

Zupanc, Tomaž; Pregelj, Peter; Tomori, Martina; Komel, Radovan; Paska, Alja Videtič

2011-02-18

Substantial evidence from family, twin, and adoption studies corroborates implication of genetic and environmental factors, as well as their interactions, on suicidal behavior and alcoholism risk. Serotonergic disfunction seems to be involved in the pathophysiology of substance abuse, and has also an important role in suicidal behavior. Recent studies of the tryptophan hydroxylase 2 showed mild or no association with suicide and alcohol-related suicide. We performed SNP and alcohol analysis on 388 suicide victims and 227 controls. The results showed association between suicide (Pχ²=0.043) and alcohol-related suicide (Pχ²=0.021) for SNP Rs1843809. A tendency for association was determined also for polymorphism Rs1386493 (Pχ²=0.055) and alcohol-related suicide. Data acquired from psychological autopsies in a subsample of suicide victims (n=79) determined more impulsive behavior (Pχ²=0.016) and verbal aggressive behavior (Pχ²=0.025) in the subgroup with alcohol misuse or dependency. In conclusion, our results suggest implication of polymorphisms in suicide and alcohol-related suicide, but further studies are needed to clarify the interplay among serotonergic system disfunction, suicide, alcohol dependence, impulsivity and the role of TPH2 enzyme. © 2010 Elsevier Ireland Ltd. All rights reserved.

Association Between Alcohol Sports Sponsorship and Consumption: A Systematic Review.

PubMed

Brown, Katherine

2016-11-01

Concerns have been raised about the impact of alcohol sports sponsorship on harmful consumption, with some countries banning this practice or considering a ban. We review evidence on the relationship between exposure to alcohol sports sponsorship and alcohol consumption. Search of electronic databases (PubMed, Cochrane Library, Google Scholar and International Alcohol Information Database) supplemented by hand searches of references and conference proceedings to locate studies providing data on the impact of exposure to alcohol sports sponsorship and outcomes relating to alcohol consumption. Seven studies met inclusion criteria, presenting data on 12,760 participants from Australia, New Zealand, the UK, Germany, Italy, Netherlands and Poland. All studies report positive associations between exposure to alcohol sports sponsorship and self-reported alcohol consumption, but the statistical significance of results varies. Two studies found indirect exposure to alcohol sports sponsorship was associated with increased levels of drinking amongst schoolchildren, and five studies found a positive association between direct alcohol sports sponsorship and hazardous drinking amongst adult sportspeople. These findings corroborate the results of previous systematic reviews that reported a positive association between exposure to alcohol marketing and alcohol consumption. The relationship between alcohol sports sponsorship and increased drinking amongst schoolchildren will concern policymakers. Further research into the effectiveness of restrictions on alcohol sports sponsorship in reducing harmful drinking is required. © The Author 2016. Medical Council on Alcohol and Oxford University Press.

Comparing methods of detecting alcohol-related emergency department presentations.

PubMed

Indig, D; Copeland, J; Conigrave, K M

2009-08-01

To assess the strengths and limitations of different methods for detecting alcohol-related emergency department (ED) presentations and to compare the characteristics of patients who present to the ED with an alcohol-related presentation with ED patients who are found to be risky drinkers by a questionnaire. Survey at two Sydney Australia ED over four weekends of 389 patients. Alcohol-related presentations were identified using a range of methods and were compared with presentations in ED patients who reported risky drinking using the alcohol use disorders identification test (AUDIT). Overall, 20% of ED patients had alcohol-related presentations and 28% were identified as risky drinkers by AUDIT. Diagnostic codes detected only 7% of all alcohol-related ED presentations, compared with 34% detected by nursing triage text, 60% by medical record audits and 69% by self-report. Among risky drinkers, just over half (51%) were not attending for an alcohol-related reason, whereas among alcohol-related ED presentations, nearly a third (31%) were not identified as risky drinkers by AUDIT. Not all patients with an alcohol-related ED presentation usually drink at risky levels, nor do all risky drinkers present to the ED for an alcohol-related reason. The use of routinely recorded nursing triage text detects over a third of alcohol-related ED presentations with no additional burden on busy clinicians. As these data are potentially readily accessible, further research is needed to evaluate their validity for the detection of alcohol-related ED presentations.